One Ambulance Per Minute Diverted in U.S., Study Finds

One Ambulance Per Minute Diverted in U.S., Study Finds: "One Ambulance Per Minute Diverted in U.S., Study Finds
Overcrowded Emergency Rooms Send Arriving Patients to Other Hospitals; Elderly Most Affected
By Mike Stobbe
Associated Press
Tuesday, February 7, 2006; Page A08

"ATLANTA, Feb. 6 -- An ambulance is diverted to a different hospital every minute, on average, because emergency rooms in the United States are so overcrowded, suggests one of the first national studies of the issue. The study did not measure how the delays in getting to hospitals affected patients' survival, but the study's lead author said it could not have been for the better."

This is part of our preparedness for major accidents, transportation incidents, HAZMAT incidents, terrorist incidents and natural disasters. Our Emergency Medical Services (EMS), once considered among the best in the world because of innovations like the paramedics programs implemented nation-wide, has deteriorated to an overall poorly trained (for HAZMAT, terrorist and natural disaster), under-appreciated core of emergency medical technicians and paramedics. These EMS workers--private and public--are underpaid and forced to contend with hospitals that are far too often closed for receiving or unprepared for the caseloads, the traumas, and the disasters. Add to these factors the problems faced in the rural areas where it may be over 25 miles to the nearest hospital, and that one not fully staffed on a 24-hour basis.

Our EMS system is an essential link to our homeland security and disaster preparedness. Still, we have lowered the academic standards for EMS workers, allowed a patterm of underpayment across the nation, and failed to recognize the important link these workers play in our lives. If we want to find out how important these folks are, just ask someone who has needed their help.

Before my words are miscontrued, there are many excellent EMS workers in the field. There are some fine EMS training facilities. But the EMT-A and EMT-B training courses have been fodder for many for-profit training schools that are only concerned with making the dollar via our financial aid funding programs and keeping the quality of training to a "minimalist" standard. The same is true of those schools training our medical assistants, massage therapists, medical insurance processors, and IT technicians. Having worked as a faculty member and administrator for two of these training programs, and reviewed EMT, Paramedic and Medical Assisting textbooks, I have seen the dynamics I have described in full detail. CBS News 60 Minutes has run a segment on how these for-profit schools are committing fraud at different levels. In my experience these programds often run on a "barely legal" approach, often crossing the lines of decency and law, but not worried about getting caught because of the concerted effort to CYA and because the oversight by federal and state authority is, at best, paperwork oriented. Even the accreditation process and reviews are paperwork oriented rather than a critical evaluation of the way in which these programs actually function.

"'Most of the people that arrive by ambulance are older, and they have more serious medical conditions,' said Catharine Burt of the National Center for Health Statistics. 'So the fact that they're being delayed . . . whether it's two minutes or five minutes or 15 . . . I can only assume that's going to have some impact,' she said. About half a million ambulances were diverted from their original destinations because the receiving hospitals' emergency departments were too crowded, the survey data from 2003 indicated. The study, released Monday, is being published in the journal Annals of Emergency Medicine."

In responding to an emergency medical situation, a major accident, a transportation incident, a terrorist event or a natural disaster, minutes count. Training counts. Organization and inter-agency cooperation counts. It begins with making sure our EMS workers are properly trained, properly compensated, appreciated and able to bring emergency patients into trauma centers that are open and able to help people in the gravest of circumstances and conditions.