Gonzalez to Pederson: Pivot to different ambulance model

A bicyclist who was critically injured near the Hawthorne Bridge was rushed to hospital for treatment by a Portland Fire & Rescue crew because the nearest AMR ambulance was 20 minutes away in Washington County.

PORTLAND, Ore. (KOIN) -- A bicyclist who was critically injured near the Hawthorne Bridge was rushed to hospital for treatment by a Portland Fire & Rescue crew because the nearest AMR ambulance was 20 minutes away in Washington County.

That incident led to a faceoff between Portland City Commissioner Rene Gonzalez and Multnomah County Chair Jessica Vega Pederson.

The crash

The bicyclist was not hit by another vehicle, just crashed near the Hawthorne Bridge on July 1.

PFR Lt. Rick Graves said the crew found the bicyclist on the ground with "significant bleeding, head trauma, bleeding out of the ears. (They) recognized the importance of getting this individual to the hospital very quickly so they had a chance at surviving."

When the firefighters got the injured bicyclist to the OHSU emergency room, Graves said there were "some significant medical interventions occurred that were very important to occur in a timely fashion."

Letters between leaders

Shortly after that, PFR Chief Ryan Gillespie wrote to EMS Medical Director Dr. Jon Jui to ask for immediate measures be taken to positively impact ambulance service levels.

"The status quo is endangering our community and our firefighters," Gillespie wrote in an email obtained by KOIN 6 News.

The status quo he referred to is the Multnomah County requirement that two paramedics are staffed in each AMR ambulance. That is unlike most other counties which allow one paramedic and one EMT to be teamed.

"Engine 21 responded on a trauma system entry patient. There were no ALS (Advanced Life Support - 2 paramedics) ambulances available to respond," Gillespie wrote to Dr. Jui. "Allegedly there were two BLS (Basic Life Support - 2 EMTs) ambulances in proximity on low acuity calls, however AMR did not reassign these resources to the trauma system entry."

Engine 21 was forced to transport the patient because there were no ambulances assigned to the incident.

Gonzalez, who is running for mayor of Portland, wrote to Vega Pederson about the need to pivot to the 1:1 model to alleviate the crisis.

"This has substantial public health and public safety ramifications for our whole region," Gonzalez told KOIN 6 News.

To date, Gonzalez said he hasn't heard a response from Vega Pederson. He's afraid someone is going to die.

"The system is melting down, and you're not communicating clearly as to what progress has been made or not made," he told KOIN 6 News. "It's a real problem."

Previously, it was his understanding that it was mandatory that the county spend the last 4 months in mediation with AMR per their contract.

"For those reasons, we have been giving the parties space to resolve their differences and hopefully improved the ambulance system, which is in crisis," he wrote to Vega Pederson. "We learned last week however, that the “confidential” mediation is optional... we continue to see dangerous level zero incidents."

As a result, he wants the city and county to collaborate more closely on Emergency Medical Services.

"I'm just asking that Portland Fire and the City of Gresham Fire Department be at the table as we resolve the system going forward," he said.

Gonzalez said he wants to stay solutions-focused and find ways the City of Portland can use the fire department and CHAT team to alleviate low acuity calls -- and to partner with Multnomah County to tailor an EMS plan.

Pederson statement

KOIN 6 News reached out to Vega Pederson for comment and received a lengthy statement. In part, she said:

"I am aware of the emails below, and our Health Department has already been in communication with Chief Gillespie regarding this incident. BLS (Basic Life Support) ambulances should be utilized for transport in this type of scenario and we have an active protocol to support that approach. …

"I continue to work to hold AMR accountable for their contract and to our community - right now through mediation. It is a major focus of my office to resolve this issue. …

"I’m committed to reaching a settlement through mediation (with AMR) that guarantees better response times without sacrificing accountability or service quality. Confidentiality is routine and necessary for this type of process. Mediation between Multnomah County and AMR is currently ongoing."

The cyclist

The bicyclist survived with the emergency care received at OHSU. No further information about the bicyclist is available.