Paramedics are not quite ready to dial 911, but more and more, city ambulances are becoming contaminated with bed bugs.
"One just happened, actually, on my last shift when the person didn't even realize that he had bed bugs," said paramedic Jojo Abuan, who's been with the city's Department of Emergency Medical Services for nearly six years.
The problem of bed bugs is also forcing EMS to ask for more resources from the Honolulu City Council. In the current fiscal year, the department is spending $17,000 to decontaminate ambulances of bed bugs. During the next fiscal year, which begins July 1, that cost is expected to rise to $25,200.
"It is going to go into good use and it's going to keep ambulances in service, which will lead to lives saved," said EMS spokeswoman Shayne Enright.
If an ambulance is found to have bed bugs, the vehicle can remain out of service for as long as three hours while it undergoes treatment by technicians at Ecolab Inc. Although a "reliever" ambulance can be brought in, taking any ambulance out of circulation poses a possible threat to patients.
"That's taking one of our 20 ambulances out of the community," said Enright. "Somebody nearby could be having a heart attack and that does jeopardize their care."
However, paramedics do all they can to keep bed bugs out of their rigs. Every ambulance carries a spray that kills bed bugs on contact, a plastic bag to place around patients and a Tyvek suit which can be worn by patients or paramedics.
"The community pays for Emergency Services to operate at a really high level, and we want to continue to do that," said Abuan. "We're hyper-vigilant on what to look for and how to prevent them from getting into our ambulances.
EMS also keeps a permanent data base of known bed bug infestations, so paramedics can take all of the necessary precautions before treating a patient. In addition, paramedics are trained to see the tell-tale signs of bed bug infestations.
"You can see some of their feces, some brown staining on (patients') mattress (and) on clothing," said Abuan. "If you look in the right places, for example, places that are dark, they kind of like that."
EMS never refuses to transport a patient to the hospital if bed bugs are present, but by the end of the month, paramedics will begin handing out pamphlets to patients known to have a bed bug infestation.
"That will lessen the amount of time that the ambulance will have to go out of service," said Enright. "That's why it's very important that the patients do inform us right away."
According to Orkin Pest Control, Honolulu came in at number 45 last year of the top 50 U.S. cities with bed bugs. Chicago was number one, followed by Los Angeles and Columbus, Ohio.