Emergency Medical Services (EMS)

Putnam County EMS has had a long and interesting history.  Below is a very brief undertaking to retell the story. 

Before 1980

Prior to 1980, ambulance operations in Putnam County were privately owned.  For many years, dating back into at least the 1960s, ambulance operations were run by funeral homes.  In those days, prehospital treatment was nonexistant; the ambulance, which was often a hearse, came and got you and rushed you to the hospital, and hoped they got you there in time.  In 1970, increasing wage and hour laws and other state requirements began putting the crunch on funeral homes, and they stopped doing ambulance transports that year.  In October 1970, a county-subsidized ambulance service operated by Bethel Newport took over as the funeral homes stopped.  We are unsure about many of the events in those days, and what care the personnel were able to give.

1980s

In 1980, Putnam County government assumed direct operation of Putnam County Emergency Medical Services at 12 o’clock a.m. on July 1st with 5 ambulances and 12 employees, including a secretary and director Eddie Burgess.  At first, the service was housed in the “Home Economics” building at the fairgrounds, then in November moved into the old Norwalk Furniture building on N. Washington Ave.  One ambulance was staffed 24-hours per day, and an additional unit was staffed from 9 a.m. to 5 p.m Monday–Friday, with personnel on-call as needed. Those early days were humble beginnings, with a very limited scope of practice for our EMTs and paramedics.  Most of the treatments that they did during that time required contact with an emergency room physician prior to administration.

In 1983, Randy Porter replaced Eddie Burgess as Director of Putnam County EMS.  Other changes took place as well; an additional 24 hour ambulance was staffed, bringing the service up to 22 full-time employees.  PCEMS has a long history of pursuing excellence; beginning in 1983, the State of Tennessee awarded Putnam County EMS with an “A” rating, which was their highest rating available.  PCEMS maintained that rating every following year, until the State discontinued that rating system. 

The rest of the 1980s saw several progressive changes.  All on-duty ambulances were staffed with at least one Paramedic.  These Paramedics received much more extensive standing orders and protocols than what had previously been in place, allowing them to more quickly treat common emergencies.  PCEMS also got a new home in 1985, moving into the new emergency services center on Carlen Drive in east Cookeville.  This would be the main operations center until moving to the current facility in 2009.

1990s

In 1990, Director Porter was appointed to the State of Tennessee EMS Regulatory Board, a position in which he served for eight years.  He was instrumental in helping shape the rapidly expanding field of EMS within the State.  Things were also rapidly changing at home.  In 1991, the first substations were opened in Monterey and Baxter, each staffed with an ambulance 24 hours per day.  In 1994, another major revision of standing orders occurred, under the direction of Dr. Sullivan Smith, giving EMS a very broad scope of practice in Putnam County.  This year, PCEMS became the first pre-hospital ambulance service in Tennessee to perform 12-lead ECGs in the field and transmit them to hospitals.  In the same year, Tennessee’s first Pertrach surgical airway was performed by a PCEMS Paramedic.  The rest of the 1990s brought increases in call volume, staffing, and the addition of an Assistant Medical Director, Dr. Alex Case, who is a cardiologist.

2000s

By 2000, Putnam County Emergency Medical Services, now a 20 year old department, was staffed by 43 full-time and several part-time employees, using eight ambulance vehicles. Medical Director, Dr. Sullivan K. Smith became the State of Tennessee EMS Medical Director and remained in that position for two years. An additional Assistant Medical Director, Dr.Brian Dockery, joined our team as well.  Dr. Dockery is an interventional cardiologist; his addition brought our total team of physicians up to three.  These doctors provide medical oversight with standing orders, as well as respond alongside the ambulances when available to deliver even more advanced care in the field.

