By Adam Swift
Fire Chief Christopher Bright and representatives from Cataldo Ambulance gave a detailed dissertation on the staffing issues facing ambulance companies and EMT and paramedic services across the nation at Monday night’s City Council meeting.
Ward 3 Councillor Anthony Cogliandro filed the motion for the chief and Cataldo Ambulance, the city’s ambulance provider, to appear before the council to address issues with response times to emergency calls in the city.
Cogliandro emphasized that the motion was not filed in any way to speak badly about the fire department or Cataldo Ambulance, but to see if there was anything the city could do to help with concerns about response times and staffing shortages.
“This is something that we talk about quite frequently, and it has been an industry-wide problem throughout the country,” said Bright.
Councillor-at-Large Marc Silvestri said some of the response time concerns came to his attention when he was at an emergency call on the corner of Newhall Street. While the fire department arrived quickly, he said it took 17 minutes for an ambulance to get there.
“The response time is just unacceptable right now in the city of Revere for the ambulances,” said Silvestri.
Cataldo Ambulance President Dennis Cataldo gave a detailed overview of the issues facing his industry, and the healthcare industry in general, in the wake of staffing shortages over the past several years.
In general, Cataldo said the EMT and paramedic work is typically seen as a stepping stone to other medical positions, so there has always been a high turnover rate.
In addition, the early days of the Covid pandemic essentially put a stop to the in-person training needed for new EMTs and paramedics.
With the shortages, Cataldo said ambulance companies have to pay attention to how they deploy resources and make sure the right ambulance gets to the right place depending on the level of care needed for a patient.
“What we are seeing in the industry, for good or for bad, is that some response times based on patient acuity will be longer,” said Cataldo.
The calls are triaged and ambulances sent out be information received by the caller.
“If you harken back to years ago when there were plenty of ambulances available, this six-minute response time was the standard and no one was expecting to stay on the scene for 10 or 15 minutes,” said Cataldo. “But today, things are different; not only are calls being triaged and the appropriate ambulance being sent, but you are also trying to leave ambulances available for the more serious patients that might need them.”
When there are calls for patients not facing life-threatening situations, it lowers the ability to deal with more serious calls, Cataldo said.
Still, he said Cataldo Ambulance has worked its system well to be able to provide services when they are needed in a timely fashion to patients who need the highest level of care the most.
“We monitor these response times closely and we meet with the chief on a regular basis,” said Cataldo. “Revere is a very, very busy community, so the three vehicles you see in one location (on the American Legion Highway) are not even close to what we need to support the community on a regular basis.”
Revere sometimes needs as many as six to eight ambulances at one time to respond to calls, which leads to Cataldo Ambulance calling for mutual aid from surrounding communities.
“We are always shifting resources and trying to get the most utilization and provide the best response we possibly can,” said Cataldo, adding that the company is also working hard internally to increase its staffing levels.
Rob White of Cataldo Ambulance also noted that staffing shortages and the consolidation of local hospitals leads to increased response times.
With longer wait times in emergency rooms and with patients they transport to hospitals, White said the ambulances are out of service longer before they can head back out for additional calls. He said the past decade has also seen a rapid increase in the number of non-emergency calls for ambulances.
Ward 5 Councillor John Powers asked if there was any way additional ambulances could be stationed near Oak Island and Point of Pines, or potentially at the new Point of Pines fire station.
Bright noted that the additional bay at the new fire station is designed for the department’s fire boat, and does not have additional space for an ambulance.
Cataldo and Bright noted that there are additional ambulances deployed throughout the city for large events, such as the sand sculpting festival, or when there is a major storm forecast.
Bright was also asked about the possibility of the fire department providing ambulance service.
The chief said it would be prohibitively expensive, with the cost of outfitting a single ambulance at about $1 million.
“If we really wanted to do something like that, we’d have to hire a whole other department to staff the … ambulances around the clock,” said Bright. “I’m not sure if that is a direction we want to go in.”
Cogliandro said he was disappointed that the city did not find a way to use ARPA federal funds to help increase emergency response staffing levels.
“This is not a Revere issue, it’s an everywhere issue,” said Cogliandro. “But I hope we can get staffing levels up as soon as possible.”