Paramedic Time Bomb

We’ve all heard about the Los Angeles Fire Department’s dispatch problems in sending the wrong personnel to medical emergencies. These are tragedies and fat lawsuits waiting to happen. We’ve heard that there are problems on the other side of the dispatch call as well, with an understaffed paramedic force so stressed and overworked that workers sometimes require psychological counseling. That’s another bomb with a short fuse.

In one recent case, a senior paramedic refused to take a woman suffering a miscarriage to the hospital of her doctor’s choice. After the woman refused to go to a slightly closer emergency room, her husband was handed the dead fetus in a plastic container and she rode there in the family car. The paramedic has been disciplined, and county and city investigations continue.

Other seemingly endemic problems include firefighters’ low regard for paramedics, even though medical calls account for 80% of emergency calls to the Fire Department.

Next month, the Los Angeles Board of Fire Commissioners is expected to formally approve an ambitious, expensive long-range plan to address the problems. Steve Rubin, budget director for Mayor Richard Riordan, questions parts of the plan, such as the call to train 500 new paramedics over the next five years, saying that the need hasn’t been proven. But the alternative that the mayor has backed--to hire 100 temporary paramedics--is insufficient and solves nothing in the long run, unless those people are kept on the force.

Perhaps it won’t be possible to train 500 new paramedics because of unforeseen budget problems or because of continuing legal costs associated with the Police Department’s corruption scandal. But it’s a goal to shoot for, particularly with projected losses from retirements and resignations. Right now there are only 392 full-time paramedics to help respond to 250,000 medical incidents a year.

The Fire Department also wants to staff 40 additional rescue ambulances. The goal, said Chief William R. Bamattre, is to have at least one highly trained rescuer and an ambulance at each of the city’s 103 fire stations. Again, it’s a reasonable target. The proposal also calls for tripling the number of paramedic captains who supervise field crews. Promoting more qualified paramedics in the department might also be the only way to ensure that paramedics are given due credit for their work.

The prompt dispatch of the right medical personnel to emergencies is one mark of a well-run city. Another is that those paramedics are not exhausted and pushed to the brink when they arrive. Bamattre’s proposal is perhaps too much, but Riordan’s counterproposal is clearly too little. The paramedic force needs more fully trained full-time personnel.