# AMR cant staff, fire/ sheriff transport



## eastlossalt (Oct 3, 2021)

From what I'm reading AMR LA lost a lot of people yesterday 10/1 and didn't have the staff for North LA county causing fire to transport in engines and deputies in their patrol cars.


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## DrParasite (Oct 3, 2021)

why?  I've heard LA county (in general) is a huge mess, but this sounds like an internal AMR issue, where AMR corporate should be sending additional units and/or staff from other projects to assist.

the obvious solution would be for LA county to stand up their own 3rd service EMS solution; with all of the paramedics they have in the FD, and unemployed paramedics looking to get hired, it should be a simple task to staff their own EMS system, instead of relying on private companies where this happens. 

I'm curious what the county's risk management/legal department thinks of the practice of transporting in engines and deputy's vehicles, as well as the state DOH; If they sign off on it, then let the PD transport the drunks and the EDPs (and the stabbing and shooting victims, just like Trenton and Philly do), and the engines transport sick patients and AMR can pick up the rest when they become available


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## Fezman92 (Oct 3, 2021)

So AMR being AMR.


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## CALEMT (Oct 3, 2021)

There’s no alternative ambulance company they can utilize in cases like this?


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## akflightmedic (Oct 3, 2021)

Agree on PD transporting the majority of drunks and psychs 100% !!! Something I really like about the PD in the city where my base hospital is, they have no issue transporting those patients and do it all the time. Major respect for their Police Chief and dept practices/policies which allow this and encourage this. 

COVID pushed the world into realizing work from home and virtual can darn near get anything done which has been great. Especially with college courses and doctor visits...I love me some tele-med !! No more dragging my sick butt out of bed, miserable at docs office, waiting forever...simply schedule tele med and its right there from home and on time! 

Hoping COVID will also push our EMS in a better direction. More community paramedicine encouragement, more specific crew arrangement for certain calls (like the psych NP and a Medic for psych calls), and hopefully more Paramedic initiated sign offs. So sick of being forced to transport if someone really wants to go for no obvious reason. In the crisis contracts we get to do this and no one bats an eye, but routinely the practice is forbidden. Would love to see a Medical Uber type situation, Medic crew says we are not taking you  but here is the voucher for Uber to get you to triage/lobby.


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## akflightmedic (Oct 3, 2021)

Oh...and as far as AMR, they have the resources to prevent this or fix this. Time to be held accountable and come off that multi-billion dollar profit and reinvest back into the staff and equipment.


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## GMCmedic (Oct 3, 2021)

LA is weird


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## GMCmedic (Oct 3, 2021)

akflightmedic said:


> Oh...and as far as AMR, they have the resources to prevent this or fix this. Time to be held accountable and come off that multi-billion dollar profit and reinvest back into the staff and equipment.


Agreed. The GMR/AMR/Air Evac (insert whatever other services are under the umbrella) model of dropping a base or ambulance service wherever possible is a bubble that will eventually burst. One way or another.


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## Fezman92 (Oct 3, 2021)

akflightmedic said:


> Oh...and as far as AMR, they have the resources to prevent this or fix this. Time to be held accountable and come off that multi-billion dollar profit and reinvest back into the staff and equipment.


Funnily enough a bunch of my coworkers and I were having this exact convo earlier today because they’re really trying to put a decahedron into a triangular hole here. My office or whatever you want to call it is going to blow up in corporates face because they’re so inflexible. It’s not going to be pretty. We got the contract for the Linc and our office isn’t seeing a dime from it. They also have a problem with HR, only one person for our entire northeast region so the poor woman has to deal with easily hundreds of applicants to go through.


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## Virgil (Oct 5, 2021)

All AMR divisions in the SoCal area are maxed out. SD is lost, and Riv is probably not far behind tbh.


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## fm_emt (Oct 6, 2021)

DrParasite said:


> where AMR corporate should be sending additional units and/or staff from other projects to assist.


From what I am seeing, this is surprisingly difficult to do in California, with its patchwork county by county system. I.E, I am accredited in County A, but County B has a bunch of shifts open. I cannot just hop on a truck in County B because I do not have accreditation in County B and have not paid their fees, done their protocol test, had my minimum of "5 ALS contacts," etc etc. If the company wanted me to be able to do that, it has to go all the way up through Cal OES or something and has to be requested via them.

