A woman with stroke symptoms in Midwood, Brooklyn, waited for an ambulance for six hours, finally arriving at the hospital with telltale signs of advanced brain damage. In Forest Hills, Queens, bystanders waited for three hours next to a man lying unconscious in the snow before they were able to flag down help. And in Crown Heights, Brooklyn, a mother in labor who started calling 911 at 8:30 a.m. on Monday did not get an ambulance until 6 p.m., too late to save the baby.

As a blizzard bore down on New York City on Sunday and Monday, 911 dispatchers fielded tens of thousands of calls, trying to triage them by level of severity, from snowed-in cars at the low end to life-threatening emergencies at the highest. But even the ambulances assigned the most serious of the calls sometimes could not get there. At least 200 ambulances got stuck on unplowed streets or were blocked in by abandoned cars, city officials said Tuesday.

As the backlog of calls grew — it ultimately reached 1,300 at its highest point — an unusual directive went out across the computer screens within ambulances, emergency workers said. It told them that after 20 minutes of life-saving effort on a nonresponsive patient, they should call a supervising doctor, who would make the call about whether to give up. While it is rare for a person to be revived after 20 minutes, it is usually up to the medical crew to decide when to call the doctor.

Mayor Michael R. Bloomberg defended the city’s response to the storm on Tuesday, and called the digging out of ambulances the city’s first priority. He said nearly 170 stranded ambulances had been dug out by emergency crews, with 40 more still stuck Tuesday morning. Still, the impassibility of many streets made routine ambulance runs into odysseys, sometimes with life-threatening or fatal consequences.

In East Midwood, volunteer ambulances managed to complete nine calls on Monday between getting stuck in drifts and between abandoned cars. One was to a 74-year-old woman on Lawrence Avenue who appeared to be having a stroke. Her home-health aide had called 911 at 9 a.m. on Monday, said Yakov Kornitzer, the chief of operations for the East Midwood Volunteer Ambulance company, and in the early afternoon, she finally ran to the local precinct station for help.

When the ambulance arrived at 3 p.m., it was unable to get closer than several blocks away. Two emergency workers, two paramedics and six police officers carried her on a stretcher through knee-deep snow, but by then she was unresponsive and her limbs were already flexed, indicating serious damage to her brain tissue.

“We did the best we could,” Mr. Kornitzer said. “If small cars wouldn’t have gotten stuck, we would have been able to get through.”

When a fire broke out five blocks from Elmhurst Hospital, emergency workers pulled patients in on sleds and toboggans, said Dario Centorcelli, a hospital spokesman. As at other hospitals, doctors and nurses stayed, sleeping on cots. At Lutheran Medical Center, a registered nurse and an orthopedic technician spent the day Monday driving around Brooklyn in a Hummer, to ferry exhausted staff members back and forth.

In Rego Park, one volunteer ambulance partnered with a four-wheel-drive Suburban to patrol streets. About midnight, they were flagged down on Queens Boulevard and 62nd Drive, where bystanders said they had called 911 three hours earlier for a man lying face up in the snow.

He was unconscious but still alive, suffering from severe hypothermia, said Ron Cohen, the public information officer for the Forest Hills Volunteer Ambulance Corps. The emergency workers carried him about a block to the vehicle, and he made it to the hospital alive. “I think a short time longer and he may not have been,” Mr. Cohen said.

And while emergency workers strained to do what they could, in at least one case, it was not enough.

Fire Department officials said they received a 911 call at 8:30 a.m. on Monday from a woman in labor in Crown Heights. But because her birth was not imminent, she was assigned a nonemergency status. Dispatchers tried to call back several times in the next few hours to check on the woman, but got no response, the Fire Department said.

At 4:30 p.m., a second call came in, saying there was bleeding and the baby was crowning, and dispatchers called for police and medical crews.

Around 5:20 p.m., police officers, trudging through the snow because their cars could not get through, found the woman outside 97 Brooklyn Avenue and brought her into the vestibule. It was not clear if the woman was just waiting outside or was trying to make it to the hospital on her own; Interfaith Medical Center was about eight blocks away.

The baby emerged. Satomi Onikura, 34, a nurse who lives in the building, said she saw five or six police officers surrounding a woman swathed in blankets. The baby was laid out on blankets and was not breathing. The umbilical cord was still attached. “We were all in a panic,” she said.

An officer got scissors and dental floss to sever the cord from another neighbor, Valerie Veator, 24. Her father had been an emergency medical technician, and spoke on the phone with the police.

The lobby was freezing and wet from the snow and wind. Ms. Onikura did chest compressions until the emergency medical crew, whose ambulance had been stuck, finally arrived to take the mother and baby to the hospital, but the baby did not survive.

(Source: NY Times)