# Buffing Calls @ Private NYC Ambulances



## adamNYC (Jun 27, 2015)

Anyone here buff calls while working at a private NYC ambulance? I'm curious because I've heard rumours about guys who are doing it at more than one private company. I would like to know about your experiences, if its worth doing, what the risks are, etc. Me personally I know I am SAFEST doing it at my Volly. At a private service where one is expected to be doing dispatched Txp or SNF emergencies, I can see how it would be a problem if a particular unit or person(s) are coincidentally always getting "flag downs". I would prefer not to risk my job over some buffing action.


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## RocketMedic (Jun 27, 2015)

As in generating calls you happen to run across? I see no problem with it, many patients do not enter the heath care system through 911. Follow local regulations and you'll be fine.


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## adamNYC (Jun 27, 2015)

As in listening to PD/EMS radio and lights and sirens to that call before 911 EMS gets there


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## ERDoc (Jun 27, 2015)

If you aren't called, don't respond.  Your private employer won't like the fact that they are paying you to respond to other people's calls that they aren't getting paid for.  If you are that desperate for an adrenaline rush, there are plenty of vollies out on the island that could use some extra hands.


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## adamNYC (Jun 27, 2015)

This coming from a guy with a NY State Buff patch 

If you read my post or my signature, you would know that I do volunteer.

If you have ever worked a private, you would know that we do collect insurance information. Of course there will be the homeless or those without insurance.


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## ERDoc (Jun 27, 2015)

You seem to miss the sarcasm in my patch.  I know you volunteer but that doesn't seem to be enough for you.  I am just recommending that instead of buffing other people's calls when they don't need the help that you find someone else that does need the help and put your enthusiasm to good use.   I worked privates for just under a decade (quite possibly for the same company you work for) so I am well aware of how it works.  I also vollied for a bit longer.  I could PM you a few agencies that are very busy (and have fairly active knife and gun clubs), they might even be willing to pay for your train ticket out to Suffolk.  Be careful taking your volley ambulance out to buff calls.  Things may have changed since I was there but NYS was a home rule state and each company had its own operating certificate that defined the area it was allowed to operate in.  Taking you ambulance out of your approved area to buff calls (without being mutual aided) can tweak some noses and get you in trouble with the state.  Not to mention your district is now not covered.


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## Mufasa556 (Jun 27, 2015)

I suggest you don't do that. I differ to those who know the area as the EMS culture in NYC may be different, but here in Los Angeles they have specific rules against. Although I've heard of guys doing it out here, it's a great way to get chewed out by an FD Captain. 

I'll run still alarms, observed incidents, or other public initiated calls all day, but I'm not jumping calls. The thrill isn't worth the headache if or when you finally step into a steaming pile of uh oh.


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## DrParasite (Jun 27, 2015)

ERDoc said:


> Your private employer won't like the fact that they are paying you to respond to other people's calls that they aren't getting paid for.


That's not how it works.  They will hear the call on the scanner, and get there before the 911 ambulance arrives.  They will often pick up the patient and transport them to the ER (while charging the patient and collecting insurance, just like the 911 ambulance).  When the 911 ambulance arrives, they will frequently take a cancellation, as there is already an ambulance on location.

Many employers won't object, as long as you aren't late to your scheduled pickups.  after all, it's extra revenue for them.

But I wouldn't do it if it could get you in trouble at work.  No need to lose your job over that type of crap.

a better plan would be to get a job with one of the agencies within the FDNYEMS 911 system.


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## Jim37F (Jun 28, 2015)

When I worked private ambulance here in LA, the company launched an internal investigation on a crew who still alarmed enough calls that they were accused of listening to a scanner and conveniently choosing routes that would put them on scene of traffic collisions and the like prior to the 911 service providers arriving on scene...last I heard it was determined to be merely a coincidence. Out here that will get not just your employer, but you personally as well in trouble with the county EMSA. Very frowned upon here. As Mufasa said, I don't know how different NYC area EMS culture in this regard is, but I find it difficult to imagine that it's officially condoned. So unless you have a specific "Yes it is OK to listen to the scanner and jump on a call some other agency is actively dispatched too and does not know, much less agree to, you taking it from them" in writing on official letterhead (like an official policy or protocol) I simply would not do it if I were you.


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## ERDoc (Jun 28, 2015)

DrParasite said:


> That's not how it works.  They will hear the call on the scanner, and get there before the 911 ambulance arrives.  They will often pick up the patient and transport them to the ER (while charging the patient and collecting insurance, just like the 911 ambulance).  When the 911 ambulance arrives, they will frequently take a cancellation, as there is already an ambulance on location.
> 
> Many employers won't object, as long as you aren't late to your scheduled pickups.  after all, it's extra revenue for them.
> 
> ...



Like I said, it's been awhile since I was in the field.  The company I worked for told us NOT to buff calls because there was no way to know who did and didn't have insurance.  If we came up on a scene, we were to stabilize until the vollies came along, unless we could find out if they had insurance.


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## RocketMedic (Jun 28, 2015)

The concept behind this is horrifically disorganized.


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## adamNYC (Jun 28, 2015)

ERDoc said:


> .  Taking you ambulance out of your approved area to buff calls (without being mutual aided) can tweak some noses and get you in trouble with the state.  Not to mention your district is now not covered.



Yea its called a charter license. We were told at our orientation not to go buff calls outside of our chartered area because other vollies have jurisdiction over that area. Even if someone called us directly we cannot go outside of our area. Doing so will put that charter license at risk. NYC Community EMS I hear can buff calls wherever they want. If anyone has info on them let me know.








One thing I have personally experienced working a private is legitimate flag downs. Ped hit by a car, MVA, etc. What cracked me up is when FDNY BLS showed up the FD LT told them we "buffed" the call. I responded "We were on our way to a nursing home emergency actually" when everyone waved at us to pull over assuming we were there for them. We called dispatch and they reassigned the emergency to another unit and let us do the flag down job


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## akflightmedic (Jun 28, 2015)

adamNYC said:


> I responded "We were on our way to a nursing home emergency actually" when everyone waved at us to pull over assuming we were there for them. We called dispatch and they reassigned the emergency to another unit and let us do the flag down job



This is a horrible plan. Over the years on here and in other forums, this has been debated quite frequently with different providers from different areas having drastically different protocols for such a situation.

But think about it this way...You were on your way to an "emergency". The fact that it is a nursing home is irrelevant as they have true emergencies there and you were determined to be the closest unit for that emergency. Because you passed by or were flagged down for a "cooler call" (my words) you elected to stop for this one as opposed to continuing to the original call.

Now, a second unit has to be dispatched to the FIRST emergency. The second unit is presumably farther away than you originally were or they would have been sent to start with. You just delayed that first emergency for who knows how long? The delay very well could have contributed to the person in the home to becoming worse or dying. The truth of the matter is we do not know, it could have been nothing. Regardless, it was your first "emergency" assigned. If it was a routine transport then no worries, but you stated it was an actual emergency. Good job delaying care to the one who called first.

While I understand it is hard to drive past people flagging you down, your duty is to continue to your first assignment. Yes there is another emergency right in front of you, so what....the emergency is not yours. 

In general, it is poor policy to abort one emergency over another without all the information to analyze and you simply cannot do that until you have someone on scene most times.


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## adamNYC (Jun 28, 2015)

Be that as it may, we were specifically instructed at company orientation that we must stop for any flag downs regardless if we had a patient or if we were enroute to an emergency. 

Duty to Act

And we didn't buff that one. Legit flag down my first month of EMS.


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## akflightmedic (Jun 28, 2015)

As I said in my first statement...every agency has varying protocols.


