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People are also using us as a social safety net because they don't have a family physician, or they think they'll get into the emergency room faster if they come with us." In July 2016, Paramedic services added two ambu- lances to its fleet and in sep- tember adjusted shift start times. as a result, paramed- ics were able to slightly lower average response time from nine minutes and 37 seconds in 2015 to nine minutes and 29 seconds in 2016, despite an increase in the number of calls. a staff report said: "The improvements seen … will be short-lived at the current rate of growth in call response time volume. Fore- casted funding … may need to be adopted on an accelerated timeline if growth continues at or above current levels." The Paramedic services Master Plan proj- ects the region would need between one and eight more ambulances in 2018 to meet the need. december 2016 was a particularly challeng- ing month, with an influx of calls -- more than 145 a day, as compared to 135 a day in septem- ber -- that stretched paramedic resources thin. More than 20 per cent of the time, there were three or less ambulances available to respond to calls and more than two per cent of the time, there were no ambulances available to respond to calls. That's known as a code red. "although we view december as a statisti- cal outlier, we still need to be able to respond to these situations," said Van Valkenburg. "But what we are noticing year over year, is that in that last quarter there is an increase." The jump in calls doesn't reverse itself the next month, but continues into the following year. January, for example, saw on average more than 140 calls a day. Van Valkenburg couldn't say why the spike in calls is happening. Most of the time in 2016, calls were characterized as urgent, meaning a person's life or limb might've been at risk. about 27 per cent of the time, they were categorized as prompt, with a person suf- fering serious injury or illness, scheduled or deferrable. com- mon reasons for calling for an ambulance include respira- tory problems and shortness of breath, falls, general weakness and abdominal pain. coun. sean strickland questioned whether the region was getting enough informa- tion to justify increasing para- medic resources. "an increase in call volume is a real chal- lenge, but without an understanding of where that call volume is coming from and if they're not really emergency-type calls, why would we provide more resources?" asked strickland. Van Valkenburg replied: "If folks are calling 911 for an ambulance, we don't have the ability to say no." "I was not implying that at all," strickland said. Van Valkenburg followed up by saying the Ministry of health and Long-Term care is developing a triage tool to categorize calls more specifically, yielding more revealing statistics than are currently available. Paramedics face spike in call volume "If folks are calling 911 for an ambulance, we don't have the ability to say no." Stephen Van Valkenburg Chief of paramedic services, Region of Waterloo By the Numbers Total calls in 2016: 48,600 Total calls in 2015: 45,400 response time 2016: 9:37 response time 2015: 9:29 December 2016 More than 145 calls per day, compared to september's average of 135