The husband of a Hazelwood woman is dead and she’s blaming the city.
Sharon Edge says for two-and-a-half days, she made desperate calls to 911 during last week’s big snowstorm.
Paramedics never came and her husband, Curtis Mitchell, never got the treatment she believes would have saved his life.
Mitchell started feeling very sick two Fridays ago – the night the big storm hit.
More details and video at the link. The short story is that the family is charging that the Pittsburgh EMS crew refused to get out of their ambulance and walk the distance, through the unplowed streets, to the house. The patient couldn’t walk, so the EMS crew cleared the call.
There are a couple of other stories at the KDKA site, although a couple that might have provided more context about the weather and work conditions seem to be unavailable.
Generally, I don’t like to comment on media reports of this kind of thing, because I understand that more often than not they don’t include all the facts, just the ones that fit the narrative that the editors have decided to advance. With that being said, I do have some comments.
Average annual snowfall for Pittsburgh is 42 inches. Which compares to Boston, Detroit, Chicago, and a few other northeast cities. So, snow is not exactly unknown out there. Two feet of snow in one storm is a lot, and it’s going to cause problems with emergency responses off all types. Those problems could last up to 48 hours after the snow starts. I don’t know what contingency plans Pittsburgh EMS has for large snow storms, if any. I know that my service will hire extra people and put extra ambulances in service. Sometimes we’ll also staff a third person on some ambulances, although that has fallen out of favor. During heavy snow, if some streets aren’t plowed for a day or so, we’ll even send the fire department to calls that normally they wouldn’t go to as a temporary measure. Or, we’ll send an extra ambulance if one is available. As both a service and as individuals, we understand that a heavy snow storm is going to make getting to patients and moving them back to the ambulance, is going to be teh suck. We also understand, and out dispatchers try to convey to callers, that calls for less serious emergencies may be delayed. Callers seem to understand that.
I don’t know what the policy is in Pittsburgh, but it would seem not to be similar to what we do. Which surprises me because their system has a generally very good reputation.
The big question here is whether these two paramedics failed to follow established procedure, or if the established procedure failed the patient (and by extension the paramedics)?
This partial transcript tells us what happened, or at least part of it, but it doesn’t answer the bigger question of why it happened.
Not only did the ambulance crew not walk to the address, but the comments of the 9-1-1 operator make it seem as if that decision was within their protocols. Again, it’s hard to know, no it’s impossible to know, from the limited transcripts available.
It will be tempting and easy for the management to blame the paramedics, but I have to wonder if the problem really goes much deeper and reveals lack of preparedness for severe weather across the system? That’s the bigger question that should be answered whether or not the individuals involved are disciplined. That will be the real test of EMS management in Pittsburgh, not their response to media reports.
Above, I mentioned temporarily expanding fire first response under unusual weather circumstances. While that might have help here, because having more hands to carry equipment (and patients) under these conditions is helpful, permanently changing the policy in a knee jerk, after the barn door has closed, fashion is not a solution. It’s not even a band aid approach. It’s theater meant to impress the media and citizens that something is being done about the problem! Not necessarily something helpful or serious, but something that will impress the rubes.
We have to protect our phoney baloney jobs here, gentlemen! We must do something about this immediately! Immediately! Immediately! Harrumph! Harrumph! Harrumph!
Yeah, that sort of thing. Fortunately Pittsburgh has come up with a ready made solution,
Emergency officials in the city of Pittsburgh have revamped their procedures.
Pittsburgh firefighters are now responding to calls considered less of a medical emergency.
As I wrote above, there are times when the fire department should be sent, even if it’s not medically necessary. Extra manpower is sometimes helpful. The key word is temporary.
“We’ve been open to EMS’ vast call volume whereas in the past it was just strictly life-threatening situations – difficulty breathing, stroke, heart attack, altered state of consciousness,” Pittsburgh Fire Lt. Marc Kelly said. “But now, we share more of EMS’ humungous call load. They have so many calls. We were never part of that before. Less critical.”
This isn’t about improving response, it’s about helping to preserve fire fighters jobs. You’d think that if the problem is not enough ambulances, you’d hire more EMS workers and put more ambulances on the street.
“We don’t have the expertise to judge the critical calls and the non-critical so we go on them regardless of it and the experts will advise us,” Kelly said. “Because the medics get there eventually and they help so we’re available, willing.”
I’m not even sure that’s a coherent sentence. I do know that having people standing around with blank looks on their faces at medical calls isn’t any help. However, it seems that the PFD is following the Rahm Emmanuel prescription of never letting a crisis to go waste.
I hope that the people that run EMS in Pittsburgh do the correct thing in this case. Which is to identify the cause of the problem and fix it. Whether that turns out to be two lazy employees that need to find other careers, or a system that doesn’t have a staffing and response plan for severe weather conditions isn’t the issue. The issue is how management responds and investigates.
No matter what the ultimate outcome, there are lessons here for individual responders and system managers.
Let’s be smart enough to learn them and use them to improve our services.
Rogue Medic has predictably been all over this story and has some more insights. He’s made a couple of points that I have, but also has some thoughts based on his knowledge of the area. I’ve been to Pittsburgh once, about ten years ago. My impression was of a typical northeast industrial city, but one with pretty steep hills. Which only add to the complications of responding in the snow.