So where is your "duty to act" to the first person who called? That goes out the window? I am trying to stimulate logical discussion with you...

And if you stop for a flag down and I or a family member is in back, I will have a lawyer on speed dial as your duty to act is now with whoever is in the truck.


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## adamNYC (Jun 28, 2015)

What you say makes total sense to me. What I did was based on what we were told to do. If I had an unstable pt in the back however its highly unlikely I would stop for a flag down.


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## akflightmedic (Jun 28, 2015)

Ok, now that we established that basically what I stated is "possibly right" in theory and you are merely following orders....have you taken it upon yourself to inquire as to why these orders exist? Have you asked what happens if you do not follow them? Have you been shown these orders in writing and agreed to them?

Basically, is this a written company policy?

Do you see where I am going with this?

Aside from the legal ramifications of you not being protected, is there not an ethical duty to act to those already in need of your assistance? 

I know not everyone is as stubborn as I am, but when I am given directions/orders I have to understand them and I have to see them written down. Do you have this in place?

This discussion is not just about liability, this is about growth, both personal and professional within ourselves. We ask ourselves...am I doing the right thing for my patient? Is this best practice to follow if it is not an absolute corporate policy? Don't I have a duty to act for those who call me first?

I do not think this is a black and white reply as the world to me is about 99% gray. Regardless, what say you?


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## RocketMedic (Jun 28, 2015)

What if the call you buff is uninsured?

Whole idea is rotten.

FWIW, if you tired that here, I would politely, yet firmly, ask you to leave.


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## NomadicMedic (Jun 28, 2015)

For all of you guys who are saying, "if you tried that here…" You should know that the New York City EMS system functions very differently than anywhere else.  For some strange reason, in the city, whackers seem to be tolerated more so than anywhere else,especially if they call themselves "buffs".


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## Brandon O (Jun 28, 2015)

New York has weird lingo.


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## adamNYC (Jun 28, 2015)

akflightmedic said:


> Ok, now that we established that basically what I stated is "possibly right" in theory and you are merely following orders....have you taken it upon yourself to inquire as to why these orders exist? Have you asked what happens if you do not follow them? Have you been shown these orders in writing and agreed to them?
> 
> Basically, is this a written company policy?
> 
> ...



Good point. I'm going to hit up chain of command about it.


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## ERDoc (Jun 28, 2015)

I think the reason it is tolerated there is because most in FDNY have some form of volley background.  You have an entire city covered by a municipal service but there are areas that also are covered by a volley organization.  It is even more bizarre when you get out on Long Island.  Adam, I'm pretty sure you answered your original question when you said, "We were told at our orientation not to go buff calls outside of our chartered area because other vollies have jurisdiction over that area. Even if someone called us directly we cannot go outside of our area. Doing so will put that charter license at risk."


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## adamNYC (Jun 28, 2015)

I was asking about buffing while working privates. 

Volly we do buff. Just not house jobs or outside chartered area.


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## ERDoc (Jun 28, 2015)

I would say that question is best answered by your company as each one is different.  I wouldn't actively buff calls, if you happen to come across something then help out but the let agency that has jurisdiction run the show and transport.


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## adamNYC (Jun 28, 2015)

On the non-buffed private flag downs that I've had we have always transported. And I would sure as hell rather be doing that then going for a non emergency txp job.


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## ERDoc (Jun 28, 2015)

We have different work ethics I guess.  The private is paying my paycheck, then I am doing their jobs.  Just because you come across a scene doesn't mean it is an emergency.  I used to stop, call it in if no one had and get out as quick as I could once 911 showed up.  I only transported from a scene I drove up on once and that was because it was right outside the hospital and it would have taken the vollies longer to get there than it would have taken to walk the stretcher inside.


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## Jim37F (Jun 28, 2015)

I think being flagged down is different than "buffing" a call...yes your original nursing home call could be a legit stroke while this may only be a fender bender....but until proven otherwise there is an equal chance it's the other way around, the SNF call could be any number of BS BLS complaints that we all encounter while there's a trauma center criteria patient up under the dash...

I don't know about you guys, but here, we'll get a change in response if another call comes in that we're closer to the new one, someone else (the next closest unit) will get dispatched to the original call in our place while we run the new one.

....but that's for being flagged down for an incident in your path that you can't just drive by (like a TC of some kind) otherwise my previous post still stands, I would not ever "buff" someone else's call without explicit permission from my employer, preferably coupled with them saying "why aren't you taking those calls?"


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## drl (Jun 28, 2015)

Interesting how that works in NYC. If I did that as an IFT EMT in my county, I'd be out of a job faster than I could open my mouth. Unless we're officially pulled into the 911 system, we're only allowed to control the scene and begin treatment for still alarms/MVAs that we happen on; for transport, we have to wait for the contracted 911 provider.

If we're responding to another emergent call or transporting any patient, we're not allowed to stop.


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## Smitty213 (Jun 28, 2015)

akflightmedic said:


> Ok, now that we established that basically what I stated is "possibly right" in theory and you are merely following orders....have you taken it upon yourself to inquire as to why these orders exist? Have you asked what happens if you do not follow them? Have you been shown these orders in writing and agreed to them?
> 
> Basically, is this a written company policy?
> 
> ...



I wholeheartedly agree with you on the "not abandoning your duty to the first dispatched patient", and NY has no official "duty to act", soooo there's that. However, having spent some time in the past at a large private in a NY metropolitan area I can say that it is not out of the question that a "flag down" would take precedence over a dispatched call for the simple reason that you are driving a billboard and so cruising by an incident could "knowingly tarnish the companies reputation", which in many cases is against policy (however self centered it may be). 

To the OP, was not even intentionally researching the topic, but I stumbled across a now repealed law that made it a serious violation to do what you're talking about doing, in the exact area you are talking about doing it. So is it illegal? Not anymore technically according to the state, but it was obviously a major issue at one point so I would avoid doing it so you don't tick off the wrong people and have the law reinstated.


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## adamNYC (Jun 28, 2015)

Smitty: Link to that article/page/website etc. ?


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## NomadicMedic (Jun 28, 2015)

Reminds me of the old "wrecker wars" when all the tow truck companies would listen to scanners to hear when the PD called for a hook. They'd all beat feet to the scene to be the first and get the tow.


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## Smitty213 (Jun 28, 2015)

I found it while trawling amongst the NY PHL 3000, I believe it was a law titled "Suffolk County emergency medical services". It laid out very specific guidelines to prevent the kind of "buffing" you're describing, even as far as laying out rules for driving your ambulance back from a hospital through an area that was not yours to cover.


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## Smitty213 (Jun 28, 2015)

Like I said, it's no longer technically in effect, but it was only repealed in '11 so the problems are probably still in recent memory for most, henceforth my advice to tread carefully...


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## ERDoc (Jun 28, 2015)

Smitty, I believe I found the section you were referring to.
https://www.health.ny.gov/professionals/ems/art30.htm#BM3017

This only applied to Suffolk County, which would not have affected Adam.  It was written because several of the privates were doing exactly what Adam is talking about and buffing the vollies calls.  I think I remember it coming about because someone with political connections got picked up by a private that buffed a volley call and he/she nearly **** a brick when they got the bill.


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## Smitty213 (Jun 28, 2015)

That is the one! And yes, I know it only applied to Suffolk County, so while it didn't pertain to the five boroughs, it's dealing with the same general area/culture/group of providers (last I knew, many of my Island friends were involved in the City and vice versa), so I figured it held some relevance. And that's a very interesting backstory!


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## ERDoc (Jun 28, 2015)

Don't quote me on the back story, but something like that stands out in my memory.  You don't mess with the vollies on LI.


