POSTED ON SEPTEMBER 26, 2007:
EMSA has ambulance contract, but city councilor questions service
When the Emergency Medical Service Authority's contract was renewed in January until 2012, the debate was apparently settled over whether the Tulsa Fire Department or the EMSA is the best choice to run the city's ambulance service.
However, a recent episode has at least one city leader questioning whether another five years of EMSA was really the best call Mayor Kathy Taylor could have made.
It happened about three weeks ago when a morning rush hour car accident near 21st and Garnett put four people in need of immediate medical attention.
An ambulance arrived about five minutes after the crash, but a second ambulance took almost half an hour to arrive.
"Why is that?" Councilor Maria Barnes demanded to know during last week's City Council committee meeting when she took EMSA to task for the hold-up.
EMSA spokeswoman Tina Wells answered that the delay was because other ambulances were tied up on other calls during that 30 minutes.
She compared it to an emergency room, stating that someone who arrives earlier with a comparatively minor condition will take a backseat to a late arrival with a more serious condition.
Wells later told UTW that another factor slowing response time is that "the system gets overloaded because people access it at a level not appropriate for their condition."
The EMSA spokesperson pointed to an Urban Tulsa Weekly article from earlier this year which reported on the strain such calls are placing on the entire health care system (see "Band-Aids or Tourniquet?" at HYPERLINK "http://www.urbantulsa.com"; www.urbantulsa.com, from the March 8-14 issue).
She further commented to UTW that last month, EMSA transported 1,362 patients with life-threatening emergencies to hospital ERs, but 2,423 whose conditions were not considered life-threatening, which included sore throats, backaches, minor trauma (scrapes and such) and general illnesses.
During last week's inquisition, though, Wells said, according to EMSA's contract with the city, they're required to provide an ambulance on the scene of a life-threatening emergency 90 percent of the time within eight minutes and 59 seconds of receiving a call, and within 12 minutes 90 percent of the time for a non-life-threatening injury.
"EMSA has met and performed better than that standard, but this incident involved second and third units beyond the first and the injuries were not life-threatening, and they were receiving treatment from the first unit during that time," she said.
"A heart condition isn't life threatening?" rebutted Barnes, referencing a transcript of a local TV news station's report on the incident, which reported that one of the patients had a previous cardiac history and was complaining of chest pains.
"That reporter had partial information," Wells answered, adding that if she herself were not bound by federal law from divulging complete information about a patient's medical condition, she'd be able to present a fuller picture of the circumstances, which would vindicate EMSA and its performance.
Barnes wasn't satisfied.
"How many EMSA vehicles are on the streets every day?" she asked, implying that sufficient vehicles should have been available for an immediate response.
Wells said she didn't know how many vehicles EMSA has deployed on any given day, but that it depends on various circumstances, such as availability and projected call volume.
"I would think EMSA would have 20 trucks on the streets in Tulsa--we're funding them and funding them pretty good," Barnes later elaborated to UTW.
"That's not right that someone would have to wait 30 minutes for an ambulance," she added.
Barnes said, for what the city is paying EMSA, an immediate response 90 percent of the time shouldn't be acceptable--it should be guaranteed 100 percent of the time, with qualified paramedics always available to respond immediately to every call.
Wells, though, said a 100 percent guarantee isn't the norm for emergency responders because it's not cost efficient.
"You can buy any level of service you want, but at what point are we buying something we don't really need?" she said.
Deputy Mayor Tom Baker, who formerly served as Tulsa's fire chief and currently serves on the EMSA board of trustees, concurred, but on different grounds.
"It sounds good to think people would be better served having a higher number of paramedics, but it's better to have a few trained people doing it several times a month than have more paramedics who only do it once or twice a month," he said.
Deputy Fire Chief David Dayringer said he doesn't know how often a second ambulance is called to the scene of an emergency, but said, "In the vast majority of calls, a fast response doesn't necessarily translate as a medical benefit."
The incident that sparked the discussion happened in Councilor Dennis Troyer's district, but Barnes said some of her own constituents requested she address the matter, and not just based on the particular 30-minute delay in question.
The four patients who were directly affected have not voiced any complaints, formal or otherwise, but Barnes said, "Do they even know they can complain?"
She said there are numerous other instances of slow response time and poor performance on the part of EMSA, both in her own firsthand experience and episodes that have been brought to her attention by others--many of whom weren't aware of any recourse available to them until they heard Barnes speak out about her own bad experience.
"Other councilors say we have a top-notch ambulance service, but EMSA is not on their game," she said.
"Between the fire department and EMSA, I want it to be the fire department that comes to save me," the councilor added.
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