# Las Vegas Fire looking to take over transports from AMR



## Amberlamps916

I was wondering why this topic hasn't been discussed yet on this forum. It's pretty controversial..... especially when one of the board members compares fire medics to doctors and private medics to nurses.



http://www.reviewjournal.com/news/a...as-fire-chief-over-patient-transport-takeover


----------



## DrParasite

it's not controversial because they are doing it, but rather Las Vegas has been doing it stupidly for years.  two ALS ambulances to the same call?  can you say duplication of services and redundancy?

Was the comment stupid and wrong?  absolutely.  

but the underlying problem is having two transporting agencies responding to calls in the same primary area, with each having a financial interest in transporting the patient.


----------



## Amberlamps916

It looks like Reddit users are having a field day with this.....

http://www.reddit.com/r/ems/comments/1zrf3z/las_vegas_ems_shake_up/


----------



## SandpitMedic

I'm in Vegas
I will chime in later... It's poppin right now though.

Glad to see someone brought it up.


----------



## Amberlamps916

SandpitMedic said:


> I'm in Vegas
> I will chime in later... It's poppin right now though.
> 
> Glad to see someone brought it up.



That's good to know. I'm sure many of us would like to hear an insider's point of view on how things are going in sin city.


----------



## TRSpeed

Lots of us in the field are interested although most don't post on here


----------



## SandpitMedic

*The scoop is this:*

I have been typing this throughout the day on my iPhone between (lots of) calls; I apologize if there are grammatical errors or for going off on a sudden tangent.

BACKGROUND:

In Las Vegas we run a dual response system. Every activation of the 911 system (depending on the geographical area in regards to which agency responds) will result in an AMR or MedicWest (MWA) ambulance AND an FD unit, either an Engine/Ladder or a Rescue (Mod ambulance) or both for many Delta (highest priority) level calls such as codes, big traumas, etc. 
(Note: AMR and MWA are essentially the same company, but technically different at the local level; both owned by Envision- see my post in the employment section for a further breakdown of details on areas.)

Las Vegas, as most of you perceive it, is all VEGASSSSS BABYYYYY! However, the city/county boundaries are all wonky. For instance, the Strip is not part of the City of Las Vegas. It is actually the Township of Paradise, Clark County, Nevada, USA. It is an unincorporated part of Clark County, of which is about 75% of the area you all percieve as the greater Las Vegas area. The City of is very small in comparison, and that said is only about 25-35% of AMRs response area. (1/2 the County area is AMR's,including ALL of the City of Las Vegas, and the other half is MWA's, including the City of North Las Vegas. So AMR is the agency that has the contract with Las Vegas Fire & Rescue (LVFR) AKA City Fire.
Another Note: The City of Henderson (just in case you look at a map and think "well what about this area") is not included. They are self sufficient Fire/EMS and started out that way, never having private EMS.

Status quo has been that the fire agencies do not transport (unless it's a cop/FF/VIP/cool trauma they want) ever for general calls. That is why the private agencies exist, even though these fire agencies do have their own perfectly capable(in theory), although limited number, of ambulances. I don't want to bad-mouth the Fire Medics, as the FD AND CITY COUNSEL did to us, so I will do my best to keep my own opinions to myself about their quality of care vs. ours in this public forum. Mind you, we're talking about medics who have little to no regular pt care/transport outside of showing up, and _maybe_ giving you a set of vitals. As far as them being the "quasi doctors" on scene and we're the "nurses" according to the City Counselman... Well he clearly has no idea what he is talking about... Considering we are all trained to the same standard, and now even at literally the same exact school: LVAPEC. Talk about a political clown show. My own comment about them not having regular pt ongoing assessment/critical txp experience is not the same thing... Most of them do have experience and the all are trained to the same standard. To clarify, what I mean is that they just don't do pt care... As in they don't transport... We do... They have been out of that aspect of the game for a while. Some things I see, I just shake my head.

STORY TIME:

Basically, it was shock & awe by Las Vegas Fire & Rescue (LVFR) who did not notify AMR of their intentions. A couple of weeks ago an article published in the local paper (Las Vegas Review Journal) about LVFR's Chief's plan to take over 80% of pt transports in their response area (the City) by the end of Summer. That was when AMR learned of the plan, and somewhere in the region some AMR big wigs were likely breaking stuff in their offices. AMR management was essentially stone walled by LVFR when they attempted to contact them and were told "we will call you when we need you." As of last Monday LVFR severed the CAD from AMR dispatch. Of course as you can imagine, memos are being sent out, legal action is being threatened, and big wigs are pooping bricks and banging their heads against the wall from being blindsided with the potential loss of ~25% of their transports (which honestly a lot of which is a nasty area with "customers" without health insurance anyways. Not that it makes a difference in quality of care, but rather to point out that there is no profit involved.) The current contract expires after this year, and LVFR has indicated they have no desire to renew. 

On the ground level, there are numerous complications including contract provisions, Union efforts (AMR & LVFR,) citizen complaints over being billed by an agency already funded by their taxes, personnel issues, resource management and availability, supply costs, etc. LVFR has a desire to reduce their budget, and they think they're going to be taking in big bucks and cut costs by transporting. Frankly, they don't have the current man power, resources, or idea of what they're really biting off, and it's more than they can chew. They are not factoring the non-payers, Medicare/Medicade delayed and reduced payments, costs of using their own supplies, overtime, system status based rapid resource redeployment (posting,) mechanical/repair costs, their units holding the wall at the ER(s), hiring costs for the man power they're gonna need. Apparently, their Cheif's vision is now that they transport, checks will start raining on them (read: the City, not the firemen) next week... 

On the day to day, since Monday, AMR crews tell me that they're still busy as hell. They are still running their butts off and call volume is not decreasing. Also, I guess this is only going on during the daytime, since LVFR runs 24hour shifts...and this is Vegas- they would literally run 24 calls in 24 hours. Most firemen are not thrilled about this either, for there will be no more gym time or the rocking of Lay-Z-Boys...
Literally last night while waiting for a bed for a pt, LVFR brought in some "un-true emergency" and had to hold the wall. In discussion with the firefighter as we sat for about 20-30 minutes he asked "Is it always like this? I've never seen it like this." When I asked how long he'd been doing this he said 8 years.... 8 YEARS! LOLz.. I replied "You've never had to hold the wall in 8 years of EMS... Welcome to reality. No more vitals and back to station... Time to work." He didn't get upset but actually acknowledged that he would indeed have no time for the gym, training, napping, etc... 

In my opinion, as I said, they are biting off more than they can chew. Turning non-transporting paramedics into transporting paramedics overnight. Essentially for them, this will turn a call that used to be 15 minutes long into an hour and 15 minutes or longer call. It's just not sustainable, and also becomes a safety risk if they go for 24 hours.

