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Home > Topics > 911
July 08, 2014
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EMS News in Focus
by Arthur Hsieh

Emergencies at hospitals still require 911

Just because an incident happens in a health care facility doesn’t automatically mean that the facility is capable of managing it without outside assistance

By Arthur Hsieh

Last week a report about a veteran dying from sudden cardiac arrest while on the campus of a VA hospital caught national attention. There was a lot of criticism over why the patient wasn’t moved to the facility’s emergency department by hospital personnel, rather than waiting for an ambulance to arrive. This comes as the nation’s health care system for its veterans is under a dark cloud of poor management practices in providing care.

If you have ever seen a VA medical facility, you probably understand why their policy is to call 911 and request an ambulance, rather than “just” transporting the patient by gurney. They are big — really big.

Judging from an aerial map of the hospital, it covers several square blocks in Albuquerque. While it’s not clear where the cafeteria is, I imagine the ability to muster a rapid response team and get them to the incident within a couple of minutes would be a challenge for any major facility.

Trying to do effective CPR on a moving hospital gurney? Not likely. Location of the closest AED? Unknown at this point.  I’m sure that information will become known in the future. 

Initial reports indicated that the ED entrance was merely 500 yards away. That’s 1,500 feet, greater than a quarter mile, almost two football fields in distance. I’m not sure about you, but I have never muscled a gurney that far in my career. 

The bottom line is, just because something like this happens in a health care facility, doesn’t automatically mean that the facility is capable of managing it without outside assistance. Frankly, EMS providers are probably the best trained and equipped to manage this incident like any other response.

Whether there was an unnecessary delay, time will tell. In this case, dialing 911 was still probably the best call to make. 

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.
Comments
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Steve Seldom Seen Stahl Steve Seldom Seen Stahl Tuesday, July 08, 2014 6:33:45 PM I'm sorry I disagree. Hospitals are well equipped to handle this type of incident. It is a good distance from the ER, but there are many small hospitals with the same protocol. If a patient drops dead in the parking lot of the ER at most hospitals I've worked at, an ambulance must be called to transport the person inside to the ER. I believe it has to do more with the litigious society we live in and perpetuate than the common sense that should be applied in most cases.
Dominick Walenczak Dominick Walenczak Tuesday, July 08, 2014 9:14:42 PM I seem to recall a hospital system being fined because one of its on-campus facilities DID NOT maintain the same level of care throughout the facility because they weren't able to work a code. Joint Commission found that unacceptable. Plus, all buildings part of the contiguous hospital campus fall under EMTALA. I would argue negligence here. As far as calling 911, we're always the safety net for when something gets bungled and needs to be bailed out. Does not make the situation right. And once it became clear that an ambulance wouldn't be coming for some time, wouldn't a sound person suggest that salvation lies a mere 500 yards away?
Ken Smith Ken Smith Tuesday, July 08, 2014 10:06:03 PM Ummmm. . . "Merely 500 yards away. . .almost two football fields in distance." Sorry, but I'm pretty sure that's five football fields. :-)
Steve Jacobi Steve Jacobi Friday, July 11, 2014 9:32:40 PM Art are you really that out of touch for EMS? What is wrong you and your attitude that hospitals need Paramedics to rush in an save the day? I bet the employees at San Francisco General are laughing their asses off at your attempt to belittle hospitals. Is this the same crap you teach to students? Hospitals are perfectly capable of handling emergencies but are restricted to doing so once outside of the ER doors or property which is not theirs. Did you not learn this in the Bay area? There were privately own nursing homes and dialysis centers in the middle of major hospitals which were MANDATED to call 911. It is extremely frustrating for the employees of these hospitals to not be able to answer an emergency within their walls but heaven forbid it they do. Some EMS agency or FD will scream foul and demand that hospital be fined.
Steve Jacobi Steve Jacobi Friday, July 11, 2014 9:37:23 PM No it has to do with regulations including those enforced by EMS and Fire. Hospital employees also can not abandon their patients. The first time an ER physician steps outside of those walls, some ambulance will pull up with EMTs or Paramedics expecting to talk to the doctor. They will be all too happy to report this doctor to their county and state to get his or her license tarnished and the hospital fined. Why? Because like Arthur, they have issues with hospitals and doctors. Whatever suits will be brought by the EMTs and Paramedics against the hospital for call jumping and violating a policy concerning a physician in the ER.

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