By Larry Compton
I was at work in a different part of the state when I received the call from our 11-year-old daughter – “Dad, I’m in an ambulance with mom and we are headed to the hospital.” As I drove 100 agonizing miles to Atlanta Medical Center, I had little idea that the life of my spouse would only be saved by the decisive actions of an ER physician or that I would spend the next five nights sleeping on the intensive care unit floor. I would later learn that our terrified child called 911 after my wife collapsed due to a pulmonary embolism, triggering an immediate response from Candler Park’s own Atlanta Fire Station 12 followed by ambulance transport.
Much later, when I finally returned home with my recovering spouse, empty packaging and surgical tape was strewn about the house; testimony to the efforts of emergency medical responders during those first critical moments.
Experiences like this show the importance of timely and skilled emergency medical care in Candler Park.
The purpose of this article is to inform interested neighbors on how Emergency Medical Services (EMS) are staffed, organized, and dispatched in our area. Understanding how EMS functions allows residents to advocate for proper resourcing. This topic can be a bit complicated, but if you would like answers to the following questions I would encourage you to keep reading:
- Question 1 – What ambulance service covers Candler Park?
- Question 2 – What is the difference between an Emergency Medical Technician and a Paramedic?
- Question 3 – What is the role of the Atlanta Fire Department in EMS response?
- Question 4 – What actions are being taken by our local government officials to improve EMS services in 2024?
Sources and Methods
Medical first responders in the City of Atlanta are real-life superheroes who save lives every shift. They fearlessly serve our community through action packed shifts of constant response calls. The information contained in this article was gathered through personal interviews with two paramedics that have worked in the Atlanta metro area and research. My primary source is a paramedic who worked in Fulton County for six years and Dekalb County for 12 years.
EMS Personnel Types
EMS personnel are classified into types by level of training. The State of Georgia Department of Public Health (DPH) recognizes six different provider levels for EMS: Emergency Medical Technician – Responder (EMT-R), Emergency Medical Technician (EMT), Emergency Medical Technician-Intermediate (EMT-I), Advanced Emergency Medical Technician (AEMT), Cardiac Technician (CT), and Paramedic (PMDC). For simplicity purposes, I will discuss these provider levels in three groups: EMT-Basic (EMT-R/EMT), EMT-Intermediate (EMT-I, AEMT, CT), and Paramedic. The scope of practice for the three main provider types increases from EMT-Basic with Paramedic being the highest skill level of emergency responder. Refer to Table 1 for a scope of practice description for each provider type.
| Provider Type | Scope of Practice Summary |
| EMT-Basic | Operate ambulance, take vitals, CPR |
| EMT-Intermediate | Perform some airway interventions, administer some medications |
| Paramedic | Advanced airway interventions, interpret EKGs, administer sedatives and narcotics for pain management |
It is important to note that the paramedic providers have the greatest scope of practice and the most training requirements of all EMS provider types. Paramedics normally start with an EMT license and then attend a 15 month or longer educational program. An exam and 1200 clinical hours are required to complete paramedic license requirements. State of Georgia regulations classify ambulance units as Basic Life Support (BLS) or Advanced Life Support (ALS) with the primary difference being the requirement that ALS units have at least one paramedic present on the ambulance. For serious medical emergencies an ALS unit is preferred.
EMS Organizational Structure
EMS services are regulated by the Georgia DPH. This is one reason that there is no City of Atlanta EMS service as currently exists for police and fire responders. The DPH organizes Georgia into 10 EMS regions consisting of multiple counties. The administration of each region is controlled by a Regional EMS Advisory Council (REMSAC). The primary function of the REMSAC is to set EMS Response Zone (ERZ) boundaries for each region and designate the zoned ambulance provider to respond to public 911 calls. Although many ambulance companies may operate as general transport providers (e.g. hospital to hospital transfers), the 911 responding services are specified per zone. In general, the ERZ boundaries correspond to county boundaries although city governments may provide for dedicated EMS within city boundaries. The City is in Region 3, which includes Cobb, Douglas, Fulton, Dekalb, Gwinnett, Clayton, Rockdale, and Newton counties. Fulton County and Dekalb County are designated as separate ERZs.
