Sunday 24 October 2010

Limited Ambulances

The Paramedics of Winnipeg union is taking advantage of the current civic election to push for more ambulances, with a snappy website and PR campaign. You can't fault them for that: more paramedics means more union dues and less work for each medic. It's in their interest to increase their base. Is it in our interest, knowing that the money for each additional ambulance has to come from somewhere else?

I was going home last Monday and
saw a firetruck rushing off to an emergency at a school on Archibald. There was an ambulance in the parking lot that had beaten them there,
and the fire fighters were casually strolling towards the entrance, chatting about something, knowing that they were not actually needed inside. Further down the same road on the same day, there was both an ambulance and a fire truck at an apartment building that was not on fire.

A couple weeks ago, the lady sitting behind me on the bus had a seizure. We called 911 and waited for help. The firetruck showed up first, and the ambulance later. There was another instance where I was playing ball and no fewer than 3 emergency vehicles showed up after a girl got stung by a bee. It wasn't even a killer bee. Just a regular one.

The point is that there is a lot of duplication and unnecessary effort in our emergency response system. This wastefulness doesn't sit well with me. Virtually every medical emergency, regardless of how small, requires two different teams to respond, because the fire truck might get there first, but only an ambulance can actually take somebody to a hospital. This is costly: Edmonton has 40 ambulances and spends $50m per year on that service. Winnipeg, with 60% the population of Edmonton, has only 18 ambulances but spends $44m on paramedic services -- almost the same amount (according to this editorial).

Our combined fire/paramedic system may produce quick response times, but it is a failure in terms of cost-effectiveness in my humble opinion. I agree with the paramedics union: we need more ambulances, but at the same time we need to end the experiment of combined fire/paramedic service and potentially make corresponding cutbacks to the fire service. We also need to work with the health authorities on reducing the time that paramedics spend parked at a hospital twiddling their thumbs as they wait to transfer ownership of the sick guy.

If we can make that procedural improvement, and bump up the number of ambulances a little bit, then we can have good response times while also saving money by cutting the fire fighters loose to focus on dumpster fires and other things that they are best equipped to handle.


Keeping on theme: here's a video from laid-back tunesters Ambulance Ltd. This one has a bit of a Lou Reed vibe to it. Ciao:



reedsolomon.matr1x at said...

I agree with you except to say I don't think the Fire service needs cutbacks. There is clearly waste and it would behoove whoever wins the mayors race to work on that.

RM said...

How about having the WRHA accept the patient delivered immediately instead of making the paramedics wait until they can be seen by the Doctor. Currently, the paramedics wait at the ER. Nobody waits with me, my wife, or my kids if they drive, walk, or get a taxi to the ER. All we get is a triage nurse, and ignored.

Unky Duck said...

There's a LOT more fire responders than ambulances. The WFD will arrive first in the majority of cases. Paramedics on-scene quicker results in better outcomes. THEN the ambulance arrives..and transports as required.

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