MAPLEWOOD, NJ — A child steps off a school bus and has a seizure. The many parents at the bus stop call 9-1-1. Nearly 20 minutes pass until an ambulance arrives. In that time, onlookers, parents and children become more and more frantic.
This is not a cautionary tale; this happened last month in Maplewood and now officials are taking a hard look at emergency protocols to ensure it does not happen again.
On March 23, an 8-year-old boy stepped off his school bus at the corner of Ridgewood Road and Ridgewood Terrace. As he suffered a seizure, his mother lay him down on the curb and several bystanders called 9-1-1, reporting the details of the emergency and the location. Approximately eight to 10 minutes later, a Maplewood police officer arrived; he immediately began administering oxygen as he requested an ambulance.
And yet, it wasn’t until much later that an ambulance actually arrived, while no support from the Maplewood Fire Department was ever requested by dispatch. While parents on the scene say it took 22 minutes for an ambulance to arrive, Maplewood Fire Chief Michael Dingelstedt told the News-Record the actual time was 19 minutes, which township officials believe is still too long.
According to Mayor Vic DeLuca, the child is doing well, but township officials and residents remain concerned about the amount of time that elapsed before emergency medical personnel arrived.
“First, it was a horrible situation,” DeLuca said at the meeting. “We can give you a whole lot of information about it because we’ve looked into it. We’ve heard tapes and reports from police and the fire department. I think what we need to do is make sure it never happens again.”
DeLuca said that, although help took too long to arrive, protocol was followed — in this instance it just wasn’t sufficient. According to the mayor, REMCS, this area’s emergency dispatch service, received the call and immediately checked to see if Maplewood’s ambulance was available; it was not.
So REMCS checked with South Orange; however, according to DeLuca, the South Orange Rescue Squad was unavailable as it does not run during the day. Following protocol, according to Dingelstedt at the meeting, the dispatch attempted to hail SORS, waited two minutes then tried again.
From there, REMCS contacted MONOC, a private ambulance service that operates in this area, which was dispatched. According to township officials, MONOC has canceled the ambulance it was going to send, which led REMCS finally to reach out to University Hospital in Newark, which sent the ambulance that eventually arrived at the scene.
But, MONOC Chief Operating Officer Jeff Behm said that this is not exactly true.
Behm told the News-Record that REMCS contacted MONOC at 3:37 p.m. requesting emergency medical services. By 3:41, MONOC had a paramedic unit, which rides in an ambulance, dispatched to the scene. The medic unit, which is stationed at Rosehill Place in Irvington, made it to the scene 12 minutes later, despite the fact that GPS said the travel time would take 15 minutes. All in all, from the time MONOC received the call to the time it arrived on scene, 16 minutes had elapsed.
“When you have a child having a seizure, every second feels like an hour,” Behm told the News-Record during an April 15 phone interview. But he stressed that MONOC got there as quickly as it could.
Behm added that the MONOC medics began transporting the boy at 4:08 p.m. and arrived at the hospital at 4:16 p.m.
As for the confusion regarding a canceled ambulance, Behm explained that MONOC at no point recalled its medic unit, which does respond in a fully-equipped ambulance. The confusion came because dispatch requested medics as well as BLS, which is a basic life support ambulance.
According to Behm, the BLS ambulance was recalled at 3:39 p.m. for two reasons. First, there did not need to be two ambulances on scene, especially as a medic duo was perfectly capable of dealing with the situation. Second, the closest available BLS ambulance was in Orange, which has a contract with MONOC stating that MONOC will always maintain a sufficient ambulance presence in the municipality. MONOC’s other local ambulance was out. On top of that, another emergency call originating from Orange came in.
Therefore, the BLS ambulance was canceled and the ambulance manned by the medics responded solo.
Nevertheless, the response time of 19 minutes is deemed too long by township officials and residents.
“This could have been a situation where all those ambulances were out at one time; we need to figure out what’s our backup at that point and that’s on us,” DeLuca said at the meeting. “We could have sent a (fire)truck up there with some personnel who were trained but, as I understand, there was never a call to our fire department.”
Dingelstedt agreed with DeLuca that the incident bears further investigation.