The general consensus is that this will fail in short order due to the complications I've noted as well as others. The good news is that there is not yet dissent among the crews... Everyone in the field is still friendly and professional from what I have seen despite executive management throwing jabs and trying to decapitate each other. 

There are many good editorials on the Las Vegas Review Journal's website on the topic with numbers and facts that have been substantiated.

Personally, I have no real dog in the fight, as its not my area, although jobs have already been threatened. To me I would imagine that LVFR (if successful) will need to expand their capabilities and hire more paramedics. Hopefully 3rd service it out or have single roll medics like FDNY or SFFD. And where one job is lost another and better one is born, and I'm all about that. On average these guys are making >80k annually without overtime and >100k with overtime. Sign me up.

Any questions? I started this post 5 hours ago.


----------



## FoleyArtist

Great write up. Loads of helpful information. Sooo I have an interview for medic on the 19th. IF I pass everything will this affect hiring?



SandpitMedic said:


> I have been typing this throughout the day on my iPhone between (lots of) calls; I apologize if there are grammatical errors or for going off on a sudden tangent.
> 
> BACKGROUND:
> 
> In Las Vegas we run a dual response system. Every activation of the 911 system (depending on the geographical area in regards to which agency responds) will result in an AMR or MedicWest (MWA) ambulance AND an FD unit, either an Engine/Ladder or a Rescue (Mod ambulance) or both for many Delta (highest priority) level calls such as codes, big traumas, etc.
> (Note: AMR and MWA are essentially the same company, but technically different at the local level; both owned by Envision- see my post in the employment section for a further breakdown of details on areas.)
> 
> Las Vegas, as most of you perceive it, is all VEGASSSSS BABYYYYY! However, the city/county boundaries are all wonky. For instance, the Strip is not part of the City of Las Vegas. It is actually the Township of Paradise, Clark County, Nevada, USA. It is an unincorporated part of Clark County, of which is about 75% of the area you all percieve as the greater Las Vegas area. The City of is very small in comparison, and that said is only about 25-35% of AMRs response area. (1/2 the County area is AMR's,including ALL of the City of Las Vegas, and the other half is MWA's, including the City of North Las Vegas. So AMR is the agency that has the contract with Las Vegas Fire & Rescue (LVFR) AKA City Fire.
> Another Note: The City of Henderson (just in case you look at a map and think "well what about this area") is not included. They are self sufficient Fire/EMS and started out that way, never having private EMS.
> 
> Status quo has been that the fire agencies do not transport (unless it's a cop/FF/VIP/cool trauma they want) ever for general calls. That is why the private agencies exist, even though these fire agencies do have their own perfectly capable(in theory), although limited number, of ambulances. I don't want to bad-mouth the Fire Medics, as the FD AND CITY COUNSEL did to us, so I will do my best to keep my own opinions to myself about their quality of care vs. ours in this public forum. Mind you, we're talking about medics who have little to no regular pt care/transport outside of showing up, and _maybe_ giving you a set of vitals. As far as them being the "quasi doctors" on scene and we're the "nurses" according to the City Counselman... Well he clearly has no idea what he is talking about... Considering we are all trained to the same standard, and now even at literally the same exact school: LVAPEC. Talk about a political clown show. My own comment about them not having regular pt ongoing assessment/critical txp experience is not the same thing... Most of them do have experience and the all are trained to the same standard. To clarify, what I mean is that they just don't do pt care... As in they don't transport... We do... They have been out of that aspect of the game for a while. Some things I see, I just shake my head.
> 
> STORY TIME:
> 
> Basically, it was shock & awe by Las Vegas Fire & Rescue (LVFR) who did not notify AMR of their intentions. A couple of weeks ago an article published in the local paper (Las Vegas Review Journal) about LVFR's Chief's plan to take over 80% of pt transports in their response area (the City) by the end of Summer. That was when AMR learned of the plan, and somewhere in the region some AMR big wigs were likely breaking stuff in their offices. AMR management was essentially stone walled by LVFR when they attempted to contact them and were told "we will call you when we need you." As of last Monday LVFR severed the CAD from AMR dispatch. Of course as you can imagine, memos are being sent out, legal action is being threatened, and big wigs are pooping bricks and banging their heads against the wall from being blindsided with the potential loss of ~25% of their transports (which honestly a lot of which is a nasty area with "customers" without health insurance anyways. Not that it makes a difference in quality of care, but rather to point out that there is no profit involved.) The current contract expires after this year, and LVFR has indicated they have no desire to renew.
> 
> On the ground level, there are numerous complications including contract provisions, Union efforts (AMR & LVFR,) citizen complaints over being billed by an agency already funded by their taxes, personnel issues, resource management and availability, supply costs, etc. LVFR has a desire to reduce their budget, and they think they're going to be taking in big bucks and cut costs by transporting. Frankly, they don't have the current man power, resources, or idea of what they're really biting off, and it's more than they can chew. They are not factoring the non-payers, Medicare/Medicade delayed and reduced payments, costs of using their own supplies, overtime, system status based rapid resource redeployment (posting,) mechanical/repair costs, their units holding the wall at the ER(s), hiring costs for the man power they're gonna need. Apparently, their Cheif's vision is now that they transport, checks will start raining on them (read: the City, not the firemen) next week...
> 
> On the day to day, since Monday, AMR crews tell me that they're still busy as hell. They are still running their butts off and call volume is not decreasing. Also, I guess this is only going on during the daytime, since LVFR runs 24hour shifts...and this is Vegas- they would literally run 24 calls in 24 hours. Most firemen are not thrilled about this either, for there will be no more gym time or the rocking of Lay-Z-Boys...
> Literally last night while waiting for a bed for a pt, LVFR brought in some "un-true emergency" and had to hold the wall. In discussion with the firefighter as we sat for about 20-30 minutes he asked "Is it always like this? I've never seen it like this." When I asked how long he'd been doing this he said 8 years.... 8 YEARS! LOLz.. I replied "You've never had to hold the wall in 8 years of EMS... Welcome to reality. No more vitals and back to station... Time to work." He didn't get upset but actually acknowledged that he would indeed have no time for the gym, training, napping, etc...
> 
> In my opinion, as I said, they are biting off more than they can chew. Turning non-transporting paramedics into transporting paramedics overnight. Essentially for them, this will turn a call that used to be 15 minutes long into an hour and 15 minutes or longer call. It's just not sustainable, and also becomes a safety risk if they go for 24 hours.
> 
> The general consensus is that this will fail in short order due to the complications I've noted as well as others. The good news is that there is not yet dissent among the crews... Everyone in the field is still friendly and professional from what I have seen despite executive management throwing jabs and trying to decapitate each other.
> 
> There are many good editorials on the Las Vegas Review Journal's website on the topic with numbers and facts that have been substantiated.
> 
> Personally, I have no real dog in the fight, as its not my area, although jobs have already been threatened. To me I would imagine that LVFR (if successful) will need to expand their capabilities and hire more paramedics. Hopefully 3rd service it out or have single roll medics like FDNY or SFFD. And where one job is lost another and better one is born, and I'm all about that. On average these guys are making >80k annually without overtime and >100k with overtime. Sign me up.
> 
> Any questions? I started this post 5 hours ago.


