Grand Jury Report on California Air Ambulance Deal Prompts Look at Ground Ambulances

VICTORVILLE -- A grand jury report regarding an exclusivity arrangement of sorts between the county and Mercy Air has prompted some to question a similar situation with American Medical Response, the only private ambulance company in the area.

Fire personnel and rescue workers have been vocal that there are not enough ambulances in the area at any given time, specifically citing problems with a lack of available beds at area hospitals.

A local union steward for the International Association of EMTs and Paramedics said that he hears a dispatch for "level zero" -- meaning that there are no available AMR ambulances throughout the High Desert -- an average of once per 12-hour shift he works.

"I think people don't realize that we are understaffed on paramedic units up here. There are usually 10 to 12 staffed ambulances throughout the day to cover Victorville, Adelanto and Apple Valley. But if there's a crash on I-15 with multiple patients or bed-delays at a hospital, they run out pretty quickly and you end up having no one to respond to a 911 call," Kenneth Sexton, the union steward, said.

The only other ambulances that operate in the High Desert are County Fire ambulances, and Sexton said there are only two of those, based in Hesperia.

"Our ambulances can hardly keep up anymore. They're constantly going and I don't see any relief any time soon," Division Chief Sid Hultquist of the San Bernardino County Fire Department said, referring to County Fire ambulances that assist with medical aid when AMR is unavailable.

Sexton also said that AMR has an exclusive contract with area cities, meaning that no other private ambulance company can offer services, and that the addition of more units is impossible, unless AMR decides on its own to add them.

While Sexton said problems with AMR not meeting appropriate response times are minimal, but he still believes the area is far under-staffed for the population.

"I just think that as taxpayers we should have more resources available to us. If they are at level zero (a patient's) chances of survival have dwindled considerable compared to what it would be if there were more units available. Also, I think competition is a good thing," Sexton said.

Contributing to the problem are hospital-to-hospital transfers and an abuse of the 911 system. If a patient is stabilized at a local hospital and then needs to be transferred to a trauma center in another area, that ties up the already short number of ambulances, Sexton said.

"People also believe they'll be seen faster if they call 911 for an ambulance -- they won't. So you have people calling in for the flu and taking away resources from those who really need it and when those critical patients do come in, they'll be seen first anyway, and that's when you get bed-delays," Sexton said.

A bed-delay is when a paramedic unit stays with the a patient at a hospital because the facility has no bed to take the patient to.

"We transport so many patients, I get around 10 pages a day that my ambulance is on bed-delay and unavailable for other calls. It's not unheard of for ambulances to be waiting three hours for a bed. They're just waiting in the hallway with a patient on a gurney because of a lack of beds in the area," Hultquist said.

As with many other problems afflicting the High Desert, it seems this comes back to rapid growth as well, Sexton speculates.

"There are a lot of things they can't control as far as call volume, but I think they should be better prepared. Call volumes have gone up considerably in the past few years, but the staffing level hasn't," Sexton said.

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