About NY EMS

[Jeff2mars]

Hello, I'm a french EMT and I'm looking for informations about EMS of NY.

I know there are FDNY, hospitals and volunteers EMS, so I would know how many ambulances are running by day in New York (Manhattan, Queens,...)

If someone from NY or elsewhere can help me!!
thanks

 

[alphatrauma]

Just curious... are you looking to work in NY, or is your inquiry for research/study?

 

[Jeff2mars]

no it's just to compare with my city, and because I like NY and EMS... I could ask you for L.A. too

 

[MrBrown]

Los Angeles (in particular) is one of the worst systems in the world; City and County EMS are both run by thier respective Fire Departments. Up until the late 1990s the City had civillian Paramedics employed by the Fire Department while the County has always used dual-trained Firefighter/Paramedics since 1970. At some point in the late 90s the LA City FD decided that single-role Paramedics cost too much money so *slap, somebody bright spark over there had the flash idea of making Firefighters into Paramedics.

Now I do speak slightly higher of Los Angeles than some other systems, not every Firefighter is a Paramedic although I know it used to be true that there was no promotion on the EMS side of the operation so most people would leave and go back to the Fire chain to get promoted; I'm not sure if the same still holds true today but it would not suprise me.

While the City FD has a few transport ambulances for the most part the Firefighter/Paramedics either ride a fire truck or a rescue squad and don't actually have to worry about transporting patients because that is taken care of by the private ambulance companies.

Apart from the fact deployment of these guys is horrendously flawed from a medico-professional standpoint (compare depth and breadth of exposure a Paramedic on a fire truck who does not transport and might treat the patient for 10-15 minutes gets compared to a Paramedic who works on a transport ambulance) thier Paramedic training is also grossly inadequate. I heard from a Lieutenant in the County Fire Department that his Captain would go the mess room and say we need some people for Paramedic school, if he didn't get enough volunteers he'd say right; um ... you, you and oh you, be at Paramedic school Monday morning!

At least the County standing orders adequately reflect the amount of training and faith the medical director obviously has in these guys .... they are one to two pages long and always end in "contact base hospital".

 

[terrible one]

While the City FD has a few transport ambulances for the most part the Firefighter/Paramedics either ride a fire truck or a rescue squad and don't actually have to worry about transporting patients because that is taken care of by the private ambulance companies.

At least the County standing orders adequately reflect the amount of training and faith the medical director obviously has in these guys .... they are one to two pages long and always end in "contact base hospital".

City has more than a few boxes. close to 100 up a day.
but everything else was pretty much on the money.

The thing that is sad in LA ems is the FFs don't want to be medics (not their fault) but the system is set-up so that in order to be a FF you have to be a medic, therefore you get poorly educated medical professionals who don't really care much about the medical aspect of the job and would rather put the wet stuff on the red stuff.

 

[terrible one]

Another sad thing in LA is many of the national or state studies take place in this system due to the high volume of calls/number of teaching and research hospitals in the area.
So when you don't see a lot of new procedures/medications available in CA or even nationally take a look at where the trial study took place (if it was in LA you can guess why it's no longer available to other EMS systems)

 

[alphatrauma]

Here are some FDNY Vital Statistics from 2008

>>> www.nyc.gov <<<

221 FireHouses and 30 EMS stations... :sad:

 

[46Young]

Hi, I worked EMS in NYC, hospital based, BLS from 3/03 to 10/05, and ALS from 10/05 to 10/07.

Units are broken up into either BLS or ALS. The unit's number identifies it's home batallion, and the letter denotes ALS or BLS. A,B,C,D and so on are BLS. S,U,V,Y,etc. designate ALS. Henry and Zebra units are Haz-Tac, units that are hazmat trained. So, 46Young is an ALS unit in the 46 batallion.

Most units have a designated street corner from which they respond, called a CSL, or "89". BLS units are dispatched to lower priority calls (jobs), along with cardiac arrests, and any ALS call where the medic unit has an ETA of more than 10 minutes. ALS units are only dispatched to high priority call types, not for sick calls, injuries, EDP's, conscious ETOH, etc.