----------



## Amberlamps916

Some fire departments here in California are already using this as an example of why they should take over transports from private ems.


----------



## gonefishing

Addrobo said:


> Some fire departments here in California are already using this as an example of why they should take over transports from private ems.



And now they are talking about giving half or all of it up. LOL!


----------



## SandpitMedic

Yes this will likely affect hiring, and there will likely be a temporary freeze. Although, the busy season is right around the corner, so we will see. Ask your POC during your interview process. They may be holding testing to have a hot list or actively hiring new bodies. Testing and interviews are all done on the same day.

The problem with all of these FDs trying to take over is that they seem to have forgotten why they first started contracting out. There is a lot of overhead. 

These departments over the last 13 years have been having unlimited budgets and funding and heavy rescues and exorbitant trainings and things of the like due to the public "heroitis" phase post 9/11. All of the sudden people are looking around and wondering wtf is all the money. It's confusing to boot... "Wait a minute, this fireman makes $100,000 a year? And doesn't take people to the hospital in that ambulance? Why do those guys have different colored shirts? Well if they're the fire department why do they go on medical calls?" Etc etc. 

So now you have these departments trying to justify their own existence and salaries and benefits atop that. 

You have to think that they see AMR making millions, sure. However, that is irrelevant. AMR also pays 1/4 to 1/3 of what firemen make, spends less on equipment (not the latest greatest high tech stuff), has national accounts with medical equipment suppliers (cheaper in bulk), can wait unteen months for reimbursements, etc. More room to profit, unlike the fire depts.


----------



## TRSpeed

Fire needs to go bls, stop paying them 3-4x times the salary of a teacher that has at minimum a  Bachelor's. Its ridiculous, maybe there is good fire ems systems but these FD in Cali just ruin it for them. I like how OCFA blatantly says private medics provide a lower standard of care to its citizens. And LVFDR said almost the same thing comparing there medics to DRs and AMR medics to Nurses.

I know there is many very intelligent fire medics on this forum but you guys are the exception not the rule.


----------



## TRSpeed

Too many people become medics just because they want to go fire but have no interest in EMS. Its just impossible to get a Fire job if you are not a medic. 

Then what happens is you get an abundance of new medics that have no desire to stay on the ambulance. They :censored::censored::censored::censored::censored: and moan for running calls even if its slow, etc. Then they don't get a fire job, stay in ems but hating every minute of it. Being a medic needs to just stop being a requirement to become a fire fighter.


----------



## ITBITB13

TRSpeed said:


> Too many people become medics just because they want to go fire but have no interest in EMS. Its just impossible to get a Fire job if you are not a medic.
> 
> Then what happens is you get an abundance of new medics that have no desire to stay on the ambulance. They :censored::censored::censored::censored::censored: and moan for running calls even if its slow, etc. Then they don't get a fire job, stay in ems but hating every minute of it. Being a medic needs to just stop being a requirement to become a fire fighter.



This. Couldn't have said it better myself.


----------



## terrible one

TRSpeed said:


> Too many people become medics just because they want to go fire but have no interest in EMS. Its just impossible to get a Fire job if you are not a medic.
> 
> Then what happens is you get an abundance of new medics that have no desire to stay on the ambulance. They :censored::censored::censored::censored::censored: and moan for running calls even if its slow, etc. Then they don't get a fire job, stay in ems but hating every minute of it. Being a medic needs to just stop being a requirement to become a fire fighter.



Shhh.... Don't tell the real heroes that. They have cancer at 3-4x the average citizen. They deserve a boat, lifted truck, dirt bike, trailer, and a stay at home wife for their service. They clearly are the real paramedics on scene.


----------



## SandpitMedic

While I agree with you all, it is not the firefighters in the field making this happen. They are already burnt out after 2 weeks. They started out all high and mighty with their mostly Type A personalities... "We can do it, we can do anything, we're firemen." That type ya know... They are hating it. 

It is the department heads and city counsel officials making this happen.

AMR is already having reduced call volume and rumors of lay-offs are buzzing. Overtime is nonexistent, and to those of you testing.... Sorry, doesn't look good for hiring in the near future.


----------



## terrible one

SandpitMedic said:


> It is the department heads and city counsel officials making this happen.




This is true.


----------



## Amberlamps916

Any updates as to how it's going in Vegas?


----------



## Handsome Robb

The biggest issue I see is LVFD being selective about transports and lettingAMR or MWA transport the patients they don't think will pay. If that's the case AMR and MWA could be in real trouble but I really don't think this will last. 

With that said I've been watching closely and will absolutely apply and test at any of the FDs down there. I could live here, fly down for my shift and still come out above what I'm making now. :lol:


----------



## rmabrey

Is AMR self sustaining in vegas? It'll be hard to top that if FD is going to support themselves on 911 only.


----------



## fortsmithman

TRSpeed said:


> Fire needs to go bls, stop paying them 3-4x times the salary of a teacher that has at minimum a  Bachelor's. Its ridiculous,



That's because Fire have better labour unions than EMS.   Some areas Fire makes more than police.


----------



## RocketMedic

I think AMR or MWA could be self-sustaining, but not both if this continues.


----------



## Handsome Robb

rmabrey said:


> Is AMR self sustaining in vegas? It'll be hard to top that if FD is going to support themselves on 911 only.




I doubt it. But even as big as they are they can't have a division that has near no reimbursement.


----------



## TransportJockey

Robb said:


> I doubt it. But even as big as they are they can't have a division that has near no reimbursement.



At least one that size. ABQ ran in the red for over a year with minimal call volume. But we were a very small operation


----------



## Handsome Robb

TransportJockey said:


> At least one that size. ABQ ran in the red for over a year with minimal call volume. But we were a very small operation




I don't know their numbers but I know we do like 75k a year so I'd bet that's probably close to what they do since they've got three splitting it.


----------



## rmabrey

Robb said:


> I doubt it. But even as big as they are they can't have a division that has near no reimbursement.



I was curious cause my shop is completely self sustaining and one of the most profitable at 30,000+ runs a year. We do IFT as well which is obviously where the money is at. The city used to reimburse us and bill for 911 but they lost a lot of money. We took over billing for transport rights in the city. I guess my point is it is possible for them to be self sustaining in vegas, but I doubt fire can do It. No cost to the city is always an attractive offer.


