Union says two-tiered system opens city to lawsuits
By Fran Spielman
Chicago Sun Times
Copyright 2006 Chicago Sun-Times, Inc.
All Rights Reserved
The Chicago Fire Department will add one ambulance for emergency calls, three more for non-emergencies and four advanced life support engines in 2007, under a long-awaited expansion tied to Mayor Daley’s pre-election budget.
It’s the city’s largest expansion of emergency medical services in six years — but it doesn’t sit well with Pete Houlihan, EMS director for the Chicago Firefighters Union Local 2.
Houlihan said Chicago would be better served if all four of the new ambulances were advanced life support (ALS) — and if the 12 basic life support (BLS) ambulances were converted to ALS. That way, 911 dispatchers wouldn’t have to go through a flip-chart of questions, then make a judgment call that could be the difference between life and death.
‘DISPATCHING IMPROPERLY’
“As long as you have a two-tiered system, they’ll have to determine what level of service you’re getting. It shouldn’t be that way. If it’s deemed an emergency, the patient should get an ALS company. Anything short of that is opening the city up to lawsuits on dispatching improperly,” Houlihan said.
“It’s like going to a doctor over the phone. You can hear the complaint, but you also have to look at the patient. . . . Fortunately, no one has died. But it has happened where [a BLS ambulance responds and] they need an upgrade to ALS. That means they’re dispatching improperly.”
Particularly galling to Local 2, Houlihan said, is that the city is adding an ALS ambulance only because it was too big and “wouldn’t fit” into the firehouse to which it was assigned.
Fire Commissioner Ray Orozco Jr. denied that BLS ambulances offer second-rate service.
“The two-tiered system works because we have different types of injuries just like fire responses are different. . . . If 60 percent of your runs are BLS, we have to allocate the right resources for the right type of incidents,” Orozco said.
“What it allows us to do is save those ALS ambulances for when we really need them. As the system continues to grow — and the system will continue to grow as we look at it long term — it’ll accomplish that even more.”
‘FISCALLY RESPONSIBLE’
The Fire Department has a two-tiered system of ambulance service to reserve the most costly and sophisticated treatment for severely ill or injured patients.
There are 59 ALS ambulances, each staffed by two paramedics qualified to administer intravenous medication. ALS ambulances are stocked with drugs and equipped with heart-monitoring devices. The city also has 40 ALS engines with at least one paramedic, an EMT and advanced life support equipment.
Orozco had originally hoped to add up to six BLS ambulances and 10 more ALS engines. He settled for three BLS ambulances, one ALS ambulance and four ALS engines.
“We can always hope to have a lot, [but] I have to be fiscally responsible in my position,” the new commissioner said.