“As you mentioned, Mayor, we did have an opportunity to review the tapes that were from central dispatch at police headquarters and conversation that went back and forth between police headquarters and REMCS. We’re reviewing the whole incident,” Dingelstedt said at the meeting. “This was an unfortunate series of events where our backup ambulance was not available.”
Dingelstedt stressed, however, that dispatch did take the proper steps. Some residents at the scene stated that, not only did the ambulance take too long to arrive, but that no directions as to how to care for the child were given during the wait; however, Dingelstedt said at the meeting that, listening to tapes, some callers were indeed given instructions on how to act.
The Maplewood Fire Department did not dispatch emergency personnel because the department was never called. Dingelstedt explained that, although the fire department responds to life-threatening emergencies, this particular incident was not classified as one requiring the response of fire department emergency personnel.
“Dispatchers used medical cards for coding. Even if a call is rated as “advanced life support,” it might not meet the criteria for a life-threatening emergency,” Dingelstedt said at the meeting.
“The current dispatch procedure defines life-threatening emergencies as CPR, respiratory arrest, cardiac arrest, unconscious, major motor vehicle accidents, multiple patients, mass casualty incidents and violent calls, such as a shooting or stabbing,” Dingelstedt told the News-Record recently. “The dispatchers at REMCS also use Emergency Medical Dispatch Guidecards, which assist them in prioritizing responses to medical incidents.”
“It’s difficult to accept that with a young child on the sidewalk,” Dingelstedt said at the meeting, “but they followed the proper procedure with that.”
But DeLuca responded: “I think they followed the proper procedure; I think we need to have a discussion about the proper procedure.”
Behm, on the other hand, disagrees and believes that this was a life-threatening emergency. According to Behm, the MONOC paramedic unit would not have been sent out were the situation not deemed life-threatening.
“It is a life-threatening emergency, which is why the paramedics were sent,” Behm said. “If it is your policy to send a ladder or firetruck for life-threatening emergencies, they should have sent it.”
DeLuca stressed that the township needs to have “an in-house conversation” to learn all the fact and ensure that a similar situation does not occur again.
Two residents who were at the scene of the incident, spoke out at the Township Committee meeting April 5, demanding that protocols be set in place to prevent this from happening again.
One such resident was Tom Cebula, who told the committee that multiple calls were placed to emergency dispatch and that the police officer on scene was encouraging bystanders to continue calling. According to Cebula, it took 22 minutes for an ambulance to arrive from University Hospital in Newark.
“During this 22-minute period of concern, parents and child stood by, shocked, as the town and the neighboring town failed to supply basic medical services,” Cebola said during public comment at the meeting. “On March 23, I believe this town could have done a better job. When you call for medical service you deserve a fast response and I don’t believe 22 minutes is sufficient.”
Cebola agreed with DeLuca that the system requires a hard look, saying, “It’s too easy to call this an anomaly and to rely on the strength of the typical response time. It’s too easy to blame the 9-1-1 operator and say they should have done something differently.”
According to resident Stephanie Barber, in the time it took for an ambulance to arrive, those on scene had enough time to collect an off-work emergency room doctor who lives a few blocks away, and there was enough time for the principal and school nurse from Marshall School to arrive on scene.
“As far as the child was concerned, this was a very traumatic event for all of us there,” Barber said at the meeting. “We certainly have a lot of questions.”
And she tried to get some answers; according to Barber, the following day she called the fire department to find out what had happened and was told by dispatch personnel that assistance could have been rendered more quickly had someone called from a landline, and that the fire department should have been called directly.
But DeLuca told Barber that calling the fire department directly is not necessary because, as protocol dictates, dispatch will call the department if this is deemed necessary.
According to Maplewood Police Capt. Joshua Cummis, calling from a landline would not have expedited the response time.
“The landline comes directly to us, but a cell phone in town will hit us 90 percent of the time,” Cummis said at the meeting. “Sometimes it may go to a tower and go to another location. They ask where you are, they hear Maplewood and they automatically transfer it to Maplewood dispatch.”
Even with these answers, the township is looking further into the issue.
“The fire department is currently reviewing the dispatch procedures, including the order in which mutual aid ambulances are requested, and these issues will be discussed at the new Public Safety Committee meeting,” Dingelstedt told the News-Record.
Editor’s Note: This story is different from its print version due to information received by the News-Record after the print deadline.
Concerns stem from long ambulance wait added by Yael Katzwer on
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