It was a helpless feeling in the face of a possible heart attack, says Michael A. Buckley, a cardiac rescue technician with the Lineboro Volunteer Fire Co.
"We get there and this poor patient's lying there in pain and we can't do anything."
Now they can.
Lineboro's Basic Life Support ambulance became an Advanced Life Support system last week, equipped and staffed to provide the emergency aid that can be critical in cases of cardiac arrest, respiratory failure or loss of consciousness.
The new status means that northeastern county residents will no longer have to wait for an ALS ambulance from Hampstead, nine miles away and a 15-minute drive at best. Manchester Volunteer Fire Co. is closer to Lineboro, but has only a basic ambulance.
Lineboro ambulance crew members say they know of no instances where a patient died because advanced care was not immediately available.
But Mr. Buckley says that's difficult to say definitively. For example, if a heart attack victim cannot be resuscitated, might he have lived if an ambulance had arrived sooner with heart-stabilizing drugs, a defibrillator and cardiac monitor?
To meet state qualifications to become an ALS unit, Lineboro had to have at least four cardiac rescue technicians (CRTs) in the ambulance division.
In July, three members of the company -- Bill Meushaw, Brad Kent and Mr. Buckley -- completed the 180 classroom and 80 clinical hours of training, and passed state exams to win CRT certification.
Volunteers Randy L. Fuhrman and Tim Bare had completed CRT training earlier.
Linas J. Saurusaitis, who joined the company after moving to Lineboro six months ago, is a paramedic, the highest emergency medical status an ambulance crew member can attain in Maryland.
Charles E. Barnhart, county emergency medical services training coordinator, helped Lineboro get provisional ALS status about a year ago from the regional council that oversees emergency medical services.
When a "trouble breathing" or "chest pains" call requiring a medic unit from the Lineboro area came in during the provisional status period, the county emergency operations center dispatched two companies. A Lineboro unit went to the call as a basic ambulance with a CRT or paramedic on board. Hampstead brought its advanced equipment, which the Lineboro crew borrowed at the scene and loaded onto its ambulance before taking the patient to the hospital.
That arrangement ended last week after Mr. Barnhart and Dr. Robert Gossweiler, medical director for county emergency services, inspected Lineboro's ALS equipment, quizzed technicians on how they would handle hypothetical emergencies, and authorized them to go into service as a medic unit.
The new equipment includes a heart monitor with defibrillator paddles, medicines and laryngoscopes for insertion of tubes into the trachea. The state government furnished the $8,000 monitor.
The fire company spent about $1,000 to equip the ambulance.
As CRTs, the technicians are allowed under Maryland law to give 15 specific medications and operate the heart monitor.
As a paramedic, Mr. Saurusaitis can give two drugs that the CRTs are not permitted to administer: dopamine, which strengthens the heart's pumping ability, and adenosine, which "resets" the rhythm of a heart beating uncontrollably. He also is qualified to insert tracheal tubes to open a patient's airway.
The Lineboro ambulance crew members have heard questions from other companies in the county: Why do you want an ALS unit when you don't have many calls?
Mr. Fuhrman's answer is, "We owe it to the people of our community to provide this service."
In 1991, the Lineboro ambulance responded to 282 calls; 105 of them required ALS service, said Capt. Ted Mills, of the company's emergency medical service.
The medic unit has been a dream deferred for Lineboro volunteers. About 15 years ago, the company applied for medic status, Mr. Fuhrman recalls. "But the state turned them down. They said, 'You don't run enough calls.' "
The issue rested until several new members joined the company and became interested in trying again for the advanced status.