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Failing Ohio health-care to blame for questionable 911 calls, some say

By Suzanne Hoholik
The Columbus Dispatch

COLUMBUS, Ohio — The call goes out over the loudspeaker at Station 15: Respond to a seizure on Rhoads Avenue.

Columbus paramedics Laura Elford and Warren Turley jump into the ambulance, switch on the lights and siren, and drive a mile through the Near East Side neighborhood to a two-story house.

Elford grabs the orange medical-supplies case as they head for the house. A woman at the door says her grandson is upstairs with a fever, not a seizure.

They go up to find 1-year-old Jamie Wallace Jr. in the arms of his mother, Donshay Ramsey. She tells paramedics that his temperature is 100 degrees and that she gave him Tylenol just before they arrived.

Elford tells Ramsey that the Tylenol should start working soon. If Jamie pulls at his ears or mouth, she should call them back or call her pediatrician. And it might help to open a window and turn on the fan.

“Give him lots of fluids and keep him cool; see if his temperature comes down,” Elford says.

Ramsey’s sister had taken the car that day, and Ramsey had no way to take her son, who’s insured through Medicaid, to her North Side pediatrician. She called 911. Later that day, she called the pediatrician.

The Columbus Division of Fire answered 107,351 calls for medical help last year, a 13 percent increase over the year before. Many times, paramedics said, the calls could have been handled by a family doctor.

The division doesn’t keep track of what is a true emergency and what isn’t, but officials attribute the increase in calls partly to a lack of basic health care, transportation and money to pay for a doctor’s visit.

“Everybody believes it to be true, but I’ll stop short of saying it’s true,” said Assistant Fire Chief Robert Coles. “It’s a reasonable assumption to make.”

When paramedics are taking care of a nonemergency, and other 911 calls come in, paramedics from other parts of the city have to respond, which can mean a longer wait in a life-threatening situation. And as the economy worsens, more people are at risk of losing their jobs along with their health insurance.

Thirteen percent of Franklin County residents younger than 65 -- 128,000 people -- already are uninsured.

Patient advocates such as Cathy Levine say people using emergency medical workers for minor problems are further examples of the nation’s broken health-care system.

“They don’t have a regular place to go, they don’t have a place to call for advice and ask, ‘Do I need to be seen?’ and they don’t have a way to get there,” said Levine, executive director of the Universal Health Care Action Network of Ohio.

The most common run for Columbus paramedics is to check on an ill person. Some call regularly, so much so that paramedics know their names and addresses by heart.

Call screening stopped in Columbus about 15 years ago, Coles said, after patients across the nation died when dispatchers decided not to send an ambulance.

“It’s better for us to have gone and not really be needed than not have gone and be needed,” he said.

The paramedics at Station 15, on E. Livingston Avenue, are kept busy. During an eight-hour period last Wednesday, Elford and Turley handled 10 runs, including eight medical calls. One call was to stand by for a police drug raid; the other, which was canceled, was for a fire.

Four of the medical calls did not require transporting someone: the child with the fever, a car crash in which no one was injured, a report of a seizure that was canceled, and a man lying in a parking lot who turned out to be drunk.

They took four others to hospitals:

  • An 18-year-old high-school student with severe pain on his right side.
  • A 54-year-old man who had pain all over his body and couldn’t walk. He had seen his doctor the week before. The paramedics carried him up from the basement to get him to the ambulance.
  • A 20-year-old man who called 911 because he had trouble breathing. He met the paramedics in the street carrying his backpack, saying he wanted to go to a hospital.
  • A 55-year-old woman, who has Medicaid and Medicare, who also had trouble breathing. She had a cold and had been smoking and drinking beer.

Elford gave her a breathing treatment during the ride to the hospital, and checked her blood pressure and heart rate.

The woman said she had been at the hospital two weeks earlier, coughing up blood.