While the world is facing the pandemic, local fire departments are also facing several issues related to ambulance services.
Lincoln Fire Chief Josh Vincent said his department, which provides its own ambulance service, has recently been inundated with overlapping medical calls.
“Currently, we are running at 43 percent meaning 43 percent of the time we have two calls going on at the same time,” the chief said.
He said the department has two ambulances, so if a third comes, the department sends its advanced life support capable fire truck to handle the call. This fire engine, of which Lincoln has only one, has the equipment to treat patients on site but is not capable of transporting them to a hospital.
Vincent said this problem expands when there are more than three calls. Lincoln has in recent months gotten as many as five service calls in the space of half an hour at certain points. This can lead to some people having to wait for an ambulance.
At the same time, the chief said that the state as a whole is seeing a shortage of paramedics, meaning some departments or ambulance services have issues staffing trucks. He said all of these things are compound at once to make getting an ambulance to every call difficult.
“The companies that we normally call to back us up are also experiencing a shortage and also down on trucks,” Vincent said, “for the first time that I can think of we are being told there's no ambulances to come.”
Pell City Fire Chief Tim Kurzejeski said while his department has not faced any issues with hiring paramedics, they are having issues with wait times for ambulance services. Pell City, unlike Lincoln, does not run its own ambulance service but instead contracts with Regional Paramedical Services, a private company that handles ambulance service for all of St. Clair County and many surrounding counties. As another difference, Kurzejeski said his department’s entire fleet of four fire engines are ALS capable and half of his staff are licensed paramedics , something that he says is not the norm.
“I am very fortunate and blessed,” Kurzejeski said, adding that the different situation is only because of a focus on public safety by the Pell City Council.
Yet still even with these differences, he said his department has still had wait times on ambulances.
“It doesn't affect our response at all. We are still running the same trucks at the same response time,” Kurzejeski said, “but when you get there, there is more of an understanding now that there could be a truck coming from Jefferson County."
The chief also said he has great appreciation for Vincent and Lincoln Fire as they have helped Pell City multiple times with transport while also dealing with their own calls in Lincoln.
Kyle McDonnell, deputy director for RPS, said these issues are caused by a perfect storm of issues.
The first is the paramedic shortage that Vincent mentioned. McDonnell said for several reasons, including health risk and lower pay, not a lot of people are going into the paramedic field.
“I have been teaching EMT school for 16 years now, and our numbers are half of what they were when I started,” he said.
McDonnell said one issue is that the majority of ambulance services in Alabama are private companies that make most of their money off insurance claims and aren't funded on either the federal, state or local level.
“Those numbers don’t change drastically,” he said. “So we don’t have the money to pay these guys what they are worth.”
McDonnell said the pandemic has made many people in emergency medical service make the calculation of personal risk through COVID exposure and their pay, which sometimes leads people to decide to go to other fields. While he said staffing has been an issue for years, the pandemic has put added pressure on paramedics and ultimately exasperated the issue.
McDonnell said another pandemic related factor is extended wait times at emergency rooms. He said the pandemic has strained most hospitals to where they are full of patients. McDonnell said the hospitals are doing all they can, but are also dealing with a shortage of nurses and COVID patients.
“Hospitals are just full, they are beyond full,” McDonnell said. “So it's causing us to have our ambulances tied up at the emergency room waiting to turn over patients for two, three and four hours at a time.”
He said RPS has even had to send managers and support staff to wait with patients at hospitals in order to free up paramedics.
McDonnell said in some extreme cases full hospitals have caused RPS to divert ambulances to hospitals hours away including Vanderbilt in Tennessee or Mobile in south Alabama. He said these kinds of transportation times can lead to paramedics using half of their 24 hour shifts on transporting one patient, and when they get back they are exhausted.
McDonnell said the final issue is people calling 911 when their medical issue may not require it.
“We have a lot of that going on more so now than we did.” he said. “There's always been abuse of the system but there is an extremely high amount of abuse of the system going on right now.”
McDonnell said while RPS and other ambulance services have to take any patient to the emergency room if requested, they are sometimes doing it for people with a broken hand or hurt foot which could be handled by someone's general practitioner or an urgent care.
“Those three things are just compounding and making it awful,” he said “There's times where we’ve not had ambulances to send and we have had to wait until one got cleared up and that's a scary situation.”
All three men agreed that the system itself is strained.
“There is truly a strain on the EMS system in general,” Kurzejeski said “it's not just our county, it's not just two or three counties, it’s not just this state.”
McDonnell said one thing to realize is that strain isn’t just because of the pandemic but it's something that has been brewing for years and all ambulance services can do now is try to work out of the hole.