Detroit EMS

[HotelCo]

http://detnews.com/article/20100916/METRO08/9160409

...
It happens all too often in this city. You call 911. Granny fell, you tell the operator. Or a woman's been shot. Or a man has gone into cardiac arrest. Then you wait for an ambulance. And you wait some more.
No one really knows what the ambulance response time is in Detroit, but for people who work in the ambulances for a living, they say it is unacceptable.
...

 

[DrParasite]

yeah and???

an old lady fell on the streets, and it took the paramedic unit 15 minutes to get there. that's a great response time!!! If that happened where I worked, if we were busy, you can wait 30 minutes or more for an ambulance.

The sad truth is most urban cities (Philly, DC, NYC, Newark, etc), the EMS system is grossly understaffed, and this stuff happens. it happens more often than the public wants to believe.

Not only that, but the public won't fund and push for appropriate staffing until they experience the need to an ambulance personally. Then they make a huge deal about it.

It happens. Until the public realizes that EMS is a critical part of public safety, and needs to be funded as staffed as such (and not be band aided by PD or EMS as a first responder), this stuff will continue to happen.

And Detroit isn't the only City that doesn't have a FD or PD first responder. There are others.

 

[Hockey]

Did you read the article fully Dr?

Its not just 15 minutes. Its hours sometimes

You may understand it, but the public doesn't. Glad the DetNews is getting it out there

 

[DrParasite]

I read the article. it doesn't change what I said.

this HAPPENS ALL THE TIME. It's not different than philly FD's circle of death (when the engine company stands around a dying patient because no ambulance is available). Or how in Philly, PD freqently transports GSW victims to the hospitals, because EMS has an extended response time. Detroit is not unique in this problem.

Many places have a non-transporting FD unit babysitting hoping an ambulance shows up. But it doesn't help get the patient to the hospital.

Many agencies hold BLS calls (such as the elderly fall victim) especially if they are holding higher priority life threatening calls. Most of the time the patient doesn't suffer (die) because of this, they might wait longer than that want, but they don't die.

The AHJ decides what level of EMS service they want. most understaff and underfund their EMS system, and it seems Detroit is no different. The fault in this lies in the management and politicians who under staff the system, and the public who permit this to happen.

again, no one complains until it takes the ambulance too long to show up for THEIR emergency.

 

[FLEMTP]

I read the article. it doesn't change what I said.

this HAPPENS ALL THE TIME. It's not different than philly FD's circle of death (when the engine company stands around a dying patient because no ambulance is available). Or how in Philly, PD freqently transports GSW victims to the hospitals, because EMS has an extended response time. Detroit is not unique in this problem.

Many places have a non-transporting FD unit babysitting hoping an ambulance shows up. But it doesn't help get the patient to the hospital.

Many agencies hold BLS calls (such as the elderly fall victim) especially if they are holding higher priority life threatening calls. Most of the time the patient doesn't suffer (die) because of this, they might wait longer than that want, but they don't die.

The AHJ decides what level of EMS service they want. most understaff and underfund their EMS system, and it seems Detroit is no different. The fault in this lies in the management and politicians who under staff the system, and the public who permit this to happen.

again, no one complains until it takes the ambulance too long to show up for THEIR emergency.

+1 on that. I worked in detroit... this is nothing new and has been going on for YEARS. Yes you read that right.. YEARS!

Im glad i left when I did!

 

[LonghornMedic]

I've worked EMS in two large cities and this very rarely happened. You can have urban EMS and still provide excellent service. Obviously Detroit is completely mismanaged and is an embarrassment to all EMS professionals. Our non-code 3 responses are around 12-15 minutes. Code 3's average less than 7 minutes. Maybe Detroit EMS should be removed from the fire department. That would be a good start.

 

[94H]

I know for a fact that at some time last yr FDNY EMS had 30 calls holding in the CAD. FDNY EMS also does not do mutual aid to it means loooooooooooooooooong wait times. Personally Ive waited 45 minutes for a pediatric trauma (broken arm).

