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Paramedic shortage blamed for Ore. county’s growing ambulance response times

AMR and Metro West debate over ALS vs. BLS model to deal with shortages and improve times


KGW News/YouTube

By Bill Carey
EMS1 Staff

MULTANOMAH COUNTY, Ore. — Multnomah County’s ambulance crews, managed by the county’s EMS provider American Medical Response (AMR), have been falling short in meeting emergency response time standards established by both the county and AMR, based on new data from Multnomah County EMS.

From September to February, about one out of every three ambulances failed to respond to life-threatening Code 3 emergencies within eight minutes, KGW8 reported.

For the six months before March, ambulances arrived late for medical emergencies 28% of the time, according to a recent county report obtained by Williamette Week.

AMR and Metro West have pointed out a shortage of paramedics, saying staffing issues are causing delays. Multnomah County and AMR agree that EMS crews should get 90% of emergency calls on time, but they disagree about how to fix the current problems.

To address staffing shortages and improve ambulance response times, AMR is proposing to modify the current standard for its EMS workers by hiring Emergency Medical Technicians. According to an AMR spokesperson who spoke to KGW8, adopting a standard EMT/Paramedic staffing model would help resolve the staffing issues faced by AMR Multnomah County. EMTs require less training and have fewer qualifications compared to paramedics and can be paid a lower rate, which could reduce AMR’s expenses. Multnomah County has maintained a 2-paramedic requirement for its crews for decades, stating that it results in better patient care.

“It is the way the EMS is configured, we need the right resources at the right place at the right time,” Dr. John Jui, Multnomah County EMS Medical Director said. “I can tell you if I have two trained paramedics with you having a cardiac arrest, they’re going to do a better job than one medic, guaranteed.”

To lighten the burden on its ALS crews and improve response times, AMR has introduced its first BLS ambulance, staffed by two EMTs. The BLS system is intended to respond to minor calls. On May 1, the Bureau of Emergency Communication initiated its queue services, aimed to prioritize calls and assign them to the appropriate ambulance teams. This initiative is being implemented despite Multnomah County’s restriction that does not permit paramedics to work alongside EMTs.