A recent report from San Diego's Office of the City Auditor found firefighters are taking longer to respond to medical emergencies since a protocol change made by department officials in 2019.
The audit focused on the time it takes firefighters to prepare for deployment and reach a fire engine after a 911 call has been received. It did not focus on travel time, which can be impacted by traffic and the proximity of the nearest fire crew.
Medical emergencies represent more than 85% of the Fire-Rescue Department's calls for service. Prior to the change in protocol, the department would dispatch both an ambulance and a fire engine when a call was received. About 21% of the time, the dispatcher determined the call was a lower level of emergency and the fire crew's response would be canceled.
Under the current protocol, a dispatcher sends out an ambulance first. Then they triage the situation and deploy a fire engine only if the medical emergency meets the highest level of severity.
The audit found the process results in fewer cancellations of firefighter deployments — but it also increases the average response time by about 58 seconds. In the most severe medical emergencies, that amount of time can make the difference between life and death, the report stated.
"There is a trade-off with that system," City Auditor Andy Hanau said at the March 11 meeting of the City Council's Audit Committee. "It preserves resources, as they pointed out. It also slows the response to medical emergencies."
The new triage protocol was adopted without input from the City Council. The Office of the City Auditor said when city resources are so scarce, the council and public should be allowed to weigh the policy's pros and cons.
IAFF Local 145, the union that represents city firefighters, criticized the audit's methodology and said response times should be improved by building more fire stations throughout the city. Patrick Farrier, a member of the union's executive board, said the union would work with city officials and the Office of the City Auditor to weigh any new policies against the need to protect firefighters from fatigue and burnout.
"It's really important that we can, through appropriate triaging, make the right calls for both the public and to keep our responders in top shape for a 30-year career," Farrier said. "Those are things that we should definitely take into consideration."
The Fire-Rescue Department agreed to implement all three of the audit's recommendations, which include more closely tracking and reporting data for all phases of a medical emergency response.
