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'LIKE A WAR ZONE:' Oil Patch ambulance workers struggle with increase in emergency calls

BISMARCK -- Emergency medical crews in North Dakota's Oil Patch describe the challenges they face as "crazy" or "overwhelming" and "like a war zone."...

Mercy Medical Center
An expansion at Mercy Medical Center in Williston, N.D., which just three years ago downsized to a 25-bed facility with an eye toward a dwindling population, began in July.

BISMARCK -- Emergency medical crews in North Dakota's Oil Patch describe the challenges they face as "crazy" or "overwhelming" and "like a war zone."

Those descriptions, from reports compiled by state emergency medical services officials, document an exploding demand for services triggered by the influx of people and activity from the oil boom.

Eleven emergency medical services agencies, located in North Dakota's six highest oil-producing counties, have reported an increase in calls of almost 61 percent over the past five years -- and is on pace to increase by 158 percent by 2014-15.

In the most striking example, the EMS for McKenzie County, based in Watford City, N.D., saw its volume double over the past year.

The increase reflects both the population increase and booming oilfield activity as well as the resulting boost in traffic accidents, with a sharp rise in truck accidents.

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Trauma cases, from oilfield and traffic accidents, are increasing in frequency and severity, further straining medical centers and ambulance crews.

The increased truck traffic and oil activity require specialized equipment and training that emergency medical crews lack -- everything from more sophisticated equipment to extricate accident victims to training in dealing with oil rigs and training to handle mass casualties.

"It's like being in a war zone," one unidentified EMS crew member said in a state report on the emergency medical demands in the Oil Patch. "I'm scared one of us is going to be killed."

Another said, "I was terrified the first time I went up on an oil rig."

Crime and domestic violence also are increasing, and emergency medical responders can find themselves in personal danger when responding to a call before law enforcement officers arrive.

In Williston, emergency medical crews have requested body armor, said Cody Friesz, administrator of the North Dakota Emergency Medical Service Association.

"They respond to more and more violence and personal safety is becoming an issue," he said.

So-called "man camps," temporary housing complexes for oilfield workers who cannot find conventional housing, can be hard to find, located in remote areas that are not adequately marked by signs, said Tom Nehring, director of the Division of Emergency Medical Services and Trauma for the North Dakota Department of Health.

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Also, "When you get in a man camp and you've got a thousand people in it, you don't know where to go."

In addition to those challenges, unforeseen just a few years ago, emergency medical providers face problems in hiring and attracting staff and finding affordable housing -- problems confronting many employers in oil country.

"So we have a whole complex set of issues," Nehring added. Many of the people who are flocking to the Oil Patch for work arrive destitute, without health insurance, exacerbating the financial squeeze EMS services face, where officials say revenues don't meet costs.

The problems brought by the added strains to the emergency medical system are compounded because most ambulance crews are staffed by a dwindling base of volunteers -- giving rise to what officials have called "a crisis within a crisis."

"They've been primarily volunteers for years and years and years," said Cody Friesz, administrator of the North Dakota Emergency Medical Service Association.

But many of those volunteers are getting older, with no replacements in sight, and case volumes that are rising exponentially in many areas of the state's 17 oil and gas producing counties.

That means what emergency medical have called the $31 million volunteer subsidy - the estimated value of volunteer in-kind contributions - will dwindle over time, according to a report on the oil impact on out-of-hospital medical services.

"There you have a crisis within a crisis," Nehring said. "That just puts more pressure on these ambulance services."

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The report on oil impacts on emergency medical services, presented in June, focused on four counties in the heart of the Bakken Formation Boom: Dunn, Williams, Mountrail and McKenzie.

But the impacts are spreading to the other counties in the 17-county Oil Patch, as oil and gas development expand to new areas, and figures quickly become outdated, Nehring said.

In last week's special session, the North Dakota Legislature addressed the urgent needs confronting ambulance services, law enforcement and firefighters.

The disaster relief bill lawmakers passed includes a provision that priority be given to the three public safety categories in allocating money from a $30 million impact aid fund for Oil Patch counties.

That funding stream will help ambulance services, Friesz said, and officials have made it clear they want to help.

"The big question now is how do you do that?" he added. "But absolutely the support is there."

The needs in oil country are a more intense version of the strains confronting ambulance services across North Dakota, Nehring and Friesz said.

"There is a concern across the entire state," Friesz said. "This is an industry that needs to consider transitioning to full-time staff, at least in the day-time hours.

"It's completely stressing the medical industry out there. Hospitals are maxed out and EMS services are running into the same problems," Friesz said.

Related Topics: HEALTHCARE
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