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It's get sick and wait season

Diabetic Nancy Maschinot was dehydrated from vomiting and had waited in the emergency room for more than three hours.

Maschinot, 48, went to Morton Plant Hospital one morning this week, unsure what was wrong. By 3 p.m., she was so weak she could hardly lift her head.

"I'm getting sicker by the minute," she said, her eyelids falling shut. "Three hours is a little much."

This time of year, visits to local ERs spike precipitously, driven largely by the influx of seasonal residents and the onset of cold and flu season, health officials say. Last month, ambulances transported a record-setting 10,572 patients in Pinellas County.

That's one person every four minutes.

Tampa Bay's ERs are so busy, in fact, that local ambulance operators often have to bypass the nearest hospital for one with space to treat more patients, officials say. A backlog at one emergency room can touch off a domino effect of delays at several others.

"It's going through the roof," Chuck Kearns, director of Emergency Medical Services and Fire Administration, told the Pinellas County Commission this week.

The problem of overwhelmed emergency care services is playing out across the country, in part because of the aging baby boomers. A federal study released this month found that, on average, an ambulance is diverted every minute from its original destination because of crowding.

Patients are feeling the impact.

"I haven't eaten all day and I'm fading," said Maschinot, who has health insurance but cannot afford to spend a lot of time away from the UPS store she owns. "I should have gone to the doctor earlier, but I was monitoring myself and we didn't have the money."

People are having to wait longer to see an ER doctor or get a bed assignment, health officials say. If taken by ambulance, they may be rerouted from their preferred hospital to another one that may charge their insurance differently, resulting in more out-of-pocket costs, Kearns said.

"There is a real negative effect on customer service," he said.

Most of the hospitals in Pinellas are spending more time on "bypass" status, meaning ambulances have to bypass them for other facilities, records show.

Clearwater's Morton Plant, for example, spent 251 hours on "bypass" from October 2005 to January 2006. During the same months the previous year, the hospital was on bypass only 155 hours.

"We have a process that is quite well-oiled and easily able to adapt to changing needs," said Jeff Barnard, the executive director of the Pinellas County Office of the Medical Director. "We're doing remarkably well compared to a lot of counties in managing a high volume of patients."

Hospital administrators can put their facilities on "bypass" if they see a slow-down in the emergency rooms. Or county dispatchers may do so if an ambulance has to linger because a hospital has no room for the patient.

But diverting ambulances to available hospitals is not a bad thing, Barnard said. Rather, it ensures that paramedics turn over patients quickly.

"Simply put, we've got a fixed number of ambulances in this system (58 in Pinellas)," Barnard said.

The months of January and February are the toughest because that's when flu hits hardest. This year, Florida is one of 13 states with widespread influenza, says the federal Centers for Disease Control and Prevention.

Times staff writers Aaron Sharockman, Lisa Greene and Will Van Sant and Times researcher Angie Drobnic Holan contributed to this report.