AHS - EMS Wait Times

[Flames0910]

This honestly should be the way it is. I think movies have given a very false understanding of when you actually should be calling an ambulance.

I don't think we should be gatekeeping whether people are allowed to call the ambulance or not. Expecting people to diagnose their own medical condition (oh it's just a little lightheadedness and faintness of breath, no problem) can quickly turn into a more expensive medical problem down the line (oops, turns out it was a stroke and the person crashed and injured another person while driving themselves to the hospital).

It's not like riding in the ambulance is this fun joyride that people are abusing and adding to wait times. The guidance people are given (and should be given) is literally "when in doubt, call 911."

[Mathgod]

Originally Posted by btimbit

Half their units are stuck waiting at the hospital with patients because the hospitals don't have the resources to admit patients in a timely manner.

Quoted for truth. Solving this problem would alone reduce the high wait time problem to a huge extent. Hospitals really should have people whose job it is to stay with patients until they get seen by a doctor, so that paramedics could be on their way and attending to the next call instead of sitting in emergency rooms for hours on end. Why more isn't being done on this front is something I don't understand.

[timun]

Originally Posted by Mathgod

Why more isn't being done on this front is something I don't understand.

$$$$$$

[WhiteTiger]

Originally Posted by Flames0910

It's not like riding in the ambulance is this fun joyride that people are abusing and adding to wait times.

This...actually is a significant problem that people are abusing, which adds to wait times.

[DoubleF]

Originally Posted by Old Yeller

I don't disagree, but ambulances are designed to be quite visible/audible where as my black SUV is probably slightly less so. Also compounded by the fact I'm driving dangerously because my kid is in the back turning blue and it could potentially be setting a dangerous precedent.

Well, a kid turning blue is a revival/resuscitation situation I mentioned earlier in the post. I really meant more like the thumbs up broken arm/leg scenarios or the "Lulz be more careful next time" scenarios in media.

Originally Posted by Flames0910

I don't think we should be gatekeeping whether people are allowed to call the ambulance or not. Expecting people to diagnose their own medical condition (oh it's just a little lightheadedness and faintness of breath, no problem) can quickly turn into a more expensive medical problem down the line (oops, turns out it was a stroke and the person crashed and injured another person while driving themselves to the hospital).

It's not like riding in the ambulance is this fun joyride that people are abusing and adding to wait times. The guidance people are given (and should be given) is literally "when in doubt, call 911."

Huh? That was not what I was trying to imply at all. I'm not trying to gate keep. Calling 911 is not purely the same as calling for an ambulance. Your post actually falls into the category of what I was trying to (badly) say. I'm trying to add to a concept of a rule of thumb as to how to fastest get access to medical attention.

As someone else said, if medical attention is not around the corner after calling 911, definitely you should immediately consider getting someone to drive quickly and safely to the nearest medical centre. It honestly might be faster. IMO that's a great rule of thumb.

I agree with your concept that someone driving the injured individual should always be the basis for sure. I thought that's implied. When in doubt, call the ambulance, yes.

I'm just saying that in the movies, people call the ambulance for all sorts of things. I'm just saying that there's plenty of scenarios where someone goes, "Should we go to the hospital or not?" where those you likely can ascertain that you can get someone to drive the person down vs calling an ambulance. The people that get all upset that they are charged a fee for an ambulance ride are often (but not always) those types of people that should have driven down themselves or gotten a ride.

I know many people who have called an ambulance because they couldn't be darned to go to the hospital themselves and preferred the paramedics look at the individual in their home. There's literally people whose idea is that calling EMS is basically a convenient mobile nurse to their door who will and should hang around for a few hours to make sure the person is OK. I've literally heard of people mad that the paramedics left after 15 minutes with instructions to drive to the hospital if conditions worsen. They expected the paramedic to stick around for a few hours to see if conditions would worsen. IMO, in some instances, movies perpetuate this concept.

[Johnny Makarov]

Originally Posted by 81MC

Me too. Except imagine the mental anguish thinking ‘well, it has to arrive any minute now. Just one more minute. Yep, k, one more minute.’ Then you get in your car, realize the hospital is 20 minutes away and you have no way to monitor the child, and navigate an unfamiliar city, and move traffic out of your way, and not crash because you’re so jacked on adrenaline.

30 minutes later you’ve told yourself it’s just another minute and that waiting is all you can do. Ihgggggg

Well if my child looks like they are dead even 10 mins is too long.
Course i live 3 mins away from the Children's but even if i was like in Tuscany I wouldn't wait.

[GirlySports]

So are they blaming the caller now? She wasn't clear enough so dispatch made it low priority?

[Zevo]

Originally Posted by Mathgod

Quoted for truth. Solving this problem would alone reduce the high wait time problem to a huge extent. Hospitals really should have people whose job it is to stay with patients until they get seen by a doctor, so that paramedics could be on their way and attending to the next call instead of sitting in emergency rooms for hours on end. Why more isn't being done on this front is something I don't understand.

Every province is critically short of Er Docs and Nurses too. That's also not an easy or quick fix.

[wireframe]

Originally Posted by Mathgod

Quoted for truth. Solving this problem would alone reduce the high wait time problem to a huge extent. Hospitals really should have people whose job it is to stay with patients until they get seen by a doctor, so that paramedics could be on their way and attending to the next call instead of sitting in emergency rooms for hours on end. Why more isn't being done on this front is something I don't understand.

Great idea. Seems perfect to me.


Some people seem to get worked up about administrative expenses in public budgets and I think this is related. We see it in our health system all the time - complaining that too much money is going to administrators and is therefore wasted. The logical view is that administrators are doing work that would otherwise have to be done by doctors, nurses, or other highly paid staff.


