Fire Trucks at medical scene

[socalmedic]

When did Grove get ALS ambos? They also use Care for transport, Also, IIRC, a OC unit is not truly a medic unit unless it has two medics, anything else is considered a PAU and while some depts will send one, like FVY, every ALS call is supposed to have 2 medics riding in the hospital.

in 2006 i believe they still transported, this report and stats are from 2006. yes you must have 2 paramedics on transporting units or it is just a PAU however this is also just numbers on how many ALS call ins where made, PAU is allowed to call in and do ALS Tx. maby someone from care is reading this, i think GG now contracts with OCFA for a medic van to Transport.

 

[jgmedic]

in 2006 i believe they still transported, this report and stats are from 2006. yes you must have 2 paramedics on transporting units or it is just a PAU however this is also just numbers on how many ALS call ins where made, PAU is allowed to call in and do ALS Tx. maby someone from care is reading this, i think GG now contracts with OCFA for a medic van to Transport.

I worked for Care in 06-08, a lot in Grove, they had medic squads that responded with the "BLS" engines, but the Care grove ambos had been there for years.

 

[46Young]

What's wrong with debt if you're getting a degree that isn't along the lines of ethnic studies? If the only people who went to graduate professional schools (law school, medical school, pharmacy school, etc) were people who could pay out of pocket, there would be a lot less physicians, lawyers, pharmacists, etc.

I'm talking about making rent, not getting a college loan.

 

[46Young]

I'm definitely not arguing for the fire service to hand over all rescue/extrication stuff to EMS and handle fire suppression only. It doesn't have to be all or nothing. Just look at TEMS.

For the vast majority of SWAT calls, the ambulance staged down the street is just fine (fairly similar to rescue calls, in which medical attention may be needed, but the rescuers can take the patient to EMS without hampering pt care). Then LE agencies started looking at that small percentage of SWAT calls in which having a paramedic able to go in along side them would be beneficial.

Did they start sending their cops to paramedic school? No. Did EMS systems start taking over all SWAT operations? No.

They trained a few of the paramedics in the EMS system some essential SWAT things, provided the equipment they needed to go in, and now they have a few medics able to go in with the SWAT team, who do the bulk of the operations and all of the coordination.

Maybe I read his post wrong, but it looked like he was saying that EMS agency didn't need fire whatsoever to do rescue, and then provided a link. The info contained in the link only referred to EMS supporting these rescue operations, not being able to do anything and everything involved. I think it's great that they train to be an integral part of these operations, but it sounded like he was saying that they could handle any tech rescue or hazmat on their own.

 

[Shishkabob]

Just FYI I never mentioned HazMat... that was dave.



However, around these parts, 3rd service county based EMS does a big part of the extrication simply because you won't always get a volly fire dept on scene to help.

 

[46Young]

Just FYI I never mentioned HazMat... that was dave.



However, around these parts, 3rd service county based EMS does a big part of the extrication simply because you won't always get a volly fire dept on scene to help.

I've heard of that. FF's go to rescue school to learn that stuff, so there's no reason why EMT's or medics can't do the same. I know that some engines carry a limited amount of extrication equipment. What type of vehicle does ATcEMS turn out for cut jobs? What can they handle?

FYI, around my way we have heavy rescues that are either hazmat or TROT. When I hear rescue, I think cut jobs along with TROT stuff which is high angle, swift water, trench, confined space, building collapse, and also hazmat. When I read your link it mentioned supporting roles for both TROT type rescue and hazmat alike.

 

[DrParasite]

Maybe I read his post wrong, but it looked like he was saying that EMS agency didn't need fire whatsoever to do rescue, and then provided a link. The info contained in the link only referred to EMS supporting these rescue operations, not being able to do anything and everything involved. I think it's great that they train to be an integral part of these operations, but it sounded like he was saying that they could handle any tech rescue or hazmat on their own.

