Firestorm: An Accurate Portrait of the Struggles Faced by EMS Today

ER Over crowding.System abuse.Lack of resources.Lack of treatment pathways.Its all there!

Last night, I was in Philadelphia for the Chronicles of EMS 3 City Meetup for the premier of Firestorm, a documentary about the Los Angeles Fire Department and their struggles to provide efficient appropriate care to the citizens of Los Angeles in a setting where resources are often scarce, hospitals are closing, and abuse of the system is out of control.The atmosphere is described by one LAFD Captain as “The Perfect Storm” with no relief is sight, and from what I saw last night, that statement couldn’t be more accurate.

Firestorm focuses mainly on the men and women ofLos Angeles’ Station 65, which houses two Paramedic Level Ambulances.It is one of the busiest stations in the city.They deal with everything that one would expect to deal with in an urban setting.The spectrum ranges from violent crime, like shootings and stabbings, MI’s and major cardiac events, to stubbed toes, fevers, and abdominal pain patients.Their options for patient pathways are limited, just as they are in almost every otherEMSsetting that you’ll find, and their task times are increasing due to ER closures and generalized overcrowding.On numerous occasions, ERs inLos Angeleshave wait times in excess of 24 hours.

One scene that was particularly telling of the struggles that the LAFD faces featured a woman and her young son.She wanted the 2 year old evaluated because he had a fever and had appeared to have been shaking.The child, from the assessment that one could make by watching the movie, was clinging to the woman, appeared to be acting in the shy and bashful manner that you would expect from a kid under the age of 3.The LAFD Medic painted a picture of his assessment, that in short and without straight out saying the words said “He seems to be okay now, and would be more appropriately evaluated by a pediatrician.He doesn’t need an ambulance.”The woman’s reaction?”I’d still like to get him checked.We all have our opinions.”The Medics then did the right thing, and loaded the kid up and transported him.

Now, this woman will probably sit in the Emergency Room for 12+ hours, with her already sick child, around a number of people who are also sick, exposing him to more germs, and an environment that he should be spared, only to go into the ER, and be seen by a doctor who is going to tell her to take the kid home, give him fluids, and Motrin for his fever.I wonder how this same scenario would have played out in Northeast England?(Mark? care to shed some light?)

The movie also deals in some detail with the closure of Martin Luther King Jr Hospital, a trauma center and primary hospital for the units from Station 65.The Hospital had many struggles, the crescendo of which was the death of Edith Rodriguez, who was allegedly ignored when she collapsed in the Hospital’s ER waiting room.

The footage is painful to watch.The woman is lying on the waiting room floor being ignored by staff.At one point, you can see the Hospital’s janitorial staff cleaning up around her.The staff reportedly refused to help her because she had already been “discharged.”There were even a few 911 calls made by concerned citizens who were also in the Hospital that day.The dispatcher’s comments?”There’s nothing an ambulance can do.You need to let the staff know.”A few months after the incident, Martin Luther King Jr Hospital closed.

If you weren’t able to see Firestorm on Sunday night, I urge you, as soon as possible, to get a hold of it and watch it.It will confirm for all of you that the problems that you face within your system are real.When you are done watching it, find a few friends who don’t do this job, and sit them in front of a TV and have them watch it too.People need to understand the challenges that we are dealing with, and the potential direction that Pre Hospital Care could go in throughout the Nation if we don’t act now.