----------



## Tigger

I'm surprised they don't just do what the city of Colorado Springs did; charge a franchise fee to the ambulance contractor. 

AMR now pays the fire department 1.8 million a year to operate in the city. Fire department gets money and doesn't have to delve into transport. Course it's done some terrible things to the AMR operation too...


----------



## SandpitMedic

AMR was paying $500,000 annually to the city for transport rights. No longer, though.

AMR is still bumping along just fine with only a slight decrease in volume now that this is starting to normalize. It's a busy, busy, busy system- mostly in the evening into the morning. And the City Of is only a part of AMR's area (mostly county as explained before.) MedicWest is not the primary for City's areas, and it is not affecting operations at all.

LVFR does transport some TROLLs too (transient residents of lovely Las Vegas) and not just the "good" calls. It is a matter of resources, and AMR still responds with LVFR most of the time. City Fire has an academy of 35 (out of the 40 that started) and are due to hire more in the Fall. <--Robb-- 

MWA hiring is open/on-going while AMR hiring has ceased for most positions according to operations folks.


----------



## Handsome Robb

SandpitMedic said:


> AMR was paying $500,000 annually to the city for transport rights. No longer, though.
> 
> AMR is still bumping along just fine with only a slight decrease in volume now that this is starting to normalize. It's a busy, busy, busy system- mostly in the evening into the morning. And the City Of is only a part of AMR's area (mostly county as explained before.) MedicWest is not the primary for City's areas, and it is not affecting operations at all.
> 
> LVFR does transport some TROLLs too (transient residents of lovely Las Vegas) and not just the "good" calls. It is a matter of resources, and AMR still responds with LVFR most of the time. City Fire has an academy of 35 (out of the 40 that started) and are due to hire more in the Fall. <--Robb--
> 
> MWA hiring is open/on-going while AMR hiring has ceased for most positions according to operations folks.




That timing could work out quite nicely...

Thanks dude.


----------



## Handsome Robb

Gonna be a fight around here for fire jobs though with one department slated to lay off 35 July 1.


----------



## Imacho

TRSpeed said:


> Fire needs to go bls, stop paying them 3-4x times the salary of a teacher that has at minimum a  Bachelor's. Its ridiculous, maybe there is good fire ems systems but these FD in Cali just ruin it for them. I like how OCFA blatantly says private medics provide a lower standard of care to its citizens. And LVFDR said almost the same thing comparing there medics to DRs and AMR medics to Nurses.
> 
> I know there is many very intelligent fire medics on this forum but you guys are the exception not the rule.



That's exactly why I left so cal moved to Charlotte NC. We're 3rd service and all fire is BLS.


----------



## SandpitMedic

Imacho said:


> That's exactly why I left so cal moved to Charlotte NC. We're 3rd service and all fire is BLS.



Oh Medic... My dream job. Charlotte-Meck.... 
Sigh...


----------



## NomadicMedic

SandpitMedic said:


> Oh Medic... My dream job. Charlotte-Meck....
> 
> Sigh...




System Status Management is part of your dream job?


----------



## SandpitMedic

http://www.mynews3.com/content/news...response/10Lz81vAFECE1dwWt9DJxA.cspx?rss=3406

Shots fired by LV AMR GM. Alleging, with some factoids, delayed response times have sky rocketed since the take over of primary response by LVFR. 

Video is also there. Referencing a call a friend of mine had with a stabbing victim that died while AMR was literally posted 200 yards away behind a building, yet did not get the call.


----------



## SandpitMedic

DEmedic said:


> System Status Management is part of your dream job?



My company already does this.
One headache for another? Maybe, but I'll be on the East Coast at least.


----------



## Angel

update:
http://www.ems1.com/ems-management/articles/1895203-AMR-Vegas-transport-changes-causing-long-delays/


----------



## Fire51

This is just to ridiculous that it has gotten this bad! It seems like this whole private ambulance vs the FD is getting worse around the world and its the worse in Vegas. From what it seems like the FD is not going to win this one, they are going to have to alert AMR of  calls, I mean come on  we are in this job because we want to provide the best patient care that we can! Not see who is better or more well trained crap!

I know they had to see what system would work better but it's not this way, not when there's a ambulance 200 yards away of a stabbing victim and doesn't even know it because the FD wants to transport more and won't let AMR know about calls unless they need them. I really hope they can fix this so it works out for both companies and most of all the patients. Sorry I needed to vent and tell my opinion.


----------



## TransportJockey

I don't know abotu you, but I'm just in this job for the money and the chicks


----------



## SandpitMedic

Angel said:


> update:
> http://www.ems1.com/ems-management/articles/1895203-AMR-Vegas-transport-changes-causing-long-delays/



See post #34


----------



## Handsome Robb

TransportJockey said:


> I don't know abotu you, but I'm just in this job for the money and the chicks




I knew there was a reason we get along.


----------



## Aprz

I don't like this stunt that the fire department is doing, however, I do believe it can still work. Give them time.


----------



## SandpitMedic

Why Aprz?

You dislike the play, yet want to see it succeed?


----------



## PotatoMedic

http://www.jrn.com/ktnv/news/Family...tim-suing-city-fire-department-257426131.html

Wonder how this will play out.


----------



## SandpitMedic

Oooooh
This is good.    I predict a victory.

I wonder if AMR is backdooring their legal fees. 

That last part is based purely on my own curiosity, and in no way is it based on. any fact/evidence.


----------



## Fire51

3 mins is a pretty fast response time but their trying to get the point across that there was a private ambulance right across the street that is more then capable to provide ALS to the patient. What if the FD was 10 min away? They are right, this battle is mostly about money and not patient care.


----------



## SandpitMedic

This is a dramatic public game changer. Placing public safety and emergency services above all else, and I hope it will be on the next national cable outlet as a headliner. ATTENTION AMERICA.....


----------



## Aprz

FireWA1 said:


> http://www.jrn.com/ktnv/news/Family...tim-suing-city-fire-department-257426131.html
> 
> Wonder how this will play out.


What I mean is that just because they aren't doing so hot right now doesn't mean they can't do it or won't do it well later on. That's like when a new ambulance provider takes over a 911 contract there are usually some problems here and there within the first couple of months.

I don't like that Las Vegas Fire suddenly doing this, and I don't like how poorly they looked at AMR's employees.

I'm hoping in the end, this will be good for those AMR employees. Somebody has to run the call. Maybe those guys will get hired at the Fire Department on dedicated transport units and better pay and benefits.