That could very easily be argued:

http://www.uh-ems.org/rescue.html

http://www.city.pittsburgh.pa.us/ems/html/rescue_division.html

 

[BLSBoy]

That could very easily be argued:

http://www.uh-ems.org/rescue.html

http://www.city.pittsburgh.pa.us/ems/html/rescue_division.html

Staffing R1 with just 2 people is not adequate.

 

[esmcdowell]

This is exactly the problem

A. To say that Fire-based EMS is wrong/bad juju/whatever else you want to say is not helping the major problem in EMS. For one, I ask if any of you have ever been to say...Arcadia, NE, a town of 500 people, where the nearest Ambulance is over 30 minutes away, the helicopter, closer to an hour, but the local FD has a dozen emt-b's who can be on the engine and to your side in less than 10 if you have a major medical problem. Or Luther, MT, a farming community, where the ambulance can be over 2 hours away, phone service is spotty at best, and the helicopter is 45 minutes to not available, but Bob from the next ranch over, who is a firefighter/emt can go get the specially designed 4x4 engine with BLS equipment and can use the much more reliable radio network to reach a QRU medic/firefighter in another 4x4 that can be there in 20 minutes, and Bob can be back at your door in 15 minutes. Saying that Fire based EMS is wrong just because the larger departments have yet to work out the kinks isn't helping the problem, it IS the problem.

B. To all of you non-U.S EMS providers who keep talking about cookie cutter EMS and medic mills and poor education standards, I say step up to the plate, if you really are as smart as several of your degrees require you to be, then you most certainly should know that you hold as much, if not more power than all of us American EMS providers who would like to see the system changed to better help the people who dial those three numbers. Again, to talk of the U.S's nationally poor standards is horribly untrue, i know several emt's medic's and even our hated brothers firefighters who wish that there were more we could do for the people that put their trust and money in our abilities.

C. To those of you saying that us dual role providers are somehow less than you single role EMS "professionals" I say b***s**t, I know Firefighter/Medics that are better medics and better overall care providers than any single role Medic I have ever met.
D. Okay, that's it for me, but i do want to end on this note, If you aren't helping the problem, you ARE the problem...

 

[JPINFV]

A. "Have yet to work out the kinks?" Exactly how long are you going to give them before you tell them that 2-4 paramedics on every vehicle with lights and sirens does work well?

B. Would Bob the volunteer FF/EMT be an EMT if it took 1-2 years of education to become an EMT? I bet the physicians at the emergency room they're delivering to still had to go through 4 years of undergrad, 4 years of medical school, and at least 3 years of residency. Additionally, why is it the responsibility of paramedics in other countries to effect change in a country foreign to them?

C. Since you admittedly come from a rural area, exactly how many single role paramedics do you know? Would you be willing to compare the average paramedic from, say, Boston to an average So. Cal. paramedic-FF?

 

[LonghornMedic]

I've always been of the opinion that if you want to run EMS, run the entire thing. As such, the vast majority of EMS in the Greater LA Area (since the medics on the engine, private company provides 2 EMTs and an ambulance is common in both LA and OC areas) has always made absolutely zero sense to me.

L.A. County is a bizarre world when it comes to EMS. They invented modern EMS as we know it. But they have never evolved since. The heavy handed "mother may I" is ridiculous. The use of private ambulances as a taxi service for FF/Medics makes no sense at all. The one thing I do like is County's use of squads. When I worked EMS in Las Vegas, every department had to have the latest and greatest rescue ambulance and they don't even transport(except Las Vegas and Henderson FD)! Talk about a waste of tax payer money. Or sending an engine company to a Bravo level broken arm. The best was sending a truck company to Code 2 Alpha responses. Something like a non-code response for a infected toe nail and having a $500,000 piece of equipment and four FF is such a waste. Here, only EMS is dispatched unless it's a critical call and then they'll send FD.

 

[LonghornMedic]

I've heard of that. FF's go to rescue school to learn that stuff, so there's no reason why EMT's or medics can't do the same. I know that some engines carry a limited amount of extrication equipment. What type of vehicle does ATcEMS turn out for cut jobs? What can they handle?

