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Most Lucas County hospitals resume service after all 8 under EMS bypass Monday night

As of 4 p.m. Tuesday, the University of Toledo Medical Center is still on bypass. It will still handle serious emergencies.

TOLEDO, Ohio — Most Lucas County hospitals are again accepting EMS patients after all eight were on bypass Monday night.

As of 4 p.m. Tuesday, the University of Toledo Medical Center is still on bypass. It is unable to accept ambulatory patients at this time, but will still handle serious emergencies.

All Lucas County hospitals were operating on EMS bypass Monday night. Under EMS bypass conditions, hospitals are still open, but transfer times for patients could be substantially longer.

Toledo Fire & Rescue Department spokesman Sterling Rahe confirmed the news to WTOL 11. He said areas across the country have experienced this during the COVID-19 pandemic.

"This is a good time to remind folks that the systems we have in place can only take so much capacity," Rahe said. "If you're sick or have a medical emergency, obviously call 911. But for things you can contact your physician or go to urgent care for, this is a time for that."

Rahe could not recall another time when all hospitals in the county were on bypass. Matt Heyrman, the deputy county administrator over public safety, also said he is not aware of this happening any other time.

Heyrman said crews are working to evenly distribute patients between hospitals as much as possible. 

When one hospital goes on bypass, EMS transports patients to the next closest hospital. However, if all county hospitals go on bypass, they are all forced to resume taking EMS traffic.

"The patient capacity doesn't change obviously and the challenges don't change," Rahe said. "We take [patients] to those hospitals, but the transfer may take longer."

Hospital leaders say what happened Monday night was a domino effect. Once one hospital was on bypass, it put a strain on the others until all eight were at a breaking point.

"It's something that we've talked about. We've known that it could happen, we've come close in the past, but in my experience, this is the first time that we've had all eight emergency departments in the city go on EMS diversion," said Dr. Brian Kaminski, vice president of Quality and Safety at ProMedica.

Leaders say every hospital has its own tipping point and there are no strict criteria for making the call, rather a combination of circumstances.

Local hospitals were at their limit and there's a number of reasons why they ultimately made the call.

"It's waiting times in the emergency departments. It's the in-patient status of the hospitals, meaning the capabilities of each hospital to take patients who might be admitted from the emergency department. It's staffing resources, it's the number of patients that are actually being held in the emergency department that are waiting for a bed," Kaminski explained.

Kaminski also says the severity of a patient's sickness also plays a role, some require more staffing resources than others.

Mercy Health's Chief Clinical Officer Dr. Kevin Casey says it's unfortunate it happened, but it is a process to help make sure the best care is given to the people who are already in the hospital.   

"When that happens, each hospital has to balance the tension of being able to provide safe and high-quality care for the next people that come in the door, and still provide that safe and high-quality care for the people who are already in the hospital," Casey said.

And yes, COVID-19 is part of the strain hospitals are feeling too.

"The delta variant came along and now we have an increase in COVID cases, but we still have that pent-up demand for care, we have a lessened fear of COVID," Kaminski said.

"If it weren't for COVID, we wouldn't be going on bypass at all and we would have more than enough capacity," Casey agreed.

Health leaders say it's hard to make a decision like going on EMS bypass, but it's necessary if they don't feel it is safe to take care of that next patient for the next few minutes or an hour.