The last 2 days I worked a night shift in a small city for the first time in a few years. As I mentioned previously I work part time for AHS on my days off from my regular job.
This community is about 20,000 people and runs 2 ambulances that work 12 hour shifts.
It’s about 15 min away from a larger city of 100,000 people where my parents live. This Peticular city has 5 Ambulances.
Day 1 Night Shift we came on, and we were the only ambulance in town. The other crew was on a transfer to the city (a transfer meaning an ambulance drove a patient from one hospital to another – this topic will be covered in another blog)
Leaving me and my partner the only ambulance in town.
20,000 people and one ambulance.
We got our first call out immediately.
An 80 year old who fell down at a lodge and needed assessment. A lodge, or old folks home, is where families spend 2000, 3000, or up to 5000 dollars a month to home their elderly family members. You pay for this facility to care for your family members but these facilities have a policy to not pick up patients off the floor. No matter how they got there. No matter if they aren’t even hurt.
If your family member is on the floor. An ambulance needs to be called to pick them up.
We get on scene and we meet the sweetest old lady. She felt bad for slipping out of her chair and sliding to the ground because she had to go pee before bed.
Naturally my partner and I assessed her, got her vitals and did the paper work and tucked her back into bed. She didn’t want to go to the hospital, just needed to be picked up off the floor.
This whole process takes about 45 minutes to an hour From the time we get the call, arrive on scene, do an assessment and do the paperwork.
Why does a lodge have a policy to not pick up their residents from the floor ? Don’t families pay these facilities to take care of their residence ?
So for those 45 to 60 minutes if anyone else in this community needed an ambulance, where would it be coming from ?
The closest ambulance would be the city 20 min away, and that’s even if they had an Ambulance available.
We finish this call and go back to station.
Immediately we get another call. Back to the lodge. Another resident of this old folks home fell and needed picked up off the floor. Dispatch notes say no injuries.
Our second ambulance is still on a transfer.
We go to the lodge. Again, no injuries, old man just needs picked up off the floor. The lodge has a policy of NO LIFTING.
So again 45 to 60 minutes goes by.
We respond. We assess. We do paper work. Life him off the floor. Tuck him. Into bed and get back in service
Another 45 to 60 min where this community’s closest ambulance for a potential 911 call is 20 minutes away because were tied up at the lodge.
We finish this call and get another one right away. By this time its nearing 10 PM
My shift is 6 pm to 6 am.
A 40 Year old complaining of chest pain.
Chest pain can be caused by a variety of things.
The most concerning, the heart.
We respond and get to the patient.
She states she had this pain 4 weeks ago and didnt bother to get it checked out. And had it again 2 weeks ago, went to the hospital and all tests determined no apparent cause of this pain, then good thing being it wasnt her lungs or heart. Very likely just a muscle strain.
She had it again last week and ignored it. And again today she experienced this pain at midnight and decided to call 911.
We asked what was wrong and she said well there was pain but it’s gone now.
She doesnt know if she wants to go to the hospital or if she should just leave it till later.
I just want to say. 911 is an EMERGENCY SERVCE. If you call 911 your probably concerned about your life or immediate well being .
We asked “well what do you want to do?” She says “well I’m not sure, maybe I’ll stay home and ill go to my doctors later in the week.”
But she couldn’t make up her mind. She decided she wanted us to take her to the hospital. Even tho her pain was gone and all her vital signs were normal. Then she decided to stay home
Then she wanted to go. Then she changed her mind. Then she wanted to go.
You should probably know as an emergency Services provider we CANNOT refuse transport of anyone wanting 911. We cannot refuse anyone saying they want an ambulance ride to the hospital. And we cannot tell anyone they SHOULDN’T call 911.
The slogan “You Call, We Haul” is appropriate.
This particular call takes us 2 hours. This person, now experiencing no pain whatsoever and who was home with family members probably could have driven herself to the hospital. (5 minutes down the road)
In that 2 hours, this community has no ambulance except for the neighboring community 20 min away. Assuming they had one available.
This call finished and we get paged to drive to the city because all 5 of their ambulances are tied up and are busy. This is a very common occurance. So we leave our town of 20,000 people to drive to the city of 100,000 people to do coverage. Because out of the 2 cities WE ARE the only ambulance available.
After arriving in the city we hang out at a local coffee shop for 20 min and a call comes in. An 75 year old man fell down a set of stairs and is currently unconscious. Its 8 blocks away from where we are sitting.
We respond lights and sirens.
Keep in mind now that we are on this call. There isnt an ambulance for the 2 cities for over 30 min away.
We arrive at a residence and find a gentlemen conscious at the bottom of the stairs. We figure out he tumbled down at least 20 flights of stairs and his head is sitting in a pool of blood.
We assess and see his head has a 5 inch cut along his scalp and a probable concussion.
After an assessment we ruled out any neck or back injury and we stood him up. He was able to walk back up the stairs and we sat him in a chair. We re checked his vitals and they were good. He didnt want to go to the hospital. It took some convincing that he should go. Especially after falling down a full flight of stairs. He began feeling sick and threw up, a sign of a head injury, likely a concussion.
We take him to the hospital.
My partner and I finish this call and get to sleep Around 2 am. Shift ends at 630 am
Day 2, I Arrive on shift at 6:30 PM again. The crew we are releiving is in the city where my parents live 20 min away. The 2nd crew is in another city on a transfer. So we drive to the city to relieve them so they can go off shift.
We arrive at this hospital to find 8 Ambulances parked in emergency . Each with a patient in the hallway waiting for a bed. 8 ambulances means 8 patients means 16 paramedics waiting .
An ambulance crew cannot drop off a patient until the hospital accepts delivery of that patient. So if a hospital does not have a bed. They dont accept delivery and the paramedics wait WITH THE PATIENT until they take over care.
At this time 8 ambulance crews are waiting for the hospital to take over care.
This means 8 ambulances are tied up and not able to respond to 911 calls.
So this means that the city and other surrounding communities are without ambulances until these crews can drop off their patients and get back into service.
We take over care of a 50 year old patient our other crew brought in 1 hour prior who was experiencing some chest pain.
Now that we were at the hospital we just had to sit and wait.
2 hours goes by, a bed isnt open for us yet so we continue to wait. A couple of crews were able to get a bed before us, as they had a more serious patient then we did, and some new crews come in. 3 more hours goes by, and we are still waiting. More crews were able to get beds and we were the last crew left. It’s getting close to 2 am and we finally were able to get a room for our patient. After 6 hours. We clean up and head back to the station and we were able to get some shut eye by 3 am and end our shift at 6 am.
I think about these types of situations a lot. And this particular situation is not limited to my area only, It’s a North American issue. Canada and the States.
I think about my friends and family. If they ever needed 911. Will there be an ambulance available for them ?