Dynamic Ambulance Deployment

[Dutch-EMT]

Here in Europe, most ambulances are stationed in ambulancestations.
In the netherlands, all ambulances are stationde at permanent locations.
In the bigger cities in the US, there is something like dynamic ambulance deployment.

Did see something about Albequerque Ambulance Service on the net.
The ambulances are parked through the city on stragetic spots.
How does this work exactly?

Are ambulances always parked on the same places (parking lots near the highways etc)
Or can those locations be at every random parking lot?
Are ambulances also stationd near hospitals to respond quickly on interclinical transports?

Are ambulances refill their meds and equipment at the hospitals? Or do they need to drive to their base every-time?

 

[RocketMedic]

Basically, a shift is spent roaming between preset "posts" which are generally in high-traffic, high-volume areas or at thr intersections of major arterials. Each truck is positioned by dispatch to cover as large an area of predicted calls (not distance) as possible.

 

[Ewok Jerky]

Our dispatch has a plan based on most efficient response by X number of units available. For example, we cover 3 cities in county with a large rural territory as well. When we have all 8 units available we can have 3 in the each larger city with 2 in the smallest. If only 1 unit is available it goes smack in the middle of county. If 2 units are available they go on either side of the geographically middle city. 3 units, one in each city...so on and so on.

While each post is just coordinates or intersections, we obviously find the shadiest tree or warmest coffee shop to post at. Sometimes the post is at a fire station, or a hospital, or one of our garages. But don't get to comfortable because as unit levels go up and down we are constantly moving from post to post. We used to "domino post" where the unit returning to service posts at the closest post and everyone else moves over all down the line, but now the new unit just goes to the open post even if it takes 30 minutes to get there. We run 12 hour shifts so restock is usually at change of shift.

Our other system is in a larger city and everyone has a designated post, you update the CAD of your location as you move through the city until you reach your post.

 

[Shishkabob]

Typically they are pre-set locations that give rapid access to major roads, say at a gas station right off the intersection of 2 highways, so you can go north, south, east, or west pretty quickly. They are also typically in the places more likely to get calls (such as downtown) or in places that although not off a major highway, get decent call volume and thus you keep someone there.

As for restocking, my agency does it at the hospital; we have a truck with pretty much all the equipment you'd need, from all bandages to all drugs and more, and they'll meet you at the hospital if you request.

 

[WolfmanHarris]

Most of Ontario does a hybrid system where vehicles have a station but they may be moved from station to station as coverage changes. Some have more complicated plans. For instance by service has 15 different deployment plans based on day/time which prioritize station coverage differently. Once we get to six units left available (usually have 35-40 on) we drop to strategic intersections instead of stations but that's rare. We can spend a lot of our shift mobile but that's likely bouncing from station to station without quite getting there.

 

[Ensihoitaja]

We use a dynamic deployment system. All our ambulances start their shift at our one station. Day cars start between 0500 and 1100. Night cars start between 1400 and 2130. We have 2 posts that are somewhat removed from the rest of the city that are a priority for coverage. Other than that, the dispatchers have software that recommends where to post ambulances based on historical call data. They occasionally modify the posting plan based on special events and that sort of thing. All the posts are intersections. Once you get there, you have some freedom to roam that area. We also have medics assigned to the airport, they respond solo and aren't part of our regular posting plan (there is an ambulance at the airport that is)

Our ambulances are pretty well stocked, it's rare that you'd need additional stock during a shift. If we do we either have a lieutenant bring supplies to us or go back to our station.

 

[Outbac1]

In Nova Scotia all units have a home base to start and end shifts at. As calls come in, in any particular area other available units will be moved around for coverage. Almost all movements are to another base or a halfway post. All bases have crew quarters, chairs, couches, kitchens, washrooms, garages etc. Posts are usually smaller and without garages, supply rooms etc.. In urban areas if it gets very busy and the area is down to 1 - 2 units they may get posted to a central location until another unit frees up. Then both will be posted to a base or post as available.
As it is a province wide system all units have the same supplies on board, except only ALS medics carry narcotic pouches. An empty unit,(no patient), is an available unit and can be tasked with calls anywhere they happen to be. So if you take a transfer to another area and do not have a return transfer you can be tagged for a call, or coverage, anywhere on your way home. Good for the patients, not necessarily for you.

 

[Tigger]

I work occasionally in a larger city that uses "system status management." I loathe getting moved from post to post, but oh well.

Our base is located east of the city we cover, so the ambulances deploy from there and are immediately sent to posts. Depending on the hour of day and number of ambulances on, they're spread out over about ten posts (peak staffing is 14 ambulances or so). Generally speaking the less ambulances on, the more centrally located they'll be, though during rush hour an effort is made to keep the ambulances posted near highway access (we don't have much of a gridlock issue here). We also have a few ambulances based out of outlying fire stations. While ostensibly they are there to cover suburban fire districts, more often than not they can be found on calls in the city. They can also be pulled for coverage when we have are down to two (I think) city based ambulances. At night this is not allowed and they can sleep, but are still available for any call, no matter where.

The ambulances are stocked pretty well and most days you can get buy with no restock. If you need sometimes a trip back to base can be arranged but more than likely a wheelchair/detox driver will come out with your items. The supervisor also carries a whole bunch of meds and narcs for restock.

I am happy to work primarily at a station based gig. We only post when we have one ambulance left, and then it's a quick 15 minute drive to the center of the county until another unit gets back in town.