Fire/Municipal services turfing distant/undesirable calls?

medicdan

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As many know, I work for a fairly large private service, almost entirely PB (as the basic driver on an ALS truck). I am based in a mid-size urban service, but we are frequently in many of the surrounding suburban communities.

We're pulled for calls by the municipal department fairly often when they don't have trucks available (we generally match or hold better response times because we have trucks around), but recently our dispatch has been getting more and more calls from the suburban departments, looking for assistance.

We're not being called for mutual aid, but to transport patients to hospitals the local fire department does not want to go to (often in the city). Generally, the ALS fire ambulance will arrive on scene, hear the patient wants to go somewhere undesirable, and they call us. Because we rarely have trucks in the suburban communities, it can take us 20 or 30 minutes to get down there, L&S.

I did three of these my last shift earlier this week. On the last one, the (ALS) crew was inside, with no equipment, no vitals, no interventions for at least 20 minutes before we arrived. They gave us a short hand-off and brief demographics, but nothing else. This patient was had acute SOB, and while the crew did step up her home N/C, they had done no other treatment or assessment as far as we know. Their parting comment to us was "you're just going to BLS this in, right?". Nevertheless, the patient got an NRB, IV, three nebs and a trauma room. Last I heard, the patient was admitted to the ICU.

Not all of the patients are unstable, and I absolutely recognize the importance of keeping resources in the response area, but this just seems to be poor patient care-- delaying transport and definitive treatment, or not performing a full assessment when it's warranted. Even if the responding fire department crew isn't transporting, shouldn't they be completing a PCR, indicating the patient was assessed, treated and care transferred?

Is this phenomenon common to other areas? We are a private, and in general dispatch will not refuse calls, but isn't this a bit excessive? I'll hold off on generalizations about the work ethic of some of these firefighters.
 

terrible one

Always wandering
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Very common in the Los Angeles area. Several FDs with their own transport rigs call nearby privates when they don't want to transport. Definetly don't agree with it.
 

sir.shocksalot

Forum Captain
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There are several departments here in CO that are starting to do the same thing. Granted, this is by contract and the private ambulance companies are well aware that we are getting the FD hand-me-downs/sloppy seconds etc.

I hate paying taxes for a FD that will just contact a private ambulance company to come transport me if I'm not good enough to get a ride in a FD ambulance. If I call 911 and the FD decides to call a private ambulance, I shouldn't have to pay taxes for the FD or their ambulances. It's a slap in the face to tax payers. God forbid the fire department actually take on ALL the responsibilities required of an EMS system.
 

Symbolic

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How things are run here as well. In the city the fire department runs the show and has a contract with SW ambulance to transport BLS calls. So they get called quite often for things they don't want to deal with. Rather unfortunate.
 

Anjel

Forum Angel
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Yea it happens here with one company I can think of.

But usually its because they just bit off more than they can chew and they need a lot of help.

Ok sure it's bad patient care. But another way of looking at it is...more money for your company. Better funding for new ambulances, maybe raises? The FD isn't gonna be able to bill for much if at all.

As a tax payer this makes me kinda peeved. But looking at the business aspect. Bring on as many pts that you can get.
 

terrible one

Always wandering
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Except that many of the calls we did it for were transients that weren't goig to pay anyway
 

feldy

Forum Captain
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You company covers quite a large area and does not seem to have a problem with negociating contracts to expand. Maybe bring up to someone higher up the need to have a few trucks posted in the more suburban areas and obtain a contract in those suburban areas.

I remember doing a ride along with a company on northshore and we had to respond L&S 25 mins to pick up a chest pain at a fire station (the pt walked in). They have no transporting ambulances. I remember thinking that it was ridiculous they we had to drive all the way up there.
 

NomadicMedic

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It happens in King County Washington all the time.

The medics in South King are spread very thin and will take only the most critical patients.

Having been a BLS provider there, I speak from first hand experience.
The phrase, 'You're only a few minutes from the hospital, just drive fast" has special meaning to anyone who's worked a BLS rig in Renton, Kent, Tukwila or the surrounding areas.

As a basic, it was exciting to get patients that should have been transported ALS.

Now that I'm an ALS provider, I'm just disgusted...
 
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