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Covid-19 is causing ambulance delays and longer ER waits — even for those without coronavirus – CNN

https://www.cnn.com/2021/01/22/health/covid-19-triage-emergency-care/index.html

Or having a severe asthma attack and fighting for every breath but having to wait an extra minute or two for help.

“As resources get stretched thin, it just takes longer to respond,” said Shawn Baird, president of the American Ambulance Association.

While some parts of the country are experiencing more delays than others, many places are seeing delays of “two or three minutes over target times. Those tend to be averages,” Baird said.

“When you’re responding to a time-sensitive emergency, like cardiac arrest or stroke or severe shortness of breath, diabetic emergencies — a whole host of things that are not Covid-related, but you need someone timely — a few minutes can make a real difference in the outcome,” he said.

“If the current rate of surge continues, I would think we’re within just days or weeks of significant time delays.”

‘We’re now at that precipice’

It’s difficult for Americans to understand that if they seek immediate care, they may or may not get it now, said Dr. Ryan Stanton, a board member of the American College of Emergency Physicians.

“As Americans, we assume we always have access to care. We assume that the challenges of Covid are going to hit other people — not us,” said Stanton, an emergency physician in Kentucky.

“We’re now at that precipice that we warned about, that if we lose enough access, it’s going to be access for everybody. And we could lose lives. We could have permanent damage.”

As hospitals start to max out, medical workers beg officials for new Covid-19 mandatesAs hospitals start to max out, medical workers beg officials for new Covid-19 mandates

At Stanton’s hospital in Lexington, “the Covid floor has spilled over to the entire hospital,” he said.

That influx can mean delays for anyone with mild or moderate emergencies. On good days, those patients have little to no delay in getting the care they need. But sometimes, “you may have to wait for three or four hours,” Stanton said.

“There are areas of the country and communities where that wait is significantly if not several times longer.”

And when hospitals get overwhelmed, “that totally adds to the problem that emergency ambulances face,” said Baird, the ambulance association president.

There are two major impacts on the ambulance system, he said.

First, “we often have to call around and verify which hospitals may be already at capacity or on divert,” meaning their resources are maxed out and they can’t take any more patients, Baird said. So that ties up ambulances.

CDC: New, more contagious variant could worsen pandemicCDC: New, more contagious variant could worsen pandemic

Then, once an ambulance crew finds a hospital with space and resources, “we have to be able to transfer care to the ER team.”

Previously, those transfers took no more than 15 minutes. “Now it’s taking hours in some areas,” Baird said.

“In fact, I talked to an ambulance service in Visalia, California, (on Monday) morning — American Ambulance there — and they’re now deploying EMT and paramedic teams just to be stationed at the hospital to sit with ambulance patients that come in,” he said.

“One paramedic might have three or four patients that are arriving by ambulance. They’re monitoring outside the ER for up to hours before they can get admitted into the ER. But they have to be able to send their ambulances back out to answer other emergency calls. So they’re actually deploying their EMTs to basically work in a triage tent outside the hospital doors.”

A parking garage doubles as a temporary emergency room at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California.A parking garage doubles as a temporary emergency room at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California.

When the next available bed is hours away

In the Birmingham, Alabama, area, Regional Paramedic Services has been transferring patients from local hospitals to out-of-state hospitals hundreds of miles away due to a lack of available beds and the need to increase bed availability.

“This takes ambulances several hours per patient to accomplish, stressing the medics and system,” Baird said.

In Muskogee County, Oklahoma, a medic has been assigned to work full-time at a hospital to attend to patients arriving by ambulance so the ambulance can respond to other 911 calls as the medic waits for a hospital bed to open up, Baird said.

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And in hard-hit Los Angeles County, some ambulances with patients on board have waited for hours outside hospitals because they’re out of space.

Since the current Covid-19 surge started around Thanksgiving, the number of 911 calls has increased about 20% to 30%, said Dr. Marianne Gausche-Hill, medical director of the Los Angeles County EMS Agency.

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