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Las Vegas Fire & Rescue spars with private ambulance company AMR


Las Vegas residents are hearing plenty about the future of emergency medical transport service in the city these days. But here’s a little news that’s guaranteed to do your heart some good.

Las Vegas Fire &Rescue once again has increased its save rate for cardiac responses to 44 percent for all heart attack patients, Chief William McDonald says. That’s a dramatic increase from approximately 30 percent last year — which was already well above the national average of just 5 percent. (Even that national average figure is deceiving, because approximately half the patients who survive suffer from a severe medical impairment.)

In a world free of politics, those numbers would be celebrated. Instead, they’re likely to be sniffed at as the city Fire Department continues to joust with private ambulance service American Medical Response for future control of emergency transport in Las Vegas.

McDonald says he believes his outfit’s actions speaker louder than any words: Increased training of both professional firefighters and civilians continues to pay off with tangible results — saved lives.

The city firefighters currently transport approximately 30 percent of emergency patients with AMR transporting the rest to local hospitals, according to published reports. The department, McDonald says, is well capable of transporting 50 percent without having an impact on response times or buying a single extra ambulance rescue vehicle. Increasing that percentage would save the city several million dollars a year, but of necessity would also have an impact on AMR’s transports and staffing. AMR challenges the chief’s assertion.

“When you talk about privatization, there is a major difference when it comes to firefighter paramedics,” McDonald says. “We have to have a fire department. As long as we have that expense, I am committed to finding ways of offsetting that expense for taxpayers.”

Meanwhile, AMR argues that its services already save Las Vegas residents millions every year because the private company, and not the taxpayer-funded department, handles the majority of the transport calls.

The issue has simmered from time to time but boiled to the surface following the release of a 2012 report from the International City/County Management Association, which criticized the current two-headed strategy of dispatching the Fire Department and AMR on the same calls. The report noted that the city could save up to $14 million annually by assuming all responsibility for emergency transport.

That, of course, would mean that AMR would see its business in the city drop precipitously. The private company has countered that it could save taxpayers as many millions if it took over all emergency transport service. It’s a statement bolstered by similar rhetoric in the management association report.

The undeniable difference, however, is that the city must have a well-trained fire department on duty around the clock. It isn’t an option.

McDonald shows no sign of softening his argument.

“In this case, these export transports by firefighters, which have saved so many lives but have cost significantly less than private transports, have returned nearly $30 million (in recent years) to offset costs for taxpayers.”

Firefighters in a voluntary capacity have also been reaching out to the community with compression-only CPR seminars and training in the use of the Automated External Defibrillator device.

Although he believes the department eventually can handle up to 75 percent of all emergency transports, McDonald allows, “We always think there will be a place for a partner.”

AMR is a professional operation and has also shown it knows the ways of City Hall, but those cardiac save numbers might make it even more difficult for the company to argue that it can compete with the Fire Department when it comes to patient service.

That 44 percent cardiac save rate also figures to give members of the City Council palpitations as they try to balance their political interests and do right by the taxpayers.

John L. Smith’s column appears Sunday, Tuesday, Wednesday, Thursday and Friday. E-mail him at jsmith@reviewjournal.com or call (702) 383-0295.