Emergency Department, Trauma Unit Closures Increasing Patient Wait Times in Los Angeles County

Los Angeles Fire Department officials during a Fire Commission meeting on Monday said that the closure of six emergency departments in the city over the last 18 months has increased the time required for paramedics to bring patients to hospitals, the Los Angeles Times reports.

Los Angeles paramedics now drive as long as 11 minutes to bring some patients to hospitals, compared to an average of eight minutes and 23 seconds in March 2004, according to Capt. William Wells.

In non-life-threatening situations, city ambulances sometimes drive up to 20 minutes to take a patient to a specific hospital. In addition, paramedics often have to wait for beds to open at local hospitals because remaining EDs have to admit a greater number of patients.

Because of recent closures, about 28 patients each day that would have gone to EDs in East Los Angeles, Gardena, Century City, Van Nuys, Duarte and Granada Hills are taken to other hospitals.

EDs at Robert F. Kennedy Medical Center and Suburban Medical Center also are scheduled to close. The closures would leave 75 EDs in Los Angeles County, down from 94 in 1994.

Increased driving and wait times could affect patient care and cause ambulances and paramedics to travel out of their designated coverage zones, which could contribute to less protection in the event of a fire or accident, according to Los Angeles Fire Chief William Bamattre.

Fire department officials said that residents should not be concerned about increased drive time because most paramedic calls do not involve life-threatening situations, the Times reports.

Wells said the department-mandated limit for trauma travel is 30 minutes.

If paramedics cannot find a trauma center open within a 30-minute radius, they must deliver patients to EDs that are less-equipped to handle serious injuries. Such a situation occurs "nearly every weekend," and paramedics try to deliver these patients to EDs that are linked to trauma centers, the Times reports.

Officials in September announced plans to close Martin Luther King Jr./Drew Medical Center's trauma unit, which last year handled 2,150 trauma cases, including victims of car accidents and gunshot wounds.

Paramedics might continue to bring trauma patients to King/Drew's ED, which is expected to remain open. However, King/Drew does not have the capability or staffing to handle serious trauma, according to Wells.

Many local activists and politicians have said additional wait time to take gunshot or stabbing victims to the next closest facility could lead to deaths.

Wells said, "Most times, there is no rush to get to a hospital. The only real rush is the trauma patient" (Chong, Los Angeles Times, 11/2).