BLS units can be any combination of EMT and medic, but have only BLS equipment, and are restricted to BLS protocols. ALS units must be double medic. Here are the protocols:

http://www.nycremsco.org/

When enroute to the hospital, the crew will only give notification to the hospital with a seriously ill pt. The driver will give a brief notification to the dispatcher, who then calls the ED. I like this method as it frees up the medics to work on the pt without the ED staff hassling them with more questions when work needs to get done.

NYC 911 EMS is controlled by the FDNY, who dictates GOP's, SOP's, protocols, and employs single role medics. Suppression units are CFR-D certified only, and dispatch to high priority ALS calls only. Hospital based and private EMS providers also operate within the system, under a FDNY contract.

The general rule of thought is that if you want the benefits, go with FDNY. If you want better pay, better schedules and working conditions, and want to go to college to progress to another career, go with the hospitals. If you can't ge thired otherwise, if you're waiting on FDNY or a hospital, then go private.

When I left in "07, the city averaged around 3000-3500 calls/day citywide.

EMS works 8 hour days, although I've heard that they're experimenting with 12's.

What else do you want to know?

 

[firecoins]

I can vouch for everything 46 Young just posted.

 

[Rob123]

I can vouch for everything 46 Young just posted.

Totally agree

Hello, I'm a french EMT and I'm looking for informations about EMS of NY.

I know there are FDNY, hospitals and volunteers EMS, so I would know how many ambulances are running by day in New York (Manhattan, Queens,...)

If someone from NY or elsewhere can help me!!
thanks

I'm a volunteer with a BLS corps in an area of New York City that's fully covered by hospital based 911 and FDNY.
We basically respond to calls in one of four ways.
1. Direct calls from community members
2. We buff calls heard over 911 radio
3. Mutual aid
4. Stand by at community events

 

[ExpatMedic0]

I can vouch for everything 46 Young just posted.

So both you guys are saying a lot of the medics work as basics on a BLS unit? Why is that? It seems like from a statistical stand point there is a shortage of medics in NYC, I read only 1 in 10 ambulances are ALS?

 

[firecoins]

So both you guys are saying a lot of the medics work as basics on a BLS unit? Why is that? It seems like from a statistical stand point there is a shortage of medics in NYC, I read only 1 in 10 ambulances are ALS?

Budget cuts, hospital closing etc. There are not alot of ALS buses to work on. BLS pays quite a bit more in NYC than elsewhere.

 

[ExpatMedic0]

Do the Paramedics on the BLS rigs make Paramedic wage or EMT-B wage?

 

[firecoins]

Do the Paramedics on the BLS rigs make Paramedic wage or EMT-B wage?

Depends. If one is hired as a medic but doing a bLS shift, he gets paid as a medic. If one was hired as BLS, he gets paid BLS. BLS makes alot more than elsewhere.

 

[46Young]

Totally agree



I'm a volunteer with a BLS corps in an area of New York City that's fully covered by hospital based 911 and FDNY.
We basically respond to calls in one of four ways.
1. Direct calls from community members
2. We buff calls heard over 911 radio
3. Mutual aid
4. Stand by at community events

My bad, I've run jobs with Corona, Forest Hills, GOVAC, Queens Village among others. Good times and always a motivated crew!

 

[Jeff2mars]

Thanx 46Young.
- I think I understood ALS must arrived in 10 minutes and if it's longer BLS is also dispatched. So the deadline for ALS is 10 minutes, right ? and what's the deadline for BLS ?
- I also would to know how many BLS and ALS are in NY (the number of ambulances that can respond on manhattan, queens, and others..)
- Are engines or ladders dispatched before BLS or ALS ? (in first responders, to save time)
- I don't understand what is "suppression units".

When enroute to the hospital, the crew will only give notification to the hospital with a seriously ill pt. The driver will give a brief notification to the dispatcher, who then calls the ED

here too. We have white code for minor trauma in which we transport to nearest hospital without calling emergency physician supervisor. And we have red code for major trauma, sickness or "life-threatening" in which we must call emergency physician supervisor to get advices, orders and hospital. Physician can decide to dispatch on site a medical team with emergency physician, nurse and ems driver.


