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When the rig DOESN'T respond.

Discussion in 'EMS Talk' started by Jon, Aug 1, 2008.

  1. Jon

    Jon Administrator Community Leader

    Southeastern PA
    EMS Training:
    MedicAngel brought the topic up in another thread...If we are going to have this discussion... let us have it in a seperate thread.

    OK.. what happens in YOUR area when a rig isn't staffed and misses a call?

    Can a rig be dispatched if it isn't fully staffed?

    What is the dispatch procedure? How many minutes, how many pages?

    What happens when the service misses a call? Does everything start over when they are dispatched for another call 30 minutes later?

    How is next due determined? Does the clock start over for them?

    Lets not argue paid vs. vollie.... just discuss how it works in your town.
  2. motownems

    motownems New Member

    East Coast
    EMS Training:
    I am an attendant/assistant for a vollie ambulance service in the town where I go to college. It is a very rural area (think one stop light town).

    Anyways we have mutual support agreements with the surrounding ambulances services. As I understand it, if no one acknowledges Control after the fourth page out, Control will then page out one of the agencies we have mutual support agreements with. That being said I am not aware of the last time this has actually happened.

    As far as staffing goes; EMT and driver minimum… however depending on were the EMT/Medic is coming from they might link up with the rig on scene.
  3. Jon

    Jon Administrator Community Leader

    Southeastern PA
    EMS Training:
    4th page out? How many minutes total?
  4. JAM-EMT

    JAM-EMT New Member

    Houma, LA
    EMS Training:
    Here, when shifts aren't filled we just file as OOS and the closest in service squad takes over for that time.
  5. motownems

    motownems New Member

    East Coast
    EMS Training:
    Jon, I cannot speak as to how long that would be in terms of minutes, as I have never been around (no pun intended) when it has happened. I just remember one particular slow evening I was flipping through the SOP/SOG and read something about it.
    Last edited by a moderator: Aug 1, 2008
  6. Jon

    Jon Administrator Community Leader

    Southeastern PA
    EMS Training:
    In the county I volunteer in:

    For a BLS rig:
    Page at 0 minutes
    2nd Page at 4 minutes
    Station polled over radio for "Response Check" x2 at 6 minutes
    Next Due company dispatched at approx. 7 minutes, and initial company is on a 4 hour "zero response" timer... if they get another call in that 4 hour window, the next due company is co-dispatched with them.

    For ALS, it is a little different. I'm not sure if they have a shorter time window... but if they fail to respond, they are OOS and their ALS Coordinator gets called.

    The County I work in is similar... I think they might have a 3+3+3 timeframe for 9 minutes total.

    Another local county requires that ambulances only be statused as in service if they have a crew for them. So you come on shift at 7a, call County, tell them you'll be in ambulance XYZ-2 until 1900 with Paramedic ______. At 1900... your truck is off the county's radar.
  7. W1IM

    W1IM New Member

    Berkshire County, MA
    EMS Training:
    I am on a volley squad in an even more rural town than motownems (think no traffic lights and 26 people per square mile).

    We get 3X pages about a minute apart and then another squad is toned. EMTs all carry radios when they consider themselves on duty (when they are in town and haven't had anything to drink). When paged, those who decide to respond will radio directly to dispatch to let them know who is coming. When at least 2 EMT's have radioed in, then another squad will not be toned out and the repeat tones for us will stop.

    We typically get 2 EMT's in the ambulance and a First Reponder to drive. We are trying to get a waiver to allow transport with one EMT and a First Responder. Depending on the situation, the ambulance will sometimes meet the EMT's between the station and the scene or even on scene.

    Once we had a call for a 1 month old having seisures. EMT's responded that they were 15min away from the station, so the fire chief had the one First Responder who was available take the ambulance to the scene and do what he could for the infant. EMT's arrived and took over. Mutual aid ambulance arrived shortly after that and the pt was transported.
  8. BossyCow

    BossyCow New Member

    Rural (no... really, really rural) Washington Stat
    EMS Training:
    Wow! You guys have a stop light????

    In our service, There's a page and one minute later, if no response a second page. We have had calls when there wasn't an EMS volunteer available and the responding ff called for mutual aid from the closest responding agency. We have yet to have no one respond on a call but with the changing demographic of our area, I'm sure it will happen.