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## Smitty213 (Jun 28, 2015)

ERDoc said:


> You don't mess with the vollies on LI.



Four years of college with numerous Islanders taught me just that...


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## Tigger (Jun 28, 2015)

adamNYC said:


> As in listening to PD/EMS radio and lights and sirens to that call before 911 EMS gets there


Lights and sirens to a call you were not dispatched to? That is just plain stupid.


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## 46Young (Jun 29, 2015)

I worked in the NYC 911 system from 2003 - 2007, for Hunter Ambulance-Ambulette from 2002-2003, and MVVAC for a short tint in 2002. My understanding is that the vollies or privates could buff a street job, but not go into a residence or any other non-street scenario, like a subway, restaurant, anything that you couldn't "happen to pass by accidentally." With the privates, I would be careful with "getting flagged down," because the company can reference the time you went 10-63, your expected 10-88 time and expected route, and can see if you deviated from a reasonable route to happen upon the street job. The excuse of avoiding traffic won't always work.

The FDNY and voluntary BLS crews will probably be happy to take the cancellation, but the ALS may want their usual BLS people to get their back instead of some unknown quantity in a private or volly bus. When I worked 46E and 46Y, we had problems from some local vollies buffing house jobs, and would be in the apartment before we got there. They got in trouble with the Conditions Boss a few times. Don't make that mistake. Stick to street jobs like MVA's.

Edit: When working for a private, your paycheck comes from revenue from scheduled calls, and you also screw the other units because one of them will have to take your original call, probably turning into a late job. If you want to work NYC 911 jobs, get a NYC 911 job.


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## Bullets (Jun 30, 2015)

This concept is so freaking weird to me. If a private ambulance company was listening to our channel and responding to calls, L&S especially, without being specifically requested, our PD would ticket the EMTs for reckless or careless driving and probably charge them with interfering with an emergency incident. It would be a huge deal


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## CAR1 (Jun 30, 2015)

I speak as a resident of NYC and a former vollie EMT. There is currently no purpose for vollies in NYC.all the vollies in NYC get their calls via listening to PD and buffing. Yes there are some vollies who have a loyal following of patients who actually call their emergency hotline number (mainly hatzolah), but those are few and far between. vollies were created in NYC when the ems coverage stank. now in 2015 my personal feeling is that most vollies should be shut down, problem is they are all friends with the politicians who get them grants for new ambulances, and if the city would shut them down there would be a whole outcry about how the city doesn't care about dying patients, and 95% of voters have not a clue how the ems system works. This will all come to an end one day when unfortunately someone will get hurt by a speeding ambulance to a call they were not really assigned to. This was my main reason for leaving the vollie, I couldn't stand risking my life to beat a dispatched ambulance to the call.

(I should also mention that there technically is a mutual aid agreement between FDNY and the vollies, most agencies can count on one hand the times they have been called)


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## RedAirplane (Jul 1, 2015)

CAR1 said:


> I speak as a resident of NYC and a former vollie EMT. There is currently no purpose for vollies in NYC.all the vollies in NYC get their calls via listening to PD and buffing. Yes there are some vollies who have a loyal following of patients who actually call their emergency hotline number (mainly hatzolah), but those are few and far between. vollies were created in NYC when the ems coverage stank. now in 2015 my personal feeling is that most vollies should be shut down, problem is they are all friends with the politicians who get them grants for new ambulances, and if the city would shut them down there would be a whole outcry about how the city doesn't care about dying patients, and 95% of voters have not a clue how the ems system works. This will all come to an end one day when unfortunately someone will get hurt by a speeding ambulance to a call they were not really assigned to. This was my main reason for leaving the vollie, I couldn't stand risking my life to beat a dispatched ambulance to the call.
> 
> (I should also mention that there technically is a mutual aid agreement between FDNY and the vollies, most agencies can count on one hand the times they have been called)



Or... If there is a valid resource, use it? 

If an ambulance is licensed, equipped, and trained to minimum standards, it shouldn't be stopped from participating in 911. I mean legitimately. 

It just reduces response times.


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## Flying (Jul 1, 2015)

RedAirplane said:


> Or... If there is a valid resource, use it?
> 
> If an ambulance is licensed, equipped, and trained to minimum standards, it shouldn't be stopped from participating in 911. I mean legitimately.
> 
> It just reduces response times.


Agencies can have the shiniest equipment and the best training, but when the people staffing the ambulance are not compensated adequately for their time and labor, the system as a whole suffers.


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## RedAirplane (Jul 1, 2015)

Flying said:


> Agencies can have the shiniest equipment and the best training, but when the people staffing the ambulance are not compensated adequately for their time and labor, the system as a whole suffers.



I don't understand. Are you saying volunteers are inadequately compensated? If they were compensated any more, they wouldn't be volunteers. 

And being a volunteer myself, I'm partial to volunteers (with professional standards, not the respond from home in pajama types).


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## RedAirplane (Jul 1, 2015)

And personally, I'd rather have a 3 minute response time when my heart stops, knowing that any ambulance (private, public, or volunteer) may respond, rather than wait in arrest for 4-5 minutes for the fire pros.


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## Tigger (Jul 1, 2015)

RedAirplane said:


> Or... If there is a valid resource, use it?
> 
> If an ambulance is licensed, equipped, and trained to minimum standards, it shouldn't be stopped from participating in 911. I mean legitimately.
> 
> It just reduces response times.


It's not just about response times. In fact, response times have been shown to be of little impact to patient outcomes. 

Not to mention that EMS service is provided (professionally) by FDNY, private companies, and hospitals. All of them are accountable for the area that they serve, yet they have no control over these volunteers. Not to mention, these providers need the revenue from transport to sustain their operations to provide service to their area. If an agency just came in and snatched up their patients, how are they supposed to that? There is a reason contracts are signed.


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## Flying (Jul 1, 2015)

RedAirplane said:


> I don't understand. Are you saying volunteers are inadequately compensated? If they were compensated any more, they wouldn't be volunteers.


What I meant is that people who volunteer have little incentive to provide a certain level of service outside of wanting experience, feeling important or what we could collectively call "goodness".

In terms of the system, goodness can only go so far when trying to provide a consistent service to a growing patient population.

Generally, "wanting to help people" can go only so far as a reason to want to continue doing this for years as a profession.

Personally, I gave it an honest shot and eventually decided that performing manual labor and being expected to be clinically competent is something that I should be paid for.


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## RedAirplane (Jul 1, 2015)

Flying said:


> What I meant is that people who volunteer have little incentive to provide a certain level of service outside of wanting experience, feeling important or what we could collectively call "goodness".
> 
> In terms of the system, goodness can only go so far when trying to provide a consistent service to a growing patient population.
> 
> ...



I have a lot of thoughts on this matter, and disagree, but I can respect your viewpoint.


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## RedAirplane (Jul 2, 2015)

Tigger said:


> It's not just about response times. In fact, response times have been shown to be of little impact to patient outcomes.
> 
> Not to mention that EMS service is provided (professionally) by FDNY, private companies, and hospitals. All of them are accountable for the area that they serve, yet they have no control over these volunteers. Not to mention, these providers need the revenue from transport to sustain their operations to provide service to their area. If an agency just came in and snatched up their patients, how are they supposed to that? There is a reason contracts are signed.



Think ICS. When there is a disaster, resources of a type are grouped. Fire engines, BLS ambulances, ALS ambulances. Then they are deployed where they are needed, instead of where they are ordinarily contracted to be. So similarly, any ambulance that wanted to be in the system (and there was a need for) could be deployed.

