A heartbeat away
from needless tragedy

Listening to ambulance calls in Marion County is one of the easiest ways to realize we’re just a heartbeat away from needless tragedy.

No, we’re not talking about emergencies the county’s dedicated and capable ambulance workers handle. We’re talking about emergencies that, for reasons sometimes legitimate and sometimes not, they can’t.

Simply put, Marion County is perilously close to not having ambulances available when life-or-death emergencies arise.

When a heart stops beating, lungs stop breathing, or blood relentlessly gushes from an injury, seconds count. Our expert ambulance crews usually save the day. What quickly becomes apparent, however, is that one of the days, our luck is going to run out.

It’s not just a shortage of on-call ambulance workers that threatens the system. It’s a seemingly ever-increasing number of instances of misuse, overuse, or downright abuse of the system.

Monday wasn’t a particularly unusual day for the ambulance service, but it provided several examples.

With insufficient responders available in Tampa, an ambulance from Hillsboro was dispatched to Tampa, 19 miles away, because a woman in her 90s had fallen.

A few minutes later, someone wanted to transfer a patient from a nursing home in Goessel to a hospital in Newton. Normally, this call would have gone to the ambulance in Hillsboro, but with that ambulance occupied in Tampa, dispatchers tried to get a crew from Peabody. Unable to locate sufficient responders in Peabody, they dispatched a Marion ambulance to drive 28 miles to Goessel then 15 miles more from Goessel to Newton.

With the county ambulance in Florence also having insufficient responders available, that meant every ambulance crew in Marion County was occupied. For the next 82 minutes, if a heart had stopped, it very likely would have had no chance of being restarted.

As a community, we’ve made our choices and set out priorities. We choose not to spend money necessary to safeguard against legitimate problems such as this and instead make sure we have such things as multiple police officers and sheriff’s deputies on duty round-the-clock and a small army of clerks available anytime anyone steps foot in any government office — unless, of course, it’s lunch time, break time, or one of a burgeoning number of holidays.

The Tampa patient had potentially life-threatening injuries. Occasionally people need to be transferred from nursing homes to hospitals. And if a nursing home is in our county, it’s probably our responsibility to make the transfer even if an ambulance has to go 28 miles to get to the scene when a Newton ambulance would have been only half as far away.

These calls aren’t the problem. The problem showed up a few hours later, with county ambulance crews still as thin as they were earlier in the day. This time, the ambulance based in Hillsboro was summoned not to a Marion County site but to that same hospital in Newton where the Marion ambulance had taken a patient a few hours earlier. The assignment was to return a patient — possibly the same patient — back to the nursing home in Goessel.

Hillsboro is closer to Goessel than Marion is, but Newton is closer still — at least two miles closer, to be exact. And the call originated not from Marion County but from Newton’s county, Harvey. Why was a Marion County ambulance dispatched? Could it be that Marion County charges less? Or could it be that the Newton hospital, which seems very interested in competing with Marion County hospitals by opening clinics here, is more than willing to provide profitable clinical services but not so willing to provide less profitable ambulance services?

While the Hillsboro ambulance was off on its non-urgent errand of mercy, a call came in for yet another transfer to Newton, this one from a Peabody nursing home. Dispatchers again tried to locate an ambulance crew in Peabody but couldn’t. They then tried to get a crew from Florence. Again, there was insufficient response. So a crew from Marion was dispatched 16 miles to Peabody to make yet another transfer to Newton.

For the next 36 minutes, Marion County once again tempted fate with no ambulances available.

While the Marion ambulance was still en route back into the county, the Hillsboro ambulance was called out again for a child who had swallowed lighter fluid in Hillsboro.

It sounded like a legitimate emergency, but in the end the ambulance didn’t transport the child — which would, of course, meant that the child’s family would have had to pay for the run.

Instead, the ambulance followed the family to Hillsboro Community Hospital as family members drove the child to the hospital.

No transport, no bill. Still, the ambulance crew remained with the case for the next 32 minutes even after the family had technically declined their services.

This is nothing new for the county ambulance service. One out of every three or four calls they go on result in no transport and thus no reimbursement of the county’s considerable cost. But cost isn’t the real issue. Given the fragile nature of the ambulance system, the question is whether the county can continue to afford to tie up scarce medical resources responding to calls from people who don’t actually want an ambulance, for which they would have to pay, but only want someone to tell them whether they should go to a hospital.

It also is time to adopt a clearer policy on runs originating outside the county. Residents of the Burns area seem to have no problem calling El Dorado ambulances to come into Marion County. Why Newton ambulances can’t handle at least some of the transports to and from Marion County nursing homes, especially when the call originates in Newton, seems incomprehensible.

No one wants to discourage people from seeking prompt medical attention, but unless the county is willing to invest in incentives that will ensure additional ambulance workers are available to handle those true emergencies or adopts policies to discourage overuse of its ambulance service, we’re all living on borrowed time.

— ERIC MEYER

 

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