----------



## SandpitMedic

Aprz said:


> What I mean is that just because they aren't doing so hot right now doesn't mean they can't do it or won't do it well later on. That's like when a new ambulance provider takes over a 911 contract there are usually some problems here and there within the first couple of months.
> 
> I don't like that Las Vegas Fire suddenly doing this, and I don't like how poorly they looked at AMR's employees.
> 
> I'm hoping in the end, this will be good for those AMR employees. Somebody has to run the call. Maybe those guys will get hired at the Fire Department on dedicated transport units and better pay and benefits.



They are not a startup 911 contractor. They are the established government fire and rescue service provider that is unprepared and possibly liable for the death of this citizen. 
Unable to meet the service standard previously provided due to a **** measuring contest.
Apples to oranges my man.


----------



## Bullets

First, can someone explain what you mean by "holding the wall for 20-30 minutes"

Second, when i look at the map of the City of, what are all the little holes in the boundary of the city? And if most of the tourist  area is in Paradise, then isnt that good for AMR?


----------



## TransportJockey

Bullets said:


> First, can someone explain what you mean by "holding the wall for 20-30 minutes"
> 
> Second, when i look at the map of the City of, what are all the little holes in the boundary of the city? And if most of the tourist  area is in Paradise, then isnt that good for AMR?



Waiting at the ER, usually against a wall, until there's a room ready for your patient


----------



## SandpitMedic

Those holes are Clark County.

Paradise isn't like it's own city, it's Clark County also. Shared with MedicWest with wonky boundaries on the strip.

Yes, that's good for AMR, but not what this about.


----------



## CFal

3 minutes is a phenomenal response time, the fact that there was a private ambulance that could have gotten there slightly quicker in this isolated situation should have no bearing on it at all.


----------



## SandpitMedic

We will see if that "3 minutes" hold up or if it turns out to have been longer. 

Still. Practically in the parking lot dude....


----------



## Tigger

SandpitMedic said:


> We will see if that "3 minutes" hold up or if it turns out to have been longer.
> 
> Still. Practically in the parking lot dude....



While I agree in principle, I doubt it has any practical bearing for the case. The fact of the matter is that the agency having jurisdiction met the response time guidelines for their area. That alone will likely preclude any substantive action.


----------



## Handsome Robb

As bull:censored::censored::censored::censored: as I think what LVFD is pulling is I highly doubt those 3 minutes woulda made a difference.


----------



## SandpitMedic

Hijack.... Off topic.


----------



## SandpitMedic

Clark County Fire Chief weighs in on the issue. In summary, he is a big fan of privates, so that fire can do fire things.

Video

http://m.jems.com/video/news/heated-debate-over-las-vegas-ambulance-s


----------



## Fire51

That's good to hear their not going to try the same thing. I don't get the whole thing about jumping in the back of the private ambulance to continue care when you already have a paramedic transporting, it's not hard to give them all the info they got but that's just a opinion. If they work together well then great for them.


----------



## SandpitMedic

Well he has to make it sound like they're contributing. And they do great compressions/bagging on the ride in to allow me to focus on other ALS interventions. Teamwork and taking direction when they ride in is always appreciated. Plus bouncing ideas off of each other is a benefit for pt care as well.


----------



## SandpitMedic

Additionally, of the 5% or so of actual critical calls they probably ride in less than half of the time.... So maybe like 2% of the time they ride in. And it's like I said in my previous post....


----------



## socalmedic

I am a fan of the Fire Medic retaining care on critical calls if they have already provided interventions or gotten the majority of the information gathered. from a patient care standpoint information will not as easily be lost or forgotten and there will be less of a delay in transporting because time will not be wasted giving me report. besides it gives me time during the transport to get a head start on my documentation. 

as an example, I recently had a stroke patient who the fire medic was on scene of for about 5 min prior to my arrival. I then got the gurney ready for the patient so he had the patient for about 10 minutes prior to giving me report. the report I got was unknown downtime, unwitnessed event, the patient was non-verbal. we treated as such, transported non-emergent and gave report as unknown downtime. family later told the hospital that the downtime was only 40 minutes. it turns out that they had told the fire medic this as well and it was either not communicated to me or I didn't hear it. However this discovery was too late for TPA and it ended up being a sentinel event. had the fire medic transported with me this information would have gotten to the doctor and proper treatment could have been provided. this is why I like the first medic on scene to retain care for sick patients. 



Fire51 said:


> That's good to hear their not going to try the same thing. I don't get the whole thing about jumping in the back of the private ambulance to continue care when you already have a paramedic transporting, it's not hard to give them all the info they got but that's just a opinion. If they work together well then great for them.


----------



## exodus

Fire51 said:


> That's good to hear their not going to try the same thing. I don't get the whole thing about jumping in the back of the private ambulance to continue care when you already have a paramedic transporting, it's not hard to give them all the info they got but that's just a opinion.* If they work together well then great for them.*



That just sounds like you have a gripe against fire medics and are afraid your ego's clashing.


----------



## Fire51

exodus said:


> That just sounds like you have a gripe against fire medics and are afraid your ego's clashing.



I don't have anything against fire medics actually, I just didn't get the point of them continuing patient care. But from what some people are saying there are times where it's a good thing. I just think it's really important for fire and privates to work great with each other and have a great relationships to.


----------



## mined

Certainly there are pros and cons to a split system. On the one hand the ffmedic would get back to the action faster if they turn over care. On the other hand can they guarantee continuity of care for their patient. Yes, on paper a medic is a medic, however, we have all seen paper medics. FF/ medics in all area are held to a higher standard they everyone else. They do not ride the lazy boy or hang out in the gym all day. when they are not on a call they train and train and then they train some more. We are still the Johnny and Roy of old who perform on multiple levels am do it well. As for the money side of it, municipalities that bill patients do so under the same guided lines as private care companies including the handling of medicare and medicaid. The bottom line is that 80% of fire calls are EMS related and the departments should be capitalizing resources that direction while maintaining a fire ready status. Keep in mind they are only running 911, they are not running the other 98% of the private calls like interfacility transports, dialysis runs, and clinic visits. I have been in the system for 30 years so I have seen it all, don't be afraid AMR be happy you can now dedicate to the other 98%.


----------



## SandpitMedic

mined said:


> Certainly there are pros and cons to a split system. On the one hand the ffmedic would get back to the action faster if they turn over care. On the other hand can they guarantee continuity of care for their patient. Yes, on paper a medic is a medic, however, we have all seen paper medics. FF/ medics in all area are held to a higher standard they everyone else. They do not ride the lazy boy or hang out in the gym all day. when they are not on a call they train and train and then they train some more. We are still the Johnny and Roy of old who perform on multiple levels am do it well. As for the money side of it, municipalities that bill patients do so under the same guided lines as private care companies including the handling of medicare and medicaid. The bottom line is that 80% of fire calls are EMS related and the departments should be capitalizing resources that direction while maintaining a fire ready status. Keep in mind they are only running 911, they are not running the other 98% of the private calls like interfacility transports, dialysis runs, and clinic visits. I have been in the system for 30 years so I have seen it all, don't be afraid AMR be happy you can now dedicate to the other 98%.



