Seen as Pushed to the Brink : Hospital System From Paramedic Viewpoint

Times Staff Writer

When Los Angeles Fire Department paramedics arrived at the scene of a knifing in Boyle Heights early Friday, they found the victim, Sylvia Vasquez, 29, within walking distance of County-USC Medical Center.

But the woman was moved only to the Medical Center parking lot. There, a Fire Department helicopter picked her up and airlifted her to the nearest open trauma center--Huntington Memorial Hospital in Pasadena.

As labor troubles spread through the Los Angeles County health care system this week, restricting access to the trauma centers of public hospitals, the paramedics were among the best witnesses to the effect of the walkouts.

14 Years' Experience

In 14 years as a Los Angeles Fire Department paramedic, for example, field supervisor Tim Wilson said he has seen more than his share of shootings, stabbings and seizures. But Wilson, who oversees the department's downtown Los Angeles/Hollywood district, said the community's system of emergency health care system was pushed to the brink by the labor strife.

Wilson, who was accompanied by a reporter for a portion of his 24-hour shift that concluded Friday morning, described his workers' situation as he sat at his desk in Fire Station 6 on North Virgil Street:

"We'll always be able to get to you. But then trying to find a place for you (is another question)."

During his wearying shift, Wilson's paramedics were faced with a gloomy but inescapable fact: The three major county medical centers affected by the job action--County-USC, Martin Luther King Jr./Drew and Harbor-UCLA--had all closed their doors to most traumatic care patients.

Even before the strike, the county's trauma center network was near the breaking point, Wilson added, due in part to dropouts last year by private hospitals citing financial hardships. The 5-year-old system is designed to ensure that critically injured patients are within a 20-minute ambulance ride of a facility with an around-the-clock surgeon and specialized personnel.

Cedars-Sinai Filled

As a result, Thursday night the closest trauma center to downtown Los Angeles was Cedars-Sinai Medical Center in West Los Angeles. But Cedars-Sinai had reported to the Fire Department that it was filled to capacity and could take no more patients.

With the 20-minute transportation maximum in mind, one means by which the Fire Department coped was by stationing a helicopter on a landing pad at City Hall.

At about 9 p.m. Thursday, the copter, which had also been available to handle medical emergencies before the strike, was dispatched to a field at Dorsey High School off La Brea Avenue to transport to UCLA Medical Center a security guard who had been clubbed in the head with a baseball bat. The helicopter was necessary, paramedics said, because County-USC and Cedars-Sinai were unavailable and it was doubted that an ambulance could reach UCLA within 20 minutes.

Three hours later, the helicopter was dispatched to the County-USC grounds to pick up Vasquez, 29, who was reported in fair condition Friday afternoon at Huntington Memorial with a stab wound in her chest.

Earlier in the evening, Wilson had stopped at County-USC to inquire about the emergency room situation there and at other public hospitals.

Deserted Parking Lot

After striding through a virtually deserted lot usually teeming with ambulances, Wilson said he was told by a physician, "The only case they would accept is if someone had a heart attack in the emergency room parking lot."

Not that the public hospital situation was entirely without fluidity. At King Medical Center late Thursday night, city paramedics were granted entree with a 1-year-old seizure victim who had been discharged from the same facility earlier in the day after being rushed there by another city ambulance.

Physicians at King also sought to save the lives, unsuccessfully, of two drive-by gang shooting victims who were transported by the county Sheriff's Department.

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