GUNNISON, Colo. — The evening after Thanksgiving, a small ambulance service that covers an enormous swath of southwestern Colorado bought a name {that a} affected person wanted an emergency switch from the hospital in Gunnison to a bigger one with an intensive care unit 65 miles away in Montrose.
The affected person — a 78-year-old man — was experiencing atrial fibrillation, an irregular heartbeat that normally isn’t life-threatening. However for sufferers like this one with power well being circumstances, a historical past of cardiac points and hypertension, the situation could cause a stroke or coronary heart failure.
Staff from Gunnison Valley Well being Paramedics rolled the affected person, who was on a gurney, out of the hospital and into the frigid evening air. AnnieGrace Haddorff, the emergency medical technician on name, helped load the affected person into the ambulance and jumped into the driving force’s seat. Paramedic Alec Newby bought into the again and hooked the affected person as much as a blood stress cuff; a pulse oximeter, which measures coronary heart price and blood oxygen saturation; and an electrocardiogram, which data the center’s electrical exercise.
“Your coronary heart is clearly pissed off,” Newby informed the person because the ECG confirmed the atrial fibrillation.
The ambulance pulled onto U.S. Freeway 50 for the one-hour-and-15-minute drive previous clusters of properties amongst rolling hills of sagebrush, the expansive Blue Mesa Reservoir and the gaping Black Canyon of the Gunnison, with its craggy spires.
The affected person was secure sufficient for the lengthy drive, which lined solely a sliver of GVH Paramedics’ 4,400-square-mile service space. It’s greater than twice the dimensions of Delaware and is the most important response zone for an ambulance service in all of Colorado. A typical hearth or emergency medical service response space ranges from 100 to 400 sq. miles.
Lately, interfacility transports or transfers, often known as IFTs, like this one have change into more and more widespread for GVH Paramedics, forcing the workforce to drive far outdoors its already huge zone. Earlier than the pandemic, the variety of transfers rose as a result of the inhabitants of Gunnison County was steadily growing, extra vacationers had been being drawn to locations like the favored Crested Butte ski resort, and GVH Paramedics had expanded its companies to bigger metropolitan hospitals outdoors Gunnison County.
However now the workforce is being known as to maneuver sufferers extra ceaselessly, and higher distances, as a result of the hospital beds within the comparatively shut cities of Montrose and Grand Junction are full of covid-19 sufferers. The workforce is repeatedly required to drive sufferers to Denver, which is round three hours and 40 minutes from Gunnison.
Officers from the ambulance service fear that they could discover themselves unable to answer an emergency as a result of their assets, which embrace six ambulances however solely sufficient employees to function three of these autos, are tied up on a long-haul switch.
What had been as soon as 2½- or three-hour journeys to Montrose at the moment are far longer excursions, “and that takes assets from this neighborhood,” mentioned CJ Malcolm, chief of emergency companies. “We had been doing that pre-covid, however now the state is so impacted, it’s like a every day a part of our lives.”
Earlier than the pandemic, all of the ambulances can be concurrently out on 911 calls or IFTs lower than 10 instances a yr. Now, Malcolm mentioned, it’s occurring with higher frequency. In these circumstances, GVH Paramedics leans on the emergency response workforce in Crested Butte, about 28 miles from Gunnison, or the response to the affected person is delayed.
In 2018, GVH Paramedics made 166 IFTs, requiring almost 40,000 miles of journey and a complete of 987 hours of ambulance operation, in accordance with information collected by the workforce. Final yr concluded with 260 IFTs, over 70,000 miles of journey and a complete of 1,486 hours of ambulance operation. That’s a 50% enhance in time on the street.
“Anytime we’ve one or two ambulances out on an IFT, this leaves an enormous tract of land with just one ambulance to reply,” Malcolm mentioned. “This can be a reasonably terrifying place to be put into after we can simply have two or three 911 calls in a row.”
In August, for instance, Gunnison Valley Well being hospital transferred greater than 60 sufferers, 37 of whom had been transported by GVH Paramedics. That implies that no less than as soon as a day that month, a GVH Paramedics crew was taking a affected person out of city, Malcolm mentioned. And if crew members aren’t scheduled to be again in Gunnison by 1 a.m., they need to spend the evening in a lodge to keep away from driving alongside treacherous mountain roads whereas overly drained.
GVH Paramedics’ service space covers nearly all of Gunnison County, a big portion of Saguache County and sections of Montrose and Hinsdale counties. It comprises mountain ranges, canyons and large expanses of excessive desert. With round 6,600 full-time residents and a college, Gunnison is the most important city the workforce serves. The encompassing cities — together with Tin Cup, Pitkin and Ohio Metropolis — are villages with a few hundred folks or former mining cities the place the artifacts from the growth instances outnumber the residents.
GVH Paramedics’ 21 full-time employees members and 10 to twenty people who work as wanted have certifications in wildland firefighting and backcountry medication expertise, together with swift-water, ice and avalanche rescue. To take care of the elevated calls for from IFTs, they’ve added an additional employees member to every shift, and off-duty staffers are being known as in to help.
Because the pandemic drags on, the variety of IFTs will most likely proceed to extend. By mid-November, the variety of folks within the hospital with covid-19 in Colorado was staggeringly excessive, approaching the December 2020 peak of 1,847. Hospitalizations remained above 1,500 by the top of the month. In consequence, 93% of the state’s acute care hospital beds and 94% of ICU beds had been getting used as of Nov. 30, in accordance with information from the Colorado Division of Public Well being and Atmosphere.
“I don’t assume we see the capability issues easing anytime quickly,” mentioned Cara Welch, senior director of communications on the Colorado Hospital Affiliation.
Including to the pressure are folks searching for care they delayed due to the pandemic and different respiratory viruses, resembling respiratory syncytial virus, circulating within the state, Welch mentioned.
Kelly Thompson, chief of operations of CareFlight of the Rockies, an air ambulance service that operates in Colorado and different components of the West, agreed with this evaluation. “We’ve already been transporting giant numbers of youngsters with RSV which can be sick, and you’ve got covid on high of all of this,” Thompson mentioned. “It’s an enormous concern. That is the time when we’ve a variety of sick folks.”
In early November, to handle escalating issues about hospital capability, Colorado hospitals and well being techniques activated tier 3 of the state’s affected person switch system — the best stage. Which means covid and non-covid sufferers may be moved with out their consent from a hospital that doesn’t have sufficient capability to 1 with extra space. Hospitals can even ship sicker sufferers to medical facilities with extra specialised care.
Because the GVH Paramedics crew members approached Montrose with their affected person over the latest vacation weekend, Newby known as the hospital to let the employees know they had been arriving. They pulled as much as the emergency room entrance, and Newby and Haddorff rolled the affected person right into a hospital room. The Montrose hospital employees took over, shifting the affected person from the gurney to a hospital mattress as Newby up to date them on the affected person’s medical data.
Quickly they had been again within the ambulance, headed for residence. “IFTs may be hectic,” mentioned Haddorff as she maneuvered the twisty mountain street bathed in moonlight.