    If no response is heard from our agency after a second tone out, dispatch then tones out the nearest adjacent district to ours.
  9. wwrescueEMT

    wwrescueEMT New Member

    At the volunteer department i'm on, it happens quite a bit (though not as often as it used to) where we have one hell of a time getting the truck out. Our first rig out has to have an IV tech on it. While I was a basic, it would often occur that I was the only one down at the station paging and re-paging for an IV-tech.
    In the city, we are not supposed to roll with one person unless we know that someone else is going to the scene. When the call is out of the city, you don't leave the city without an IV Tech in your rig and a full crew (at least 2 EMTs and maybe a firefighter driver).
    We go up to three pages with approximately 5 minutes between pages and when the time comes that it's up to about the time when the fourth page would be, we page out for mutual aid.
    If there's a call half an hour later, we go through the same process.
    Then, of course when you get the third call and it's a code or car accident (after the first two were granny-go-booms or something to that effect) you get every EMT in the city there.....:glare:

    ...Thank goodness our cops are all first responders...it's saved our butts on more than one occassion.
  10. ILemt

    ILemt Member

    Central Illinois
    In my area this is the protocol:
    * note: in my area responding to scene in POV is forbidden, crew must board ambulance at station first.

    1st Page by county dispatch
    (If crew hasn't announced "en route to station" or "Ambulance X en route to call") then...
    Second Page at 4 Minutes
    If no traffic has been received by county dispatch by the 8 minutes mark, then a rig from the nearest town is dispatched, the first unit is marked OOS and the coordinator is called.

    Now... (here is the part that burns me and proves ill for patient care)
    Lets say that a one-rig service is already on a call and dispatch has a second 911 call... Protocol says that dispatch must still page them for 8 minutes before dispatching a unit from a nearby town (knowing full well that the original crew is unable to respond)

    This also applies if a service has more then one rig but they are all tied up.
    Dispatch will page for 8 minutes before turning the call over to a free unit.
    Last edited by a moderator: Aug 1, 2008
  11. MikeRi24

    MikeRi24 New Member

    paid service (which I work for) is dispatched simultaneously with the vollie FD companies (I am also in one of those) in my area. baiscally, it works like this: ambulance company is notified by fire dispatch of the call, ambulance and fire are dispatched by the respective agencies. 95% of the time, within 30 seconds of the call going out, one of our chiefs will call responding. all 3 of our chiefs are either medics or basics and have a full jump bag and monitor on thier rigs. when we get a cre together at the fire station, we will roll our EMS vehicle. if no one from the fire hall calls repsonding in 2 or 3 minutes, the dispatcher will go "are there any XXXXXXX units on the air?" and then after a few more minutes, another company would get toned out. We never have a problem getting a response crew together, and if for some reason we do, the ambulance crew can usually handle it, I have never actually seen another company get mutual aided for an EMS call. by the time that actually happens and they get a crew and get to the scene, the ambulance crew has it under controll and is ready to roll.
  12. silvercat354726

    silvercat354726 New Member

    Hudson Valley, NY
    We have an AMA (Automatic Mutual Aid) Policy in effect for our county where I volley. We get three sets of tones, if we don't crew it is suppose to go to the paid service. If we have another call when we are on the AMA we get one set and the next nearest squad gets three pages out, than to the paid. But if the next nearest squad is on AMA too, they just go to the paid service. The only thing I don't like about the AMA policy is that it is a long drawn out policy and response time is bad at times. Our capitan can call control and have us taken off the AMA at anytime.
    After our first page it is a minute after the first page the second set of tones go out, same for the three page. One minute between pages, it cuts the delay of response time down. Also if our paid service is listening and arent busy they will sometimes relocate closer as they finish giving out the pages.

    Our county really thought about response time and wanted to cut the delay of patient care down. The county also tends to change the way the work the whole AMA policy. When they first put the AMA policy into effect they would page the squad out and the paid service. During the summer the paid service is swamped so the actually follow the AMA policy as it was written.

    Also if we are out on another call and we get another call, they will page out our squad and the paid will get the following pages. We do have EMT's with jump bags to go to the scene if needed.