I'm not primarily EMS, I'm a software guy looking at getting into economics. I love efficiency.

The whole business of-- AMR takes 911, Pro takes IFT, Rural/Metro takes CCT... rather than factoring calls in based on proximity wreaks of inefficiency. I know **why** it is the way it is today (exclusive operating zones and what not), but I think with some economic modeling we could come up with legislation that makes companies happy, reduces response times, and most importantly for me, always has the closest appropriate unit respond.


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## Tigger (Jul 2, 2015)

RedAirplane said:


> Think ICS. When there is a disaster, resources of a type are grouped. Fire engines, BLS ambulances, ALS ambulances. Then they are deployed where they are needed, instead of where they are ordinarily contracted to be. So similarly, any ambulance that wanted to be in the system (and there was a need for) could be deployed.
> 
> I'm not primarily EMS, I'm a software guy looking at getting into economics. I love efficiency.
> 
> The whole business of-- AMR takes 911, Pro takes IFT, Rural/Metro takes CCT... rather than factoring calls in based on proximity wreaks of inefficiency. I know **why** it is the way it is today (exclusive operating zones and what not), but I think with some economic modeling we could come up with legislation that makes companies happy, reduces response times, and most importantly for me, always has the closest appropriate unit respond.



I'm not disagreeing on its relative inefficiency, though I think you are seeking a solution for a problem that does not exist. Companies that run transfer services rely on extreme efficiency in that they need their ambulances to be patient loaded as much as possible. No patient is no money, so as soon as a drop off is complete it's time to head elsewhere for another transfer. The smart company runs at backbreaking UHUs if they want to make money. There just isn't that much room or time for them to be running 911 (which often is not financially worth it). It isn't like there are dozens of ambulances sitting around waiting for transfers while 911 calls are dropping right next door.


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## Eddie2170 (Jul 6, 2015)

There are a lot of different topics being thrown around here.

Firstly (from my understanding) the OP both Volunteers outside of NYC & operates as an EMT with a Private based Contract & IFT EMS service. Very different areas, different rules, etc.

Within NYC you have 4 types of services

FDNY EMS - municipal EMS members operating under the FDNY Bureau of EMS

FDNY EMS Participating Hospital Units (Called Voluntaries - note different from Volunteer) 911 unit essentially identical FDNY units except either hospital employees or outsourced. Dispatchers see no difference in these units, computer sends closest unit.

Community Ambulance Corps, run by Volunteers - i.e. Central Park Medical Unit & College Point Ambulance Corp. (Staffed by volunteers - ability to be dispatched by FDNY EMS in the event of a Mobilization of the Mutual Aide Task Force)

Private Ambulance Services - Contracted to Facilities & Businesses as well as Hospitals for Facility Emergencies or IFTs

911 Calls are answered by the closest available 911 unit - Municipal (FDNY) or Voluntary (Hospital) 911 unit. Again the CAD (computer) sees no difference in these - closest goes.

Volunteers can receive direct calls to their station. Usually elderly or family/friends etc. That have used the volunteer service since the early days of NYC EMS. They typically only do this in the community served by their ambulance. OR! They 'Buff' meaning they listen to both the NYC EMS frequency &/or the NYPD precinct frequently and will beat the 911 unit in order to bill & serve the community.

** Usually ** this is not a big deal. Most 911 units actually appreciate it, (although the supervisors may not) the unit remains available & they may get a break. There are plenty (1.6 million jobs in 2014) of jobs to go around. Unless it is a 'good' or 'bad' job depending on your outlook they may get a little lip from the crew. But again usually not a big deal & the 911 units in the area generally are aware of the volunteers local to them.

Privates on the other hand have their own dispatch their own call takers etc. Etc. & are completely independent of the 911 system & in many cases will drop calls to 911 in times of unforseen high volume. They are very busy without 911 calls.

If a private crew were to take it upon themselves to 'buff' by radio & respond to a 911 call they could absolutely do so. The 911 crew dispatched again probably wouldnt care as most are slammed all day with jobs. Again unless it seemed like a 'good' job. IF they were to get in an accident along the way & were using lights & sirens they would certainly be reprimanded if not fired. The private company would probably not mind either as long as the pt were insured.

The only time i think this would be a big deal is if it was a both ALS & BLS dual response because the FDNY units would more than likely not be able to be driven by a Private crew if both Medics were treating the pt.

NOW- if ANY Ambulance is 'flagged' by a civilian or patient, regardless of Unit status or type of Ambulance THEY MUST STOP. so while going to another call & you stumble upon an MVA or Security outside a residence says there is a call inside the building that Crew Must Stop. They are not required to transport the patient but they MUST stop make pt contact & provide treatment until either the 911 unit arrives or they choose to transport the patient themselves. They are a walking billboard they will get in trouble or even lose their state cards if they did not stop. They are a NY STATE certified ambulance with a State Certified EMT on board and they are licensed to work within NYC. The public & lawyers dont care who you work for. With a patient on board out of service due to whatever reason doesnt matter. If you have a critical patient simply explain the situation & document appropriately.

To answer the OP's question. If i were working a private i would not buff 911 jobs. I used to get slammed enough working for a private to want 911 jobs. If you get in an accident or are seen by another crew or supervisor going lights & sirens unauthorized youre probably getting fired & if you get into an accident you're probably getting sued too, bet you have a drivecam in your Bus, reckless endangerment taking it upon yourself to drive dangerously when not instructed to do so. If you get flagged you get flagged is what it is. If you 'happen' to be 'near' a job that drops, take a slow roll by & see if you beat the 911 crew. But dont get in trouble. Get your 911 experience on a 911 truck.


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## Bullets (Jul 6, 2015)

RedAirplane said:


> And personally, I'd rather have a 3 minute response time when my heart stops, knowing that any ambulance (private, public, or volunteer) may respond, rather than wait in arrest for 4-5 minutes for the fire pros.



If your in NYC, you arent getting an ambulance in 3 minutes no matter who is staffing the rig and providing the service



Eddie2170 said:


> There are a lot of different topics being thrown around here.
> 
> 
> NOW- if ANY Ambulance is 'flagged' by a civilian or patient, regardless of Unit status or type of Ambulance THEY MUST STOP. so while going to another call & you stumble upon an MVA or Security outside a residence says there is a call inside the building that Crew Must Stop. They are not required to transport the patient but they MUST stop make pt contact & provide treatment until either the 911 unit arrives or they choose to transport the patient themselves. They are a walking billboard they will get in trouble or even lose their state cards if they did not stop. They are a NY STATE certified ambulance with a State Certified EMT on board and they are licensed to work within NYC. The public & lawyers dont care who you work for. With a patient on board out of service due to whatever reason doesnt matter. If you have a critical patient simply explain the situation & document appropriately.
> ...



Wait, if an ambulance is dispatched to a call and while enroute to that call someone tries to flag them down, they HAVE to divert and treat that flag down?


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## Eddie2170 (Jul 7, 2015)

Bullets said:


> Wait, if an ambulance is dispatched to a call and while enroute to that call someone tries to flag them down, they HAVE to divert and treat that flag down?



If you were to be on the way to a call regardless of the priority & get flagged down you have to stop (or put on blinders) but you really wouldn't know what it is until after you stop. & once you stop you have to act. If someone is waving you down youre obviously going to stop & then obviously its too late.

If you had a critical pt on board & were on the way to the hospital you simply speak to the flagger & explain the situation & notify dispatch & document appropriately.

If you didnt stop you better watch your back, hope they didnt take a picture or get the #of bus etc etc. & even if they didnt nothing a quick 311 call couldn't fix. It's much easier to just stop. Happens often enough too.