Seriously?


----------



## TransportJockey

mined said:


> Certainly there are pros and cons to a split system. On the one hand the ffmedic would get back to the action faster if they turn over care. On the other hand can they guarantee continuity of care for their patient. Yes, on paper a medic is a medic, however, we have all seen paper medics. FF/ medics in all area are held to a higher standard they everyone else. They do not ride the lazy boy or hang out in the gym all day. when they are not on a call they train and train and then they train some more. We are still the Johnny and Roy of old who perform on multiple levels am do it well. As for the money side of it, municipalities that bill patients do so under the same guided lines as private care companies including the handling of medicare and medicaid. The bottom line is that 80% of fire calls are EMS related and the departments should be capitalizing resources that direction while maintaining a fire ready status. Keep in mind they are only running 911, they are not running the other 98% of the private calls like interfacility transports, dialysis runs, and clinic visits. I have been in the system for 30 years so I have seen it all, don't be afraid AMR be happy you can now dedicate to the other 98%.



I... don't even know where to start.... so much ignorance


----------



## Angel

troll post? <_<


----------



## SandpitMedic

*Data indicates some new issues!*

http://m.reviewjournal.com/news/fir...medics-abandoning-poor-minority-neighborhoods

Apparently, LVFR is transporting those wealthier patients and leaving the poorer and less fortunate without ability to pay for AMR to transport. And sometimes there is an extended delay while they decide whether they can respond to the wealthier neighborhoods. 

I don't see this going anywhere but South on LVFR if this preliminary data is verified. How do you respond to claims as a government organization dedicated to serve when you get called out for only helping people who can pay?! So then this was always about money (as I suggested early on) and not about patient care evidently.


----------



## terrible one

mined said:


> Certainly there are pros and cons to a split system. On the one hand the ffmedic would get back to the action faster if they turn over care. On the other hand can they guarantee continuity of care for their patient. Yes, on paper a medic is a medic, however, we have all seen paper medics. FF/ medics in all area are held to a higher standard they everyone else. They do not ride the lazy boy or hang out in the gym all day. when they are not on a call they train and train and then they train some more. We are still the Johnny and Roy of old who perform on multiple levels am do it well. As for the money side of it, municipalities that bill patients do so under the same guided lines as private care companies including the handling of medicare and medicaid. The bottom line is that 80% of fire calls are EMS related and the departments should be capitalizing resources that direction while maintaining a fire ready status. Keep in mind they are only running 911, they are not running the other 98% of the private calls like interfacility transports, dialysis runs, and clinic visits. I have been in the system for 30 years so I have seen it all, don't be afraid AMR be happy you can now dedicate to the other 98%.




Love it! I think you'd be more at home at firehouse.com with the real heroes.


----------



## RocketMedic

Glad to know the FD medics here are training constantly while I just sit here...


----------



## Medic Tim

mined said:


> Certainly there are pros and cons to a split system. On the one hand the ffmedic would get back to the action faster if they turn over care. On the other hand can they guarantee continuity of care for their patient. Yes, on paper a medic is a medic, however, we have all seen paper medics. FF/ medics in all area are held to a higher standard they everyone else. They do not ride the lazy boy or hang out in the gym all day. when they are not on a call they train and train and then they train some more. We are still the Johnny and Roy of old who perform on multiple levels am do it well. As for the money side of it, municipalities that bill patients do so under the same guided lines as private care companies including the handling of medicare and medicaid. The bottom line is that 80% of fire calls are EMS related and the departments should be capitalizing resources that direction while maintaining a fire ready status. Keep in mind they are only running 911, they are not running the other 98% of the private calls like interfacility transports, dialysis runs, and clinic visits. I have been in the system for 30 years so I have seen it all, don't be afraid AMR be happy you can now dedicate to the other 98%.


what area are you in? and are you one of the said superfiremedics?


----------



## SandpitMedic

He drives and techs... At the same time. Super Duper!


----------



## NomadicMedic

Only warning. Keep it civil and on topic. Fire vs Private battles almost always get nasty and if this one does, I'm comin' back swinging.


----------



## TransportJockey

DEmedic said:


> Only warning. Keep it civil and on topic. Fire vs Private battles almost always get nasty and if this one does, I'm comin' back swinging.



You can't hit me neener neener lol


----------



## PotatoMedic

Transport Jockey!  Can I write your eulogy after DE gets back?


----------



## MonkeyArrow

FireWA1 said:


> Transport Jockey!  Can I write your eulogy after DE gets back?



Nah, he's already filled up his obligatory one post "what happened" internet eulogy with his sig. There's his name, his certs, 1 obligatory ems related quote, and one forum quote. What more can you ask. Add in his User CP and you can run it in the paper


----------



## PotatoMedic

MonkeyArrow said:


> Nah, he's already filled up his obligatory one post "what happened" internet eulogy with his sig. There's his name, his certs, 1 obligatory ems related quote, and one forum quote. What more can you ask. Add in his User CP and you can run it in the paper



For some reason I now want to make sure that my NREMTP number will be on my headstone when I die.


----------



## TransportJockey

MonkeyArrow said:


> Nah, he's already filled up his obligatory one post "what happened" internet eulogy with his sig. There's his name, his certs, 1 obligatory ems related quote, and one forum quote. What more can you ask. Add in his User CP and you can run it in the paper



Lol I like your thinking


----------



## SandpitMedic

All of the LVFR fire medics I talk to are sooooo over this. They are already burnt. Generally the outlying stations are taking the hit. The busier districts haven't changed that much; say maybe 4 more transports per day.


----------



## Handsome Robb

mined said:


> Certainly there are pros and cons to a split system. On the one hand the ffmedic would get back to the action faster if they turn over care. On the other hand can they guarantee continuity of care for their patient. Yes, on paper a medic is a medic, however, we have all seen paper medics. FF/ medics in all area are held to a higher standard they everyone else. They do not ride the lazy boy or hang out in the gym all day. when they are not on a call they train and train and then they train some more. We are still the Johnny and Roy of old who perform on multiple levels am do it well. As for the money side of it, municipalities that bill patients do so under the same guided lines as private care companies including the handling of medicare and medicaid. The bottom line is that 80% of fire calls are EMS related and the departments should be capitalizing resources that direction while maintaining a fire ready status. Keep in mind they are only running 911, they are not running the other 98% of the private calls like interfacility transports, dialysis runs, and clinic visits. I have been in the system for 30 years so I have seen it all, don't be afraid AMR be happy you can now dedicate to the other 98%.