In my opinion, many of the staffing issues in California are created by the bureaucracy and red tape that California itself has put in place and can't manage to get rid of. When I worked in Texas or Oklahoma, it was not much of an issue at all to go work in another part of the state. Just put on a different shirt and hop on a truck. 

This is just based on my own observations having worked in CA many years ago, moved away, and recently came back. it's a lot of the same nonsense, different day. If I'm wrong, I'd love to learn more about the system.


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## Jim37F (Oct 6, 2021)

Idk how tight things are at Care and McCormick, the other two private 911 Ambulances with County Firr... but what about any of the 80 bajillion private rigs waiting for the next BLS discharge to SNF, or SNF to ER for "abnormal labs"... those are fully LACo accredited EMTs and Ambulances (officially at least, I know some of the IFT crowd is real sketch, but especially given that other recent thread about AMR FTO saying "make up vital signs" AMR isn't exactly cream of the crop elite either)

It's not like they're all super sketch fly by night dialysis mobiles, there's definitely some decent companies, and a few that are IFT only that bid on the EOAs that I'm sure would love to get their proverbial foot in the door (even if a long shot)

From a regulatory standpoint point, even with LAs system, seems like PRN, Liberty, AmbuServe, MedCoast, or (shudders) Ambulnz, and the others should be able to backfill AMR in an emergency situation (amd half of AMRs units being out of service should qualify)


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## CCCSD (Oct 6, 2021)

CA EMS…in spite of sound ideas, just keeps failing everyone.


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## jgmedic (Oct 6, 2021)

CALEMT said:


> There’s no alternative ambulance company they can utilize in cases like this?


They called all the neighboring companies and no one had shorter ETAs than AMR.


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## Jim37F (Oct 6, 2021)

Sounds like the other companies weren't aware of AMR's inability to meet needs, and thus they didn't have anyone posted for those calls. AMR *should* have a backup provider (or LACo should have) that when they knew they were so short, should have been told "Hey, we need to activate Automatic Aid, go send your units to post in this area so they're available"

If it's not already a contractual requirement to have an EOA, it should be, and probably will be in the next contract negotiations, but even though I think those are years off, LA Co (whoever Fire and/or EMS Agency regulators) *should* say have that set up


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## ffemt8978 (Oct 6, 2021)

Does anyone else hear "Entrance of the Gladiators" when reading any thread about California EMS, particularly LA?


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## VentMonkey (Oct 6, 2021)

ffemt8978 said:


> Does anyone else hear "Entrance of the Gladiators" when reading any thread about California EMS, particularly LA?


I was thinking more along the lines of the theme song from the Benny Hill Show, but I guess they’re about one in the same.


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## fm_emt (Oct 8, 2021)

VentMonkey said:


> I was thinking more along the lines of the theme song from the Benny Hill Show, but I guess they’re about one in the same.


this is accurate. On multiple occasions recently I've gone to get something and went "Oh yeah, that's back in Texas." 

I still enjoy going to work. I feel like an AEMT with some midazolam on most shifts. Our "ALS transfers" are basically "they're on a cardiac monitor only." Easy work, I guess.

It's also making me think about what I want to be when I grow up. Have any of you gone into law enforcement at 47 years old? I've been half pondering getting my POST certification and finding a low key LE gig somewhere. Although I guess truck driving schools are looking for people too.


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## CALEMT (Oct 8, 2021)

fm_emt said:


> low key LE gig



No such thing. You could get killed in a small town just as easily as you could in a big city.


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## FiremanMike (Oct 8, 2021)

fm_emt said:


> this is accurate. On multiple occasions recently I've gone to get something and went "Oh yeah, that's back in Texas."
> 
> I still enjoy going to work. I feel like an AEMT with some midazolam on most shifts. Our "ALS transfers" are basically "they're on a cardiac monitor only." Easy work, I guess.
> 
> It's also making me think about what I want to be when I grow up. Have any of you gone into law enforcement at 47 years old? I've been half pondering getting my POST certification and finding a low key LE gig somewhere. Although I guess truck driving schools are looking for people too.


I remember my brief stint in critical care how many MICU runs we'd get that would turn into ALS or even BLS runs before we got there.  There was one hospital (2 hours from base) that was notorious for hanging blood and calling for a MICU for transfer (there was a time when medics couldn't transport when blood was hanging).  Of course by the time we got there the blood was done, then it was 2 hours back to the receiving hospital, 1 hour to back in service.

