美国国家公共电台 NPR No Mercy: After The Hospital Closes, How Do People Get Emergency Care?（在线收听）

No Mercy: After The Hospital Closes, How Do People Get Emergency Care?

LULU GARCIA-NAVARRO, HOST:

When small towns lose their hospitals, people with health emergencies often need a helicopter to get them to critical care. But air ambulances aren't required to respond to every call, and precious time can slip away while first responders scramble to book a flight. Sarah Jane Tribble reports from Fort Scott, Kan., on what can happen when people in rural America call for help.

SARAH JANE TRIBBLE: Robert Findley had closed up his popular auto body shop on a cold February evening. He went out to get the mail and slipped on the icy driveway. When he came back inside, he laughed it off as he told his wife Linda about the fall. He ate dinner, went to bed. The next morning, Linda called for help.

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LINDA FINDLEY: Yes, I need an ambulance.

UNIDENTIFIED 911 DISPATCHER: And what's going on?

FINDLEY: My husband fell yesterday and hit his head. And now he's went to sleep this morning, and I can't wake him up.

TRIBBLE: Fort Scott's EMS crew took one look at the 70-year-old's eyes and suspected a brain hemorrhage. Robert needed to get to a hospital with a neurology center - the closest is 90 miles north in Kansas City. Fort Scott's hospital closed in December.

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UNIDENTIFIED EMS WORKER #1: We are triage red. Can you dispatch the nearest air ambulance?

TRIBBLE: That's the EMS worker asking for a helicopter medevac. So the dispatcher in Fort Scott dials Air Methods.

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UNIDENTIFIED AIR EVAC DISPATCHER: Did you want to remain on the line while I check with my closest available or would you like me to give you a call back?

UNIDENTIFIED EMS WORKER #1: I will remain on the line.

TRIBBLE: Air Methods is one of the biggest air ambulance operators in the U.S. It has helicopters at bases in towns near Fort Scott. The company's dispatcher begins searching for a medical crew that can get to the Findleys fast. Within a minute, she's back with an update.

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UNIDENTIFIED AIR EVAC DISPATCHER: My Nevada crew is not available and my Parsons crew has declined. I will be reaching out to...

TRIBBLE: Earlier this summer, Linda Findley sat at her kitchen counter and listened to the 911 call.

FINDLEY: I didn't know that they could just refuse. I don't know what to say about that.

TRIBBLE: Air ambulance companies aren't required to report response times or say why flights are turned down. There is also no requirement that the closest aircraft will come.

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UNIDENTIFIED EMS WORKER #2: Fort Scott to EMS 1.

UNIDENTIFIED EMS WORKER #3: 10-4.

TRIBBLE: I asked someone else to listen to that 911 call. Joe House is a paramedic and leads the Kansas Board of Emergency Medical Services. House says it's pretty typical. Flights can be declined because of bad weather and safety issues. The crew that says no might be on another call or recovering from previous trips, House says.

JOE HOUSE: If we could somehow wave that magic wand and have a singular center that can send the closest available resource to the patient when they need it, that would be phenomenal.

TRIBBLE: Rural communities nationwide are increasingly dependent on air ambulances. As local hospitals close, towns must figure out how to provide emergency care. Minutes can make the difference between life and death.

RICK SHERLOCK: In medicine, time is tissue. It's the amount of brain tissue damage that occurs in a stroke. It's the amount of sepsis that can set into a system or trauma that can set into a system.

TRIBBLE: That's Rick Sherlock, president of the industry trade group the Association of Air Medical Services. He's pointed to Fort Scott as a town where air service has helped fill the gap in rural health care. Back in Fort Scott, it takes Air Methods about seven minutes to find a pilot. The pilot says it will take 38 minutes to get to Robert Findley.

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UNIDENTIFIED PILOT: In route to the helipad, mile zero.

TRIBBLE: So Fort Scott's EMS crew drives to the helipad next to the closed hospital. That's where Linda found a paramedic manually pumping oxygen into Robert's unconscious body.

FINDLEY: They told me in the ambulance that it would be a little bit before the helicopter got there. I should come home, pack things and head that direction.

TRIBBLE: We don't know how long it took, and we don't know if that time mattered. Air Methods wouldn't talk about Findley's case. Officials in charge of Fort Scott's emergency operations say they aren't sure how long the crew on the ground waited.

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UNIDENTIFIED EMS WORKER #4: Vitals are all stable. I'm just supporting the ventilation. We'll see you here in a few minutes.

TRIBBLE: Linda Findley believes the local paramedics did everything possible to save her husband, but she has questions about how long the air ambulance took to get there. Just days after being flown to Kansas City, Robert Findley died.

I'm Sarah Jane Tribble in Fort Scott, Kan.

GARCIA-NAVARRO: And Sarah Jane Tribble is with Kaiser Health News.