Sure fire medics train and train and train on fire suppression, not EMS.

 Fire medics are held to a higher standard my ***, I take offense to that post. There's very few fire medics I'd let touch me or my family.


----------



## rails

Robb said:


> <snip> There's very few fire medics I'd let touch me or my family.



It really seems to depend on the area. In my area, the fire medics are generally _very_ good. The same can't be said of all areas, though. I imagine that call volume (and resulting experience) plays a part.


----------



## TransportJockey

rails said:


> It really seems to depend on the area. In my area, the fire medics are generally _very_ good. The same can't be said of all areas, though. I imagine that call volume (and resulting experience) plays a part.



Exactly. Plus where I've worked there are no fire medics. Private ambulance or third service had all the medics and all the experience


----------



## rails

TransportJockey said:


> Exactly. Plus where I've worked there are no fire medics. Private ambulance or third service had all the medics and all the experience



Yep, I'd believe that. Especially in rural/semi-rural areas in Texas, it's pretty common for private services to exclusively run the 911 medical calls.


----------



## TransportJockey

rails said:


> Yep, I'd believe that. Especially in rural/semi-rural areas in Texas, it's pretty common for private services to exclusively run the 911 medical calls.



And rural new Mexico too.


----------



## Handsome Robb

Apparently Nevada as well besides Las Vegas.


----------



## SandpitMedic

North Las Vegas Fire Dept, with their 2 rescues (ambulances), have taken a play out of Las Vegas Fire & Rescue's playbook.

They are now transporting, although with their limited resources they are doing only 5 transports per day, and are not able to cover the massive area alone. This has caused about zero disturbance on the ground at MedicWest. 

However, Northtown (as we call it) has big plans apparently. They have a vision of a full fleet of fire based EMS/third service ambulances and are seeking to hire a full regiment of single role paramedics in the near future to staff this endeavor. They only lack one thing... Money. They are seeking a grant or grants, supposedly for 2 years of initial funding. After that who knows... That city has nearly filed for bankruptcy several times in the last few years. The PD & FD, as well as other public services have taken major cuts to funding, so it is hard to imagine they will be able to successfully sustain a new EMS division from the ground up after that grant cash runs out.

All these municipalities think the paper is going to start raining down if they take over transporting. Who knows.?


----------



## TRSpeed

Thing is medicare reimbursement rates are higher or are going to be for public services. I think. But don't remember where I read that or else Id site the source.


----------



## SandpitMedic

I'm interested in seeing the source on that.


----------



## 46Young

mined said:


> Certainly there are pros and cons to a split system. On the one hand the ffmedic would get back to the action faster if they turn over care. On the other hand can they guarantee continuity of care for their patient. Yes, on paper a medic is a medic, however, we have all seen paper medics. FF/ medics in all area are held to a higher standard they everyone else. They do not ride the lazy boy or hang out in the gym all day. when they are not on a call they train and train and then they train some more. We are still the Johnny and Roy of old who perform on multiple levels am do it well. As for the money side of it, municipalities that bill patients do so under the same guided lines as private care companies including the handling of medicare and medicaid. The bottom line is that 80% of fire calls are EMS related and the departments should be capitalizing resources that direction while maintaining a fire ready status. Keep in mind they are only running 911, they are not running the other 98% of the private calls like interfacility transports, dialysis runs, and clinic visits. I have been in the system for 30 years so I have seen it all, don't be afraid AMR be happy you can now dedicate to the other 98%.



I agree that in an ideal situation, the first-in medic should continue care during txp. However, it's a detriment to staffing if your only medics exist on the suppression apparatus. It's unreasonable to give up the engine medic for every patient needing ALS. If a fire department insists on providing the best patient care, and providing tx/txp in a timely fashion, the department will staff their ambulance with either one or two paramedics, preferably single role. In an EMS system where every employee is an employee of that jurisdiction, they're all held to the same training standards. There should be a system in place to properly give report and hand off the patient. In that case, the second (transport) medic is perfectly capable of continuing care without any hiccups. The transporting medics will likely be working with the same fire crews, so transfer of care should be smooth.

The problem is when you have only firemedics on apparatus, and a private agency transporting, because the hiring standards and training are inconsistent, and the average tenure of their employees are typically short (generally newer, inexperienced medics). I've worked for several privates, and the training is typically poor. You may get a brief inservice for a new procedure or piece of equipment, and this typically occurs on a different day, not while on shift. Their days are spent running constant calls.

I find it hard to believe that the firemedics "train train train" all day in EMS when not on a call. I'm a firemedic. We get 8 hour continuing ed. three times a year, on duty and OOS, quarterly on-line training, and some occasional in-station drills, probably for an hour or two twice a month. That's probably more training than most privates, and probably the same amount of training that a third service does. This is a department that is is training-intensive. Firemedics are no more proficient than a third service or hospital based medic. If anything, the firemedic has more job security, so the QA/QI is more lenient, and the testing can be less strict as well. 

If anything, the firemedic has to devote equal time to suppression training. This isn't too difficult to do, so long as you actually devote at least an hour to training in either fire or EMS every day (not including a street drill). From experience, I can say that wearing multiple hats becomes very difficult when you add additional specialties, such as TROT, Hazmat, and Heavy Rescue Squad training. There's just too much training to be good at three or four things.

The above all relies on the firemedic taking EMS seriously, and not as a necessary evil in order to do fire. I find that our most proficient medics are those that started in single role EMS and escaped to fire, or those that joined the FD because there's no other good EMS employers where they live. I also see firemedics that truly enjoy EMS initially, but grow to resent it years later because they keep getting detailed to an ambulance when they would prefer equal time on a fire piece. That would somewhat describe me. We spend most of our time running BLS, so I tend to become disinterested in EMS (not outright resentment - yet), and this results in doing less training and reading about emergency medicine. It takes a good tour or two of good ALS calls to renew my interest in EMS. Understand that I started EMS in NYC, where an upgrade to ALS means that you see mostly ALS patients, and you aren't dispatched to any BLS calls. That was an important benefit to going ALS - way less "nothing" calls. Now, that's 80-90% of my call volume. Recently, though, I had a V-tach with a pulse, a respiratory arrest, and two patients with agitated delerium where I got orders for ketamine and versed. I might not see that degree of action again for three or four months. 

All-ALS transport systems (fire or single role) suck for that reason, IMO. Also, realize that single role medics typically burn out in 7-10 years on the average, so the problem of becoming disinterested in EMS after some years is not specific to the fire service, not in the least. I have 12 years in EMS, with at least full time hours on an ambulance, so I can vouch for the 7-10 year estimate for burnout. If I was still sitting on street corners doing EMS in NYC, I would be burnt as well.