5 hours of my day for a BLS run...


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## CALEMT (Oct 8, 2021)

So on the topic of AMR staffing issues. It's not just in the LA area. On Facebook I saw a post regarding AMR's response times in the city I reside in. Apparently they've gone level 0 365 times between 7/2-9/28. I guess on multiple occasions the Fire department and local PD had to transport pt's because of ETA's from 30 minutes to an hour. I get that everyone is hurting from local govt to private. 

Also from my understanding is its ALS across the board up here. ALS fire with ALS AMR and AMR is the sole provider for the area up here.


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## VentMonkey (Oct 8, 2021)

And yet none of this is still enough to restructure our approach to public education regarding the proper utilization of clearly depleted resources. 

It seems as though CV-19 is less of a pandemic than this is. I guess it’s not as easy of a sell to our fear-mongered society as a virus.


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## E tank (Oct 8, 2021)

VentMonkey said:


> I guess it’s not as easy of a sell to our fear-mongered society as a virus.


all depends on who's doing the selling....


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## VentMonkey (Oct 8, 2021)

E tank said:


> all depends on who's doing the selling....


Clearly it has yet to be anyone worth mentioning.


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## DesertMedic66 (Oct 8, 2021)

VentMonkey said:


> And yet none of this is still enough to restructure our approach to public education regarding the proper utilization of clearly depleted resources.
> 
> It seems as though CV-19 is less of a pandemic than this is. I guess it’s not as easy of a sell to our fear-mongered society as a virus.


Public education needs to increase, EMD utilization needs to improve, EMS crew initiated refusals need to start, 911 patients should be transported to closest most appropriate and not bypassing 5 other appropriate hospitals for preference, alternative destinations for transport, the list goes on and on. 

For my ground job starting in Nov we are now going to be doing TeleDoc conferences for our low level Medicare patients and discharging them on site and also transporting them to alternative destinations if needed. This is going to have us staying on scene longer but might reduce the ED overcrowding a little bit which will help reduce bed delays.


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## FiremanMike (Oct 8, 2021)

DesertMedic66 said:


> EMS crew initiated refusals need to start


Ugh, from an administrative standpoint, these a nightmare.  We had it in our protocol for about 6 months, it was _not_ a good thing.

Look at some of the patients your people turf now, then make it worse because you're actually empowering them to refuse to transport..


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## Jim37F (Oct 8, 2021)

DesertMedic66 said:


> Public education needs to increase, EMD utilization needs to improve, EMS crew initiated refusals need to start, 911 patients should be transported to closest most appropriate and not bypassing 5 other appropriate hospitals for preference, alternative destinations for transport, the list goes on and on.
> 
> For my ground job starting in Nov we are now going to be doing TeleDoc conferences for our low level Medicare patients and discharging them on site and also transporting them to alternative destinations if needed. This is going to have us staying on scene longer but might reduce the ED overcrowding a little bit which will help reduce bed delays.



Of course this is LACoFD, where even if the reason all the ambulances are not available is because they're all on 4+ hour bed delay waits at the hospitals, and someone who called to get checked out and is now saying "Ok, well I don't really think I want to go to the hospital anymore" County will literally sit there and argue with the patient until they decide to just go to the hospital, where inevitably the hospital won't allow them to go to the waiting room instead stay on the gurney holding the wall for however many hours, and County will turn around, go to the next call wondering why there's such a long response time....

So yeah, I don't see them embracing refusals and alternate destinations anytime soon


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## E tank (Oct 8, 2021)

When ambulance companies are offering sign on bonuses at the level hospitals were for RN's not that long ago and counties still want nothing to do with EMS aside from telling them how to do their jobs, there's a fundamental problem. With the exception of the rare excellent payor mix county, most want nothing to do with EMS.

 When some well intentioned individuals in the late 60's and early 70's thought that they could graft some genteel and sophisticated hospital medicine onto street level delivered service in the police and fire response models, they had no idea what they were getting themselves into.

The idea that there was no meaningful difference between calling the fire department for a drunk neighbor's winter beater being on fire and your renal failure grandpa in hyperkalemic arrest was delusional at best...on too many levels to articulate here.

