Led by the Texas A&M Transportation Institute (TTI), a team of public agencies is conducting research to speed up cross-border transportation for heart attack and stroke victims. Other agency members include members of the Texas Tech University Health Sciences Center El Paso (TTUHSC El Paso) Department of Neurology, El Paso Fire Department personnel, and Mexican ambulance operators.
Delays that occur at the border can have life and death implications since mortality rates increase sharply depending on how much time passes from incident to treatment. Quickly getting patients the care they need is sometimes challenging, however, with tightened security measures at the border.
Evaluating Ambulance Cross Border Operations and Its Impact on Public Health in Border Regions is a project funded by TTI’s Center for International Intelligent Transportation Research (CIITR) and TTUHSC El Paso. The ultimate goal of the project is to work with U.S. Customs and Border Protection (CBP), international bridge operators, and other border agencies to establish an operational protocol to expedite ambulance cross-border operations in the El Paso-Ciudad Juarez binational region.
“We are in the early stages of conducting meetings with all the stakeholders. We’re looking at current operational protocols and determining where the process can be streamlined to get emergency patients to El Paso hospitals quicker, so treatment can begin earlier,” says David Salgado, TTI associate transportation researcher for CIITR and principal investigator on the project.
Currently, when a patient suffering a stroke or heart attack is transported from Juarez to El Paso, Mexican ambulances carry them to the border, where they must have the proper paperwork to be allowed to cross. Once cleared by CBP, the patient is transferred to an El Paso Fire Department (EPFD) ambulance that takes them to a U.S. hospital. In cases where the proper paperwork is missing, a border agent must ride with the patient to the hospital until the individual’s status is confirmed.
“Stroke is the number one cause of disability in the United States,” says Gustavo Rodriguez, M.D., TTUHSC El Paso neurologist. “It is imperative that stroke patients be treated quickly with a specialized clot-busting drug. Otherwise, the patient can suffer permanent damage.” Dr. Rodriguez says the medical community of El Paso is aware that delays sometimes occur at the border.
“Part of the delay occurs because, currently, CBP is not notified that an ambulance is en route to the border with a patient,” Salgado says. “Perhaps a pre-notification process can be established in which not only is CBP notified, but so is the EPFD. Consequently, Mexican ambulances, CBP, and the EPFD are fully coordinated and aware of the situation in real time.”
Researchers are currently studying how many patients are being transported and the magnitude of the delay problem. To that end, other stakeholder meetings are being planned, as well as a workshop to outline recommendations.
“If there is a weak link in this process, we need to find it,” says Lt. Oscar Salazar of the El Paso Fire Department. “If the border is part of the problem, we need to fix it. We want to make this as seamless as possible.”