Terror consumed Bobbie Paxton late Feb. 25 when she awoke and glanced at her alarm clock.
The glowing numbers were swirling around the room in streaks of red light, and Paxton -- filled with fear and nausea -- raced to the bathroom while her husband called 911.
"The next thing I knew, there was a very kind man helping me in my bathroom get my head out of the john," Paxton said. "I have no idea what the response time was, but it was very, very quick. It seemed like 30 seconds."
Paxton, 70, of Iowa City, was experiencing an acute vestibular attack, or a severe episode of vertigo, that had her fearing for her life. The Fire Department had responded to the call.
"I thought I was having a stroke," she said. "I was scared out of my mind and so relieved help was there to get me to the place I needed to be."
Medical calls to fire departments are increasingly common in Iowa and nationwide -- in part, because aging baby boomers have boosted the country's median age, emergency officials say.
The Iowa City Fire Department, for example, took 2,765 calls for emergency medical services last year, compared with 162 fire-related calls last year and 2,234 EMS calls in 2007.
The Cedar Rapids Fire Department handled 5,427 EMS calls last year, topping the 4,459 fire-related calls last year and the 5,002 EMS calls in 2007.
Nationally, the number of EMS calls to fire departments has increased nearly 300 percent since 1980, according to the National Fire Protection Association.
The increase in medical calls -- paired with fireproofing advancements and stricter building-code requirements -- has changed how many departments train firefighters and hire recruits, said Greg Buelow, spokesman for the Cedar Rapids Fire Department.
"We have made a concerted effort to hire firefighters who have paramedic certification," Buelow said. "Before, they would get hired and sent to (EMS) training. Now they have to have that to get into the department."
In addition to an aging population, longer life expectancies and fire-prevention improvements, Buelow said the increase in EMS calls also comes from a decline in preventive care.
"EMS is being used as a source of primary care," he said. "Rather than going to the doctor, it becomes a medical emergency, and they call 911."
Regardless of the cause, fire departments nationwide are stepping up to fill the medical emergency gaps in their communities, Buelow said.
"Ten to 15 years ago, you wouldn't think about the fire department for helping with confined space rescues or haz-mat calls," he said. "Now, the fire department is definitely involved."
'It's all about minutes and seconds'
Mounting EMS needs have stretched fire department budgets and resources and, in some cases, have slowed down response times, said Roger Jensen, deputy chief for the Iowa City Fire Department.
"It's all about minutes and seconds," Jensen said. "It's potentially the worst day of a person's life when they call us and need us. So time is of the essence."
Last year, it took Iowa City firefighters eight minutes and 43 seconds or less, 90 percent of the time, to respond to an incident in town, according to department statistics. That's up from the seven minutes and 33 seconds for an urban call in 2009.
Iowa City's response times to suburban communities have risen since 2009 as well, according to department records. Firefighters' suburban response times last year came in at nine minutes and eight seconds or less, 90 percent of the time, up from the eight minutes and 26 seconds in 2009.
The steady rise in incidents sometimes has firefighters responding to call after call and has doubled their workload, Jensen said. In response to the rising demand, Iowa City identified the northwest zone as a region needing better emergency response coverage.
The city opened a fourth fire station at 2008 Dubuque Rd. in October and installed new technology -- videoconferencing equipment and second-counting clocks next to exits -- aimed at lowering response times. Jensen said data on response times since that station opened isn't yet available.
"But we believe this calendar year will demonstrate, in no uncertain terms, the wisdom of the placement of that fire station in terms of reducing travel times," Jensen said. "We are expecting to see an improvement there."
Although Cedar Rapids response times have remained steady, fire officials said they're redistributing their resources by moving the central fire station from a flood-damaged building on Third Street NW to the city's east side and by building a west-side station.
The new stations will include upgrades designed for faster response times. Sleeping quarters, for example, will be located closer to the apparatus base.
'Tough to tell'
Although urban fire departments with paid crews are reporting a rise in total calls -- specifically EMS calls -- some rural volunteer departments are seeing the opposite trend, said Mark Espe, chief of the Jefferson-Monroe Fire Department in Swisher.
"The past two years, overall, our call volume has been down," Espe said. "We have talked with other departments and agencies like ours, and they seem to be in the same boat."
Swisher's total call volume has dropped from about 200 to about 175, and Espe said he can only speculate about the decline.
"Maybe people are just being more careful," he said. "It's tough to tell."
Even with a drop in total calls, Espe said, EMS calls have become a focus for the department.
About 75 percent of the requests for service are medical in nature, he said, and the department is expanding its EMS training requirements for volunteers.
As emergency demands shift nationwide, more departments are diversifying their services by offering medical assistance, said John Hall with the National Fire Protection Association.
About 65 percent of the country's fire departments offered emergency medical services in 2002, according to the U.S. Fire Administration. That number reached 69 percent in 2010, according to the administration's fire service.
That expansion has mirrored the demand in calls for medical service, which have risen from 5 million in 1980 to 18.5 million in 2010. Hall said the increase is the result of a combination of factors, including public awareness that neighborhood fire departments offer medical services.
"Once a community becomes aware that a good qualified EMS service is available, they might start using that rather than going to the doctor," he said.
Either way, Hall said, "They're busier than ever."
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