 

[ohnoyoudidnt]

Buffalo is the same way, nightly you will hear fire dispatch say no ambulance available and most of the time there are a ton of calls holding, though our response times are slow there "normally" is never more than a 20 minute wait. But then there are "those" nights when you might wait up to an hour or more if dispatch deems you to be non critical during their EMD'ing. Its not just a Detroit thing, its in allot of cities, though Detroits EMS I think leads the race to "horrible".

 

[46Young]

I know for a fact that at some time last yr FDNY EMS had 30 calls holding in the CAD. FDNY EMS also does not do mutual aid to it means loooooooooooooooooong wait times. Personally Ive waited 45 minutes for a pediatric trauma (broken arm).

You waited 45 minutes for medics? Why not transport? As BLS, I was never onscene for more than 10 minutes on the average, unless something prevented me from departing, such as difficult removal, a multi story walkup, etc.

In NYC 911, they'll hold the priority 7's and 8's, and maybe a sick job or two if the call volume spikes. Did the peds injury come over as an injury major or injury minor? The major is a 5, and the minor is a 7, IIRC.

 

[lightsandsirens5]

It's not different than philly FD's circle of death (when the engine company stands around a dying patient because no ambulance is available). Or how in Philly, PD freqently transports GSW victims to the hospitals, because EMS has an extended response time. Detroit is not unique in this problem.

Many places have a non-transporting FD unit babysitting hoping an ambulance shows up. But it doesn't help get the patient to the hospital.

In this state (WA), our RCWs and/or WACs (can't remember which) state that if a transport licensed vehicle is delayed to the point that a patients life if put in danger, any vehicle, preferably an emergency one, should be used to transport the patient to the hospital. I know this is rarely done, and rarely if ever enforced, but it is still an out for us. We have done it in my county. We had a situation a while back where all of our ambulances were out and the next nearest one would take an hour to arrive. The guy sure a heck didn't have an hour. Maybe 10 minutes. Well, he rode to the hospital in a fire engine that day. No FD circle of death for him. The law basically says that you could transport someone in anything from a fire engine to a cop car to a pickup truck to a Subaru Justy and everything in between if you need.

I admit that 90% of the time that law is utilized in rural areas. I'm not sure if it ever gets used in Seattle, or Olympia. I can see how this could be an issue in a city the size of Philly, they prolly would not want engines out of service for that kind of stuff, but all I'm saying is that in WA at least, it seems to be working.

 

[DrParasite]

In this state (WA), our RCWs and/or WACs (can't remember which) state that if a transport licensed vehicle is delayed to the point that a patients life if put in danger, any vehicle, preferably an emergency one, should be used to transport the patient to the hospital.

There are NUMEROUS problems with a protocol like this. The biggest by far is the liability of transporting a sick patient in a vehicle not designed to transport.

Lets say you do scoop and run in the fire engine or police car. do you have the equipment to properly secure said sick person? maintain an airway? bag someone? and lets say the person dies. then the lawsuit comes.

did they die because you didn't wait for the appropriately equipped unit to arrive, or because you transported a sick person in a vehicle not designed for sick people?

The protocol is good in theory. it really is. The problem is ANY time an ambulance is delayed, it could be used. the person is having chest pain, EMS is 10 minutes out, well, lets scoop and run to the hospital, since the 10 minutes could put the life in danger (neglecting the fact the the hospital is 40 min away).

If a civilian wants to transport in a POV, then that is their prerogative. but if a trained emergency responder does that, and he or she is doing that because the EMS system is not staffed enough to handle the call volume (which rural systems are, but not having a close enough ambulance) than that's a recipe for an expensive lawsuit.

 

[Rottweiler]

It is way worse than you all think.

Corruption, no money, what are shocks? Broken lighting..

You should see what the Police cars look like.

Oh and when you need something fixed? hahahhaha 2 3 months?

 

[ohnoyoudidnt]

It is way worse than you all think.

Corruption, no money, what are shocks? Broken lighting..

You should see what the Police cars look like.

Oh and when you need something fixed? hahahhaha 2 3 months?

I hear horror stories daily from the couple friends I have working in the city. The most recent story being one of the medic rigs not being able to stop do to bald tires & no brakes sliding into an intersection t-boning another truck. On that same night another crew hit a pot hole, one of the bald tires on their rig blew and they drove into the side of a bridge ripping the box of. It's not a place I want to work anytime soon.