When I have had to take an ambulance in the past, the EMS guys stayed with me in the hallway until I was admitted. Those were all pre-covid, so the wait time was less than an hour but it still seemed strange. Just hire a few more people for the admitting area who take care of patients until they get into a bed.

[btimbit]

You can't just hand patients off to anybody though, needs to be a nurse or doctor watching them. And we already need more of those anyway

[wireframe]

Originally Posted by btimbit

You can't just hand patients off to anybody though, needs to be a nurse or doctor watching them. And we already need more of those anyway

Not everybody involved needs to be a doctor. As long as doctors and nurses are available, other people (like NAs) can easily cover most of the issues that come up. I understand that there is a shortage of doctors. The solution is to assist doctors by doing other work for them.

[bizaro86]

Originally Posted by btimbit

You can't just hand patients off to anybody though, needs to be a nurse or doctor watching them. And we already need more of those anyway

Paramedics aren't nurses or doctors. It would seem reasonable to me that you could have an equivalent level of care for a hand-off, allowing the paramedics to get back on the road.

There are a lot less hospitals than ambulances in Calgary as well - even if we had to take one nurse to supervise the ambulance drop off area patients if that frees up multiple ambulances at a time its probably a good trade.

[Hemi-Cuda]

Originally Posted by bizaro86

Paramedics aren't nurses or doctors. It would seem reasonable to me that you could have an equivalent level of care for a hand-off, allowing the paramedics to get back on the road.

There are a lot less hospitals than ambulances in Calgary as well - even if we had to take one nurse to supervise the ambulance drop off area patients if that frees up multiple ambulances at a time its probably a good trade.

At the very least give the EMS guys a dedicated intake person or a way to bypass the line. I watched 2 EMS guys stand in line at the Airdrie UC yesterday with a patient for almost an hour before they were triaged, seems like such a horrible use of their time

[iggy_oi]

This may come off as a “radical” idea so this is your warning to stop reading now if you don’t react well to that sort of thing, but maybe we should try asking EMS workers what they think is and isn’t working under the current systems before coming up with solutions and changes that might not be practical and/or could negatively impact patient outcomes.

[btimbit]

Direct quote from my fiancee, a ACP and Supervisor in Calgary

"More doctors, more nurses, more medics. Some people have suggested stuff like EMT's watching waiting areas. That's dumb. Don't spend money fixing symptoms, spend it fixing the problem. Stop treating healthcare workers like garbage so they stop leaving, give the budget increase to reach proper staffing levels. The waiting area problem isn't great but still is the wrong focus, we can't fill a schedule anyway"

[RichieRich]

Originally Posted by iggy_oi

This may come off as a “radical” idea so this is your warning to stop reading now if you don’t react well to that sort of thing, but maybe we should try asking EMS workers what they think is and isn’t working under the current systems before coming up with solutions and changes that might not be practical and/or could negatively impact patient outcomes.

Like ask the actual day to day workers? Go figure!!
Instead often upper management gets asked and some political and other-agenda solution gets offered up that does not include any discussion with the front liners. I think it’s the same in almost all jobs.

But yeah, fix the root cause not the symptom.

[djsFlames]

Start a medical emergency uber service.

[wireframe]

Originally Posted by btimbit

Direct quote from my fiancee, a ACP and Supervisor in Calgary

"More doctors, more nurses, more medics. Some people have suggested stuff like EMT's watching waiting areas. That's dumb. Don't spend money fixing symptoms, spend it fixing the problem. Stop treating healthcare workers like garbage so they stop leaving, give the budget increase to reach proper staffing levels. The waiting area problem isn't great but still is the wrong focus, we can't fill a schedule anyway"

That's pretty definitive. I think we agree more than not. I agree that money and staff treatment are a problem. I was only trying to say that it makes sense to spend money on non-doctors because it can be hard to hire more doctors.

[DoubleF]

Originally Posted by GirlySports

So are they blaming the caller now? She wasn't clear enough so dispatch made it low priority?

I don't think anyone is trying to blame the caller. I'm just saying that if there's no concerns with moving the individual, I'd definitely want to be calling while driving and not just waiting for someone to arrive if possible. I'm just a type of personality that I always want to make incremental steps towards the end solution. It's working with the the existing system to make sure the success rate is highest.

Things happen, so I always like having a back up plan in case Murphy's law occurs. I am not trying to blame on the victims or the EMS. I'm just saying that's what I'd be more comfortable with as EMS cannot control the things that sometimes keep them from getting there as fast as possible. If something happened, I'd probably have nightmares forever as to whether I could have done more.

In Calgary, we're lucky to generally be around 15-25 minutes away from the closest hospital or urgent care centre. By the time the call is finished, I assume it's about 5 minutes in, so being part way there is already improving the chances that the individual is getting looked at by any professional as fast as possible.

[btimbit]

My understanding from her is she feels if they just had the proper amount of medics, the ER waiting thing wouldn't be that big of a deal. But even ignoring the hospital intake problem, even still, EMS is just so understaffed, and the amount of OT is insane. Most medics are working at least 6 day weeks, and I barely see her because it's at the point where if she doesn't pick up an OT shift, then it just gets left unfilled and that's another truck that doesn't even go out. And that's how they all feel, obligated to pick up these extra shifts because they just don't have the people to fill a schedule. As you can imagine it's leading to a lot of burnout. A lot of her co-workers have quit and moved away. The medic she was partnered with when she started and really learned from when she was new, killed himself last year. The system is at a breaking point, and the Government is doing just enough to say they're trying.

Pretty frustrating overall