You three were absolutely wrong

Code 3 for abdominal pain. At the skilled nursing facility. Which is approximately 1000 feet from the ambulance entrance of the nearest ED.

Fucking kill me.

The fire crew and the 911 ambulance crew arrive at the same time, just slightly behind a private BLS ambulance crew, already unloading an empty gurney.

I think I know where this is going.

“Which room?”

“Uh, I don’t know. We didn’t call you.”

The staff politely insists that 911 was not called. But they ask around anyway.

After a few moments, “Sir, this way. Room 45.”

“OK. Thanks.”

It’s a few turns and a few hallways down. Guess who’s in front of us?

The private BLS ambulance crew.

“What room are you guys going to?”

“Room 45.”

Two nurses are in the room, and a staff supervisor arrives, noticing that there are just a few too many people responding to a patient who essentially just needs a ride.

“So who called 911?”

“I did.”

A woman in her 30s speaks up. She appears confused and near tears.

“They told me they called for an ambulance and it was going to be 20 minutes, so I called 911.”


“My grandma can’t wait 20 minutes! She’s in pain!”

Her grandmother is sitting in a wheelchair in the room, not in any apparent distress. She’s had abdominal pain for more than a day.

Perhaps sensing everyone’s dismay for the completely unnecessary, (wo)man-made, duplicate response, the younger woman who called 911 starts crying, “I’m sorry! I don’t want to get anyone in trouble!”

Why she thinks any of us would get in trouble is beyond me. Really, she should be asking if we fine people for this shit.

(Of course we don’t. EMS agencies have no spine.)

Perhaps because of the tears, the fire captain and the staff supervisor begin to console her, “It’s OK. You did the right thing. If it was my grandmother, I wouldn’t want her to wait either.”



The entire point of the private BLS ambulance is to run these very transfers from SNFs to hospitals. The SNF did what every oversight agency would LOVE for facilities to do but usually don’t – CALL AN APPROPRIATE PRIVATE BLS AMBULANCE TO TRANSFER THE PATIENT AND NOT A 911 AMBULANCE. The patient is obviously not in extremis. The ED is 1000 feet away. She could have wheeled her grandmother over there. The private BLS ambulance gave an ETA of 20 minutes, which is a perfectly reasonable response time for a private BLS ambulance, AND THEY ARRIVED BEFORE THE 911 CREWS ANYWAY!

This is exactly the time to say to her, “Yes, you absolutely should be sorry. You were impatient and did not want to wait. You called a 911 ambulance when a private ambulance was requested. You were being selfish and you are hogging scarce resources, scarce resources that other people in this city may need. You absolutely did not do the right thing. If it was my grandmother, I’d take the time to comfort her while waiting for the private ambulance instead of spending it tying up an emergency line talking to a stranger on the phone.”

But nooo, that wouldn’t be good customer service.

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