Emergency Brings Doctor to You.

OCT17emergency You see them speeding to and fro every day. They force traffic to come to a dead stop at the height of rush hour with a blast of their horn & siren and those flashing lights. Who are they? They’re Los Angeles Fire Department’s fleet of rescue ambulances. Last year, these ambulances along with their fire engine & truck company cousins responded to approximately 350,000 calls for medical response services. In most cases, one of these vehicles arrived to help within three to five minutes after the initial 911 call was received. 

When you look below the surface, you find that a healthy number of these calls come from people who don’t have health insurance which means they don’t have a family doctor. There are other people who call 911 for almost any malady they suffer making the LAFD obligated to respond. Finally, you have people who are either lonely or mentally unstable. These patients are known as “Frequent Flyers” in fire service lingo. In all cases, what you have is a LAFD “resource” (a term describing the personnel & equipment) that is now tied up on lower priority calls. Additionally, if a patient has to be transported, the resource is obligated to stay with the patient until a bed is secured at the emergency room which can take anywhere from a few minutes to many hours. 

Because the above situations are not going away anytime soon and the call volume to the LAFD is steadily increasing, the existing response model is no longer valid. So forward thinkers in the LAFD and other fire departments around the country have adopted non-traditional solutions to this problem. 

The LAFD has decided that instead of bringing certain patients to the emergency room, they are going to bring the emergency room to the patient using what is called their “ADVANCED PRACTITIONER UNITS” (aka the “APU”). This launched as a pilot program in 2015 out of Fire Station 64 in Watts which is a community with those challenges. Here’s how it works: Now, added to the fleet of regular ambulances, is a similar looking vehicle that is staffed by a NURSE PRACTITIONER who is listed as a “mid-level heath care provider” and an LAFD paramedic. This ambulance, unlike the regular fleet, carries basic wound care and point-of-care testing supplies, select medications, a phone and a portable tablet to record an electronic patient care report. In many cases there is also a LAFD EMS (Emergency Medical Services) Captain who has pre-hospital experience. As a team, this group responds to calls that are classified as “low acuity medical complaints.” The criteria used for identifying these complaints includes past calls logged from a particular address/phone number which can give responders basic knowledge of who the patient is. 

Once on scene, this team can determine if the malady is something that can be treated & dealt with right there. If the APU staff determines that hospital care is needed, they will advise the LAFD to send a paramedic or EMT (“8 Series”) rescue ambulance for transport. But in most cases, a patient is treated and released. 

It’s important to note that the APU staff doesn’t just pick up their gear and leave. In many cases, they work with the patient to assist them in getting follow-up care for their sickness or injury and that’s taking into account that many of the people they see fit into the categories that started off this article. With that said, many of the referrals they make are to low cost or no cost sources of treatment. 

After its 2015 test period, the program was a success and did reduce the overall cost to the emergency system and allowed LAFD rescue ambulances to remain “available” for calls where acute life threatening conditions were in play. In 2018, the department is rolling out several more of these APU units with one to operate in the area where you, our The Neighborhood News readers, live and work. The next APU unit was supposed to be activated this past April but has been delayed by changes and upgrades that need to be made to the assigned ambulances radio & computer equipment. Once it does go into service (the date is still TBA as of this writing), the next APU Unit will be assigned to Fire Station 58 in the South Robertson district and will be known as “APU58.” Though the unit itself will be based near West L.A., it still resides in what is known as “Battalion 18” and includes the areas of Pico-Robertson, Mid City, Jefferson Park, Leimert Park, Baldwin Hills, Carthay Circle, Miracle Mile, and Hancock Park just to name a few.  

The APU’s arrival in our area in NOT by accident as studies of caller data demonstrates that we generate a high level of calls that fit into the criteria warranting an APU. Many of us might find that somewhat shocking, but the evidence is supported by concrete data and historical precedence. 

The next time you see one of those red “pillboxes” rolling down the street, take a closer look at the numbering as it might be APU58. If the lights and sirens are on, PLEASE, pull to the right and let them pass. They are more than likely on their way to bring the emergency room to their next patient. 

Chin Thammasaengsri is your city services columnist at The Neighborhood News who also serves as the Public Safety Liaison for the Mid City Neighborhood Council. Additionally, he is a member of the Community Emergency Response Team in Los Angeles. 


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Established in August of 2008 by writerartist Dianne V. Lawrence, The Neighborhood News covers the events, people, history, politics and historic architecture of communities throughout the Mid-City and West Adams area in Los Angeles Council District 10.

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