The Tribune

EDITOR, The Tribune

First let me share my heartfelt condolences to the family of the late Robert Valcom Jr., the young man who died waiting on an ambulance to respond.

The Ambulance service, as part of the essential Healthcare system within The Bahamas, is still at a crossroad. It appears we are content with being 20 years behind developed countries. The Government of The Bahamas is faced with an increased ambulance service cost, delayed response times and fair quality of service offered. This issue is compounded by the need for Universal Health and an overall revamping of how healthcare is delivered to Bahamians, residents and visitors.

In response to Dr. Sands comments; while we may not know if the extra 13-minute delay could have made a difference, however, we know that every second counts to save a life. Reducing the time, a patient receives medical care, was the major force in developing the EMS system. For this reason, New Providence has five ambulances operating 24/7, providing basic and advance emergency medical care. This would be more than adequate for a modest population; however, many variables prove otherwise. According to the Sanigest Internacional’s 2013 report for New Providence, more than 70 per cent of ambulance calls experience delays, with an average response time of 34 minutes. The exposure of the report prompted PHA to a specific commitment of reducing ambulance response times to 4 minutes and an improved quality of care. Currently, the average response time is 21 minutes. (The response time is calculated from the time a call is made, to the time the ambulance reaches its destination).

While I share the government’s commitment to providing quality prehospital care. I don’t believe the current Emergency Medical Services model offers the improved service the public reasonably expects. It offers the same things, while expecting different results. The goal of this administration should be to outline a clear path forward that reduces administrative and operational expenses, while improving service quality. To accomplish these goals, it is my opinion that the delivery model must radically change from a centralised thinking.

Here is what was humbly proposed to Dr. Sands and the EMS Medical Director:

• Increase the scope of the practice for paramedics and provide a first response vehicles for paramedics.

• Develop a department that focuses on non-emergency transports only.

• Subdivide New Providence into zones

• All police officers should be trained in first aid and all patrol vehicles have a first-aid kit.

• Create a substation that houses at least two Ambulance vehicles and a first response vehicle in the southern New Providence area. This substation will be located on the grounds of the Flamingo Gardens Community Clinic or the Carmichael Road Police Station. (thereby allowing emergency vehicles to provide quality care with expedience).

We need decentralizing if we want to see improvements. The rational is based on the growing population within the greater Carmichael or City 2000 (included are South Beach, Southern Shores Golden Isles and Tall Pines). With these improvements, it is possible for EMS to have an ambulance on the scene within six – 8 minutes for most locations or lower the national average to a 10 – 12-minute response times. With regard to the paramedic quick response vehicle, acute emergencies are effectively triaged, immediate treatment initiated and the need for transport determined. Far too often ambulances are diverted from true emergencies for people who have a broken toe or stomach pains for the past week.

Lastly, by providing a separate non-emergency transportation unit, you would limit the time an ambulance is used for non-emergencies. This unit can also support the public health department with home care visit and treatment.

In conclusion, the professionals within the EMS community are the hardest working members within the healthcare industry, least recognized for their role and first to be blamed. We all seek the highest level of care; It is our responsibility to ensure that the quality of care the residents of the Bahamas are receiving, is up to the highest standards. This is only accomplished with an expanded scope practice, medical oversight (online and offline medical direction) and leaders with vision.

KISHON TURNER

Nassau

April 11, 2019