Ambulance crews scrambling to find available emergency care

Posted: Sunday, April 08, 2001

ANCHORAGE (AP) -- A shortage of emergency care in Anchorage is forcing medics and dispatchers to scramble to find treatment for the sickest patients, according to hospital officials, doctors and city medics.

Patient care has not suffered yet, but doctors and emergency room officials say the situation is getting worse.

The underlying problem is a shortage of critical care nurses.

''It's not uncommon for us to be diverted en route,'' said Kurt Sorensen, a paramedic battalion chief for the municipality. ''That's when we get into shopping for a hospital.''

Ambulances are typically detoured because a hospital can't handle any more critical care patients on the floors, said Dr. Mike Levy, medical director of both the Alaska Regional Hospital emergency department and the city's Emergency Medical Services.

Either all the critical care beds are full or the hospitals don't have enough critical care nurses for them, said Levy and Dr. Dave Ingraham, medical director of the Providence Alaska Medical Center emergency department.

''The resources in the community are getting strapped,'' said Dr. Richard Brodsky, medical director of Alaska Native Medical Center's emergency department.

Three things -- a nationwide nursing shortage, an aging population needing more health care and the way in which hospitals use their space -- contribute to the problem.

Alaska Regional, for instance, says its total patient census is running about 75, less than one-third of its licensed capacity, but its 16 critical care beds are close to full. It doesn't have enough nurses to add more, said spokeswoman Kjerstin Lastufka.

''The issue is the nurses, the adequate number of nurses to go with the beds,'' she said.

At Providence, Alaska's biggest hospital with 341 beds, space is at a premium. The hospital is considering whether to build another patient tower.

In the past year, Providence and Alaska Regional have gone from diverting ambulances a few hours a month to about 100 hours a month each, according to statistics compiled by Providence trauma coordinator Barbara Simonsen.

The hospital on Elmendorf Air Force Base also routinely detours ambulances when its intensive care unit is full.

Alaska Native Medical Center has diverted ambulances only a few times in recent months.

Eleven times this year, both Providence and Alaska Regional diverted ambulances at the same time.

One ambulance crew scurried to get care for a woman having a heart attack when Providence and Alaska Regional were diverting ambulances. The Native hospital doesn't have a heart catheterization center and doesn't do angioplasty, often the preferred treatment.

''It could have been a problem,'' said firefighter-paramedic Rich Parry. ''Her heart stopped before we got to the hospital.''

The crew called Alaska Regional. Levy gave the go-ahead to take her there.

If Providence, Alaska Regional and the Native hospital all said no to critical care patients at the same time, under an agreed-upon protocol they would have to immediately take in the patients again. That happened on March 6.

This summer, Alaska Regional plans to hire nine temporary critical care nurses and will add the first graduates of a new in-house training program for critical care nurses.

Providence also is studying whether to shift beds to add another critical care unit.

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