Commissioners,

Let me explain my email that was presented to you through Mrs. Pino today May 16, 2019. I have spoke
with Matt Coughlin about EMS call numbers not being accurate when he has asked for numbers from
dispatch. When you have a set number of trucks on the road and every truck is assigned to a call, then
when you get more EMS calls coming into dispatch for an ambulance EMS goes into a status of 10-75
(every truck is on a call). When you are pulling into a hospital and get told that you need to get turned
around quick because dispatch is assigning you another call. This is not demonstrating to the
commissioners the benefit and importance of having enough trucks on the road. There are some days
that EMS only has 13-15 trucks on the road to serve this county, but other days EMS could have 20
trucks on the road. There are nights that after midnight that EMS only has 4-5 trucks on the road. Mine
you annual leave, sick leave, FMLA and light duty does sometimes play into the amount of trucks on the
road at one point in time. The north end of the county most days and nights are only covered by one
truck as Mrs. Kilgore’s report to shows or has no truck in the north end. There have been times that an
EMS unit is being dispatched from the W Street area to Century for a call which is roughly about 45 miles
or so depending on call location. Mrs. Kilgore’s report also shows that the call volume is on the rise and
the Public Safety division is not keeping up with the call load demand by not adding more trucks and
staff.

Mr. Weaver pulled me into his office after I sent this email and said that he was going to send you a
graph of how many times EMS does not meet the 10-minute response times that is allotted by the
county. He showed me the graph he was sending and stated that the commissioners would have to see
if they wanted to accept the risk of not getting ambulances to the citizens of Escambia County in a
timely manner. I am unaware if the commissioners ever received this graph or not. Mr. Weaver stated
that EMS was supposed to be at a residence or a call within 80% of the time in that 10-minute time
frame in a year. (National standard recommendations are 90% within 9 minutes) Mr. Weaver also stated
that when the dispatch center assigns more than one call at a time it shows a delay in our numbers due
to a county ordinance that says our clock actually starts at the time the crew pushes the enroute to the
call button on the mobile laptops in the ambulances and not the time it is assigned to the crew. I think
Mr. Dosh stated to you today that when we have more trucks on the road, we don’t see this 10-75
happening as much. With more trucks and staffing on the road, I can say the number of times that EMS
is going to be delayed would be less but not that it would not ever happen. Chief Nail also put out a 10-
75 directive that stated that is was unacceptable to be holding EMS calls. Chief Nail has been trying to
add more EMS trucks with Mr. Weaver’s knowledge on adding more trucks since November of last year.
I will attach the email he sent out so you will have it since I am unaware if the commissioners have
received the directive. Hopefully this sums up my email to Chief Nail in reference to wanting to meet
with the dispatch centers staff.

I am willing to meet with each and everyone of the commissioners and explained or answer any
questions you have in reference to my email.

M Jenkins

President
10-75 Directive

From: Rusty C. Nail

Sent: Friday, November 9, 2018 3:28 PM

To: ems_supervisors_alternates; ems_field_personnel

Cc: Andrew J Hamilton; Christy D. Buscaino; Jon P. Williams; Rayme M. Edler

Subject: ECEMS Directive: 10-75 Unacceptable

ECEMS Personnel,

Good afternoon. Operational changes have become necessary to avoid (or at least minimize) 10-75
conditions. Effective Saturday 11/10/2018 we will be reverting back to the practice of activating any
available Administrative, QA, or other staff (PMs and/or EMTs) up to the rank of Deputy Chief to take
calls. This will last up until the call-holding status clears.

Please work diligently to get back in service as soon as possible. Staying out of 10-75 improves our
response times to our patients, and their subsequent response times to definitive care. This will yield
better patient outcomes. It goes without saying that administrative duties will be delayed, however we
cannot risk the public welfare when adequate resources are not available to meet the call demand.

Administration will be working on several other measures to eliminate this harmful effect. Such
items include: adding additional transports, exploring contractual agreement for BLS transport
provision, and keeping all transport units at prescribed levels by utilizing emergency staffing from
available Fire PM/EMT personnel (after EMS avenues are exhausted).

It is more important now than ever that we all work together as a team to make Escambia County
EMS the best it can be as we adapt to our growing community. Please take care of each other while we
care for our citizens. Thank you and keep up the hard work.
Rusty Nail, Chief of Fire & EMS

Escambia County Public Safety

6575 N. "W" St. Pensacola, FL 32505

Office: 850-475-5530

Email: rcnail@myescambia.com

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