FYI, around my way we have heavy rescues that are either hazmat or TROT. When I hear rescue, I think cut jobs along with TROT stuff which is high angle, swift water, trench, confined space, building collapse, and also hazmat. When I read your link it mentioned supporting roles for both TROT type rescue and hazmat alike.

ATCEMS runs four Technical Rescue units, mostly in the more rural areas of the county where you may get a volly response. Those Tech Rescue units carry extrication equipment, ropes and climbing gear for high angle rescue, swift water rescue gear, bunker gear, body armor, etc. In the city, Austin FD handles extrication. And they will work together on a high angle call. EMS has scene command on all medical calls and joint command on MVA's. Hazmat is going to primarily be handled by FD with assistance from EMS.

 

[spike91]

In Florida, it is a Fire-Rescue Department. That means they run both fire and EMS crews under one organization. ALL members are MINIMUM fire fighters and EMT-B certified.

That means every medical call that gets toned out is first responded by a fire truck while they wait for an ambulance to arrive at which point they transfer care and transport. All fire trucks that I saw in my area of Florida were minimum BLS staffed equipment wise, probably had an ALS bag with the narcs also.

 

[MrBrown]

... and you just know the two minutes its gonna take the Ambulance to get there makes all the difference, because that Medicfighter (you know, the Firefighter who just hates being a Paramedic and fights it every day) is gonna do a lot of really necessary stuff right? Not.

 

[spike91]

... and you just know the two minutes its gonna take the Ambulance to get there makes all the difference, because that Medicfighter (you know, the Firefighter who just hates being a Paramedic and fights it every day) is gonna do a lot of really necessary stuff right? Not.

You, sir, clearly have never had the fortune of watching the Hillsborough County FireMedics at work. Kindly bite your tongue.

 

[BLSBoy]

Uhhh, spike, you in Hillsborough County?

 

[Dutch-EMT]

Well, reading another thread (about a broken arm is an ALS call), i think the system can be more efficient.
Sending ambulance to an broken arm? come on!!! You think this really needs an ambulance? When responding to all kind of that sort of calls, you need a lot ambulances and first responding fire trucks.

In our system, the patient will be brought to the family doctor/ GP/ physician by his/her family, neighbors, etc. Everybody here has his own familydoctor/ GP.
We don't call an ambulance for non-emergency and non-life threatening things
which can be handled without ambulance.

Ambulances (staffed and equipped) are cheaper than a firetruck (staffed and equipped). So, costs can't be a problem?!

 

[zmedic]

Most GPs here in the states
1: Don't have x-ray machines
2: Don't reduce or cast fractures

So there patients are going to the ED. A lot of these patients with broken arms happen after some sort of mechanism where they could have hurt something else (fall, MVA etc) so going in the ambulance is reasonable. On the list of garbage that people call 911 for broken arms is pretty far down the list. Lets deal with people who call for pain that they've had for the last month, fever of 100.2, transport for med refills etc.

 

[BLSBoy]

Not to mention the "entitlement" feeling that 99% of the "customers" we serve have. <_<

 

[46Young]

Well, reading another thread (about a broken arm is an ALS call), i think the system can be more efficient.
Sending ambulance to an broken arm? come on!!! You think this really needs an ambulance? When responding to all kind of that sort of calls, you need a lot ambulances and first responding fire trucks.

In our system, the patient will be brought to the family doctor/ GP/ physician by his/her family, neighbors, etc. Everybody here has his own familydoctor/ GP.
We don't call an ambulance for non-emergency and non-life threatening things
which can be handled without ambulance.

Ambulances (staffed and equipped) are cheaper than a firetruck (staffed and equipped). So, costs can't be a problem?!

At least a broken arm is a legitimate medical complaint. Most areas have the policy that anyone who calls 911 gets at least an evaluation. Only a few departments will refuse txp for minor issues. Most depts are litigation phobic. It's less risky to just transport anyone that requests it. Many of the uninsured use the ED as their primary care physician, and the ambulance as their taxi, since they won't be paying anything on either account. That's just the way it is here. People call for everything nowadays.