As any agency grows, so does the administrative work required.  PCEMS was no exception.  In 2002, Director Porter appointed an Assistant Director, Tommy Copeland, to assist in operational oversight.Field Training Officers were also added.  These FTOs were experienced Paramedics who were responsible for new and existing employee training.  Continuing education is a necessity in EMS, and the FTOs developed and taught new classes and techniques as they became available. This program is still in existence today, with 6 FTOs teaching over 100 hours of classroom material per year to PCEMS employees, as well as outside fire, rescue, and EMS agencies. In 2005, day shift supervisors were also added in an off-road position, allowing for more administrative oversight.

The 2000s also marked a significant increase in the availability for better patient care equipment.  PCEMS was the second ambulance service in Tennessee to place the FAST IO device on ambulances, ensuring medication access for the most critical patients.  We were also able to obtain new biphasic cardiac monitors for all ambulances, giving consistent cardiac care to every patient.  PCEMS was one of the first ambulance services in the state to begin using capnography in ambulances as well, a procedure that has now become a nationwide standard.  A disaster response trailer was also obtained, along with additional ambulances and crews to answer the continually rising number of calls.

Increased awareness across the nation about surviving cardiac arrest began to occur.  Putnam County EMS, in partnership with Cookeville Fire Department, with support from both County and City officials, began the Cookeville/Putnam County P.A.D. (Public Access Defibrillation) Program to teach CPR and AED use to every sophomores and seniors in Putnam County. The majority of teachers in the Putnam County School System were also trained to the same standard. In 2005, and again in 2007, the P.A.D. program received the Heart Safe Community Award for the category of Small Cities. This is an award that recognizes advances in pre-hospital cardiac arrest survival.  This award was presented by the International Associations of Fire Chiefs and Medtronics in Las Vegas, Nevada.  The P.A.D. program continues today, joined by many businesses and organizations throughout the county with AEDs and trained personnel.  An old ambulance was converted into a CPR truck, in order to transport mannequins and other training equipment to large venues.

Any discussion about CPR education and the P.A.D. program would not be complete without mentioning the name of Carmen Burnette.  Carmen was a paramedic with Putnam County EMS, as well as a field training officer.  She spent countless hours helping to develop the CPR education in high schools and elsewhere.  Under her oversight, high school students began to receive hands-on CPR training twice before they graduated.  She is personally credited with coordinating and teaching over 10,000 students CPR, some who have gone on to save lives in our community.  Carmen also did Quality Assurance review for PCEMS, as well as other agencies.  Sadly, Carmen died in 2011, following surgery for a back injury she sustained in the line of duty.  Her legacy, however, lives on at PCEMS, as well as in the Upper Cumberland and throughout the State of Tennessee.  The CPR training still continues in the high schools; in addition, Carmen’s Fund, an organization founded by Carmen’s husband, Mike, provides free layperson CPR training throughout the Upper Cumberland.  In 2012, the Tennessee State Legislature passed a bill requiring all high school students to receive hands-on CPR prior to graduation.  They named the bill the Carmen Burnette Act of 2012.

Another program that took hold in the 2000s was the Children Are Riding Safely (CARS) program.  This program provides car seat installation education for parents.  It might seem that car seats aren’t that complicated, but almost 90% of inspected car seats are improperly installed, possibly causing severe injury or death to a child involved in a collision.  This training is provided for free, and also continues today under the direction of Leah Thomas.

The later part of the 2000s increased equipment and training even more, with each ambulance receiving new automatic CPR devices, battery powered patient cots, better intraosseous devices, and multiple small additions to help with patient care.  In 2009, PCEMS moved into its current main station at County Services Drive in West Cookeville, along with several other agencies, decreasing response time to this area of the County. 

2010s

During the 2010-2020 decade, Putnam County EMS saw a staggering increase in the number of requests for service.  In the 1999-2000 fiscal year, our call volume was approximately 6700; in 2016-2017, we responded to over 17,600 calls, nearly tripling in less than 20 years.  At the same time, insurance reimbursements due to government restrictions declined, making funding more difficult.  Despite these difficulties, PCEMS was able to add some additional units and staffing, be one of the first ambulance services in the State to add the Zoll X series cardiac monitor to its ambulance fleet, enable and employ Critical Care Paramedics to provide even more advanced pre-hospital and inter-facility treatments than Paramedics, and make other small improvements.

