To the Editor:
On April 20 at approximately 11 a.m. a 73-year-old woman fell at her home on County Road 109 (Oakland Hills). After falling she was able to get herself to her cell phone and placed a call to 911. Upon making contact with the dispatch center for American Medical Response (AMR) she was asked a few questions. The communicator then transferred her call to a nurse who proceeded to ask her more questions. This nurse determined the call to be non-emergency in nature and dispatched an AMR basic life support unit to her location. Following is a timeline of the 911 call as received via a public records request from Sumter County:
• Call received by primary public safety answering point (PSAP) 11:08:20
• Call received by AMR dispatcher from primary PSAP 11:08:38
• Call transferred to nurse 11:11:54
• Call assigned to basic life support unit 11:21:19
• Basic life support unit arrives on-scene 11:46:24
• Basic life support unit transports to hospital 12:04:05
This woman laid on the floor of her home for 38 minutes and 4 seconds until help arrived at her side. During this timeframe, paramedics from the Villages Public Safety Department sat down the road less than 6 minutes away. While this woman’s injury was not life-threatening, she did ultimately require shoulder replacement surgery as a result of the injury. In addition to the fact that she laid on the floor for a long period of time, the basic life support unit was unable to provide her with pain medication as it was beyond their scope of practice. Basic life support units staffed with emergency medical technicians (EMT) are not allowed to administer pain medications. Upon being asked if she wanted pain medication, the EMT advised her that she would have to wait for an advanced life support (ALS) unit to administer the pain medication and then transport her to the hospital. Once the pain medication is administered the basic life support unit cannot transport without a paramedic on-board. She chose to be transported without the pain medication instead of taking the chance of being further delayed in transport to the hospital.
Upon her arrival at the hospital, she was visibly shaking due to the intensity of the pain. When questioned by the attending nurse as to the level of pain on a scale of 1 to 10 she described the pain as a 10. In addition to the 38 minutes and 4 seconds she waited for care and 18 minutes being packaged for transportation she experienced an approximately 30 minute transport time to the hospital in Ocala. Not clearly knowing the initial time from the fall to the point of calling 911, it is safe to say that this woman went nearly an hour and a half before any definitive care was begun.
I will admit I am significantly bothered by the fact that this injured woman, laying on the floor suffering, was my mother. But the reality is that nobody should have to wait 38 minutes for an emergency responder to be by their side and make a “real-time” assessment of the patient’s condition as opposed to a person on the end of a phone 40 minutes away. It is not uncommon for “senior citizen” callers to downplay the significance of their injury because they are embarrassed and feel like they are burdening the system. Getting a human to the patient’s side as quickly as possible (even if it’s a non-lights and sirens response) is critical. Removing the response of a fire department base from the part of the equation that is working and trying to replace it with a highly choreographed system of “if this then that” is equivalent to building a house of cards that, when it comes crashing down can, at best, increase a patient’s anxiety and at worst could cost someone their life.