GUNNISON, Colo. — The evening after Thanksgiving, a small ambulance service that covers an enormous swath of southwestern Colorado acquired a name {that a} affected person wanted an emergency switch from the hospital in Gunnison to a bigger one with an intensive care unit 65 miles away in Montrose.

The affected person — a 78-year-old man — was experiencing atrial fibrillation, an irregular heartbeat that usually isn’t life-threatening. However for sufferers like this one with continual well being circumstances, a historical past of cardiac points and hypertension, the situation may cause a stroke or coronary heart failure.

Staff from Gunnison Valley Health Paramedics rolled the affected person, who was on a gurney, out of the hospital and into the frigid evening air. AnnieGrace Haddorff, the emergency medical technician on name, helped load the affected person into the ambulance and jumped into the driving force’s seat. Paramedic Alec Newby acquired into the again and hooked the affected person as much as a blood strain cuff; a pulse oximeter, which measures coronary heart fee and blood oxygen saturation; and an electrocardiogram, which information the guts’s electrical exercise.

“Your coronary heart is clearly pissed off,” Newby instructed the person because the ECG confirmed the atrial fibrillation.

The ambulance pulled onto U.S. Freeway 50 for the one-hour-and-15-minute drive previous clusters of properties amongst rolling hills of sagebrush, the expansive Blue Mesa Reservoir and the gaping Black Canyon of the Gunnison, with its craggy spires.

The affected person was secure sufficient for the lengthy drive, which coated solely a sliver of GVH Paramedics’ 4,400-square-mile service space. It’s greater than twice the dimensions of Delaware and is the most important response zone for an ambulance service in all of Colorado. A typical fireplace or emergency medical service response space ranges from 100 to 400 sq. miles.

Every time a affected person have to be transported to a different medical facility, Gunnison Valley Well being Paramedics is left with few automobiles to answer emergencies in a protection space greater than twice the dimensions of Delaware.(Helen Santoro for KHN)

Lately, interfacility transports or transfers, also called IFTs, like this one have change into more and more frequent for GVH Paramedics, forcing the workforce to drive far exterior its already huge zone. Earlier than the pandemic, the variety of transfers rose as a result of the inhabitants of Gunnison County was steadily growing, extra vacationers had been being drawn to locations like the favored Crested Butte ski resort, and GVH Paramedics had expanded its providers to bigger metropolitan hospitals exterior Gunnison County.

However now the workforce is being referred to as to maneuver sufferers extra continuously, and higher distances, as a result of the hospital beds within the comparatively shut cities of Montrose and Grand Junction are full of covid-19 sufferers. The workforce is recurrently required to drive sufferers to Denver, which is round three hours and 40 minutes from Gunnison.

Officers from the ambulance service fear that they may discover themselves unable to answer an emergency as a result of their sources, which embody six ambulances however solely sufficient workers to function three of these automobiles, are tied up on a long-haul switch.

What had been as soon as 2½- or three-hour journeys to Montrose are actually far longer excursions, “and that takes sources from this group,” mentioned CJ Malcolm, chief of emergency providers. “We had been doing that pre-covid, however now the state is so impacted, it’s like a day by day a part of our lives.”

Earlier than the pandemic, all of the ambulances could be concurrently out on 911 calls or IFTs lower than 10 occasions a 12 months. Now, Malcolm mentioned, it’s taking place with higher frequency. In these circumstances, GVH Paramedics leans on the emergency response workforce in Crested Butte, about 28 miles from Gunnison, or the response to the affected person is delayed.

In 2018, GVH Paramedics made 166 IFTs, requiring almost 40,000 miles of journey and a complete of 987 hours of ambulance operation, in accordance with information collected by the workforce. Final 12 months concluded with 260 IFTs, over 70,000 miles of journey and a complete of 1,486 hours of ambulance operation. That’s a 50% enhance in time on the street.

“Anytime we now have one or two ambulances out on an IFT, this leaves a large tract of land with just one ambulance to reply,” Malcolm mentioned. “This can be a reasonably terrifying place to be put into once we can simply have two or three 911 calls in a row.”

In August, for instance, Gunnison Valley Well being hospital transferred greater than 60 sufferers, 37 of whom had been transported by GVH Paramedics. That signifies that at the very least as soon as a day that month, a GVH Paramedics crew was taking a affected person out of city, Malcolm mentioned. And if crew members aren’t scheduled to be again in Gunnison by 1 a.m., they have to spend the evening in a lodge to keep away from driving alongside treacherous mountain roads whereas overly drained.

GVH Paramedics’ service space covers virtually all of Gunnison County, a big portion of Saguache County and sections of Montrose and Hinsdale counties. It incorporates mountain ranges, canyons and broad expanses of excessive desert. With round 6,600 full-time residents and a college, Gunnison is the most important city the workforce serves. The encircling cities — together with Tin Cup, Pitkin and Ohio Metropolis — are villages with a few hundred folks or former mining cities the place the artifacts from the increase occasions outnumber the residents.

The Nov. 26 drive to Montrose took the Gunnison Valley Well being Paramedics workforce an hour and quarter-hour. (Helen Santoro for KHN)

GVH Paramedics’ 21 full-time workers members and 10 to twenty people who work as wanted have certifications in wildland firefighting and backcountry drugs abilities, together with swift-water, ice and avalanche rescue. To take care of the elevated calls for from IFTs, they’ve added an additional workers member to every shift, and off-duty staffers are being referred to as in to help.

As the pandemic drags on, the variety of IFTs will most likely proceed to extend. By mid-November, the variety of folks within the hospital with covid-19 in Colorado was staggeringly high, approaching the December 2020 peak of 1,847. Hospitalizations remained above 1,500 by means of the top of the month. As a outcome, 93% of the state’s acute care hospital beds and 94% of ICU beds had been getting used as of Nov. 30, in accordance with information from the Colorado Department of Public Health and Environment.

“I don’t assume we see the capability considerations easing anytime quickly,” mentioned Cara Welch, senior director of communications on the Colorado Hospital Affiliation.

Including to the pressure are folks searching for care they delayed due to the pandemic and different respiratory viruses, resembling respiratory syncytial virus, circulating within the state, Welch mentioned.

Kelly Thompson, chief of operations of CareFlight of the Rockies, an air ambulance service that operates in Colorado and different elements of the West, agreed with this evaluation. “We’ve already been transporting massive numbers of youngsters with RSV which might be sick, and you’ve got covid on prime of all of this,” Thompson mentioned. “It’s an enormous concern. That is the time when we now have lots of sick folks.”

In early November, to handle escalating considerations about hospital capability, Colorado hospitals and well being programs activated tier 3 of the state’s patient transfer system — the best stage. Which means covid and non-covid sufferers will be moved with out their consent from a hospital that doesn’t have sufficient capability to 1 with more room. Hospitals may also ship sicker sufferers to medical facilities with extra specialised care.

As the GVH Paramedics crew members approached Montrose with their affected person over the current vacation weekend, Newby referred to as the hospital to let the workers know they had been arriving. They pulled as much as the emergency room entrance, and Newby and Haddorff rolled the affected person right into a hospital room. The Montrose hospital workers took over, transferring the affected person from the gurney to a hospital mattress as Newby up to date them on the affected person’s medical information.

Quickly they had been again within the ambulance, headed for residence. “IFTs will be traumatic,” mentioned Haddorff as she maneuvered the twisty mountain street bathed in moonlight.