EMS Provider Selection
EMS providers are selected by the REMSAC for each ERZ. There are three primary models for EMS service providers. In some cases, local government fire departments operate and staff ambulances with paramedics and EMTs. Hospital systems may also provide the ERZ designated response service either as for-profit or non-profit operations. Finally, private companies can be contracted to provide EMS services in a for-profit model. In Fulton County, Grady Hospital EMS is the designated provider. Dekalb County has a contract with American Medical Response (AMR), a private EMS company with nationwide operations. This means that the City of Atlanta is serviced by different EMS providers depending on address.
Dekalb County EMS Operations
Since Dekalb County is densely populated and geographically dispersed, EMS response times can be an issue. In addition, only the largest private companies can maintain profitability in Dekalb (only two companies submitted bids for the current Dekalb contract). In 2018, the City of Dunwoody petitioned the state to allow the establishment of a separate city response zone. A year later in 2019, Dunwoody became the first city in Dekalb to fund a supplemental service within city limits under provisions of the county AMR contract. In April of 2024, the Dekalb City of Brookhaven announced a state petition to establish and fund a separate ERZ to emulate Dunwoody. The Dekalb County budget for 2024 includes $3.8 million to fund 20 positions for 5 ambulances organized under the Dekalb County Fire Department. These Dekalb County Fire Department ambulances will provide a countywide supplement for the larger private AMR operation. Since the AMR contract is expiring in 2024, Dekalb County retained the services of a consulting firm to determine a path forward for 911 EMS services. These topics are critical to public safety in Candler Park, since we are in the Dekalb County ERZ.
EMS Roles and Responsibilities in Candler Park
So, what does all this mean for Candler Park? First, it is interesting to note that the ERZ boundary is the middle of Moreland Avenue. This means that calls on the West side of Moreland in Little Five Points/Inman Park are in the Grady EMS response zone and calls on the East side of Moreland in Candler Park are in the Dekalb AMR response zone. Calls for accidents in the middle of Moreland Avenue may be serviced by both agencies depending on time to respond and/or call volume. Note that the Edgewood Shopping Center is in the Dekalb AMR response zone.
For medical calls within Candler Park, we are very fortunate to have Atlanta Fire Station 12 on Dekalb Avenue. Each Atlanta Fire Engine 12 is minimum BLS capable with many shifts having paramedics on duty to provide ALS level response. Although Atlanta Fire responds to medical emergencies, the fire department cannot provide transport services to the hospital. All transport services are provided by Dekalb AMR. This means that for most medical calls within Candler Park, Atlanta Fire will be on scene rapidly with Dekalb AMR following. Interviews with current medics indicated that Candler Park can expect response times of 15 to 20 minutes for ambulance response. These times could be extended during periods of heavy call volume in the Dekalb 911 system.
911 Call Routing
When you call 911 from Candler Park, your call will go to the City of Atlanta 911 call center. The 911 operator will ask for your address and if you need police, fire or ambulance. For medical emergencies, the City of Atlanta 911 operators will patch over to the Dekalb County consolidated dispatch center for ambulance response. In the meantime, Atlanta Fire dispatch will work on sending the fire department medical response. This happens quickly and efficiently in the background of your 911 call. In some cases, the Dekalb 911 operator may be patched in for EMS response. Although roles and responsibilities may seem complex, metro Atlanta 911 operators are true professionals who know how to handle coordinating responses from required agencies. The biggest current challenge is getting through to 911, as documented in recent AJC reporting.
Conclusion
Your choices matter in a medical emergency. In a life-threatening emergency, always call 911. In some cases that are not life threatening, it may make better sense for a healthy person to drive those in medical distress to a nearby emergency room. I hope this article has proven informative and enhances understanding of public safety services in Candler Park.
Larry Compton, a long-time resident of Candler Park, is the CPNO safety officer.