    Our rig cannot leave the station us we have an EMT on board. If it is a MVA or a fire bc we work under the fire department, and we just have an EMT we take the rig and get a firefighter to driver for us, but we normally get at least two people or more for those calls.
    Last edited by a moderator: Aug 2, 2008
  13. KEVD18

    KEVD18 New Member

    so you guys are saying that the dispatcher could receive a 911 call, dispatch it, and spend 15 minutes waiting for a crew to decide whether or not they feel like playing emt today. then, if nobody shows up, they repeat the process all over again with the next town over????

  14. MikeRi24

    MikeRi24 New Member

    well, since we use a paid ambulance service (all ambulances are ALS) which has to meet a 7 minute response time (which is hardly EVER an issue) in conjunction with the volly FD, getting care to the pt in more than 7 minutes is hardly ever an issue.
  15. firecoins

    firecoins IFT Puppet

    Nyack, NY
    Most volunteer corps have a designated crew on and available. During the day, most have a paid crew during the daytime hours. This is the hardest time to get volunteers and the buisest time of day.

    If the designated crew is out on a job, a run or whatever you want to call it, an open page will be put out for volunteers. If no one responds via radio, it goes mutual aid to the neighboring corps. Which one would based upon agreements.

    If a corp has no crew at all, the dispatchers just go mutual aid. There is no playing around with extra tones.
  16. mikeylikesit

    mikeylikesit Candy Striper

    Where you live
    EMS Training:
    in my area we are very well covered by the Volley FD's so we have yet to run across the scenario. i will ask tomorrow and find out though.
  17. Fire292Rescue

    Fire292Rescue New Member

    New Jersey
    In my county of Burlington (NJ).

    Dispatch protocols follow the "grids" that the Captain or Chief of the organization has set up.

    For us it's

    0 Minutes - Station 298, Station 188

    4 Minutes - 2nd Tap 298, 2nd Tap 188, 2nd Tap 439

    7 Minutes - Station 178 Duty Crew (Guaranteed to get them, paid crews.)
  18. mikie

    mikie Forum Lurker

    EMS Training:
    Critical Care Paramedic
    After 3min of no response, dispatch asks if anyone from the dept is on the air, they have another 1 or 2 minutes to 'answer up' before the next department is toned out.

    Usually the first person to arrive at the station answers the dispatch and if a crew isn't ready, will say "waiting on a crew". .If no staff within a min or so, they will re-tone (from the firehouse). once staffed with at least an intermediate (we're an ILS service), we can roll. If we cant get one within a few min, we'll call the private ambulance service in the area, if they're busy, we'll page another dept rather far.

    If we don't get an I or medic, we'll send a rescue squad w/o transport staffed with just basics.
  19. BEorP

    BEorP New Member

    This thread depresses me.

    Does anyone have official stats on how often the vehicle that is closest does not respond because there is no one to staff it?
  20. WuLabsWuTecH

    WuLabsWuTecH Active Member

    Wow, coming from a densely populated urban area with 100% paid services and 100% ALS rigs, these seem like long dispatch times. (Actually, there is one BLS crew now in one of the suburbs, but that's one out of close to 100 rigs that do 911 calls)

    Since I don't work for the city service where I am (I'm only a basic) I can't say with 100% certainty that this is what happens--I got some of this info through ride alongs, some of it through reading their protocols, and some of it through working with guys on the city service.

    For a BLS call-
    Dispatch 1 Medic (ALS) crew at 0 minutes.

    During the day: At time=1 minute if no electronic response (they use computers on their rigs that mark them enroute) they are radioed again. If after 3 minutes there is no electronic response and there is no radio response that the computer is OOS, then a second crew is dispatched.

    During the night: At time=3 minutes if no response they get another call and 3 more minutes, otherwise a second crew is called out.

    For an ALS Call-
    Dispatch 1 Medic and 1 Engine (staffed with 2 paramedic/ff 240s and either one or 2 basics/ff 240s) Same response times as above.

    For a more serious ALS call such as GSW, stabbing, MCA (single victim) they will dispatch:
    1 EMS (first responder vehicle i can't remember if its a basic or paramedic), 2 Medics, and sometimes an Engine.

    The average response time for anywhere in our city is about 3-4 minutes.

    That being said, I don't think we need as much coverage as our city currently has. One of the criticisms of our system is that those who want to be in firefighting, are forced to get their medic card in order to stay on with the department and you end up with firefighters who are on the medic truck who do not want to be on the medic truck. Its also costing our city a lot of money that could be spent elsewhere.

    I can't imagine a dispatch time of 15 minutes though!!!

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