The Chicago Fire Department would be required to investigate an apparent shortage of advanced life support ambulances and paramedics and prepare a “remediation plan,” under a City Council order introduced this week by a pair of aldermen.
Aldermen Bob Fioretti (2nd) and Nick Sposato (36th), a former Chicago firefighter, are responding to a report last fall by Inspector General Joe Ferguson and to a more recent joint investigation by WBBM-TV and the Better Government Association.
All three came to the same conclusion: Chicago doesn’t have enough advanced life support — or ALS — ambulances or paramedics to consistently meet response time standards, and the shortage may be putting the lives of residents and visitors in jeopardy.
The proposed order was introduced at Wednesday’s City Council meeting. Afterward, Mayor Rahm Emanuel said he has asked the Fire Department to conduct an “internal review” of city ambulance services.
Chicago currently has 60 ALS ambulances, each staffed by two paramedics qualified to administer intravenous medication. ALS ambulances are stocked with drugs and equipped with heart monitoring devices.
The city also has 15 basic life support — or BLS — ambulances staffed by emergency medical technicians who undergo less training. BLS ambulances do not have medicine or monitoring equipment. They are only permitted to transport patients to hospitals.
Emanuel has talked about ending the two-tiered system of ambulance care — which veteran paramedics call a dismal failure — and converting all 15 BLS ambulances to ALS.
The multiyear plan, which still requires union approval, would cost $750,000. It would leave the city with 75 ambulances capable of providing the most sophisticated level of care, including performing 12-lead EKGs that provide the definitive answer about whether a patient is having a heart attack.
But it hasn’t happened yet—and Sposato says it should.
“So what if you end up having an ALS ambulance transporting someone for a stubbed toe. Better that than to have a BLS ambulance for somebody who complains of abdominal pain and turns out to have suffered a stroke,” the alderman said.
“In some areas, services are just overwhelmed. They’re getting 25 or 30 runs a day. In other areas, firehouses are so far apart they’re almost ambulance deserts. If the 15 BLS ambulances were made into ALS, I don’t think there would be a shortage.”
Pat Fitzmaurice, a 30-year veteran paramedic quoted by the BGA and WBBM, agreed that converting the 15 BLS ambulances to ALS would be a “good start.”
He noted that dispatchers are “reluctant” to call for just a BLS ambulance for fear of liability. Last year alone, more than 4,000 calls “had to be upgraded to ALS” after the initial response of a BLS ambulance turned out to be inadequate, he said.
But Fitzmaurice argued that Chicago also needs five additional ambulances to handle the steady increase in calls.
“Ninety percent of all Fire Department runs are EMS, yet we stand pat with 57 ambulances and three at O’Hare” Airport, he said.
“I hear dispatchers on a daily basis saying, `Can anybody go? I have no available ambulances.’ They send BLS and upgrade.”
Fitzmaurice is a paramedic field chief on the West Side. Five of the seven ambulances under his command are among the busiest in Chicago, with an average of 20 runs a day.
He noted that a $410,000 consulting study of the Chicago Fire Department conducted in 1999 for then-Mayor Richard M. Daley sounded the alarm about the ambulance shortage.
“You know what the Fire Department did with the Tri-Data report? They used it to wipe their ass,” Fitzmaurice said.
The WBBM and BGA stories have not only highlighted incidents Sposato views as “isolated” where seriously ill or injured patients waited 16, 20 or as long as 35 minutes for an ALS ambulance.
They cited a February memo put out by the city’s Office of Emergency Management and Communications warning dispatchers to use “more measured” language over a radio than can be monitored by the news media.
“Try to provide the needed information in a manner that makes the message clear, but using a minimum of specifics. … Hopefully, we can get the message across without highlighting the fact that no ALS unit is available,” the BGA quoted the memo as saying.
OEMC spokesperson Melissa Stratton has argued that the memo was issued simply to remind dispatchers to use what she called the “approved protocols for radio dispatch.”
Chicago Fire Department spokesman Larry Langford could not be reached for comment about the proposed City Council order, which is likely to trigger hearings putting the Fire Department on hot seat.
Tom Ryan, president of the Chicago Firefighters Union Local 2, referred calls to the union’s EMS director Pete Houlihan, who could not be reached.