It’s not news to city leaders that emergency medical responses can take longer in many of the city’s low-income areas. Many residents, too, know all too well what it’s like to wait for help. Now some readers are calling for new priorities at City Hall.

• Bill Bradshaw shared a personal story:

Residents are well advised to learn CPR because you can’t always rely on first responders to get there quickly, as well trained and dedicated as they are.

My father might have lived ten years longer had my mother known a little CPR. He passed out as a result of dehydration, and stopped breathing. She called 911 but it was about 10 minutes before the paramedics arrived. They put him on a ventilator immediately and restored his heart and lung functions, but his brain had been deprived of oxygen too long and he never came out of the coma.

Two weeks later, my mother and I instructed the hospital to “pull the plug.” Fortunately, my dad had an “advance directive” stating clearly he didn’t want to be kept alive by artificial means.

That’s the other suggestion, get one of those.

• Chris Brewster focused on the differences between fire and medical responses:

I think it is important to separate out the need to have a fire station and the need to have responders in an area. A station is just that, a station. The real cost is the staffing.

Fire responses are down in San Diego, as in most parts of the U.S., due to better building codes and other issues. When firefighter advocacy organizations in San Diego and across the U.S. observed this happening, they converted to becoming medical responders, as medical responses are not going to decline. Smart move on their part, but fire engines are incredibly inefficient and costly conveyances for medical responses. As well, firefighters cost more in salary and training than do paramedics.

Firefighter advocacy organizations will likely fight the concept of fast response squads, but that is precisely what is needed. As well, they don’t necessarily need to have fire stations to operate out of. A prior paramedic contractor in San Diego used an algorithm that repositioned paramedic units dynamically, based on units out of service (due to calls). If you live next door to a paramedic-staffed station, it does you no good if that paramedic unit is on a call when you need them. In fact, you may have a greatly delayed response. Conversely, if several paramedic units are on a call in the same part of the city and other units can be repositioned, it smooths out the response time drag.

• Omar Passons urged an expansion of what we think of when we talk about “infrastructure”:

All I can really say is wow … and thank you for covering this. (Jim) Dunford is an incredibly smart, nationally renowned guy and we should be giving his department resources to do more. Our collective inability to bring real political will to bear on this issue is an embarrassment. This is a great example of why it is so frustrating to hear people talk about building new major projects while we ignore glaring holes that affect people’s lives. This is why infrastructure can’t just be about potholes and slurry seals and parks. It must be about all municipal infrastructure, including fire stations and police stations.

• Barry Pollard zoomed in on the fact that low-income areas suffered:

I am surprised all of the comments included nothing about the fact the top five areas that have the poorest response times are areas that have historically been underserved. In fact this issue redefines the word “underserved.” It is true we need better processes and more manpower and resources but this imbalance was glaring … obviously only to me!

I am not paranoid, nor am I the first one to bring up “race” as an issue, but come on folks. Do we really think it is a coincidence that underserved communities are the TOP five areas with the poorest response times? Not prepared to “blame” anyone because my sense is that blaming folks typically creates defensiveness and crazy responses. So I am just asking the question. “Why is this so?” Are we THAT unaware? Has anyone heard the term “institutional racism?” “Institutional racism is the differential access to the goods, services, and opportunities of society. When the differential access becomes integral to institutions, it becomes common practice, making it difficult to rectify. Eventually, this racism dominates public bodies, private corporations, and public and private universities, and is reinforced by the actions of conformists and newcomers. Another difficulty in reducing institutionalized racism is that there is no sole, true identifiable perpetrator. When racism is built into the institution, it appears as the collective action of the population.”

Comments have been lightly edited for clarity. See anything in there we should fact check? Tell us here

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Dagny Salas was web editor at Voice of San Diego from 2010 to 2013. She was an investigative fellow at VOSD from 2009 to 2010.

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