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City to be more selective in dispatching ambulances


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Lomi Kriel - Express-News

Have a nosebleed? Involved in a fender bender in which no one's hurt? Encounter a man on the street who's clearly been dead for days?

In the past, ambulances would routinely respond to these types of incidents, even when their presence was obviously unnecessary — tying up already overburdened paramedics, delaying their response to critical emergencies and costing $1.4 million a year.

No more. Under a new program that went into effect Monday, San Antonio Fire Chief Charles Hood said ambulances won't be sent if no one is hurt, the injuries suffered are minor or patients don't require transportation to a hospital.

Citing Fire Department statistics collected between March 2007 and February 2008, Hood said ambulances were going to scenes when they weren't needed. Of nearly 55,000 emergency calls, paramedics transported patients to the hospital less than four out of 10 times.

“If you truly need an ambulance, you're going to get an ambulance,” Hood said at a press conference announcing the initiative. “But we're just keeping those units available for more serious incidents.”

Hood said firefighters would still make all scenes — as they do anyway — able to offer basic medical care. All fire trucks also come equipped with medical equipment.

Hood is also going to focus on putting more paramedics on fire trucks, either through promotions or expanded training. Currently, a paramedic is onboard a fire truck a little more than a third of the time, he said, adding, “Our goal is 100 percent.”

Under the new program, dispatchers will better screen 911 calls to determine which require an ambulance.

Fire Department data shows six types of emergencies that often don't result in serious injuries. These include animal bites, where out of 680 emergency calls between March 2007 and February 2008, patients were hospitalized only 15 percent of the time. Of 18,179 traffic accidents in that time period, only 25 percent required hospitalization, and of 1,677 medical alert alarms, fewer than 13 percent.

If there's any doubt about a call, an ambulance will go, Hood said, adding, “We're always going to err on the side of the patient.”

But he implored the public to help make the system work by staying on the phone long enough to answer all of the dispatcher's questions.

He said 50 percent of assault and traffic accident calls are hang-ups, preventing the dispatcher from determining what type of response would be best.

“Just stay on the phone,” he said. “Give us as much information as possible.”

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**sigh** I promised myself I would stop posting in this forum. Does this mean the FD is going to stop dispatching an engine to "smoke from cooking" or police to "verbal domestics?" After all these types of calls have usually resolved themselves before the arrival of personnel, and don't you want them to be kept in service for more "serious emergencies?"

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As usual, the firemonkeys only want to respond to runs that give them wood. :roll:

Almost every big city that tries this ends up in court after someone dies, paying out millions of dollars and getting a huge amount of bad publicity out of it.

Although, given the bad press that SAFD has already gotten recently, perhaps those who do not get one of their ambulances will be better off. I wouldn't want them taking care of me, given the choice.

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Lomi Kriel - Express-News

Fire Department data shows six types of emergencies that often don't result in serious injuries. These include animal bites, where out of 680 emergency calls between March 2007 and February 2008, patients were hospitalized only 15 percent of the time. Of 18,179 traffic accidents in that time period, only 25 percent required hospitalization, and of 1,677 medical alert alarms, fewer than 13 percent.

The problem is, they received these statistics post hospital discharge. We as a profession for the most part, do not have the education required to make such a determination. Of course there are some obvious transports that we all know will be discharged quicker than we can put the ambulance back together. Everyone deserves a thorough assessment. If we cannot find a problem and the patient still hurts, they need further evaluation which we are either unqualified or under equipped to provide. Just because the patients weren't hospitalised, doesn't mean they didn't require some form of treatment in the ED. Stitches, X-rays, you know, just in case, etc. Heck, I've seen patients with casts placed on a arm and be sent home, thus not requiring an overnight stay. I do not understand the thinking. As always, you can read the statistics anyway you want. It's all in the presentation.
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