The logical progression of such good intentions is evident the state of affairs we now find ourselves in in regions where the inherent flaws can declare themselves outright. That other systems don't manifest the problems identified in this thread doesn't mean they don't exist there. They just haven't reached the stress thresholds necessary to expose them yet.

Pre-hospital ALS does not make money. What money it does generate (via door to door service for cath labs and operating rooms), it sees exactly zero dollars and the not for profit hospitals laugh all the way to the bank. Meanwhile paramedics in the field for less than 5 years already have their sights set on something bigger and better.

The answer? There isn't one, especially for dense metropolitan centers. I do think hospitals should start paying their fair share...better medical oversight  (skin in the game) and maybe even hospital based EMS as a rule instead of the exception. They can decide the level of care their employees will provide and when. Not going to happen, though...I know.

Funeral homes used to transport to hospitals and as far as I can tell, a ride in the back of a hearse would be more comfortable than on a hose bed.


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## jgmedic (Oct 9, 2021)

I dont think any of this is a surprise to anyone who's ever been involved with EMS in LA/OC or even most of CA. When these companies brown out units or dont hire because UHU's are too low, then act surprised when they cant respond when volume is higher, what else is going to happen. Not to mention all sucking at the teat of LACoFD, and the least common denominator protocol approach. As said above, until these places take a far different tack to EMS, this will only get worse.


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## Aprz (Oct 9, 2021)

I kept thinking this pandemic would make things better, expose the flaws, give better recognition to EMS, but it hasn't. In general, we seem to operate as business as usual, totally acceptable to be understaff, late, and paid poorly.


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## CALEMT (Oct 9, 2021)

Aprz said:


> totally acceptable to be understaff, late, and paid poorly.



It’s like this across the board and not just exclusive to public service. Imagine that, the government shutting down business and paying people to stay at home and now there’s shortages in the workforce.


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## OG EMT (Oct 9, 2021)

Just a few observations about this subject. That day in the area was a notable fluke. I have not seen that same thing happen before or since. But in general the Antelope Valley has always been a difficult place to run an ambulance company. It's a huge area, with a lot of poor people, and 2 to 8 hour waits for beds at the ER. How many ambulance companies bid on that EOA last time? Zero. Only AMR was interested. Nobody in the ambulance business (frontline workers) was paid to stay home. We are in the second year of a world wide pandemic. Only 10% of the usual number of EMTs were graduated last year. So, low staff, large numbers of 911 calls, many ambulances stuck offloading at the hospitals. That's what happened. Its not as much fun as hacking on AMR, but probably a more accurate explanation of that day.


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## jgmedic (Oct 9, 2021)

That’s no excuse for AMRs constant issues, maybe they wouldn’t have staffing issues if they paid their employees a living wage rather than the bare minimum. So it’s a busy poor area? Great, pay people more and staff enough ambulances, let’s not pretend there’s an EMT shortage in southern CA. People don’t work there because they can make more money and not get treated like gurney monkeys elsewhere


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## CCCSD (Oct 10, 2021)

This is what happens when you have mega medic corporations.


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## DrParasite (Oct 10, 2021)

OG EMT said:


> It's a huge area, with a lot of poor people, and 2 to 8 hour waits for beds at the ER. How many ambulance companies bid on that EOA last time? Zero. Only AMR was interested.


Sounds like a great reason for the town/county to start their own third service EMS agency, funded by taxpayer dollars... I bet you wouldn't need so many fire units, since you had more than enough EMS units to handle the call volume without the FD needing to stop the clock at every single call.


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## GMCmedic (Oct 10, 2021)

DrParasite said:


> Sounds like a great reason for the town/county to start their own third service EMS agency, funded by taxpayer dollars... I bet you wouldn't need so many fire units, since you had more than enough EMS units to handle the call volume without the FD needing to stop the clock at every single call.


I've never worked in California EMS but I feel like I read here that it's pretty common for ambulance companies to Pay the county, as well as pay Fire and then bill the patient and try ro recoup money? 

If that's the case, why would any county ever get into EMS? Not to mention the fire unions will never allow it.


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## VentMonkey (Oct 10, 2021)

GMCmedic said:


> I've never worked in California EMS but I feel like I read here that it's pretty common for ambulance companies to Pay the county, as well as pay Fire and then bill the patient and try ro recoup money?
> 
> If that's the case, why would any county ever get into EMS? Not to mention the fire unions will never allow it.


