LAS VEGAS -- Last Friday afternoon was a bad time to need an ambulance if you live in Las Vegas. Local firefighters say there were at least three instances when ambulance service was requested but the private ambulance companies said they were unable to respond.
Firefighter unions have taken their lumps recently because of overtime and sick pay, but they insist, keeping ambulance service public is much safer than turning it over to for-profit companies who -- they claim -- staff at minimum levels.
The shrill wail of a siren usually means something serious. Emergency personnel inside an ambulance are normally focused on saving lives. But a parody video created to amuse employees of Medic West at their Christmas party shows a half-dozen people crammed into an ambulance stomping a boot on the chest of a cardiac patient. The video was approved by company bosses.
The humor is aimed at firefighters, who mostly work, side-by-side, with private ambulance crews but now find themselves pitted against Medic West and AMR, two companies which are owned by the same corporation.
Dean Fletcher, the president of the Las Vegas Firefighters Union, doesn't think the Medic West video is funny at all, calling it unprofessional in the extreme to poke fun at the life or death emergencies which are all too real for the people they are supposed to serve.
The video is the latest salvo in a deadly serious competition between public and private ambulance service. In November, the I-Team reported about an astonishing success achieved by local fire departments in just the past year. There was a whopping 400 percent increase in the survival of cardiac patients through the use of hypothermia protocols in which a six-person team of rescuers keep heart attack patients packed in ice all the way to the hospital. Each member of the team has a specific function. They do not all ride in the same vehicle. Without the new procedures, a few dozen locals would not be here today.
"These are people that are dead. These are people in full cardiac arrest that are coming out, and a lot of them are walking out," said Dr. David Slattery, the medical director for Las Vegas Fire Dept.
The ambulance companies quickly acquired their own hypothermia equipment but the firefighters say there is no way a two person private team can duplicate what they do, and there is no chance the companies will increase staff since it cuts into their profits.
Fire departments are not out to make a profit and therein is the crux of the fight. The firefighters say the evidence is clear -- the private companies will do just enough to meet the conditions of their contracts with local governments. Ten years ago, they were required to arrive at emergency scenes within nine minutes, 90 percent of the time. That standard was relaxed to 12 minutes, but they still meet it 90 percent of the time.
"It doesn't matter. Their pattern has shown, if you made it 30 minutes, they would be there 90 percent of the time," said Jeff Hurley, North Las Vegas Firefighters Association.
In emergency medicine, every elapsed minute means a 10 percent greater chance the patient will die. Response time is everything. The firefighters say the private companies simply won't staff enough ambulances to cover the valley. In the 11 months from January through November of 2010, AMR and Medic West were late, beyond the 12 minute limit, more than 9,700 times.
On occasion, they aren't able to respond to a call at all. On January 5th, a call came in to 9-1-1 about a customer at the Fiesta Casino in North Las Vegas who'd been shot in the head. Records show AMR assigned Medic West to respond but the company informed dispatch that it was unable to. It had no ambulance to cover it.
The Fiesta Casino Incident Report
The firefighters allege the companies routinely play games to make it appear they are meeting the 12 minute limit. On November 15th, a man in his 50's suffered an apparent stroke near Las Vegas Blvd. and Oakey. Records show AMR changed the call identification while en route, then reassigned a different unit but still couldn't make it in 12 minutes. They punched a button claiming they were on the scene but GPS coordinates prove the ambulance was near Oakey and 1-15, one mile away. It happened again on January 12th. A call came in about a man unconscious and not breathing. A unit was assigned at 4:12. Over the next 12 minutes, AMR changed the unit, changed the address, and 15 seconds before the 12 minute deadline, pressed the button claiming they were on the scene. Except they weren't. GPS records obtained by the I-Team show they were still 1.6 miles away from the patient.
Read the Incident Reports
AMR Medic West Response
"What we are saying is, why aren't you making your response times? Why is 90 percent of 12 minutes okay? Why is it profit over our citizens? We're not a profit company over here," said Hurley.
AMR and Medic West say the firefighters have distorted the incidents mentioned in this report. Ambulance service here is a dual response system so the private companies say they depend on fire departments to cover the valley as primary first responders. They also say incidents where their crews pressed the on scene button are being mis-characterized. AMR says its average response time is seven minutes and they arrive first almost a third of the time.
Parody video shows a man stepping on a patient's chest.