 

[CAOX3]

if a trained emergency responder does that, and he or she is doing that because the EMS system is not staffed enough to handle the call volume (which rural systems are, but not having a close enough ambulance) than that's a recipe for an expensive lawsuit.

Whats a more expensive lawsuit?

Waiting 30 minutes for an ambulance or transporting them in a fire truck?

 

[DrParasite]

http://www.myfoxdetroit.com/dpp/news/sound_off/fox-2-focus_detroit-ems-response-time

 

[EMDispatch]

There are NUMEROUS problems with a protocol like this. The biggest by far is the liability of transporting a sick patient in a vehicle not designed to transport.

Depends where you are in Pennsylvania it's specifically addressed in the Good Samaritan Law: "Any person who renders emergency care, first aid or rescue at the scene of an emergency, or moves the person receiving such care, first aid and rescue to a hospital or other place of medical care, shall not be liable to such person for any civil damages as a result."

 

[Tincanfireman]

Depends where you are in Pennsylvania it's specifically addressed in the Good Samaritan Law: "Any person who renders emergency care, first aid or rescue at the scene of an emergency, or moves the person receiving such care, first aid and rescue to a hospital or other place of medical care, shall not be liable to such person for any civil damages as a result."

Now for the rest of the story, specifically, exception 1. Here's the link: http://www.concentric.net/~Maxfax/files/law2.htm.

Good Samaritan laws are normally designed to protect laypeople from liability in cases where they attempted a good-faith effort to provide care, not to cover woefully inadequate government services funded by taxpayer dollars.


8332. Nonmedical good Samaritan civil immunity.
(a) General rule.--Any person who renders emergency care, first aid or rescue at the scene of an emergency, or moves the person receiving such care, first aid and rescue to a hospital or other place of medical care, shall not be liable to such person for any civil damages as a result of any acts or omissions in rendering the emergency care, first aid or rescue, or moving the person receiving the same to a hospital or other place of medical care, except any acts or omissions intentionally designed to harm or any grossly negligent acts or omissions which result in harm to the person receiving the emergency care, first aid or rescue or being moved to a hospital or other place of medical care.
(b) Exceptions.--

1. This section shall not relieve a driver of an ambulance or other emergency or rescue vehicle from liability arising from operation or use of such vehicle.
2. In order for any person to receive the benefit of the exemption from civil liability provided for in subsection (a), he shall be, at the time of rendering the emergency care, first aid or rescue or moving the person receiving emergency care, first aid or rescue to a hospital or other place of medical care, the holder of a current certificate evidencing the successful completion of a course in first aid, advanced life saving or basic life support sponsored by the American National Red Cross or the American Heart Association or an equivalent course of instruction approved by the Department of Health in consultation with a technical committee of the Pennsylvania Emergency Health Services Council and must be performing techniques and employing procedures consistent with the nature and level of the training for which the certificate has been issued.

 

[EMDispatch]

my bad,
I totally forgot exception 1...

 

[Nakia]

Whats a more expensive lawsuit?

Waiting 30 minutes for an ambulance or transporting them in a fire truck?

You may be surprised. Not having any contact with the pt. may get you a lawsuit. Being under trained, ill-equipped, and not safely transporting a pt. after contact with the pt. is made, is also a very expensive lawsuit.
Could go either way.

 

[Nakia]

In this state (WA), our RCWs and/or WACs (can't remember which) state that if a transport licensed vehicle is delayed to the point that a patients life if put in danger, any vehicle, preferably an emergency one, should be used to transport the patient to the hospital.

I admit that 90% of the time that law is utilized in rural areas. I'm not sure if it ever gets used in Seattle, or Olympia. I can see how this could be an issue in a city the size of Philly, they prolly would not want engines out of service for that kind of stuff, but all I'm saying is that in WA at least, it seems to be working.

I doubt Seattle has used this. Thumbs up to their King County EMS. They have had some of the top numbers in the nation for years as far as overall response times. And they ARE (again) the nation EMS leaders in success for reviving cardiac arrests. Their cardiac protocols must be top notch!:usa: