By Ken Rodriguez
San Antonio Express-News
Copyright 2007 San Antonio Express-News
All Rights Reserved
Not long ago, a paramedic friend climbed into his ambulance and sped to a 911 emergency, lights flashing, siren wailing.
At the scene, he found a guy with a case of diarrhea.
My friend placed the patient on a stretcher and drove him to a hospital.
I asked if the patient was dehydrated.
“No,” my friend said. “He was fine.”
Was he an elderly gentleman?
“No, he was in his mid-30s.”
Was he confined to a wheelchair?
“No, he was able-bodied.”
Why then did you take a guy with loose bowels to the ER?
“Our policy,” my friend said, “is ‘You call, we haul.”’
In San Antonio, You Call, We Haul is crushing. Every time someone dials 911 for medical assistance, an ambulance is dispatched.
I asked Mario Guerra, assistant fire chief, EMS, if lights and sirens would respond to a person with a toothache.
“Yes, sir,” Guerra said, “911 sends an ambulance.”
Why?
“We err to the patients’ benefit,” he said.
You never know, Guerra explained, if a minor ailment is a symptom of something major. Chest pain one moment, heart attack the next. It happens.
OK, but couldn’t EMS make better use of its time by not responding to every call for tooth and tummy aches?
“Yes, sir,” Guerra said, “it would be more efficient to not always send an ambulance.”
Phoenix does not operate under You Call, We Haul. Dispatchers there screen 911 calls. Paramedics on fire or ladder trucks respond first. If an ambulance is needed, they call for one. If not, they don’t.
As one stressed-out San Antonio paramedic put it, “Considering our new chief is from Phoenix, maybe we have some changes to look forward to.”
Charles Hood takes over as fire chief in mid-April. He knows the pressure on EMS units. He was a paramedic for 18 years.
“I worked for the busiest station in Phoenix,” Hood said. “We got 25 calls a shift. I know what it’s like to get beat up.”
Yes, Hood’s been asked to improve San Antonio’s EMS system. And yes, he wants to lift the morale of paramedics.
But he cautioned: “I want to be efficient and make things work. But I would never want to make the San Antonio Fire Department Phoenix East.”
Some paramedics here wouldn’t mind the upgrade. San Antonio EMS, they say, is broken.
One recent call: Hospice patient not breathing. An ambulance arrived quickly. The patient had been dead for two hours.
A paramedic at the scene said EMS routinely responds to ridiculous calls.
“There are people who will call 911 across the street from a hospital wanting to go to another hospital because they no longer want to wait in the waiting room,” the paramedic said. “There was the man who called us at 3 in the morning because he didn’t understand why he couldn’t sleep -- and he had a Starbucks-sized cup of coffee in his hand when he answered the door.”
Guerra says EMS is trying to reduce responses to frivolous calls, and trying to eliminate unnecessary transports. But change takes time. You Call, We Haul has been policy for decades.
In 2006, EMS responded to 121,350 calls. Of those, ambulances made 54,223 hospital transports.
Not everyone asks to be taken to the ER. Paramedics tell me they’re sometimes asked to change light bulbs or make tea. On other occasions it’s, “Can you help me get dressed?”
But if someone with a hangnail asks for a stretcher, a paramedic revs the engine. You Call, We Haul kicks in. Roughly 1 of every 5 transports is non-life threatening.
“We transport people with headaches,” Guerra said.
Does Hood have a solution?
Well, in Phoenix, a guy with a headache doesn’t get an ambulance. He gets an aspirin.