By Carissa Wolf

WesCom Wire Service

BROOKINGS - A simple cut may be a minor injury to a big city dweller and require little more than a short car ride to an urgent care center. But in the wide open spaces of Curry County, a minor injury could quickly become a major .

Many rural residents are not prepared for the unexpected health problem. And when an emergency strikes after regular doctor office hours, some look for help in all the wrong places.

andquot;There's is no emergency center here after hours,andquot; says Brookings Fire Chief William Sharp. andquot;It's a sad thing that there is no emergency service other than the ambulance.

Darryn Ballance knows all about the difficulty involved in finding care for a minor emergency after all the doctors' offices in town close.

andquot;We were not prepared,andquot; Ballance remembers.

It happened shortly after the Ballance family relocated to Brookings two years ago. Ballance's son burned himself. He was crying, screaming. And Ballance did what any concerned mother with good urban sensibilities would do: She drove her son to the nearest facility staffed by trained medical personnel. That happened to be the fire department. And although firefighters are on call 24 hours a day, they still go home at night. So the station sat empty.

Ballance then went to what seemed like the next logical place to find help: The police station. And the police could only call 911.

Ballance has since become one of the area's authorities on emergency rescue services as a community relations director with Cal-Ore Life Flight, Curry County's ambulance rescue provider. But she said that many area newcomers and people seeking emergency help for the first time share her story and the confusion she experienced.

When local doctor's offices close the sick and injured often don't know where to go or who to call.

If someone arrives at the Brookings Medical Center after the facility closes at 7 p.m. they sometimes go straight to the medical center's director looking for help. It's something people can do in a small town where everybody is likely to know somebody and names and phone numbers are listed in the local telephone directory.

andquot;People who know I work at the clinic call me at home and ask, 'Are you open?'andquot; says Brookings Medical center director April Gothard. Gothard said she's not trained to give medical advice but concurs with her colleagues in health services that when in doubt, call 911.

The Brookings Medical Center publishes and distributes a brochure for those occasions when someone falls ill or injured and is not quite sure who to call or what to do.

The medical center is equipped to handle cuts that require stitches and broken bones and the clinic's pamphlet notes that urgent care services can treat nosebleeds, fever, earaches and other bothersome, but non-life threatening, ailments.

andquot;Anything life threatening -you cut off a limb or have a heart attack - call 911,andquot; Gothard says.

But Sharp warns that what may not appear life threatening could quickly turn serious simply because a person falls sick or injured in a rural area.

andquot;Keep in mind, that at the bare minimum, it's 30 minutes to an after-hours facility,andquot; Sharp says.

That 30 minutes can turn a simple cut into something much worse, especially for may of the area's senior citizens who are on blood thinners and other heart medications that may interfere with the blood's ability to clot.

You can cut yourself and think you can drive yourself to Gold Beach or Crescent City, only to find that andquot;ten or 15 minutes later your body goes into shock and you're behind a wheel,andquot; Sharp says.

Newcomers to the area may have been advised by an oldtimer that the above scenario make buying a Cal-Or Life Flight membership a good idea.

For about $55, a Life Flight membership generally covers the cost of emergency transport services up to the Medicare allowable rate after the insurance deductible has been met. Non-emergency medical transport is also offered at a discounted rate to members. A typical emergency transport that includes a plane ride to a larger regional hospital typically runs between $6,000 and $18,000 Ballance says.

The remote location of Brookings-Harbor does give patients one advantage though: they are often able to chooses which hospital they want to go to because the towns lay almost exactly at the middle point between two Level IV trauma hospitals - Curry General Hospital in Gold Beach and Sutter Coast Hospital in Crescent City.

But regardless of which hospital you choose, you'll still have a wait before you actually see a doctor. In Curry County, the average time it takes for a person to arrive at a hospital after calling an ambulance is 69.5 minutes, according to the Oregon Department of Human Services.

Small and rural does not necessarily translate into a slow EMT response time though. Brookings may lie roughly 30 miles between the closest hospitals, but Curry County EMTs' ability quickly reach the sick and injured rivals that of many of their urban and metro area counterparts.

Curry County has a sightly lower ratio of EMTs compared to most rural Oregon counties of a similar size but almost twice as many emergency transport vehicles. This has helped rescuers reach the hurt and injured in Curry County almost twice as fast as EMTs can reach emergency scenes in most Oregon counties. On average, it takes an ambulance or rescue team 18.2 minutes to reach a sick or injured person in Oregon while it only takes Curry County rescuers 9.6 minutes, according to Oregon Department of Human Services reports.

But once Curry County EMT teams reach the scene, their ability to stabilize the patient begins to trail behind most Oregon counties. Total scene time, or the time between the arrival of emergency medical personnel at the injury scene until the time the ambulance departs to the hospital, spikes in comparison to other counties. The average amount of time EMTs spend at the scene of an emergency in Oregon is 18.5 minutes. In Curry County it's 31.1 minutes.

Sharp says that Curry County's high number of elderly and cardiac patients accounts for the longer than average scene time. They simply take longer to stabilize than younger patients.

But Sharp says senior patients often have an edge that younger patients don't have when they're caught in a rural health crisis

andquot;Older people often know their body well enough to seek appropriate help.andquot;