----------



## DrParasite

*AMR, Vegas Fire Department reach deal*
By JANE ANN MORRISON
LAS VEGAS REVIEW-JOURNAL
Las Vegas’ dual response system for emergency ambulances is dying.

A 911 call for a medical emergency no longer will receive a response from both the Las Vegas Fire Department and American Medical Response. One or the other will be dispatched, not both.
After more than a month’s negotiations between the department and AMR, each side gave a little for this proposed contract, which is expected to be signed and presented to the council at its Sept. 3 meeting.

“It sounds like there’s peace in the valley,” Councilman Bob Coffin said.  Fire Chief Willie McDonald said there will be a division of labor: The department will respond to more serious emergency calls while AMR responds to less serious calls. He predicted that means the department will handle 60 percent to 65 percent of the calls, instead of the 75 percent he originally sought.

http://www.reviewjournal.com/news/fire-rescue/amr-vegas-fire-department-reach-deal


----------



## gonefishing

Whats a "serious" call? Would that be a full arrest etc and a non serious call being that of another fallen drunk? lol


----------



## chaz90

Does Vegas use PMD codes? It almost sounds like they're going to send AMR to the Alphas/Bravos and fire to the Charlie/Delta/Echos. Sucks to be an AMR medic in Vegas...


----------



## SandpitMedic

chaz90 said:


> Does Vegas use PMD codes? It almost sounds like they're going to send AMR to the Alphas/Bravos and fire to the Charlie/Delta/Echos. Sucks to be an AMR medic in Vegas...



Yes

EMD coding utilized here.

Unknown what codes exactly. As it stands it is any MVA and any Delta. I do not know yet how/if that will change.


----------



## SandpitMedic

Yeah, thats gonna suck. Honestly though, I've had many more a serious Alpha, Bravo, Charlie than legitimate Deltas.


----------



## Bullets

TransportJockey said:


> Exactly. Plus where I've worked there are no fire medics. Private ambulance or third service had all the medics and all the experience


And in NJ, Fire/Medic is not a thing, all ALS is third service privates



SandpitMedic said:


> Yeah, thats gonna suck. Honestly though, I've had many more a serious Alpha, Bravo, Charlie than legitimate Deltas.


How many 'Chest pains" turn out to be MI? how many "sick" patients end up being something serious like sepsis, MI or something. At least around here, we dont code our calls but ii find im requesting ALS more for calls that start as BLS than keeping them for calls that are sent as ALS.


----------



## SandpitMedic

This editorial is spot on! Here's the latest. From a source at AMR, they will run only Alphas and Bravos. 

http://m.reviewjournal.com/columns-blogs/glenn-cook/city-amr-shut-and-drive


----------



## terrible one

http://m.reviewjournal.com/columns-blogs/glenn-cook/city-amr-shut-and-drive

City to AMR - shut up and drive


----------



## DrankTheKoolaid

Read the Fitch report. Expect change


----------



## Rick Tresnak

Wow so much for a Governmental agency not being in direct competition with private enterprise.  Sounds like the DOG SIT mentality.  I bet Mark is beside himself.


----------



## SandpitMedic

*The storm: Las Vegas Fire Facing Two Federal Court Wrongful Death Suits Over EMS Response
*
http://www.firelawblog.com/2015/07/...court-wrongful-death-suits-over-ems-response/

Interesting. It will be very interesting to see how this plays out. One of the most notable cases was the death of a man stabbed, where an AMR rig was literally 20 seconds away near a McD's parking lot, but did not get the call. It was given to a fire unit, which was farther away, delaying treatment by several minutes, resulting in the death of the patient.

I predict this will go on and on and on for a long time. Settlements are not what they're after.


----------



## cruiseforever

It will be very interesting if the rulings are against the fire dept..  Could change how ambulances tracked and dispatched.


----------



## Summit

Interdasting


----------



## chaz90

To me, a system is fundamentally flawed when a 911 ambulance around the corner isn't dispatched to a centralized GSW while another takes 26 minutes to respond. 

Of course this is only one piece of the issue, but it's simply more ammunition for AMR. It's hard to keep getting votes and city council members on the side of the FD when the court of public opinion sees this kind of thing on the news. Since I haven't followed this lately, how is LVFR doing on ramping up their EMS staffing? Is this kind of response delay common or more of an exception?


----------



## TransportJockey

Unless they're doing a lot of internal promotions, I haven't seen a lot of postings for testing or anything for medics from LVFD...


----------



## SandpitMedic

There is a lot of hiring going on within the region - generally announcements are only open for a few days or a week and may have a cap (fills quickly). All of the major departments have academies going on now or starting in August. Also, there will be more to come. LVFR, in particular, I heard is bringing on a boatload. A couple more academies at least, is the latest gossip. A LOT of people I know got picked up- it's a good time to be a well qualified applicant in the Vegas region.

Personally, I applied for only one of the departments as opposed to a blanket spread... Just waiting to see if I get the call for one of the upcoming academies.

As for now, other things are cooking.

Anyone interested should keep their eyes open on the region.


----------



## SandpitMedic

And to the 911 comment. Yes, it is a flaw that they didn't dispatch the 911 AMR unit to that particular call. Which is why it is going to Federal Court.

This went down when the heat was turned up and the fire department started their transporting campaign. It was a power play to shut AMR out of the CAD... Unfortunately, it MAY have cost lives. That has yet to be determined.

You could say I have a bias as a private guy, but that is disingenuous. As a member of the community I find it shocking and unforgivable. That could have been me, or someone I know- left for 26 minutes while the Level 1 was only a 5 minute or less ride away... While I don't know every particular of that call, I know that there was indeed a unit seconds away - stage time or not - that was bypassed in favor of politics. I live in the first due justification of LVFR. So I take it personally. - Citizen rant over

Anyways--- EMS wise, so far... I haven't noticed a huge change- just see a lot more fire guys at the ERs.


----------



## waaaemt

SandpitMedic said:


> *The storm: Las Vegas Fire Facing Two Federal Court Wrongful Death Suits Over EMS Response
> *
> http://www.firelawblog.com/2015/07/...court-wrongful-death-suits-over-ems-response/
> 
> Interesting. It will be very interesting to see how this plays out. One of the most notable cases was the death of a man stabbed, where an AMR rig was literally 20 seconds away near a McD's parking lot, but did not get the call. It was given to a fire unit, which was farther away, delaying treatment by several minutes, resulting in the death of the patient.
> 
> I predict this will go on and on and on for a long time. Settlements are not what they're after.



Very interesting! Where I work, it's a similar situation.  We (private amb) Are required to have medics but we technically have the BLS contract so we do the bs calls only unless they run out of fire medic units.  But if there's a code around the corner from us the fire medics instead are sent even if they are all the  way across town. I don't think the public or even the hospitals  have any idea that sort of political bs goes on.


----------

