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Pitt County EMS medical director urges stepwise unification, more stations
Summary
Dr. Roberto Portela told commissioners Pitt County EMS shows strong outcomes (higher cardiac arrest survival in CARES data) but faces fragmentation and shortages of county-owned stations; he recommended unifying service agreements, improving capital replacement planning and adding more station coverage, including moving a 12‑hour peak unit to 24 hours in the southeast.
Dr. Roberto Portela, the Pitt County EMS medical director reappointed earlier this year, told commissioners on July 13 that while the county’s EMS system has made significant improvements—new computer‑aided dispatch with automatic vehicle location, upgraded electronic patient-care reporting, community paramedic programs and above‑average cardiac-arrest survival—the system still faces capacity and management challenges.
Portela said Pitt County’s survival rates for out‑of‑hospital cardiac arrest have been as high as 17.9% and were 12.5% last year compared with CARES‑reported national averages of roughly 10.5% among reporting agencies and about 8% across the whole U.S. He credited investments in dispatch, training, QRV (quick response) vehicles and peak‑time ambulances for those outcomes.
At the same time, Portela highlighted structural constraints: the county directly owns two stations (both constructed in 2003) and relies on seven contracted nonprofit rescue squads and volunteer fire departments for housing ambulances and staffing. That fragmentation complicates uniform policies, equipment replacement, personnel matters and relocation of resources as population and call volumes grow. He also warned that vehicle lead times have lengthened since the COVID era to two to three years, which complicates capital replacement planning.
His recommendations included pursuing a stepwise unification of system management and service agreements to improve transparency and oversight, strengthening the county capital replacement program for EMS vehicles, and investing in additional station coverage—specifically converting one 12‑hour peak truck to a 24‑hour unit in the southeast area to reduce response gaps. Portela said the county can use data (call mapping, cardiac arrest locations, response times) to strategically place future stations.
Commissioners asked about the unification process and whether the county would take over volunteer agencies; Portela described several models used across the state and favored a stepwise approach that maintains units while improving deployment, procurement efficiencies and oversight.