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## Tigger (Jul 7, 2015)

We aren't stopping if we have a sick patient on board, that's poor patient care. I'll happily call it in, but to stop is silly. You aren't going to get in trouble for that, even if someone complained.


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## Eddie2170 (Jul 7, 2015)

Tigger said:


> We aren't stopping if we have a sick patient on board, that's poor patient care. I'll happily call it in, but to stop is silly. You aren't going to get in trouble for that, even if someone complained.



Im not saying you have to even get out of the bus, but you at minimum have to acknowledge the flaggers existence & tell them you're notifying dispatch. I agree with you its not in your patient on boards best interest however like i said you really don't have a choice.

& forbid the patient is critical that you dont stop for & especially if your patient on board is BS like a stable drunk, i wouldnt put it past most stupidvisors to Command Discipline you on it. Every NY resident knows 311 for a civilian complaint. & if that patient you didnt stop for dies regardless of your original patients condition i guarantee you'll be in court. Id bet my card. They may not win bit that's up to your agency lawyer & the judge

No one said NYC EMS was progressive & NYC politics rules regulations  & lawyers rule the land.

Just be able to justify anything and everything you do & make sure it's not in violation of anything


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## Jim37F (Jul 7, 2015)

Yikes, that's horrible, what if you never saw the flagger, or legitimately thought they were flagging down that taxi cab? And I thought LA was lawsuit happy...:/


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## Tigger (Jul 7, 2015)

Eddie2170 said:


> Im not saying you have to even get out of the bus, but you at minimum have to acknowledge the flaggers existence & tell them you're notifying dispatch. I agree with you its not in your patient on boards best interest however like i said you really don't have a choice.
> 
> & forbid the patient is critical that you dont stop for & especially if your patient on board is BS like a stable drunk, i wouldnt put it past most stupidvisors to Command Discipline you on it. Every NY resident knows 311 for a civilian complaint. & if that patient you didnt stop for dies regardless of your original patients condition i guarantee you'll be in court. Id bet my card. They may not win bit that's up to your agency lawyer & the judge
> 
> ...


I would like to see some sort of citation stating that I must do stop. Unless it is law or company policy, I am not stopping. Also I have no idea how I would end up in court, on what grounds would that occur? 

EMS fears court like the boogeyman. While it is true that you can be sued for anything, there is nothing to say that such a suit would even move forward to a trial.


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## ERDoc (Jul 7, 2015)

It might be policy for FDNY but it is not universal in NYS.  My VAC had the policy that your duty was to the first call.  If you passed by an MVA or got flagged down, you called it in and proceeded to the first call.  I don't know if it was based in any law or was just dept policy.



Tigger said:


> EMS fears court like the boogeyman. While it is true that you can be sued for anything, there is nothing to say that such a suit would even move forward to a trial.


Don't forget, he lives in NYS.  Never underestimate the power of a stupid lawsuit in NYS.


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## Bullets (Jul 7, 2015)

Eddie2170 said:


> words and such


Yeah, unless i can clearly see the patient is dying, and im not already enroute to an ALS job we dont stop. Once i have a patient, then my priority is to that patient, not a potential patient.

Thats messed up


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## Chewy20 (Jul 7, 2015)

Eddie2170 said:


> If you had a critical pt on board & were on the way to the hospital you simply speak to the flagger & explain the situation & notify dispatch & document appropriately.



Calling absolute BS on this until you can show me written policy on it. Makes absolutely no sense, even in the EMS world. If you have a critical pt I assume you are going code 3 to the hospital. The flagger should be noticing the lights and sirens and call 911 like everyone else. They can take all the pictures they want, they don't get to interfere with my pts care because they decided to run out to the sidewalk and wave you down like a taxi.

If you are driving and go past an MVC, and you can safely switch tac channels to tell dispatch where it is then, ok I guess. Would lose zero sleep about it though, because 50 other cell phone heroes have already called it in as well.

You sound like you have read this said policy before, so waiting to see it.


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## squirrel15 (Jul 8, 2015)

Eddie2170 said:


> Im not saying you have to even get out of the bus, but you at minimum have to acknowledge the flaggers existence & tell them you're notifying dispatch. I agree with you its not in your patient on boards best interest however like i said you really don't have a choice.
> 
> & forbid the patient is critical that you dont stop for & especially if your patient on board is BS like a stable drunk, i wouldnt put it past most stupidvisors to Command Discipline you on it. Every NY resident knows 311 for a civilian complaint. & if that patient you didnt stop for dies regardless of your original patients condition i guarantee you'll be in court. Id bet my card. They may not win bit that's up to your agency lawyer & the judge
> 
> ...


I'm not in NY but I have a strong feeling you're reading something wrong. There is no possible way you are required to stop for someone flagging you down, especially if you have a patient on board. Could you post a link where you're getting this info from please.


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## DrParasite (Jul 8, 2015)

Tigger said:


> I would like to see some sort of citation stating that I must do stop. Unless it is law or company policy, I am not stopping. Also I have no idea how I would end up in court, on what grounds would that occur?


Just me shooting from the hip, but I would imagine duty to act laws come into play here.  it's one thing to ignore an emergency when your off duty in your POV, but it's quite another to ignore a flagger while in an ambulance with lights and sirens.  You might not get sued, but you can get dragged into an investigation.

Then there is the whole "court of public opinion" issue.  You might not be sued, but the headline "paramedic drives by baby not breathing" with the sub-heading "doesn't even stop to help, was late to a non-emergency run" probably won't go over very well.

Hypothetically speaking, if you did have a stable patient in the back, why would you not stop and render aid?  It's good PR, your patient isn't dying, so another 10 minutes won't affect his outcome, and if the patient is sick & dying, you can scoop and run the both to the closest ER.  Obviously this wouldn't work if you are transporting to a sick and dying patient.

Speaking as a dispatcher, I would want you to tell me about the incident and I will tell you to stop or continue to your original assignment.  I might have it already, or I might not.  I might have a unit that will end up closer to your original job, at least compared to the flagged down call.  If you are going to a toe pain, or other non-life threatening dispatch, I might tell you to stop, because the toe pain can wait a couple more minutes until another unit arrives.  Best part about all this: if something bad happens, you can always say, "I advised dispatch, who is aware of all calls in the system, and they directed me to take that action.  I was only aware of one call, so I assumed they knew the call was of a more pressing issue."


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## Eddie2170 (Jul 8, 2015)

In NY if im driving lights & sirens patient on board or not a flagger is going to assume im coming for their emergency.

This is strictly Duty to Act & Abandonment Im a NYS Emt or Medic in a NYS Certified Ambulance i am in service im responsible. I see the patient or am being directed to a patient regardless of me being assigned to another job. Im now responsible for them. End of story. Listen i know it sounds stupid i know its ridiculous. But this is NYC. Its old school its antiqued its slow reactive its barbaric. Medics do not have CPAP on some busses its not required by the city, its optional in the protocol. Let alone EMTs having glucometry god forbid. Were running 4000 calls a day. If i get flagged there's another ~400 911 dispatched ambulances to take the other one.

You can tell a difference between someone flagging or STANDING IN FRONT OF YOUR BUS IN THE CROSSWALK WHILE YOU'RE LIGHTS & SIRENS. Dead serious.

I will try to find an 'order' but this is straight medical legal. 1st day of the academy.

& i can name at least 4 emts & medics with lawsuits against them personally on top of the department & city for jobs. Yes its that. Crazy here.


