Paramedics around the world are facing some of the toughest times. The global pandemic caused by the COVID-19 virus, put EMS into a spotlight, showing many of the issues. In NYC during the initial days of COVID-19, 911 calls would hold in the dispatch system for over 24 hours. Today NYC continues to see an increase in response time, in 2013 the average was 9 Minutes and 51 seconds to respond to a life threatening emergency. Today the average response time is 12 minutes and 14 seconds, when the goal is 5 minutes.
These response times are as a result of many factors, first an increase in calls into the 911 system and second a lack of available ambulances. If we break down these issues even more, we will see that the public is relying on 911 for medical incidents that could be handled by a local urgent care or primary physician. These extra calls that range from worried well to someone with a common cold, cause undo stress on the overworked EMS system. An increase in homelessness has also resulted in increasing the workload as these patients don't have the same resources as the average citizen and tend to have an increase issue with metal health as well as substance abuse problems.
As stated, the call volume takes away available ambulances when demand exceeds supply. Overcrowding of hospitals, results in ambulances being stuck waiting to off load patients to an available bed. These issues combine to cause the response times to continue to rise to unacceptable levels.
However one of the biggest issues to affect EMS is the lack of staffing. In the United States, EMS is not considered an essential service like police or fire and the current model is also relativity new, based on standards adopted in the 1970's. For example Pelham Manor doesn't even have an ambulance and has to rely on having one respond from another town. The lack of EMS being considered an essential service also shows in how the Paramedics are treated and compensated with an appropriate salary. In NYC an EMT makes $62,393 , Paramedic base pay is $76,586 and a Sanitation Work is $83,465. So a Sanitation work makes $20,000 more to pickup trash then the person that has to pickup your grandmother.
These problems are not just limited here in the NYC area, Detroit is now merging Firefighters and EMS into a dual role as they can't get enough people to take the job. https://www.fox2detroit.com/news/detroit-fire-ems-staffing-shortages-lead-both-to-combine-roles-in-struggle-to-meet-demand
Medics in England just voted to go on strike over the conditions and treatment of there staff. https://news.sky.com/story/ambulance-workers-across-england-set-to-strike-before-christmas-12758152 https://www.theguardian.com/society/2022/dec/01/paramedic-in-england-on-why-he-backs-strike
Cleveland also falling apart https://fox8.com/news/i-team/long-ambulance-delays-continue-in-cleveland-whats-being-done-about-it/
In San Diego, city leaders gave the contract to run Ambulances to the low bidder who pays less then the previous company. As a result no Medics want to work for the new company as it's a loss of $6500 and now the company is trying to offer bonuses. Again we see a case that city leaders just care about the cost to them and not person that needs to call for an ambulance that could be dying. https://www.latimes.com/california/story/2022-12-03/falck-paramedics-signing-bonuses
So no matter were you are in the world, you are probably going to have to wait for an Ambulance longer then you should. Our elected leaders need to treat EMS the same as they do for Sanitation, Police and Fire. Provide the proper benefits and pay to get the best people possible, invest in more units when needed to avoid delays. Create education to the public on when to call and when not to call 911. Failure to act now will only compound the problems in EMS for years to come.
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