In 2014, Director Porter resigned after being elected as the Putnam County Mayor, and appointed EMS Chief Tommy Copeland.  Under the leadership of Chief Copeland and Deputy Chief Darren Ford, PCEMS continues to be one of the most progressive EMS agencies in the State.  The leadership team expanded in 2017 to include 10 Lieutenants and 4 Captains working on the ambulance, and 2 Majors, a Deputy Chief, and Chief working primarily in the office.  PCEMS received another AFG Grant in 2017, which was used to purchase cot loading systems.  This is anticipated to help with back injuries associated with lifting patients.  Safer and more economical ambulances are also being purchased, along with better patient care equipment and training. 

2019 offered a new possibility-that of teaching an in-house EMT school.  The TN legislature ruled that a certain number of EMS agencies may participate in this, and PCEMS was allowed to be one of the pilot agencies.  Due to this and the increasing needs for training, a third Major was added, whose job is to oversee all of the training within PCEMS, including this EMT school. We have also been granted funding for extrication and ballistic uniforms, as EMS's roles and environments change.  Additionally, we purchased new cots for our ambulances this fiscal year.

2020s

2020 was an unprecedented year worldwide, and Putnam County EMS, as a team of frontline medical professionals, was at the forefront.  As our county reeled in shock from the devastation caused by the March 3 EF4 tornado, we shortly thereafter joined with our nation in the challenge of responding to COVID-19.  While 2020 played a huge toll on many of us, both mentally and physically, we still continued to push through and excel, during perhaps the most challenging time of our generation.  In 2021, our team of medical directors expanded to 4 physicians as Dr. Sean Ochsenbein, an emergency medicine physician and former AEMT with PCEMS, joined us.  An extensive revision of standing orders was implemented this year, maintaining our place at the forefront of prehospital medical care.  Though COVID-19 slowed our EMT school, it did not stop it.  We graduated our first EMT-B class, and we have high hopes for their EMS futures in the Upper Cumberland!  Busier still, we have added another 12 hour truck on nights to help us keep up.  Our call volume per year exceeded 20,000.  Busy busy!  2022 was perhaps the most challenging employment year in our history at that time, as the nation-wide shortage of EMS personnel affected Putnam County and strained our ability to maintain our quality of service.  Many factors played into this problem nationally, and we are certain that our county and state leaders will continue to work toward the solutions needed to continue to serve our community. Our EMT-B class this year definitely helped, with a 100% first-time pass rate for their National Registry exam. 2023 was an expansion year for PCEMS. As the call volume continued to grow, the need for more staffing increased. Another 12-hour ambulance for both days and nights was added, in addition to another BLS ambulance Monday through Friday. Additionally, a fourth Major was added to oversee compliance aspects of the organization, including increased requirements from Medicare and regulatory agencies, as well as to oversee quality assurance and improvement. A BLS Coordinator was also added, to help make sure that our drastically increasing call volume of doctor's office and convalescent transports runs smoothly. Our EMT school program continued to excel; we graduated our first AEMT class in August of 2023, with a 93% first time pass rate. For comparison, the national average first time pass rate for this test is less than 70%. We continue currently in 2024 to push the envelope in prehospital care, adding ventilators to all of our ALS ambulances. This is just one more thing to help ensure that our most critical patients are receiving the best care possible. Along with that, an unprecedented 36% of our full-time employees are in higher-level school this year, including 14 paramedic students, 10 critical care students, and 5 community paramedic students. This is a testament to the desire of our providers to excel.

Our goal and passion at PCEMS has always been to accept nothing but the very best care and transport available for our citizens and visitors.  We have a long-standing history of excellence, and we seek to honor those who have gone before us and paved the way for pre-hospital medical care in Putnam County.

                                                                 GovDeals Online Auction-Putnam County