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## squirrel15 (Jul 8, 2015)

Eddie2170 said:


> In NY if im driving lights & sirens patient on board or not a flagger is going to assume im coming for their emergency.
> 
> This is strictly Duty to Act & Abandonment Im a NYS Emt or Medic in a NYS Certified Ambulance i am in service im responsible. I see the patient or am being directed to a patient regardless of me being assigned to another job. Im now responsible for them. End of story. Listen i know it sounds stupid i know its ridiculous. But this is NYC. Its old school its antiqued its slow reactive its barbaric. Medics do not have CPAP on some busses its not required by the city, its optional in the protocol. Let alone EMTs having glucometry god forbid. Were running 4000 calls a day. If i get flagged there's another ~400 911 dispatched ambulances to take the other one.
> 
> ...


OK so some rigs don't have cpap because its not required, San Mateo county in California doesn't require AEDs so maybe some rigs don't have them. I can show you the counties ambulance requirements. As well as county protocols. 

Which is what we are asking for you to do. Because we are all calling BS on having to stop for someone flagging you down no matter what. You have people in the back doing CPR on someone and you think its ok to stop? If it was my family member in back, you're getting sued. And you would lose that lawsuit...


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## Tigger (Jul 8, 2015)

DrParasite said:


> Just me shooting from the hip, but I would imagine duty to act laws come into play here.  it's one thing to ignore an emergency when your off duty in your POV, but it's quite another to ignore a flagger while in an ambulance with lights and sirens.  You might not get sued, but you can get dragged into an investigation.
> 
> Then there is the whole "court of public opinion" issue.  You might not be sued, but the headline "paramedic drives by baby not breathing" with the sub-heading "doesn't even stop to help, was late to a non-emergency run" probably won't go over very well.
> 
> ...


In a previous post I stated I would not stop with a sick patient and was continuing on those grounds. If my patient is stable, then sure, why not stop. Interestingly, my AMR operation instructs us not to stop with any patient onboard, just call it in.


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## DrParasite (Jul 8, 2015)

FDNY EMSC OGP 101-01 GENERAL REGULATIONS

4.1.15 Acknowledge and provide treatment to all flag down assignments, advising the
dispatcher as soon as possible.

The General Regulations of the EMS Command Operating Guide Procedures (EMSC OGP) 101-01 provides, in section 1.1, that the purpose of these regulations is "[t]o set forth standards of conduct for all members of the EMS Command." Under the heading "Member Code of Conduct," section 3.1 provides that "[t]he FDNY is a public safety service whose members must perform their duties according to the highest possible standard of conduct and ethics," and that "[t]his prescribed code of conduct is set forth to provide guidelines and define certain infractions, which are deemed serious and may result in corrective and/or disciplinary action." This section further states that "[e]ach member is responsible for adhering to these guidelines and each Supervisor is responsible for their enforcement." Under the heading "Responsibilities," section 4.1.15, which is known as the flag down rule, provides that "[m]embers of the EMS Command, regardless of job title or rank, shall…[a]cknowledge and provide treatment to all flag down assignments, advising the dispatcher as soon as possible."


While not official at all, the flag down rule is as follows: "The flag-down rule allegedly requires all personnel to render assistance to people who request it."

http://www.firelawblog.com/2013/06/27/fdny-dispatcher-cleared-in-au-bon-pain-case/


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## squirrel15 (Jul 8, 2015)

The only time I can find this is in the article you linked and the charges were dropped. And in what you posted the wording makes it seem as though it only applies to FDNY. So does every ems agency follow FDNY policy and procedure?


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## DrParasite (Jul 8, 2015)

squirrel15 said:


> The only time I can find this is in the article you linked and the charges were dropped. And in what you posted the wording makes it seem as though it only applies to FDNY. So does every ems agency follow FDNY policy and procedure?


The charges were dropped because she wasn't an an ambulance.  And because she should have never been charged in the first place, but the brass needed to do something to sooth the public outcry, not because of the actual facts of the incident.  But I digress....

The FDNY rules only apply to FDNY and FDNY related units.  so if you're not in NYC, you don't need to follow the rules and regulations of NYC or FDNY.  FDNY policies and procedures are only enforceable by others in the FDNY system.


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## squirrel15 (Jul 8, 2015)

DrParasite said:


> The charges were dropped because she wasn't an an ambulance.  And because she should have never been charged in the first place, but the brass needed to do something to sooth the public outcry, not because of the actual facts of the incident.  But I digress....
> 
> The FDNY rules only apply to FDNY and FDNY related units.  so if you're not in NYC, you don't need to follow the rules and regulations of NYC or FDNY.  FDNY policies and procedures are only enforceable by others in the FDNY system.


So op would only fall into the Flag down rule while working for FDNY then. And with that I can't find anything addressing whether you have a patient or not. And I if someone can point to it, I will be extremely shocked if you are required by law to stop when you have a patient in the back especially critical.


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## DesertMedic66 (Jul 19, 2015)

Wow, I never knew this was actually a thing. I am actually thankful that I have never heard of this and also thankful we do not have any volunteer ambulance companies here or anywhere close by. 

Out here that sort of practice would be shut down instantly. Still alarms are fine and witnessed accidents are also fine (out here the 911 company would normally still respond and take charge of the patient).

What is the point of having a volunteer company if the only way for them to get calls is to jump calls that aren't theirs? In cities with a well established 911 EMS system there is zero need for a volly company.


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## adamNYC (Jul 19, 2015)

Read all four pages. You will find that vollys DO get folks calling their private number. The most popular volly in NYC is hatzolah, and I highly doubt they buff at all since they are so busy. At all other vollys, we may get private calls, but what does one do between those calls? Sit around and wait? Thankfully, it is commonly acceptable to buff calls. 911 units are usually familiar and usedwith it, hell alot of guys in my volly also do 911 at their day jobs, and may even know the 911 ambulance staff. So its usually a friendly situation. Gives 911 guys a break from their usually busy tours as well, and some even appreciate it.


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## TransportJockey (Jul 19, 2015)

I did read all four pages and still find it ridiculous. I don't get the point of volunteer units in a major metro area that has a well developed professional EMS system that touts itself (but in all reality isn't) as the best in the world


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## adamNYC (Jul 19, 2015)

Some but not all vollys is affiliated with the FDNY EMS 911 system and has a radio designation. Our particular volley has been called on in disasters, snowstorms, etc to help out as needed. Thats 3 extra ambulances for the city to deploy as needed.


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## Akulahawk (Jul 19, 2015)

Quite a few years ago, a company I used to work for had a reputation for doing exactly what is described here: listening to the scanner and trying to beat the 911 system units to the scene. This was something I learned about after I had stopped working for them, mostly because I work for them for a very short period of time. In fact, this particular company nearly lost their County license to operate because of their practice of obviously listening to the scanner and "coincidentally" just happening to be on scene way too many times. There have been times when non-911 units have ended up taking 911 calls simply because they just happen to be there, but as in general rule, this practice of "buffing" calls (we called it jumping calls) was highly frowned upon.

In other systems, it is certainly possible (and quite likely in NYC) that because of the way the system is designed and the sheer volume of calls, this practice is possibly unofficially condoned. Regardless, make sure that you know your system and whether or not you can do it, and exactly when, without getting your backside in trouble.

This is not a practice that I personally condone simply because of the issues that can pop up.

As to the requirement that an ambulance must stop when being flagged down by a bystander, regardless of ambulance status, my take on it is simply this: if I do not have a patient on board, I have not made patient contact in any way shape or form, therefore abandonment does not apply. If I do have a patient on board, and I leave my patient for any reason, then I potentially abandoned my patient. Therefore, if I have a patient on board, I will stop to gather information and relay that immediately to the dispatch so that an appropriate ambulance can be called. I know of a particular incident in Santa Clara County quite a few years ago where an ambulance crew failed to stop for an obvious medical aid, called it in as a noninjury MVA that they happen to somehow magically assess while driving by, and the patient ultimately was a major trauma victim. The crew was queried several times over the air about that particular incident that they drove by, and at some point they were directed to provide their certification numbers over the air. I have no doubt that they were severely disciplined.

