AMR/LIFELINE Response Failures in Northern Arizona

[HardKnocks]

When most of you enjoy a 7 minute 9-1-1 average response time......

Here's for those of you that have never experienced issues covering large rural areas.

Background;

Northern Arizona is a rural area served by 3 Level-4 ER's withing a 50 mile radius with the nearest Level-1 Trauma Center approximately 100 miles to the south (Phoenix and Flagstaff to the north. The two Level 4 ER's in Prescott each have Helo's (AS-350s) stationed on the pad 24/7 and have one of the busiest Air Medivac Flight Ops in the State.

Yavapai County consists of an area of 8,125 square miles the County is larger than Connecticut, Delaware, Rhode Island and New Jersey. Yavapai County is approximately the same size as Massachusetts with only an average population of 240,000 residents. The area mostly supports Agriculture, Colleges, Recreation and Retirement Communities. It has three very busy Interstate highways and one Commercial Airport (that is used for Embry Riddle Aviation University and a recently added USFS VLAT Air Attack Base with accomidations to fully support VLAT and Rotorwing Aircraft, (including the DC-10 Supertanker).

The local Fire Departments have been dealing AMR's failures for several years now of their failure of 9-1-1 EMS availability and severe response delays without resolution.

CAMFA Chief addresses AMR Failures

AMR/LIFELINE RESPONSE ISSUES

CAMFA EMS Expansion

During a five month period of July through December of 2021 AMR 9-1-1 response stats show over 700 (Seven Hundred) 9-1-1 non-responses with response delays of up to 80 minutes for an ALS response, (and sometimes a BLS Unit was the only available response).

Now Priority One Ambulance received a CON to operate in Northern Arizona. Hopefully deficiencies in non-response and delayed response will improve.

 

[Aprz]

Is the problem just because it is rural? If a new ambulance company comes in, where are they gonna get the staff?

 

[E tank]

Might be wrong, but I'm gonna guess growth is playing a role in this...pretty typical pattern in other places. Growth outpaces infrastructure and stuff like this happens until bond measures. agency shakeups and resource redeployments stop the bleeding...

But these circumstances always leave me with the same 900 # gorilla in the room...why are the firemen the ones complaining and not the group that has the greatest interests/obligations/responsibility for the health of the community which are the physician groups and hospital administrations?

 

[DesertMedic66]

Might be wrong, but I'm gonna guess growth is playing a role in this...pretty typical pattern in other places. Growth outpaces infrastructure and stuff like this happens until bond measures. agency shakeups and resource redeployments stop the bleeding...

But these circumstances always leave me with the same 900 # gorilla in the room...why are the firemen the ones complaining and not the group that has the greatest interests/obligations/responsibility for the health of the community which are the physician groups and hospital administrations?

My guess would be that the fire departments are stuck with the patients until that ambulance finally arrives at the scene. The hospital has absolutely no idea how long a 911 call has been pending as their job doesn't really start until the patient arrives on property.

Edit: I will add that this is not only a problem in rural areas but also more densly populated area. Some of the ground ambulance response times here in SoCal can be upwards of 60 minutes for the closest BLS unit to arrive.

 

[CCCSD]

Might be wrong, but I'm gonna guess growth is playing a role in this...pretty typical pattern in other places. Growth outpaces infrastructure and stuff like this happens until bond measures. agency shakeups and resource redeployments stop the bleeding...

But these circumstances always leave me with the same 900 # gorilla in the room...why are the firemen the ones complaining and not the group that has the greatest interests/obligations/responsibility for the health of the community which are the physician groups and hospital administrations?

Because they don’t employ or fund the service.

 

[E tank]

My guess would be that the fire departments are stuck with the patients until that ambulance finally arrives at the scene. The hospital has absolutely no idea how long a 911 call has been pending as their job doesn't really start until the patient arrives on property.

Except that for all the flowery 'mission statements' of health systems pledging themselves to the 'health of the community' it seems to be a little disingenuous to let the fire departments carry water for them. Priorities are a little out of whack....

Because they don’t employ or fund the service.

Does CAFMA employ or fund? It's a county contract which by all appearances must be being breeched by AMR. What do the county commissioners have to say? Again...it seems to look like the folks with the greatest obligation and duty to act are silent if the fire department needs to make a desperate public appeal on a web site...it's amateur hour in that system.

 

[CCCSD]

I’m not disagreeing with you.

 

[E tank]

I’m not disagreeing with you.

Well, I guess there is another possibility and that very well be that the fire agency is making political hay in order to add another major revenue source from the tax base. Don't know how common that is, but I've witnessed that very tactic from a fire chief in the past.

 

[HardKnocks]

Another issue that needs to be addressed is that a starting EMT's wages are below that of a fast food worker. Local fast food restaruants are advertising starting salaries of $16 to $19 hr.

 

[HardKnocks]

Well, I guess there is another possibility and that very well be that the fire agency is making political hay in order to add another major revenue source from the tax base. Don't know how common that is, but I've witnessed that very tactic from a fire chief in the past.

I don't suspect that in the case of CAFMA, (but its still possible).

 

[johnrsemt]

my part time job covers approx the same size area. but from a county with 2 towns: town on the east side is approx 6,000 people (straddles state line) our area we cover approx 100 E-W and 80 miles N-S. into 2 states: 2 FD, 6 PD. the closest Level 3/4 hospital is 110 miles (West) Level 2 and 1's are 135 miles East and in the next state east.
Town/City on West side of the County approx 30,000 people covers approx 60 E-W, about the same N-S. They have the Level 3/4 then a Level 2 is approx 80 miles West of them.

We can go 80 miles south (not a direct line, but driving) pick up a patient; come back to town, then fuel the truck and then drive 135 miles to the Level 1 or 2 hospital. Makes it a great joy when you only have 2 or 3 ambulances in service.
What is also fun is you get 20 or 30 miles out of town it is hard to get PD or Fire support. "call if you need help". Yea if we need help we can't usually wait for 30 minutes or longer, and some of the areas we don't have radio and cell coverage.