By TIM CARPENTER
Kansas Reflector
TOPEKA — In the words of a Kansas ambulance service director, surging demand from COVID-19 patients and a shortage of EMS personnel to handle calls “is about to get critical.”
Another responding to a statewide EMS survey said this of the pandemic in Kansas: “Very concerned if there are serious trauma events or patients with critical time-sensitive illness, there will be no options for these patients to receive critically needed care.”
And, one more piece of insight: “I am concerned that we will be in situations very soon where we will not be able to find a receiving hospital for our patients. ”
Dave Johnston, president of the Kansas Emergency Medical Services Association, said these statements were included in survey responses from 85 of 160 ambulance agencies in the state. He said answers affirmed growing anxiety about sustaining ambulance services as COVID-19 cut a wider path through the population. In the four months between Aug. 7 and Dec. 7, Kansas infections have risen from 30,600 to 174,000, deaths in the state have grown from 380 to 1,856 and hospitalizations have expanded from 1,875 to 5,509.
If ambulance services become overwhelmed by routine and extraordinary demands, he said, it could compromise their ability of function at the level expected by the public. In terms of COVID-19, the situation would complicate movement of coronavirus patients to urban hospitals with greater capacity to handle complex cases. He said the greater distances required to transfer patients from hospital to hospital would consume more of each ambulance crew’s shift, especially at services serving rural areas in Kansas.
“As the increase in transfers occurs, the increase in call volume occurs, we’re concerned we will have more staff out,” said Johnston, who is chief of Reno County EMS.
Keeping ambulance services on a pandemic footing has proven to be costly and a prescription for burnout, the survey said. Kansas has a combination of ambulance services that include those in private hands and those based at fire departments, hospitals or with local government. The weight of COVID-19 is a defining issue whether the ambulance operation depends on paid staff or volunteer crews, the survey said.
“The big deal is making sure we continue having funding for personal protective equipment. That’s incredibly important. And, the state helping us with staffing,” Johnston said.
He said a rule requiring two certified persons on board an ambulance was creating problems in the field. Some agencies have been forced to dispatch one EMT to the call with an ambulance driver, but limit the first EMT on the scene to stabilizing the patient and waiting for transport backup. That second EMT might have to be drawn from a neighboring county.
The Kansas survey indicated 61% of the ambulance agencies in Kansas had staff who were unable to work due to the coronavirus. One-third said they had employees who had been compelled to quarantine or isolate. One-third reported handling an average of two or three COVID-19 patients a day, but 8% said they averaged four to six daily and 2% worked with more than 10 daily.
“We are a very small service that serves our entire county. We do not have a hospital and all of our patients have to be transferred out of county for medical care if urgent. When our ambulance leaves to take a patient, our county is not protected with medical coverage,” an ambulance director wrote in response to the survey.
The consequence was summarized by a peer: “When it is necessary to transport someone post fall to a hospital 30 to 60 miles away simply because our local hospital being at capacity … not good for the patient or their family.”
Tim Carpenter has reported on Kansas for 35 years. He covered the Capitol for 16 years at the Topeka Capital-Journal and previously worked for the Lawrence Journal-World and United Press International.