We don’t pay for fire here. In fact, I’d imagine our management would balk at this idea. Some of our EOA’s have been grandfathered and cannot be put up for bid at all. 

I don’t know if this is specific to all of the AMR divisions in Cali (I doubt it), but def not how it works in my county.


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## DesertMedic66 (Oct 10, 2021)

GMCmedic said:


> I've never worked in California EMS but I feel like I read here that it's pretty common for ambulance companies to Pay the county, as well as pay Fire and then bill the patient and try ro recoup money?
> 
> If that's the case, why would any county ever get into EMS? Not to mention the fire unions will never allow it.


It really depends what is written into the contract for the private company. For example my local AMR division has to pay the county fines for every minute they are late to a call. There are very few exemptions that the company gets for it. There is also other monthly and yearly fees the company pays to the county EMS agency. Another part of the contract is that the AMD division buys all of the fire departments medical equipment/supplies since AMR gets a better price on them.


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## johnrsemt (Oct 16, 2021)

Fireman Mike:  Crews can't initiate refusals?  Wow, so when someone calls 911 because they stubbed their toe, the crew can't say no, go to the Urgent Care in the morning.  Or "Not going to transport you because the funny feeling you are having is because you smoked pot for the 1st time"?
Wow,  half of our refusals would have to be transports at $6,000 each and 5-6 hours round trip.


Glad we don't get in trouble for our en-route to scene times:  some of them run up to 2 hours.  


I sit and laugh when I read about CA EMS:  it is sad that you can't work county to county.  When I worked in Indiana, I could work anywhere in Indiana:  yes the protocols may be a little different, and I would have to brush up on them, but I didn't have to recertify to work in another county


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## FiremanMike (Oct 16, 2021)

johnrsemt said:


> Fireman Mike:  Crews can't initiate refusals?  Wow, so when someone calls 911 because they stubbed their toe, the crew can't say no, go to the Urgent Care in the morning.  Or "Not going to transport you because the funny feeling you are having is because you smoked pot for the 1st time"?
> Wow,  half of our refusals would have to be transports at $6,000 each and 5-6 hours round trip.
> 
> 
> ...


Correct - If the person wants us to transport them, we cannot refuse and tell them they need to make other arrangements.  

We can obviously help educate them on options and potential outcomes of those options (and thus we obviously don't transport everyone), but if the patient says "no, you need to take me" it's "ok, hop in".


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## johnrsemt (Oct 18, 2021)

Thinking about it more:  Indiana was that way when I worked there, but it was different when it was 10 minute transports.  
Now FT is 42 miles gate to closest hospital.   PT is 110 miles to closest hospital; but it may be 2 hours to the patient, 2 hours back to town (fuel) then 110 miles to the closest hospital.  So we have more leeway on saying No we aren't transporting you.


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## Mitchellmvhs (Oct 21, 2021)

It’s about to get a lot worse. Riverside AMR is really short on medics right now. I’m working BLS there and we’ve been getting sent to a lot of 911 calls. I was just at our mandatory meeting today and since the vaccine was mandated I’m pretty sure we’re going to lose even more staff.


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## DesertMedic66 (Oct 21, 2021)

Mitchellmvhs said:


> It’s about to get a lot worse. Riverside AMR is really short on medics right now. I’m working BLS there and we’ve been getting sent to a lot of 911 calls. I was just at our mandatory meeting today and since the vaccine was mandated I’m pretty sure we’re going to lose even more staff.


Maybe it will push the county of Riverside to stop half-assing their EMD system and use it properly. Low level calls get a code 2 response by a BLS unit only instead of ALS everything.


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## VentMonkey (Oct 21, 2021)

DesertMedic66 said:


> Maybe it will push the county of Riverside to stop half-assing their EMD system and use it properly. Low level calls get a code 2 response by a BLS unit only instead of ALS everything.


So our county has done this for years, and has even recently gone as far as not responding to some Omega’s. 

From what I’ve seen/ heard, it’s hardly been helpful. Like a Band-Aid on a large lac.


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## DesertMedic66 (Oct 21, 2021)

VentMonkey said:


> So our county has done this for years, and has even recently gone as far as not responding to some Omega’s.
> 
> From what I’ve seen/ heard, it’s hardly been helpful. Like a Band-Aid on a large lac.


