For the first time in the county’s history, Kern County Public Health’s Emergency Medical Services Program is implementing a new surge plan to deal with a rising number of 911 calls and COVID-19 cases straining the health care system.
The new Emergency Medical Services System Surge Plan has four levels and the county entered Level 2, or the yellow tier, at 8 a.m. Wednesday. The main change in this tier is that “low acuity” calls may not receive an ambulance, depending on resources.
“The whole goal is to ensure that the ambulances are ready to respond to the highest level emergencies,” said Michelle Corson, spokesperson for Kern Public Health.
If there are not at least two ambulances available, the caller may be given other options for obtaining care such as contacting a primary care physician or urgent care.
The caller may also receive a visit from a new local strike team called Pro Safety, an approved emergency medical technician provider. Each team is staffed with two EMTs who can offer basic life support first response. They do not provide medical transportation, but should the team respond and find that is necessary, they can easily dispatch an ambulance, Corson said.
“I am comforted to know that we are able to respond and implement this surge plan to better serve our residents in these very unusual times,” she said. “We’ve got a way to flex and ensure that our higher level calls are being responded to.”
The new surge plan also relaxes the enforcement of response times that providers are typically expected to adhere to.
“It’s a time of an emergency,” she said. “We can’t possibly hold them to the same standards (as) when we’re not in a pandemic.”
Mark Corum, director of Hall Ambulance’s media services, said that this December the company is on track to receive about 10,000 requests for an ambulance — about 1,000 more than last year. But it’s not just about call volume.
The county’s new surge plan was triggered in part by its volume of calls, but it also takes into account patient offload times at hospitals and the number of units out of service for decontamination. A memo from Jeff Farris, EMS program manager, and Kris Lyon, medical director at the county’s public health services department, said that Kern County’s EMS system is showing strains on those three measures. (A fourth measure, staffing levels, was not trigger.)
There has been a 30 percent increase in ambulance offload times at hospitals. It’s a trickle-down effect: Increasingly crowded hospitals lead to ambulances idling with patients for hours, Corum said. Those waits, in turn, limit the number of ambulances available.
Corum said before the surge plan went into effect, there were two to four hour delays at Bakersfield Memorial and two to three hour delays at Adventist Health. On Monday, 37 Hall Ambulances waited over an hour to offload a patient, and one of those patients had to wait longer than four hours. Recently, one patient transported to a hospital in Palmdale had to wait 22 hours.
Many ambulances are out of commission because of time spent decontaminating them, too. Corum said the process took three employees and a manager more than two hours in spring, but now the company has it down to a process that requires one individual who can do it in 15 minutes.
But the need to decontaminate ambulances has been rising dramatically. Since March, 2,736 ambulances have been decontaminated. In December, there were 795. In the last three days there were 115, he said.
Farris’ memo said that since October, there has been a 677 percent rise in the number of units out of service for decontamination. It’s been 322 percent since November.
All of these factors combine to make it tougher to dispatch an ambulance than it was in November or December.
“It’s a perfect storm, if you will,” Corum said.
This plan is meant to free up some of those tied-up ambulances for the most serious cases: not just serious COVID-19 cases but also heart attacks and strokes.
“This surge plan alleviates some of the pressure,” Corum said.
The plan applies to ambulance companies responding to 911 calls in Kern.
This is the first time Kern County has used this kind of plan, though other counties nearby including San Bernardino, Inyo, Mono, Riverside and Fresno have been rolling out similar plans due to surges.
Corson said she doesn’t want people to be concerned about calling 911 and she encourages people to use the system if they are having an emergency.
“We don’t want people to be afraid,” she said. “We want people to know that we’re adapting. The level of service continues.”
To view the county’s EMS System Surge Plan, visit https://kernpublichealth.com/2019-novel-coronavirus/.