One airlifted, 1 DOA, three transported in wreck on FM 1343

This Saturday, there were multiple ambulances and Air Life needed to transport patients in a serious wreck on FM 1343 involving three Devine residents, Krystal Stehle and her two children, and two men from San Antonio. According to the Medina County Sheriff’s Department, the accident was first reported at 12:42.
A total of 5 people were involved in the accident.
Castroville Fire arrived on scene quickly as well as the first ambulance from AMR (which is the ambulance company local taxing districts have hired to provide EMS service).
There is a discrepancy of exactly what time the first ambulance made scene, so that remains unknown, although we know it was prompt. It arrived at 12:52 according to county dispatch, or seven minutes earlier according to AMR, who reports arriving at 12:45.
See additional editor’s notes in a separte article below.
The second ambulance that was needed this Saturday, made scene at 1:21 (39 minutes after the accident, but 29 minutes after it was requested). It responded from its post in Mico.
The third ambulance made scene at 1:55 (an hour and thirteen minutes after the accident–but only 42 minutes after it was requested by those on scene). It had to come from San Antonio because there were no ambulances closer that were able to respond.
Castroville Volunteer Fire Chief Rick Lair was one of the first responders on scene, arriving in his personal vehicle after hearing the severity of the accident over the radio. Eight other volunteer firemen also made scene to assist.
He initially called for one ambulance and then Air Life, before requesting second ambulance and a third requested later, at 1:13 according to the EMS service.
According to DPS: “On 5/13/17, at approximately 12:41 p.m., a 2001 Lexus passenger car, occupied by the driver, Michael Angel Vallejo, 19, and his front seat passenger, Carlos Puente Portillo, 20, both of San Antonio, were traveling north on FM 1343 in Medina County. A 2007 Ford truck operated by Krystal Stehle, 36, of Devine, was traveling south on FM 1343. Mr. Vallejo may have been speeding when he lost control of his car and veered into the southbound lane. Mrs. Stehle was unable to avoid striking the Lexus on its passenger side. Mr. Vallejo was taken to University Hospital in critical condition and Mr. Portillo died at the scene. Mrs. Stehle and her two minor female passengers were all taken to University Hospital in stable condition. The investigation is ongoing and all the contributing factors are not yet known. ”
(Mrs. Stehle and her daughters were on their way home to Devine around lunchtime from Castroville, after going to appointments preparing for prom. All 3 were stable and released from the hospital on Sunday according to family friends.)
In conversations with Chief Lair, he made an excellent point when he said, “Every tax payer thinks that ambulance is sitting in the barn for their brother or sister. They think when they pick up the phone and call, they are going to come,” Lair said.
He did also point out that AMR does a good job once on scene.
The following is my own recount of a timeline, after driving by the scene of the horrible accident this Saturday, and listening to emergency responders doing the best they could with the number of ambulances available in our county right now:
“At 12:45 noon, we happened upon this 2 vehicle accident between Alsatian Heights Subdivision and Castroville Hwy 90, less than 5 minutes from the city of Castroville. We saw 6-8 vehicles parked along the curvy and crowded roadway as well as what appeared to be about a dozen passersby standing by to help. Feeling that we should not crowd the scene any more than it already was, we kept driving, hoping that emergency crews would join the many good Samaritans who appeared to be anxiously awaiting an ambulance and other first responders.
After getting to my scanner, 25 minutes later, at 1:09, I heard the Castroville Volunteer Fire Department come over the radio.
“Can I get an ETA for Air Life and an additional AMR (ambulance) unit?”
Air life responded directly to the fire department, saying “Our eta is 1 minute,” and asked for a description of patient status. The Fire Department responds with a weight of patient and says he will get the vitals to them shortly.
At 1:12, the local dispatcher reports that she has spoken with AMR and that the ambulance unit has an eta of 8 minutes.
“Airlife is on the ground!” rings out at 1:15 (about 30 minutes after we drove by the wreck).
At 1:20, ground crews were still waiting on the “additional AMR unit” requested earlier, and they called for another ETA of that ambulance.
A local dispatcher responded, “The unit had an ETA of 8 minutes. They should be arriving now. I’ll call AMR dispatch back.”
According to AMR, the second EMS unit was requested at 12:52, and arrived at 1:21, which was 29 minutes after it was requested.
At 1:21, our local dispatcher reports: “Their (AMR) dispatch is advising me the 2nd unit should be on scene now. The 3rd unit has an ETA of 9 minutes.”
Airlife lifted off at 1:26.
According to AMR, the third EMS unit was requested at 1:13, and arrived at 1:55, which is 42 minutes after it was requested.

Do we need more ambulances stationed here?

Devine, Natalia and Castroville ESDs (#1 and #4) all hire the same ambulance service–a private company called AMR (American Medical Response). Our local boards are contracting with AMR to provide 1 full time ambulance stationed in some of our cities, like Devine and Castroville, and only part-time ambulances in other cities (available only 12 hours in Natalia, and 16 hours in Mico –not all day and night). The Hondo area is served by a different company called Community EMS.
Do we need to employ more ambulances in Devine and Castroville?
Our EMS service is no longer a volunteer operation. It is funded by a steady stream of tax revenue dedicated to each emergency service board in our county. Emergency Service Boards in Devine and Castroville, now contract with AMR (American Medical Response) to provide EMS services here. We have no complaints with the quality of service of these first responders, but would like to question if the number of ambulances stationed here is sufficient?

Editor’s note:

We have heard nothing but good things about the quality of service provided by AMR paramedics once on scene, but over the past couple years it has been difficult and nearly impossible to find out what the response times of ambulances actually are, and how many calls have been answered from ambulances that were still in San Antonio when called for an emergency here in Devine or Natalia or Castroville.
You may not know it, but an ambulance might not be coming from Devine or Castroville or Natalia when you call 9-1-1.
They might be responding from San Antonio, as the third ambulance had to do this past Saturday, meaning a 42 minute wait from the time it was requested. This happened because the two stationed in the area, were already called out and a third “backfill ambulance” hadn’t arrived from San Antonio yet. Had it rolled immediately after the first ambulance went out, would it have been in Castroville waiting?
Thankfully, the patient in the 2nd and 3rd ambulances weren’t in critical condition this time, but what if they are next time?
This boils down to the following question:
How many ambulances can our ESD’s afford to staff in our hometowns, rather than relying on “ hopefull backfills” from San Antonio?
And, can we get more comprehensive reports that show the time crews were actually dispatched and what time they arrived on a consistent monthly basis, so that it can better determine how often we are relying on ambulances from San Antonio?
When tyring to research call and response times, it becomes complicated because of varying equipment and separate dispatching systems between our county and our hired EMS provider for this area, AMR.
AMR Vice President of Operations Steve Dralle explains, First “The Medina County crew (stationed in our hometowns) is toned by the Sheriff’s department, then the crew sends the call to our communication center (in Dallas) to initiate in our center. There is always a minute or two between when the Sheriff’s Office gives us the call and when our crew has transmitted the call information to our communications center.”
AMR does not record the time that the sheriff’s office tones out the AMR unit. Instead, it records the time that the AMR crew has passed the information onto their separate communication center in Dallas.
However, if you want to know what time the ambulances arrived, you often have to get that info from AMR. The sheriff’s department only knows if AMR ambulances have arrived on scene if they check in with dispatch. For example, in this case the 3rd AMR unit had not checked in with our dispatch, so the sheriff’s office didn’t have a record of the third ambulance arriving on Saturday. This makes it hard to truly evaluate how often backfills ambulances are being used and how long the response time really is.

By Kayleen Holder
Editor