LAS VEGAS (KLAS) – As the Clark County Fire Department (CCFD) says there are almost 200 ambulances in Southern Nevada responding to medical emergencies, a new study shows much else of Nevada is considered an “ambulance desert.”
The University of Southern Maine’s national study on the matter – which analyzed 41 states and was published in May – defines these deserts as populated census areas with “its geographic center outside of a 25-minute drive” from an ambulance service area.
An “ambulance service area” is defined as a geographic area that includes “all roads that can be accessed within a 25-minute drive” of an ambulance station.
The report lists eight ambulance stations within Clark County, with almost all other Nevada counties listed with just one to four stations.
Nevada tops the list of these 41 states for the fewest ambulance stations per 1,000 square feet and 100,000 residents.
Jennifer Wyatt, Clark County Deputy Fire Chief, says supply chain issues exacerbated the national lack of ambulances during the pandemic. Now, she says the problem is finding paramedics to drive them as a generation retires.
“When you hire in big groups in certain years, once you hit retirement years, you see that big flux. Nationwide, we’re having that,” Wyatt said during a virtual interview Tuesday morning.
“(Applicants) would move anywhere to get a fire department job, and we’re just not seeing that because everybody’s hiring within their jurisdiction.”
“(CCFD) rescues has become the backup to the shortage of ambulances.”
While the report says EMS response times can range between four to 10 minutes in urban areas and eight to 19 minutes in rural areas, Clark County paramedics are required by contract to respond under 12 minutes from receiving a 911 call at least 90 percent of the time.
Two of the three contract-holding ambulance companies in the county proved to not do that.
Wyatt, during a November 2022 Clark County Commissioners meeting, indicated that AMR and MedicWest were meeting this obligation roughly 76 to 85% of the time.
Service area maps have been redrawn three times since early 2022 to address the tardiness between the two companies.
AMR Regional Director Kirk Schmitt points to the valley’s huge demand for service as they too struggle with staffing: “(It) essentially works out to one paramedic for every 20-plus-thousand residents and visitors.”
In early July, the company began transitioning to 911 protocols that reserve paramedics for the worst calls and dispatches advanced EMTs to other calls.
“The intent of all of this is to reserve the paramedics for the most critical patients so that they’re available to respond in the right time and in the right way,” Schmitt said inside AMR Vegas headquarters Tuesday morning.
“Then, those slightly less acute patients, we can get another resource to them, again, in a very timely matter.”
“It’s not a rationing, it’s really a recognition of how to get the right resource to the right patient.”
Three maps later, Community Ambulance is now responsible for 65 percent of Clark County’s medical calls as they’ve consistently met contractual response time obligations.
Senior Director Glen Simpson says the four square miles of territory given to them in July has led to an increase in pressure on his crews.
“It’s increased our call volume upwards of 60 to 80 for service per day,” Simpson said inside Community Ambulance headquarters Tuesday afternoon. “We’re averaging upwards of about 280 transports a day.”
As portions of Clark County are considered an ambulance desert, Wyatt and Simpson indicate crews and ambulances are increasingly being stationed throughout the valley, rather than remaining at the headquarters, to better meet this 12-minute deadline.
“More calls mean we need more staff. More staff means we need more equipment. More equipment means we need more ambulances,” Simpson said.
The study also highlights that a great distance to care is associated with poorer outcomes for patients being transported.
It also found 11 other states with each county considered to have ambulance deserts, with 15 percent of Nevada’s population residing within one of these deserts.