HONOLULU (HawaiiNewsNow) - When his ambulance answers an emergency call, Mario Fuentes brings 22 years of experience along for the ride.
But nothing prepared him for his first encounter with a huge infestation of bed bugs that scattered like ants.
"We walked in and literally the floor was moving," he said.
More and more, Oahu paramedics are having to battle bed bugs in homes while stabilizing the patient.
Two years ago it was once a month. Today, it's once a week.
Emergency Medical Services now has a data base of known bed bug sites and the list is growing.
"At our dispatch center we have a computer where we would flag the address of a past incident," EMS safety specialist Lorrin Okumura said.
"They'll always say, 'Gown up. This resident has been a previous bed bug call,'" Fuentes said.
XTERMCO's Keith Yakabe feels the paramedics' pain. He said the bed bug problem is so widespread his company kills three to four infestations a week.
"It's not seasonal, especially here in Hawaii, because the weather is pretty constant. It's all year round and it's only going to get worse," he said.
When paramedics spot bed bugs on or around patients they'll put them in a suit that covers head to toe, or in a blanket, or a large bag EMS carries to keep the insects isolated.
Paramedics also call ahead to the emergency room with a bed bug alert.
Four times this year EMS had to take more drastic measures.
"Decontaminate the entire interior of the ambulance and also the equipment that the medics have brought to the scene," Okumura said.
That costs the city $900 each time.
Fuentes said when he was a rookie bed bugs weren't part of the every day emergency vocabulary. That's changed.
"We have to be ready basically for anything and everything," he said.
Unfortunately, that now includes the small insect that's becoming a big problem.