Paramedic call volume jumps as ER 'offload delays' rise

Local paramedics are dealing with an increase in call volume and delays getting patients admitted to hospital, according to a Middlesex-London Paramedic Service performance report presented to council Tuesday. 

Overall, call volumes jumped 8.39 per cent in 2017 compared to the previous year. The number of Code 4 calls — which designates life-threatening situations — increased almost 10 per cent in 2017 compared to the previous year. 

Deputy Chief Michael Longeway said two key factors explain the rise in call volume. 

"It's mostly related to an aging population and increasing number of seniors and an increasing propensity to call 911," he said.

"Additionally, we have a large mental health population in Ontario that we serve, and we see a rise in that over the year," he added.

Another challenge cited in the report is a sharp increase in what's known as offload delay — the time it takes patients to be transferred from the care of paramedics to hospital staff. The standard offload time is 30 minutes, anything greater is considered an offload delay. 

• Hospital backlog leaves London, Middlesex without ambulances on the road

Overall, the number of offload delays jumped 44 per cent compared to the previous year.

Longeway said many offload delays are caused by hospital bed shortages that have a "ripple effect" of backlogs that back up emergency room admissions. 

"Our crews arrive to emerg and there's no place to put the patients," he said. "So they end up in offload delay. They're still under the care of paramedics, but waiting for a bed in the emergency room."

Longeway said leadership at Middlesex-London EMS is working with the London Health Sciences Centre to speed up admissions. 

"It's early days, but we are seeing some improvements in our 2018 data," said Longeway.  "It really is a big challenge. It's not just a Middlesex problem, it's a provincial problem."

Other numbers from the 2017 performance report: 

• Reaction time for Code 4 calls averaged 1 minute 18 seconds
• 89 per cent of calls were within the city of London boundaries 
• ​More than half of all patients assessed were older than 60
• Paramedics performed 45 cardiac arrest saves
• There were 29 "reportable incidents" related to vehicle collisions in 2017. Of those, four resulted in "extensive damage" while five of those incidents happened while a patient was being transferred to hospital