Yeah but when you are sending an ALS engine and ALS ambulance to every single 911 call when there is a shortage of medics on both the fire side and on the ambulance side is going to cause issues with availability of units. 

Doing that would also mean AMR would have to retrain pretty much all of their BLS staff because all they really know are 5150 transfers.


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## VentMonkey (Oct 21, 2021)

DesertMedic66 said:


> Yeah but when you are sending an ALS engine and ALS ambulance to every single 911 call when there is a shortage of medics on both the fire side and on the ambulance side is going to cause issues with availability of units.
> 
> Doing that would also mean AMR would have to retrain pretty much all of their BLS staff because all they really know are 5150 transfers.


I understand that, but we’re experiencing the same exact issues with what you’ve suggested. And staffing shortages are indeed on all sides. 

I’d agree that most of our BLS EMT’s have zero clue how much experience they are gaining except perhaps in hindsight.


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## VentMonkey (Oct 21, 2021)

ETA: Oh, and guess who gets to run low level calls when BLS isn’t available to run them…


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## CCCSD (Oct 21, 2021)

VentMonkey said:


> ETA: Oh, and guess who gets to run low level calls when BLS isn’t available to run them…


ALS?


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## VentMonkey (Oct 21, 2021)

CCCSD said:


> ALS?


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## Virgil (Oct 30, 2021)

DesertMedic66 said:


> Maybe it will push the county of Riverside to stop half-assing their EMD system and use it properly. Low level calls get a code 2 response by a BLS unit only instead of ALS everything.



Our leadership doesn’t seem to mind ¯\_(ツ)_/¯


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## CbrMonster (Nov 8, 2021)

Well from back in the day this exact thing happened in Orange County which led Amr to lose it the contracts there. It happened to be a full arrest in Fullerton and which a 45 minute eta was given so the fire engine transported the patient and they expired. 

Currently in San Diego they/Amr are consistently going -x highest I’ve heard is -7 heard it over their radios and I asked wtf is -x mean, 7 911 calls pending an ambulance dispatch, but not available units) I know mercy in San Diego is having to back up city and so is Chula Vista’s new transport units.

As far as other ambulance services backing up in la county, i just recently spoke to some old colleagues at care/falck and they’re so extremely short staffed, one cct unit left for the whole company, emt’s won’t stay there, calling out consistently, they’re running the crews their whole 24’s basically if not posting out of Station the entire time. 

My company downed 4 als 24r 911 units yesterday cause we are so short on medics, a lot have gone to falck as they are offering substantially higher pay and large sign on bonuses


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## DesertMedic66 (Nov 9, 2021)

CbrMonster said:


> one cct unit left for the whole company


That explains why we have been going down to SD to fly patients 10 miles.


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## CbrMonster (Nov 9, 2021)

DesertMedic66 said:


> That explains why we have been going down to SD to fly patients 10 miles.


Yeah I was talking to one of the nurses/operations managers that I keep in touch with, he said it’s been pretty bad.

To top it off they’re making the one cct unit in service run non stop fire/911 calls, so they’re pretty much unavailable to really operate as a cct unit 

You fly with mercy?


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## DesertMedic66 (Nov 9, 2021)

CbrMonster said:


> Yeah I was talking to one of the nurses/operations managers that I keep in touch with, he said it’s been pretty bad.
> 
> To top it off they’re making the one cct unit in service run non stop fire/911 calls, so they’re pretty much unavailable to really operate as a cct unit
> 
> You fly with mercy?


Yes sir


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## CbrMonster (Nov 9, 2021)

DesertMedic66 said:


> Yes sir


Fullerton?


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## DesertMedic66 (Nov 9, 2021)

CbrMonster said:


> Fullerton?


Nope. I’m at one of our Riverside county bases.


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## CbrMonster (Nov 9, 2021)

DesertMedic66 said:


> Nope. I’m at one of our Riverside county bases.


Ah ok


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## MedicJon88 (Nov 11, 2021)

It's only going to get worse friends. With more ER and ICUs poaching paramedics to help with patients and flight services losing clinicians left and right- no one in their right mind is going to work ground base IFT/back up 911 for well below living wages. It was bad back in the early 2000s when we didn't have a choice. Things changed, and these private ambulance services are in for a reckoning. FD here is so mad at AMR they are considering an AO program possibly going to rotating staffing ALS ambulances. I know several municipalities in southern California went to that model years back- how are they going? 

