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Drowning in Calls, EMS Can Anticipate a Measure of Relief

SAN ANTONIO -- Paramedics recently raced to the home of a 50-year-old woman who was behaving oddly.

For 24 hours, a neighbor told a 911 dispatcher, the lady had been lying on the floor, drinking beer and watching TV, surrounded by human waste.

"The woman did not need an emergency transport to the hospital," a paramedic recalls. "She needed adult protective services. She suffered from alcoholism and mental illness."

From March 1, 2007, through Feb. 29 this year, 911 dispatchers received 3,678 psychiatric-related calls. No emergency hospitalization was required, EMS logs show, in 80 percent of the cases.

EMSwould run far more efficiently if dispatchers could screen and prioritize calls. But overwhelmed call takers don't have the time.

So a psychiatric patient who forgot to take his medication often gets the same treatment as a person in cardiac arrest: an ambulance with lights and sirens.

"Something has to be done," a paramedic says, "because the paramedics are overburdened."

Help is on the way, says Fire Chief Charles Hood. Ten dispatchers will be added in August. And a system will be launched to prioritize calls.

Hood says EMS responded to 680 calls for animal bites last year. Less than 15 percent of the victims required hospitalization.

Paramedics responded to 6,309 assault calls. Less than 15 percent required emergency transportation.

Ambulances won't respond to the same calls under a new dispatch system. Fire trucks will be first responders.

Some people will gripe: I don't need a fire truck. I need EMS.

That complaint is often uttered now, but usually dropped. All fire trucks carry advanced life support equipment . About one-third of them have paramedics.

That's one part of Hood's transformation project. Dispatch is another.

The Fire Department received more than 275,000 calls last year. Seventy-three percent were medical-related. That's too many for 32 call takers to screen and prioritize.

So dispatch sends ambulances to tens of thousands of non emergency calls every year.

Scraped toes. Finger sprains. Cases of diarrhea. You name it, paramedics are asked to treat it.

Sometimes they're asked to make emergency transports in those cases, too.

Some paramedics say the Fire Department needs more than 10 new dispatchers. Hood says he's grateful for what he's getting. He calls the addition "a great start."

That's a good term. Hood has identified five common calls that usually don't require hospital transport: animal bites, DOAs, psychiatric cases, assaults (most are cut lips or other minor injuries), and medical alerts (alarm systems that trigger help for people in need).

From March '07 through February of this year, Hood says, EMS made 13,124 runs for those calls. More than 80 percent of the cases did not require hospital transport.

I asked Hood how many other non emergency calls were logged. You know, the toothache, stomachache, turned ankle variety. The chief wasn't sure.

The Fire Department doesn't have a category for nosebleeds and hangnails. If it did, there might be too many ailments and injuries to categorize.

As Hood noted, EMS might get a call about someone with a bean stuck up the nose. There's something new every day.

One day, dispatchers may be able to screen those calls. For now, Hood hopes to screen animal bites, psyche cases and the like. Over the holiday weekend, lights and sirens went all over town to more than 170 of those calls.

Call Ken Rodriguez at (210) 250-3369 or e-mail krodriguez@express-news.net

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