HAMILTON, ON, CANADA — The number of times one or no ambulances were available to respond to emergencies in Hamilton has more than quadrupled in the past four years.

By the end of October, the number of ambulance shortages, known as code zeros, had already doubled last year’s total to once every two days.

The city points the blame squarely at Hamilton’s hospitals, saying paramedics are forced to wait increasing amounts of time for their patients to be admitted to overcrowded emergency departments.

“We have scenarios where we literally don’t have any ambulances available because they’re being held hostage in emergency rooms,” said Ward 4 Councillor Sam Merulla, who is chair of the Emergency and Community Services Committee.

The committee was alerted Wednesday that response times are going up, in a report by Emergency Medical Services (EMS). The response time for nine out of 10 calls between January and October was 10 minutes and 45 seconds or less for a paramedic to arrive on scene, and 12 minutes and 33 seconds or less for an ambulance capable of transport to get to an emergency.

That is 30 seconds slower than last year for paramedics and 39 seconds more for transport ambulances. In 2009, transport ambulances arrived one minute and eight seconds faster than they do now.

The report acknowledges the number of calls per day is also going up. They’re at 195 now compared to 184 in 2010 and 174 in 2009.

But the amount of time ambulances are spending in emergency departments is flagged as the real problem. Paramedics wait an average of 61 minutes and 36 seconds to transfer patients to the hospital. That compares to 52 minutes and 13 seconds last year, and 43 minutes and 50 seconds in 2007.

“We have a master of avoidance on this particular issue from the provincial government and the hospitals,” said Merulla. “They should be putting in place a plan and a strategy and implementing that, and not providing lip service to avoid the problem.”

Both Hamilton Health Sciences and St. Joseph’s say they are doing all they can to get ambulances out as fast as possible. All of the adult emergency rooms have nurses specifically assigned to ambulance off-loading.

“We are all aware of the pressures put on EMS and we have pulled out all the stops to make sure ambulances get out there on the street ASAP,” said Ida Porteous, director of emergency services at St. Joseph’s.

A major logistical obstacle for hospitals: the backups caused by high numbers of patients taking up acute care beds while waiting for other services such as long term care or home care. About 15 per cent of Hamilton’s hospital beds are taken up by these patients at any one time, making it difficult to move patients out of the emergency room to a ward so new patients can come in.

Brenda Flaherty, executive vice-president of clinical operations at Hamilton Health Sciences, says the hospitals will continue to work with the city to find a solution.

But Merulla calls the hospital’s inability to move patients another form of downloading from the province because the city has to spend more on its ambulance service to ensure it can adequately respond to emergencies. The city agreed in June to spend $833,000 to put more paramedics and ambulances on the road.

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