Rural Areas Use Innovative Ways to Ensure Emergency Care

In the last decade, the number of ambulance calls has increased as much as 300% or more in and around McKenzie County, North Dakota. Several of the rural areas in McKenzie County have turned to Quick Response Units, or QRU's, to ensure efficient emergency care.

Quick Response Units are intended to respond to emergency calls and provide stabilizing care until an Ambulance Service arrives to transport the patient. QRU's are provided for in North Dakota law, requiring only one emergency responder, or the equivalent, such as a licensed EMT. QRU's must be licensed under a larger ambulance service, and are not allowed to transport patients. For rural calls, the QRU and the larger ambulance service may be dispatched at the same time.

In the McKenzie County area, the communities of Keene, Grassy Butte, Arnegard and Alexander all utilize QRU's to ensure emergency care. In Alexander, North Dakota, the Alexander QRU responds to a very large and unique response district, due the proximity to the Montana-North Dakota border. The Alexander district spans from south of Williston to just south of Highway 68. Fairview Ambulance and the Fairview Fire Department cover a part of the Alexander Fire District, and the Sidney Ambulance covers a part of McKenzie County out on Highway 68.

Part of our Alexander District runs under the Williston Ambulance Service license, and the other part of the Alexander District runs under the McKenzie County Ambulance District. Dispatch is operated through Bismarck, which may dispatch both Alexander and Williston at the same time, depending on the call. According to Karolin Jappe, McKenzie County Emergency Manager and member of Alexander's QRU, the agreement with Williston Ambulance is likely a remnant of years past, when there were fewer people in the area.

Since the oil boom, Alexander and the surrounding area saw vast increases in the number of residents, as well as the number of crashes, fatal accidents, and other trauma calls. According to the North Dakota Department of Transportation, McKenzie County saw 78 fatal vehicle crashes from 2012-2016. At the height of the boom, report Jappe, "It was wild, in 2014. We still had the two-lane highways, and it was insane out here. We went through some pretty tough years." The QRU is often the first medical care to arrive on-scene, providing stabilizing care to the patient until a transporting ambulance arrives. "This is life or death. If you have to wait for an ambulance to arrive from Williston, you might not make it. A few months ago, we were on a wreck and I had to help a very seriously injured person. I thought the person wasn't going to make it. But he made it," she adds.

Jappe gives credit to her three response partners for their vast knowledge and experience. "I continue to learn something from almost every call," she explained. In addition to Jappe, who is an Emergency Medical Responder, there are three other responders. Joe Mrachek and Larry Novak are seasoned, licensed Emergency Medical Technicians, and Kyle Chamberlan, is also an Emergency Medical Responder. "I couldn't ask for a better group of people. We should all be thankful that we have all these departments that are willing to do this," Jappe said.

Novak, who has spent 30 years on the emergency service, said, "It's been a rewarding experience of knowing you're helping your community, friends, and neighbors."