Ambulances Lag Behind Response Standards - NewsChannel5.com | Nashville News, Weather & Sports

NC5 Investigates: 911 Emergency

Ambulances Lag Behind Response Standards

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When you or a family member needs an ambulance, you want it right now.

But a NewsChannel 5 investigation discovered that, here in Nashville, more and more people are having to wait for that help to arrive.

Inside Saint Thomas Hospital's chest pain center, doctors know that time can be their enemy.

"Certainly in a cardiac arrest, time is absolutely critical because we have to reestablish blood flow and blood pressure within literally a matter of a few minutes," Dr. Bo Walpole tells NewsChannel 5 chief investigative reporter Phil Williams.

And while St. Thomas boasts one of the Midstate's fastest rates for opening clogged arteries -- effectively stopping a heart attack -- the damage is already being done in the time it takes to get the patient to the hospital.

"That period of time is important as well," Walpole says. "The shorter that period of time, the lower the amount of heart muscle that will be damaged.

"For every minute that goes by, there is more time that heart muscle is going to die."

But, on some days, Nashville's emergency medical system is losing the race against time.

"We just want to get you good help fast, and we strive to achieve the best response times that we can given the resources that we have," says Metro Fire Chief Stephen Halford.

Still, the National Fire Protection Association -- which sets national standards for emergency response -- recommends that when enroute to life-threatening emergencies, units equipped for basic life support should get there within 4 minutes -- at least 90 percent of the time.

But in 2006, Nashville's fire department met that response standard just 67 percent of the time.

And paramedics equipped for advanced life support, according to the NFPA, should be on the scene within 8 minutes -- again, 90 percent of the time.

But Nashville's record was just 75 percent.

Last year, that meant 7,800 patients had to wait more than 10 minutes.

Of those, 2,400 patients waited more than 15 minutes.

"If you are on the receiving end of a bad experience, and it was a bad result, it's pretty hard to swallow that you don't have enough resources," Halford concedes.

Part of the problem, paramedics says, is that Nashville just doesn't have enough ambulances.

In fact, the city completely ran out of available units last year more than 300 times.

And all the patients could do was wait.

At times, the fire department says there may be as few as 18 ambulances covering all of Davidson County.

And one small house fire can tie up three or more of those ambulances, providing emergency medical attention to firefighters who might be injured.

"I guess what you are asking me to say is that if you want better times than that, then we have to have more appropriations to give us the resources, I am in part saying that," Halford tells Phil Williams.

While the chief is asking for money to put at least two additional ambulances on the streets, he's also reviewing other policy options.

Among them:

  • refusing to send Metro ambulances on calls that 9-1-1 operators do not believe are true emergencies;
  • letting paramedics decide not to transport someone who they think could just as well get to a hospital using private transportation; or
  • taking all patients to the nearest hospitals, even if their doctors don't practice there.

"We have reached the point in our transport system where we can no longer continue to transport anybody, anytime, any place," Halford says.

But in those cases where you really do need help, the fire chief says he believes it will be there -- at least, most of the time.

Metro now has a consultant that's reviewing all the options on how the city can better use its ambulance service and improve its response times.

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