Fly car (rapid response) medics in the U.S.

ExpatMedic0

ExpatMedic0

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Anyone know of an EMS agency utilizing fly car/rapid response paramedics. I.E. 1 or 2 paramedics who respond in a non-transporting vehicle such as an SUV, car, or motorcycle with ALS equipment on board.
How does your system work this program?
What is the requirement to be one of these guys at your department?
I have done this outside the U.S. and thought it was a blast but was curious if it exist in the U.S.
 
There are 29 ALS projects in the state that operate out of probably 40-50 hospitals. 2 of those are the state police aeromedical service units

Off the top of my head i can only think of like 2-3 that dont use SUV or similar style vehicle

MONOC-operate in Monmouth and Ocean and also a hospital in North Jersey
Raritan Bay Medical Center-operates out of two hospitals

Now sometimes these agencies have critical care trucks that may have a medic and will be pulled to do ALS runs when not doing CC so you may see a box from an agency that doesnt normally use boxes for their medics, like Robert Wood Johnson and UMDNJ
 
And some of those projects also use Type III ambos as "fly cars". Still has 2 sets of gear and is a pair o'medics, but the medics have an ambo for transporting when the BLS collies fail to respond.
 
Bullets said:
There are 29 ALS projects in the state that operate out of probably 40-50 hospitals. 2 of those are the state police aeromedical service units

Off the top of my head i can only think of like 2-3 that dont use SUV or similar style vehicle

MONOC-operate in Monmouth and Ocean and also a hospital in North Jersey
Raritan Bay Medical Center-operates out of two hospitals

Now sometimes these agencies have critical care trucks that may have a medic and will be pulled to do ALS runs when not doing CC so you may see a box from an agency that doesnt normally use boxes for their medics, like Robert Wood Johnson and UMDNJ
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I believe a lot more now have ambulances. Also, with all the consolidations, there is something like 17 MICU projects in NJ now.

AtlantiCare now has a number of ALS ambulances
UMDNJ in Newark has been in ambulances for decades
JCMC EMS ALS is in ambulances
St Clare's also has ALS ambulances

And I think RWJ in New Brunswick is in ambulances, too.
 
RWJUH is between ambulances and suvs.

Per the NJ Paramedics association website is where i got my numbers from. But as you know it changes regularly
 
ALS fly cars with BLS transporting units is a pretty sensible model. ALS comes to assess patients, and rides in the ambulance if necessary, otherwise the ALS fly car can go back in service and the BLS unit can transport. This sounds fairly cost-effective, and ensures that ALS is usually available (assuming a predominantly BLS patient mix). Fairly common in CT, far as I can tell. AMR does it and Campion (I think) does it.

I'd like to hear what EM MDs think of this sort of system.
 
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I had a blast doing it in the past and would love to find a future agency that uses such a model.
 
I've always wished they would swap our system to ILS ambulances with ALS flycars but I doubt it'll ever happen.

Chargers have big trunks... :D

Our community paramedics are supposed to be in explorers or similar vehicles and eventually will have a few more "toys" than a standard ALS ambulance and go to higher acuity calls, basically copying MedStar's system. That's a ways off though. They still are trying to simply implement the program. Training start a few weeks ago.
 
We have vehicles from the rapid response unit and the special response team on the road 24/7 and the motorcycles have recently been reintroduced, but we still have ICP on regular ambulance as well
 
For those that work on an ALS flycar, do you find that the EMTs need to be well trained in ALS-assist skills, in order for the system to be effective? Do your departments work to maintain the skills, if rarely used, or do you just get by alone? I know some departments near me staff with two paramedics and two sets of gear, so the possibility of PB staffing is fairly high.
 
We run exclusively as "fly car" medics, with two medics on every call. We have the opportunity to take two medics if we need help but in most cases transport single. The BLS providers are hit or miss. Some are great, others are useless. Luckily, on most calls I have no problem doing it without help. I do like to delegate tasks to the EMTs to keep them involved and engaged. We teach a "medic assist" class a few times a year to help out the EMTs.
 
What city?
 
Swansea MA here. Private non-profit 911 ALS, community of about 18K. We run two trucks. During the busy day shifts we try to run both trucks with 2 medics. In the evenings, which are always slower we have one truck with a senior medic, the other with a more junior and typically fill in with basics or very green medics. This means that we often have to roll both trucks to a single call, often putting both trucks out of service.

Our plan is add a fly car assigned to the senior medic. Then we'd be able to send the truck plus fly car and still have an ALS truck in service.

The latest quote I have is $85K for a modified Chevy Tahoe. That includes the new vehicle with upgraded suspension and electrical. Heat/cold cabinets, lights/sirens, radios, toughbook, and a new Lucas2.
 
Why do you roll two ambulances to a single call? That's terrible resource management. A single medic with an EMT partner can handle just about everything just fine.
 
Robb said:
Why do you roll two ambulances to a single call? That's terrible resource management. A single medic with an EMT partner can handle just about everything just fine.
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Because, as I said, very often we are staffed with a very junior medic on one truck. They need the experience but should not be operating independently.
 
Simusid said:
Because, as I said, very often we are staffed with a very junior medic on one truck. They need the experience but should not be operating independently.
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Why not?

Give me one good reason why a certified paramedic cannot operate independently.

They shouldn't be on their own truck unless they cleared FTO time. If they've cleared their FTO time there's absolutely no reason they can't operate independently. If they haven't they should be on a truck with a FTO and that should be the sole responding unit. Makes no sense to put a junior medic with an EMT on a truck if they aren't capable of responding to calls without someone there to hold their hand. Might as well just send the EMTs home and leave the two medics on a single box.
 
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Robb said:
Why not?

Give me one good reason why a certified paramedic cannot operate independently.

They shouldn't be on their own truck unless they cleared FTO time. If they've cleared their FTO time there's absolutely no reason they can't operate independently. If they haven't they should be on a truck with a FTO and that should be the sole responding unit. Makes no sense to put a junior medic with an EMT on a truck if they aren't capable of responding to calls without someone there to hold their hand. Might as well just send the EMTs home and leave the two medics on a single box.
Click to expand...

In our system it's a little sketchy, I wouldn't want to rely on this. We go down to NUA 4 times a day, and with bad luck prevailing the junior medic would be the only one for 50 miles.
 
Robb said:
Why not?

Give me one good reason why a certified paramedic cannot operate independently.

They shouldn't be on their own truck unless they cleared FTO time. If they've cleared their FTO time there's absolutely no reason they can't operate independently. If they haven't they should be on a truck with a FTO and that should be the sole responding unit. Makes no sense to put a junior medic with an EMT on a truck if they aren't capable of responding to calls without someone there to hold their hand. Might as well just send the EMTs home and leave the two medics on a single box.
Click to expand...

It is an opportunity to progress from hand holding to complete independence. I know that I do not want Molly Medic with 6 months of experience going to a call unassisted while a senior medic with 18 years of experience sits in the office. This system was designed by our senior staff and it works for us.

It is clear we will not agree on this.

:deadhorse:
 
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