Since 2007, our EMS response has increased by over 40%. This increase has occurred and not been accompanied by any additional units placed in service, or the addition of adequate personnel to provide relief. The increased call volume taxes our providers carrying out service delivery, where we run out of ambulances for EMS transport on a regular basis. This increased response volume combined with lack of strategic growth has created a system that experiences constant strain pushing us closer and closer to a breaking point.
On a nearly daily basis, we run out of ambulances for transport due to that fact that all of our units are routinely tied up responding to or mitigating emergency calls. This volume results in 911 calls being held until another agency accepts a mutual aid request to answer the call, or a City of Lynchburg becomes available to respond. In many cases, suppression units (fire engines) also become tied up responding to calls and initiating EMS until a transport unit becomes available to respond. Many of our calls are "low acuity," which means non-emergent where no immediate life threat exists. This call volume can create a domino effect of protection loss to city residents.
Fire service professionals operate under the rule of thumb that an incipient stage (developing) fire can double in size every 2-3 minutes, which is why as a profession we critically emphasize the first due response area of engine companies. Our goal is to get out of the station as quickly as possible and respond as expeditiously as possible with due regard for public safety, and get water on fire in the initial stages before it develops and spreads beyond the room where the fire started and gets into the structure.
Our current call volume and frequent system overload presents the risk of devastating circumstances in the event of an emergency. The American Heart Association national average for survival to hospital admission from cardiac arrest is 28%, which we exceeded by 25% in FY2018. This is combination of many factors, including:
Advanced Life Support capabilities of our EMS resources
High-quality chest compressions provided by state-of-the-art Lucas 2 automated chest compressors
Aggressive management of cardiac arrest coordinated with the local healthcare system
As we exponentially increase the rate at which all of our resources are tied up, gaps are exposed in our high-performance network of resources and pre-hospital providers that has saved countless lives. Early CPR and high-quality compressions is what makes the difference in cardiac arrest. The Lucas 2 device that we use for chest compressions provides superior chest compressions over manual compressions, and those tools are only carried by our transport units and one EMS supervisor. When our ambulances are tied up on a regular basis and periods occur throughout the day where not a single transport resource is available for emergency response with calls holding, the resources that make the difference are unavailable for cardiac arrest victims. When suppression units are then tied up to sit on held calls that could be handled by just a transport unit, a gap in fire protection coverage is created for the response zones protected by that engine company, which could result in delayed response to structure fires, increasing the damage caused by the fire, and it's lethality.
The following video represents why seconds count in response to house fires: