“These are serious consequences.” said David Loftin, former EMS director for Region 1. “In the middle of rural areas, where a transport to the hospital is an hour, it may have a significant impact on a patient’s survival.”

Loftin said he was among the hundreds of medics and others who wrote to the state to oppose the change, contending it was harmful to patients.

The state saw it differently.

An ambulance transports a patient in DeKalb County. Last year, the state changed its requirement on ambulance staffing, deciding that ambulances could be staffed with just two basic medics. Previously, one of the medics had to have more advanced skills. Christina Matacotta/Christina.Matacotta@ajc.com

Nancy Nydam, spokeswoman for the Georgia Department of Health, told the Atlanta Journal-Constitution that the change to staffing levels was necessary to avoid having to halt essential emergency services to the public. Georgia is among the states that are affected by a critical shortage of emergency medical personnel.

EMS officials in parts of rural Georgia were struggling to find enough medics to operate their vehicles, Nydam wrote in response to questions from the AJC.

Yet another reason the change drew support was because ambulances in Georgia don’t just answer to emergency calls. The vehicles are also used to transport patients between hospitals, to dialysis and nursing homes.

In that case, those types of patients do not require “any clinical interventions above the level of EMT,” Nydam wrote.

As a result, the new rule allows for more appropriate and efficient staffing, she said.

“Forcing an agency to staff that vehicle with someone with a higher license level would not be appropriate,” she wrote. “The rule change does not lower the standard of care of patients in Georgia.’’