By Fran Spielman
The Chicago Sun-Times
CHICAGO — Mayor Rahm Emanuel’s administration tried Thursday to backtrack from a plan the city has been working on for months: to end the 11-year foray into a two-tiered system of ambulance care.
Sources told the Chicago Sun-Times that Emanuel is preparing to phase out the city’s 15 basic life-support ambulances and switch them all to advanced life support over a period of several years.
But after a story about the plan was posted on suntimes.com Thursday afternoon, the administration backtracked, and a fire department spokesman issued a statement that said: “The claim that the Chicago Fire Department is in the process of converting BLS ambulances to ALS ambulances is completely untrue. The two tier ambulance system provides Chicago with some of the best coverage in the nation, and there is no plan at this time to change the system.”
The about-face apparently stems from concerns that the plan was reported before the mayor released his budget plan, which is certain to include deep cuts within the fire department brass and possibly other areas.
The plan to change the two-tiered system, which would require union approval, would cost roughly $50,000 for each of the 15 basic life-support ambulances. It would leave the city with 75 ambulances capable of providing the most sophisticated level of care.
Chicago has 60 advanced life-support ambulances, each staffed by two paramedics qualified to administer intravenous medication. The advanced-care ambulances are stocked with drugs and equipped with heart-monitoring devices.
The 15 basic life-support ambulances are staffed by emergency medical technicians who undergo less training. The basic care ambulances do not have medicine or monitoring equipment. They are permitted only to transport patients to hospitals.
Pete Houlihan, EMS director for the Chicago Firefighters Union Local 2, welcomed the impending change.
Houlihan has long argued that the two-tiered system forces 911 call takers to “play God” by going through a flip chart of questions before making a judgment call on which type of ambulance to send.
“It shouldn’t be up to a call taker. There could be a lot of lawsuits on that if the wrong piece of equipment is sent,” Houlihan said.
Likening the current system to “going to the doctor over the phone,” he said: “It’s always better to have trained medical people view the person instead of making a life-or-death decision over the phone. It would definitely help [reduce] the city’s liability.”
Then-Mayor Richard M. Daley launched the two-tiered system in June 2000 with a goal of freeing the 10 busiest ambulances for life-threatening calls.
Critics accused Daley of “playing Russian roulette” with public safety. The city countered that 50 percent of all runs are for basic life support and that, with a new software system, questions would pop on a call taker’s computer screen based on a caller’s answers until the decision on which ambulance to send became apparent.
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