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Editorial: Paramedics answer 9-1-1 calls for splinters, cramps, plumbing

By Ken Rodriguez
San Antonio Express-News
Copyright 2007 San Antonio Express-News
All Rights Reserved

Responding to an emergency call the other day, a San Antonio paramedic discovered a man who didn’t need a hospital. He needed hardware.

“When my ambulance got to him,” the paramedic says, “he explained that he called 911 because after the plumber replaced the water heater, the faucet made an awful noise and air came out of his pipes.”

Inside siren-wailing ambulances, swerving in and out of traffic, are EMS workers racing to scenes that bewilder and frustrate.

“Over the years,” one paramedic says, “I have responded to everything — from the homeless man who wants me to look inside his ear to ‘see if there’s something in there’ to the kid at home alone who stuck a bean in his brother’s nose.

“We spend so much of our time responding to 911 calls for ridiculous reasons.”

How ridiculous?

Paramedics tell me they’ve heard the following:

“I need a ride to make a hospital appointment. I don’t have money for a cab.”

“I have a sprained ankle.”

“I have a splinter in my finger.”

“I have insomnia.”

Says one East Side paramedic: “I get lots of calls for headaches. People don’t know they can take Tylenol.”

The paramedic added: “If we are responding to a person with a headache, and a shooting comes in two blocks away, we cannot switch out. We have to make our run.

“Sometimes dispatchers really try to work with us. But when it’s really busy, they don’t have time to switch us out.”

EMS workers not only are stretched — 29 units provide service to more than 1.2 million people — they’re stressed. The San Antonio Fire Department estimates up to one of four transports for basic life support is noncritical. But that may be low. In 2000, emergency medical workers found that in more than half of their calls, “patients” did not require hospital attention.

“The system is a mess,” one paramedic says. “The system is set up to ‘transport anyone who asks to be transported.’”

A new taxi voucher program was supposed to alleviate that system flaw. Paramedics say it hasn’t.

The voucher program — initiated in January — allows noncritical patients a free cab ride to the hospital. But there’s a catch: Patients receive vouchers only after a paramedic assessment.

Assessments take time. Paramedics check vital signs, report the results to medical control and complete paperwork. After that, they may call a taxi. Then more paperwork is required.

“After doing a full assessment,” one paramedic says, “we probably could have already had them at the hospital.”

Most paramedics refuse to waste time with cab rides. In the first 71 days they became available, only 45 vouchers were issued.

For every legitimate 911 call, there seems to be an illegitimate one. Some without insurance call to receive treatment for minor ailments. Others phone in order to skip long lines at the ER.

“People now realize,” one North Side paramedic says, “that if they go to the hospital on a stretcher, they’ll get seen quicker.”

Sometimes, a guy on his back with a migraine can see a doctor before a woman bent over with a bloody face.

A paramedic friend recalls a late-night run to the home of a 19-year-old mother.

“She had three kids and was pregnant with a fourth,” the friend says. “She was drinking coffee and didn’t understand why she couldn’t fall asleep. I said, ‘Coffee will do that.’ She said, ‘Oh really?’”

My paramedic friend is used to such calls. He once responded to a woman suffering from menstrual cramps.