If that crew had a patient on board at the time, they simply could have called it in as an "unknown injury MVA, unable to stop due to patient on board," and they would have been fine.


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## adamNYC (Jul 19, 2015)

" If I do have a patient on board, and I leave my patient for any reason, then I potentially abandoned my patient. Therefore, if I have a patient on board, I will stop to gather information and relay that immediately to the dispatch so that an appropriate ambulance can be called."

At our private the rule is the tech will continue to stay with pt and the driver will treat the flagged down pt and call for another ambulance as well, either 911 or another private ambulance.


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## Akulahawk (Jul 19, 2015)

adamNYC said:


> Some but not all vollys is affiliated with the FDNY EMS 911 system and has a radio designation. Our particular volley has been called on in disasters, snowstorms, etc to help out as needed. Thats 3 extra ambulances for the city to deploy as needed.


Every place I have worked, every licensed ambulance, regardless of medical capability (BLS, ALS, CCT) could be pulled into the 911 system at any time. As an example, I used to work in Santa Clara County. In that County, within a couple of hours the number of  911 EMS system ambulances could effectively double in size. At the time, there were no volunteer ambulance services in that county. I believe that is the case still today. Even if there were volunteer ambulance services there, they all would be required to be licensed by the county and they all could be pulled into the 911 system for service.


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## Akulahawk (Jul 19, 2015)

adamNYC said:


> " If I do have a patient on board, and I leave my patient for any reason, then I potentially abandoned my patient. Therefore, if I have a patient on board, I will stop to gather information and relay that immediately to the dispatch so that an appropriate ambulance can be called."
> 
> At our private the rule is the tech will continue to stay with pt and the driver will treat the flagged down pt and call for another ambulance as well, either 911 or another private ambulance.


That is all fine and well and good as long as you have a relatively stable patient on board. As can sometimes happen, your patient could deteriorate and then you have delayed the patient's arrival to definitive care because you are no longer moving. I understand that NYC/FDNY does things a little differently. My point is that once that crew has made actual patient contact, their primary responsibility is that patient. If I'm flagged down while transporting, my duty to act is to simply alert dispatch of the flag down. If I'm not transporting, then I have a duty to act and can provide the full scope of care, including transport, if I'm flagged down or respond to a "still alarm" type of incident. 

Different systems, different responsibilities.


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## DesertMedic66 (Jul 19, 2015)

adamNYC said:


> Read all four pages. You will find that vollys DO get folks calling their private number. The most popular volly in NYC is hatzolah, and I highly doubt they buff at all since they are so busy. At all other vollys, we may get private calls, but what does one do between those calls? Sit around and wait? Thankfully, it is commonly acceptable to buff calls. 911 units are usually familiar and usedwith it, hell alot of guys in my volly also do 911 at their day jobs, and may even know the 911 ambulance staff. So its usually a friendly situation. Gives 911 guys a break from their usually busy tours as well, and some even appreciate it.





TransportJockey said:


> I did read all four pages and still find it ridiculous. I don't get the point of volunteer units in a major metro area that has a well developed professional EMS system that touts itself (but in all reality isn't) as the best in the world



TransportJockey summed up what I was going to say. Volunteer companies are great for rural areas where there are literally no calls and the closest established EMS system is hours away. Not so much for urban cities especially a busy city like NYC where there is a hospital and an ambulance on every street corner. 

Also I had the chance to talk to several Hatzolah volunteers during hurricane Sandy. Let's just say our view points were very different on most topics and they were also a little mad that we were unable to let them use our fuel trucks when the city ran out of gas. 

The point of most volunteer companies is to allow the volunteers to have a career and family and then occasionally do a station shift or go on calls. If you are that busy of a volunteer company you need to be an actual company.


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## Carlos Danger (Jul 19, 2015)

adamNYC said:


> Read all four pages. You will find that vollys DO get folks calling their private number. The most popular volly in NYC is hatzolah, and I highly doubt they buff at all since they are so busy. At all other vollys, we may get private calls, but *what does one do between those calls? Sit around and wait?* Thankfully, it is commonly acceptable to buff calls. 911 units are usually familiar and usedwith it, hell alot of guys in my volly also do 911 at their day jobs, and may even know the 911 ambulance staff. So its usually a friendly situation. Gives 911 guys a break from their usually busy tours as well, and some even appreciate it.



Yes, sitting around and waiting is exactly what one does between calls. 

Or you could inspect and clean your rig and equipment, train, study, work out, watch movies. Stuff normal EMS professionals do between calls.


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## Gurby (Jul 19, 2015)

From the other thread:



adamNYC said:


> 5. Respond with Lights and sirens for a job 5-10 minutes away. Anything more than that you prob won't get there in time.



Seems like it would be illegal to respond lights and sirens to a call you aren't dispatched to.


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## triemal04 (Jul 19, 2015)

Remi said:


> Yes, sitting around and waiting is exactly what one does between calls.
> 
> Or you could inspect and clean your rig and equipment, train, study, work out, watch movies. Stuff normal EMS professionals do between calls.


Woah there tiger, slow it down a bit.  Do you not understand?  He is not a normal EMS professional, he is a volunteer!  Do you not understand the special, one might even say mystical, status that attaches to the individual?  Volunteers are freely giving their time because of the king-size heart they have to save the world; why should they concern themselves with doing things that mere "normal" EMS folks do?  The nerve of some people...


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## DrParasite (Jul 19, 2015)

DesertMedic66 said:


> Not so much for urban cities especially a busy city like NYC where there is a hospital and an ambulance on every street corner.


New York City does NOT have an ambulance and ambulance on every street corner.  Manhattan might, but parts of Brooklyn, Queens and the Bronx definitely don't.  Staten Island, the smallest borough with an urban area of about 50 sq miles, and a population of about 475,000, only has two hospitals.

For parts of Brooklyn & Queens, the volunteer ambulance or fire department can make it to the scene before the 911 system units, especially back in the day, when NYC EMS had 20-45 minute ETA to most calls.


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## cprted (Jul 19, 2015)

This opens up a huge public safety risk ... now we have multiple ambulances running lights and sirens through the city unnecessarily.   I don't care how good of a driver you think you are, the second you flip on the lights and sirens, you double your chances of being involved in a fatal motor vehicle collision. 

Not to mention personal liability.  A lawyer would have a field day if you were ever involved in a crash.  
Lawyer: So Volunteer Bufferson, when you were driving Code 3 down the streets of New York, FDNY asked you to respond to this call and dispatched you?
Buffer: No, I was trying to beat the FDNY ambulance.
Lawyer: Putting the public at risk to try and beat the paid professional EMTs and Paramedics who were dispatched to the call?
Buffer: No its fine, we do this all the time.
Lawyer: How do you find out about these calls?
Buff: Oh I listen to a police radio for calls that sound like they might need an ambulance.
Lawyer: So nobody has asked you to come and you don't even know if an ambulance is required or the nature of the call and you're putting to public at risk by driving a half ton bomb through red lights?
Buff: But the paid guys are used to it.

I hope you either have good insurance or like the idea of someone else living in your house.


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## adamNYC (Jul 19, 2015)

I can understand your concern and i appreciate your enlightening me with the associated risks, but when all other vollys in NYC do it, and the results are highly rewarding, you keep on doing what works.