Also- why did LACoFD not ask LAcityFD for mutual aid? they have their 800s they can send.


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## CbrMonster (Nov 11, 2021)

MedicJon88 said:


> It's only going to get worse friends. With more ER and ICUs poaching paramedics to help with patients and flight services losing clinicians left and right- no one in their right mind is going to work ground base IFT/back up 911 for well below living wages. It was bad back in the early 2000s when we didn't have a choice. Things changed, and these private ambulance services are in for a reckoning. FD here is so mad at AMR they are considering an AO program possibly going to rotating staffing ALS ambulances. I know several municipalities in southern California went to that model years back- how are they going?
> 
> Also- why did LACoFD not ask LAcityFD for mutual aid? they have their 800s they can send.


I’m sure la city doesn’t have the units to spare, they’re an extremely busy agency.


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## jgmedic (Nov 11, 2021)

MedicJon88 said:


> It's only going to get worse friends. With more ER and ICUs poaching paramedics to help with patients and flight services losing clinicians left and right- no one in their right mind is going to work ground base IFT/back up 911 for well below living wages. It was bad back in the early 2000s when we didn't have a choice. Things changed, and these private ambulance services are in for a reckoning. FD here is so mad at AMR they are considering an AO program possibly going to rotating staffing ALS ambulances. I know several municipalities in southern California went to that model years back- how are they going?
> 
> Also- why did LACoFD not ask LAcityFD for mutual aid? they have their 800s they can send.


AO medic programs are a mixed bag. They tend to have high turnover rates, because a lot of depts expect you play the probie role without the pay or benefits of being a Probationary FF. If the position is directly promotable into suppression they tend to be slightly more successful, though force hires tend be much worse at the single role level.


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## Jim37F (Nov 11, 2021)

MedicJon88 said:


> Also- why did LACoFD not ask LAcityFD for mutual aid? they have their 800s they can send.


Considering AMR's EOA is the north part of the County (Lancaster/Palmdale area), even Santa Clarita the closest LA City units are already gonna be 15, 20+ minutes assuming they were all 100% available and on the initial dispatch


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## CbrMonster (Nov 11, 2021)

jgmedic said:


> AO medic programs are a mixed bag. They tend to have high turnover rates, because a lot of depts expect you play the probie role without the pay or benefits of being a Probationary FF. If the position is directly promotable into suppression they tend to be slightly more successful, though force hires tend be much worse at the single role level.


Bingo, most of the ao programs I have seen they treat the medics like crap and pay them sub Amr rates…. And frankly **** that. Playing the firefighter game and being underpaid. Pass


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## MedicJon88 (Nov 12, 2021)

I hear ya. It was a foot in the door with the basics back when multi-year hiring freeze was a thing. Obviously not a problem with Paramedics now- we get to pick where we work and dictate our schedules more or less.


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## fm_emt (Nov 13, 2021)

CbrMonster said:


> Bingo, most of the ao programs I have seen they treat the medics like crap and pay them sub Amr rates…. And frankly **** that. Playing the firefighter game and being underpaid. Pass


Agreed. I'm not going to play the rookie nonsense. That mentality is so prevalent out here and I still have no idea why. Single role worked pretty darn good at my old place in Texas. California is strange. 

Sac Metro started a single role program but of course the department changed it to suit them - you have to transition over to the fire side after 3 years or they let you go. *facepalm*


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## CbrMonster (Nov 14, 2021)

fm_emt said:


> Agreed. I'm not going to play the rookie nonsense. That mentality is so prevalent out here and I still have no idea why. Single role worked pretty darn good at my old place in Texas. California is strange.
> 
> Sac Metro started a single role program but of course the department changed it to suit them - you have to transition over to the fire side after 3 years or they let you go. *facepalm*


It’s so idiotic to force those to play hose jockey if they don’t want to be, that just enforces being a **** medic to get a fire job and not giving a damn. 

Hell I would do single role if it weren’t for that, I have no desire to fight fires anymore, I like medical. And a lifer medical is going to be better for the community as their doing what they actually want to do.


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