Emergency Response When Every Second Counts
How response times are calculated, why CPR matters, the neighborhoods most at risk and more.
Sometimes big investigations raise as many questions as they answer.
Our recent investigation on San Diego’s long emergency response times left you with a lot of questions. That’s a good thing.
We know that first responders arrive late citywide to high-priority emergencies an average of twice an hour every day. We know the greatest risk for delayed responses lies in some of the city’s poorest and brownest neighborhoods.
Here are some answers to some of the best questions we’ve received so far on emergency response delays.
What Does ‘Response Time’ Even Mean?
First responders in San Diego aim to arrive at an emergency within seven minutes and 30 seconds. But when does that response time clock start and when does it end?
The Fire-Rescue Department begins counting when it’s first notified of the call, and stops when the first unit arrives at the scene. The stat includes the time for the 911 dispatcher to figure out the type of emergency and where it’s located, a fire crew to jump on board an engine and the travel time.
The response time stats are not perfect. Here’s what happens when you call 911:
The San Diego Police Department receives 911 calls first, and transfers medical calls to the Fire-Rescue Department. Eighty-seven percent of Fire-Rescue dispatches are for medical calls.
The time for the Police Department to transfer the call to the Fire Department is not included in the response time figures.
This transfer can be simple, but not always. In the triple shooting that killed Rickquese McCoy in 2012, the Police Department knew about the incident for about three minutes before it notified the Fire Department.
Response times also measure when emergency medical personnel arrive at the scene, not when they start treating a patient. In large apartment complexes, for instance, it can take a long time for paramedics to get to someone who needs help after they arrive on scene. Jim Dunford, the city’s emergency medical director, said the city is looking for a way to measure better the time it takes to actually treat a patient.
How Do We Know the Greatest Risk for a Long Response Occurs in Poor Neighborhoods?
Five neighborhoods within 9 ½ square miles south and east of downtown have the highest risk for a delayed response: the area around Home Avenue in City Heights, Paradise Hills, College Area, Skyline and Encanto.
The ranking comes from a 2011 study done by Folsom, Calif.-based consultant Citygate Associates. Citygate developed its list of neighborhoods with the highest risk based primarily on four factors:
1. The current fire station areas with the most simultaneous incidents
2. The busiest individual fire engine companies
3. The current fire station areas where fire crews had to go outside their areas most frequently
4. The distance between existing stations
Building new fire stations in these five neighborhoods, the consultant concluded, would improve service to almost 60,000 residents, who also happen to be some of the city’s poorest and brownest.
“We don’t look at income, we don’t look at race, we don’t look at where the council districts are,” Stewart Gary, the consultant who wrote the study, told me. “If any one council district has more or fewer higher- or lower-priority fire station [addresses], that is totally by accident. I put the blinders on.”
I Live Near a Fire Station. Why Are There Late Responses Near Me?
First responders missed their response time goal for high-priority incidents more than 37,000 times over the nearly two-year period we analyzed. If you look at our interactive map documenting those incidents, you’ll likely find at least one near you. The incidents might occur near fire stations because fire crews could be out of the station responding to other problems when more calls come in.
What Does the Fire-Rescue Department Have to Say About All This?
We spoke with the Fire-Rescue Department about our research extensively, including a more than hour-long interview to go over our findings.
The department agreed that more help would have arrived more quickly to the McCoy shooting had there been a fire station a half-mile away and its fire crews were in-house. The department also says first responders cannot meet their 7:30 response time goal without more resources.
Does CPR Matter?
It’s a double whammy that the communities with the greatest risk for a long emergency response time also have some of the lowest rates of people who know CPR, according to Dunford.
The importance of CPR cannot be overstated. Dunford did a study in 2005 on cardiac arrest survival rates in San Diego. For emergency responses longer than four minutes to cardiac arrest calls, CPR gave people a chance to survive.
No one who didn’t receive CPR and waited longer than four minutes lived.
Are There Cheaper Ways to Address This Problem Than Building Brand New Fire Stations?
New fire stations are expensive. All together the five top-priority stations are projected to cost $49 million, including a year of staffing costs.
The Citygate report identified certain areas that should receive “Fast Response Squads” rather than full fire stations. These are two-person teams operating out of a storefront/SUV for medical calls and initial fire suppression. A Fast Response Squad, rather than a full fire house, is recommended for the Encanto station.
The squads are projected to cost $1 million a year each, and the city’s already negotiated with the fire union for how they would work. The city just hasn’t funded them.
The department also recently started sending a fire engine to medical calls immediately instead of waiting for the 911 operator first to triage the call to see if one’s needed. If the dispatcher later determines the engine isn’t warranted, then the crew is canceled. This change came after a city auditor recommendation. It’s projected to shave as much as one minute off response times and doesn’t cost a dime to implement.