MrBrown thanks for LA, I understand the problem about FF paramedics, here FF must be EMT and FF, because EMS are only Firefighters in France (few exceptions with red cross and others associations in Paris, Marseille...). Some firefighter don't like "EMS job" because they prefer fires, but fortunately everything is still good.
With this problem of FF paramedics, the care of victims are still good ?
what's the deadline for BLS / ALS / FF ?

* if "deadline" is not the right word, I mean the time they have to respond

 

[46Young]

So both you guys are saying a lot of the medics work as basics on a BLS unit? Why is that? It seems like from a statistical stand point there is a shortage of medics in NYC, I read only 1 in 10 ambulances are ALS?

One in ten might be a little exaggerated, but the number of ALS units vs BLS units reflects the call types. In many areas the medic units handle all call types, but in NYC medics only get dispatched to ALS jobs. We all know that a good number of 911 calls don't actually require an ambulance, and only a small fraction of those require ALS. The ratio of ALS to BLS units seeks to reflect this.

When I went ALS it was refreshing to not have to deal with EDP's, sick jobs, stubbed toes, conscious drunks, flu like Sx, etc. on a regular basis.

 

[46Young]

Thanx 46Young.
- I think I understood ALS must arrived in 10 minutes and if it's longer BLS is also dispatched. So the deadline for ALS is 10 minutes, right ? and what's the deadline for BLS ?
- I also would to know how many BLS and ALS are in NY (the number of ambulances that can respond on manhattan, queens, and others..)
- Are engines or ladders dispatched before BLS or ALS ? (in first responders, to save time)
- I don't understand what is "suppression units".



here too. We have white code for minor trauma in which we transport to nearest hospital without calling emergency physician supervisor. And we have red code for major trauma, sickness or "life-threatening" in which we must call emergency physician supervisor to get advices, orders and hospital. Physician can decide to dispatch on site a medical team with emergency physician, nurse and ems driver.


MrBrown thanks for LA, I understand the problem about FF paramedics, here FF must be EMT and FF, because EMS are only Firefighters in France (few exceptions with red cross and others associations in Paris, Marseille...). Some firefighter don't like "EMS job" because they prefer fires, but fortunately everything is still good.
With this problem of FF paramedics, the care of victims are still good ?
what's the deadline for BLS / ALS / FF ?

* if "deadline" is not the right word, I mean the time they have to respond

Correct, if ALS has a "deadline", what we call an ETA or response time of more than 10 minutes, then BLS will be dispatched to assist. BLS is also dispatched to all cardiac arrests along with ALS. BLS are expected to arrive as soon as possible.

I don't have any stats regarding the number of units citywide. Member RichardBtheEMT on www.emtcity.com works for FDNY EMS and can probably answer that.

Suppression units are fire apparatus, as in fire suppression. Engines are dispatched typically for high priority (ALS) calls, mostly to show activity, to help justify staffing. I've heard that they will actually be dispatched a minute or two before an EMS unit due to the dispatch routing system. I don't know if this is actually true, however.

In many parts of this country the EMS crew is required to call the receiving ED for each pt to advise of the staff of their expected arrival and pt condition. In NYC, this is reserved only for serious/critical pts. The crew will likely be waiting in triage with a non-critical pt for 15-30 minutes or more, anyway.

Here, EMS can be run either through a private agency, hospital based, third service (single role municipal agencies), or fire based, which may be either single role (EMS only) or dual role (cross trained personell between EMS and fire suppression). Whether fire based EMS works well or not is the suject of many a heated debate. It's tough to say, as some depts are run well, with the employees motivated to do well in EMS. Other depts use EMS as an income stream for suppression, to create or justify firefighter jobs, and have FF's who generally dislike EMS and view it as a necessary evil to deal with in order to have a fire suppression job. Whether the jurisdiction is rural, suburban, or urban is also an important factor.