Less than three months ago, two Oahu hospitals closed. Now on some days, the remaining medical centers run out of room for emergency patients.
On a busy day, Oahu ambulances will take 165 patients to island hospitals. These emergency responders are seeing a disturbing trend.
"Since December and particularly over the last few weeks, we've seen more hospitals on reroute -- more hospitals than we've seen in years," said Dr. Jim Ireland, the city's Emergency Services Director.
Rerouting of patients is done when Emergency rooms are too full or too busy. Ireland said it can be done with minimal impact to patients when crews are rerouted from just one or two hospitals, but some days ambulances are diverted from six of the island's nine hospitals.
"If that block of hospitals in Central and West Oahu are on reroute then patients have to come to Kuakini in Honolulu. Then Kuakini will be overwhelmed with patients from Waianae, Ewa Beach and all over," said Ireland.
Rerouting can add 20 minutes to a typical ambulance trip to the ER. Extra EMS staff have been helping to manage emergencies where hospitals used to be located, but now paramedics worry they will run out of places to take patients.
"We want patients to go where ERs can handle the care. When they go on reroute, they are telling us their emergency room is overwhelmed," said Ireland.
Since the closure of Hawaii Medical Centers East and West, Oahu hospitals have seen an increase in regular beds filling up. Adding to the problem, according to medical center personnel, is not enough long term care facilities to take additional patients that could be transferred. That means those in the ER can't always be admitted, and ambulances are diverted.
Hospital ERs are never closed. They will always take those whose needs are critical, but the backlog means the rest of the patients will have longer waits.
Ireland is especially concerned because medical centers have been reaching capacity so frequently without any major accidents or catastrophes. He feels something needs to be done.
"We really need that hospital to open up in the West," said Ireland.
This is not just a problem for Oahu patients. Full hospitals also force neighbor island patients to reschedule procedures and wait until more beds are available. There has even been talk about what to do in the worst-case scenario: All Oahu hospitals are on re-route. Then emergency personnel would have to decide which neighbor island hospitals patients would go to and how those patients would get there.