High risk = high reward.


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## Brandon O (Jul 19, 2015)

Sounds all very Mother Jugs and Speed.


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## Flying (Jul 19, 2015)

adamNYC said:


> High risk = high reward.


High risk to others = Marginal reward for the buff

See what we are getting at?


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## Jim37F (Jul 19, 2015)

When you're done with your shift driving home, and you get t-boned by an over eager EMT attempting to buff a call he's not assigned to, and he races through your intersection without stopping to clear it because he really really wants to beat FDNY to that call, is it still high risk high reward for you then?


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## adamNYC (Jul 19, 2015)

Yall can go on all day about the risks and how vollys shouldn't buff but that won't change how we operate. The main problem I see is why all vollies aren't called upon by FDNY 911 more often. That would put less strain on the regular 911 units and increase response times.


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## TransportJockey (Jul 19, 2015)

adamNYC said:


> Yall can go on all day about the risks and how vollys shouldn't buff but that won't change how we operate. The main problem I see is why all vollies aren't called upon by FDNY 911 more often. That would put less strain on the regular 911 units and increase response times.


Hopefully one of you asinine vollys killing someone isn't what it takes to change your broken system.  As for why you're not getting support, it's because no other place is dumb enough to have any kind of system like that.


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## DesertMedic66 (Jul 19, 2015)

adamNYC said:


> Yall can go on all day about the risks and how vollys shouldn't buff but that won't change how we operate. *The main problem I see is why all vollies aren't called upon by FDNY 911 more often.* That would put less strain on the regular 911 units and increase response times.



The answer to that question can easily be answered by pretty much all of the posts you have done so far.


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## CALEMT (Jul 19, 2015)

adamNYC said:


> but when all other vollys in NYC do it



Just because others do it, doesn't make it right.



adamNYC said:


> results are highly rewarding, you keep on doing what works.
> High risk = high reward.



This is just a bad practice all around.


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## ERDoc (Jul 19, 2015)

adamNYC said:


> High risk = high reward.



This is why you shouldn't be allowed near a patient, much less a several ton killing machine.



TransportJockey said:


> Hopefully one of you asinine vollys killing someone isn't what it takes to change your broken system.



It's happened, nothing changes since the vollies are sacred cows.


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## Tigger (Jul 20, 2015)

adamNYC said:


> Yall can go on all day about the risks and how vollys shouldn't buff but that won't change how we operate. The main problem I see is why all vollies aren't called upon by FDNY 911 more often. That would put less strain on the regular 911 units and increase response times.


Probably because based on this thread, it does not seem likely that FDNY would place all that much trust into any of these organizations. I have neither the time nor inclination to look it up, but I am betting it's illegal for you to be driving around with lights and sirens having not been dispatched to a call. That right there is enough of a red flag regarding your judgement.


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## NPO (Jul 21, 2015)

adamNYC said:


> This coming from a guy with a NY State Buff patch
> 
> If you read my post or my signature, you would know that I do volunteer.
> 
> If you have ever worked a private, you would know that we do collect insurance information. Of course there will be the homeless or those without insurance.


I mentioned it in your other thread, but this is why your volly wants you to buff. They cannot obtain their own contract (probably due to poor performance) so they need you to steal calls so they can collect money. 

It's a scam.


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## 46Young (Jul 21, 2015)

DesertMedic66 said:


> TransportJockey summed up what I was going to say. Volunteer companies are great for rural areas where there are literally no calls and the closest established EMS system is hours away. Not so much for urban cities especially a busy city like NYC where there is a hospital and an ambulance on every street corner.
> 
> Also I had the chance to talk to several Hatzolah volunteers during hurricane Sandy. Let's just say our view points were very different on most topics and they were also a little mad that we were unable to let them use our fuel trucks when the city ran out of gas.
> 
> The point of most volunteer companies is to allow the volunteers to have a career and family and then occasionally do a station shift or go on calls. If you are that busy of a volunteer company you need to be an actual company.



In the NYC 911 system the vollies are listening to the dispatch, and then trying to beat the dispatched 911 unit to the job. If you are trying to compete for a quicker response time with a unit that is a reasonable distance away (typically just a few minutes), you are dead wrong, and are also irrelevant to operations in general. The need for a response to a call has been fulfilled by city, so there is no real need to "pick up the slack."  I remember when Ed (Dispatcher #869 IIRC) would give the Glen Oaks squad (GOVAC) the jump on a call before he dispatched it out.


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## medichopeful (Jul 21, 2015)

The idea of listening to a scanner and jumping calls is one of the stupidest things I've ever heard of in my entire life. Sorry to be blunt. Culture, history, or whatever, that's absolutely ridiculous. 

Wait it out two more months then start applying to jobs where you can do 911s without this whole ridiculous setup.


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## adamNYC (Jul 21, 2015)

Some volleys dont collect insurance info


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## 46Young (Jul 21, 2015)

adamNYC said:


> Some volleys dont collect insurance info



If the volly company steals just one billable txp per day from the career department, where the txp = $500, the volly company is stealing $182,500 of revenue from its rightful recipient. That's a new ambulance, or the yearly salary for a few employees.


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## 46Young (Jul 21, 2015)

We would sometimes get screwed when the vollies would beat us to the scene (we were ALS), get the patient into the back of their bus real quick. What this meant was that we did ALS interventions and txp on the volly bus, but we couldn't bill.


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## 46Young (Jul 21, 2015)

Another issue I have with vollies trying to buff jobs is that it puts an extra (not needed) ambulance on the road, running L&S, with all of the risks to the public involved.


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## 46Young (Jul 21, 2015)

When I used to work on 46Y I knew and trusted the crews on 46B, 46G, 46E, our typical back-up (when I worked in 2007), not some randoms from F. Hills or Corona VAC. I want people I know to get my back when I'm working a tough call, not an unknown quantity with an unknown level of training, who didn't pass a professional screening/hiring process, and some sort of academy/field internship before hitting the streets.

The restrictive protocols and OLMC options are what they are because there are so many different providers operating in the NYC 911 system. Different hiring standards, different QA/QI standards, different accountability and discipline, etc.


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## graycord (Jul 31, 2015)

medichopeful said:


> The idea of listening to a scanner and jumping calls is one of the stupidest things I've ever heard of in my entire life. Sorry to be blunt. Culture, history, or whatever, that's absolutely ridiculous.
> 
> Wait it out two more months then start applying to jobs where you can do 911s without this whole ridiculous setup.



lol, a good chunk of 911 people have experience in this system.


adamNYC said:


> Anyone here buff calls while working at a private NYC ambulance? I'm curious because I've heard rumours about guys who are doing it at more than one private company. I would like to know about your experiences, if its worth doing, what the risks are, etc. Me personally I know I am SAFEST doing it at my Volly. At a private service where one is expected to be doing dispatched Txp or SNF emergencies, I can see how it would be a problem if a particular unit or person(s) are coincidentally always getting "flag downs". I would prefer not to risk my job over some buffing action.




Don't do it. I used to work with a guy at a private who used to get a ridiculous amount of flag-down jobs. A lot of us didn't know how it happened, but someone explained to me that he pretty sure he was listening in on the scanners. Made sense that he was almost always in trouble with the dispatchers because I can see how that would throw off the schedules. Came to later always have supervisor almost literally tracking him most days. He was a volley guy as well. Left us for a 911 voluntary with that pay raise they get, so I guess it worked out for him.
But I don't recommend buffing with the privates, the stress of being known to everyone in the office is probably not worth it.


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## adamNYC (Jul 31, 2015)

Yeah i keep hearing about these cowboys thinking its the wild west out here


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