FL EMS Workers Stretched Thin as 9-1-1 Calls Spike
By Dustin Wyatt
Source The Ledger, Lakeland, Fla.
Editor's note: Find Firehouse.com's complete coverage of the COVID-19 pandemic here.
A burly man with an oxygen tube wrapped around his face was wheeled out of an ambulance outside Lakeland Regional Health Medical Center on Monday evening.
He wasn't the only patient EMS workers were hurriedly trying to get from the stretcher into a hospital bed. Ambulances were backed up at the emergency room doorstep throughout the night.
A Ledger reporter observed seven in line around 6:30 p.m. A healthcare worker from Watson Clinic told the newspaper that she'd counted as many as 16 bumper to bumper in the driveway hours earlier.
These ambulances sat on the curb, unable to move as more and more 9-1-1 calls came in.
Lakeland Regional leaders at one point Monday evening sent out an urgent message to Polk County's Fire Rescue team.
"They asked: Can you not bring us anyone for awhile?" Robert Weech, Polk's Fire Chief, told the county commission Tuesday morning.
EMT workers steered patients to other hospitals when possible.
Much like their hospital counterparts, these first-responders are also being pushed to the limit, working extended mandatory overtime, coping with their own exhaustion and stress.
They've been handling roughly as many as 42% more 9-1-1 calls than usual of late. And that's at a time when the county's fire rescue division has 35 vacancies, and another 16 EMS employees are currently out of commission due to COVID-19, county officials say.
Weech is calling on Polk County residents to do what they can to relieve some of the strain.
"If you can avoid using the 9-1-1 system, this is probably a good time to do that," he said. "The system is under strain. Certainly if you have an emergency, stroke, heart attack or if you have an accident, certainly call 9-1-1. But if you have other ways of getting medical care, you need to exhaust those at this time so that we can deal with those other bigger emergencies."
Polk County's EMS division typically responds to 280 9-1-1 calls per day. In recent weeks, they've been getting an average of 340 calls per day. Some days, dispatchers answer as many as 400 calls.
"Usually the problem is in late afternoons," Weech said Tuesday, "Our system picks up right around noon and it will extend to about 8 o'clock. And that's when we are seeing our system critically, critically stretched."
For the most part, Weech said his employees have been able to keep up and 70% of patients have not seen a delay in response times.
But in some parts of the county, ambulances are reaching patients as much as four minutes slower than usual, Weech said.
That's due, in part, to the time it takes patients to get admitted once they arrive via ambulance at the hospital.
Hospitals have been feeling the squeeze throughout the summer.
On Monday, Lakeland Regional had 411 COVID-19 patients admitted, according to a Facebook post from Dr. Daniel Haight, an infectious disease specialist and vice president of Lakeland Regional's community health.
Forty-nine of those were on ventilators. Sixty-five were on high-flow oxygen, he posted, adding that 95% of the COVID-19 ICU patients were unvaccinated. Meanwhile, a steady stream of ambulances carrying more patients were lined up outside.
"That bed transfer time is really critical for us," Weech said. "Get the patient to the hospital, get them off our stretcher and get back into the system. That's the critical hand-off that has to happen, and when we start to see those delays we get really assertive."
He added, "We get our medical director on the phone and we say (to the hospital) that we have to see some relief; the system has to keep moving."
Weech said that his team is in constant communication with hospital officials to reduce off-load delays as much as possible."
"We are asking: What's your status today? What is your capacity?" he said.
Lakeland Regional Medical Center's media relations team did not immediately return phone calls or emails seeking comment for this story.
But members of its executive staff and doctors have shared their recent experiences with media outlets, and the hospital has taken action recently in response to the COVID spike.
Last week, the hospital announced it would be temporarily postponing elective surgeries requiring an overnight stay. That began Monday.
Also on Monday, Danielle Drummond, president and CEO of Lakeland Regional Health, told the Lakeland City Commission that its "experiencing record high volumes across the board."
There were 395 COVID-19 patients hospitalized at Lakeland Regional Health Medical Center as of Monday morning. This is two to three times more than the hospital's previous peak of 180 COVID patients in January, according to Drummond, which she called "disappointing."
"The sheer volume coming to us right now is stretching us," Drummond said.
Polk County Schools reported Tuesday afternoon that 112 students and 156 faculty members are among the active COVID-19 cases across the school district.
As of 2:30 p.m. Tuesday, there were 16,521 patients hospitalized statewide, according to the state's hospital association. Fourteen percent of beds are available for all patients, but only 8.2% of beds are available within hospital ICU's.
The number of Florida hospitals expecting a critical staffing shortage in the next seven days: 75.8%, according to the hospital association.
"There can be no question that many Florida hospitals are stretched to their absolute limits," Mary C. Mayhew, President and CEO, Florida Hospital Association said in a statement. "While hospitalizations continue to increase, three out of four Florida hospitals expect to face critical staff shortages in the next seven days, an increase of nearly ten percent since last week, and half of our hospitals will no longer accept transfer patients from other facilities."
Photos showing the line of ambulances outside Lakeland Regional circulated on social media Monday night.
Tuesday morning, Polk County Commissioner Bill Braswell asked Weech about that backup.
"That is actually happening," Weech said. "We were crying, we were screaming, we were on the phone saying: 'You need to release these units. And they go into action mode and they do that."
Those photos "were not an exaggeration of the truth. That is reality."
Yet through all of the challenges — the mandatory overtime, the COVID absences, the department vacancies, hospital off-load delays, the increased 9-1-1 calls — Weech said he's proud of how his men and women have responded.
"Our first responders are working hard," Weech said, "That's a group that's committed, even when there is strain. I'm very proud of those folks."
Staff writer Sara-Megan Walsh contributed to this report.
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