AMR cant staff, fire/ sheriff transport

eastlossalt

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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

The fire extinguisher is not just for show
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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
 

Fezman92

NJ and PA EMT
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So AMR being AMR.
 

CALEMT

The Other Guy/ Paramaybe?
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There’s no alternative ambulance company they can utilize in cases like this?
 

akflightmedic

Forum Deputy Chief
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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. :)
 

akflightmedic

Forum Deputy Chief
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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.
 

GMCmedic

Forum Deputy Chief
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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.
 

Fezman92

NJ and PA EMT
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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.
 

Virgil

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

fm_emt

Useless without caffeine
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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.
 

Jim37F

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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)
 

Jim37F

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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
 

ffemt8978

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

fm_emt

Useless without caffeine
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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. :)
 

CALEMT

The Other Guy/ Paramaybe?
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FiremanMike

EMS Coordinator
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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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