Inside One of the Country’s Busiest EMS Stations That Serves the City of Los Angeles

DrParasite

The fire extinguisher is not just for show
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So this is really the country's busiest EMS station and they just use a really expensive, non-transport vehicle. Correction, three non-transport vehicles

https://tinyurl.com/hj9tcyo

 

EpiEMS

Forum Deputy Chief
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Just goes to show, EMS is mostly mobile social services.

Also, fire based EMS in LA is poorly run, m'kay.


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VentMonkey

Family Guy
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Something's never change, LACOEMS is one of those things. They exemplify the word "tradition" and everything that's wrong with it in regards to EMS.

LAFD station #9, aka, "Wino-9-0's" has for decades "prided" itself on this. I didn't even read through the whole link. There was a show called "Risk Takers" years ago that did a very good job of doctoring that stations approach to EMS.

I will say, from what I have seen, and known, these crews are getting slammed in the middle of an extremely drug-infested, impoverished place in America...Skid Row. Daily, they're dealing with crack addicts, system abusers, psychotics, etc. That is literally all of their response area, as it's essentially on the east end of downtown Los Angeles.

Needless to say they see the station when they arrive, and perhaps fractionally throughout their shift. This is where the politics of a system like this cry out for change, only to fall on what would appear to be eternally deaf ears.

There's no pride in the burnout they experience. It does them no good, their patients no good, and the general domino effect of what EMS embodies no good.
 

CALEMT

The Other Guy/ Paramaybe?
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I'm pretty sure they have like 4 transporting ambulances at that station haha

While I'm not 100% sure I believe theres 2 ALS ambulances and 2 BLS ambulances out of station 9. Although while 4 ambulances are nice, its still not enough for the call volume that they see.
 

VentMonkey

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Their station is also within close proximity of the Los Angeles mission. The biggest thing this department could do to effect change would be to partner with the mission, hire mid-levels, train their paramedics to the community paramedic standard, staff them in QRV's with a medic and NP, and educate the locals/ homeless while offering weekly clinics to reduce call-volume, and unnecessary workloads.

Maybe even rotate these paramedics on 12's with the NP's while offering clinic; talk about community service.

Staffing 10 ambulances won't stop system abuse, or super-using; it's just another band-aid. I understand many of their patients may be---or seem to be---beyond this, but I can almost guarantee it would be more of a positive than anything.

...but you know? Tradition.
 

Jim37F

Forum Deputy Chief
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From a JEMS article:
L.A. City's first year was focused on simply demonstrating proof of concept, collecting data, and making sure our interventions keep patients safe and satisfied. We're focused on establishing processes, like cultivating our Patient Liaison Program to survey patients and regular chart reviews and feedback sessions. We've learned many of these things from our partners in Mesa and elsewhere, and are confident they will pay dividends as we scale up here in L.A.
So yeah a slow roll out, but certainly a step in the right direction. I'd imagine Skid Row would be among the top contenders for NP2 (assuming they haven't already added NRPU units in the year or so since these articles were first written) now that the concept has largely been shown to work, perhaps the next step is 24/7 coverage in key areas like Watts and Skid Row.

LAFD Stations 64 and 65 in Watts border my district in LACoFD's 41 district, we see them somewhat regularly at MLK and Saint Francis, I can ask them about any updates to the NRPU program or what the "water cooler" talk in stations is about its future.

But in any case, it's more than just "throw more engines and ambulances into St 9" answer. Rather than yet another thread on Fire based EMS on this website, to keep it focused on FS9 and Skid Row's particular challenges, imagine either Skid Row magically got transported into your district (or your service, be it Hall, or AMR wherever, ATCEMS, MEDIC, etc took over exclusive EMS operations for that particular district, besides simply adding more ambulances to the area, what are some other options or solutions that could be looked at?
 

VentMonkey

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From a JEMS article:
So yeah a slow roll out, but certainly a step in the right direction. I'd imagine Skid Row would be among the top contenders for NP2 (assuming they haven't already added NRPU units in the year or so since these articles were first written) now that the concept has largely been shown to work, perhaps the next step is 24/7 coverage in key areas like Watts and Skid Row.

LAFD Stations 64 and 65 in Watts border my district in LACoFD's 41 district, we see them somewhat regularly at MLK and Saint Francis, I can ask them about any updates to the NRPU program or what the "water cooler" talk in stations is about its future.
I love memory lane, lol. I remember seeing them as well, and if you ever dig up the LAFD episode of "Paramedics" the medic they shadowed (white dude) walked into Killer King one day with his patient, so naturally I gave him sh*t.
But in any case, it's more than just "throw more engines and ambulances into St 9" answer. Rather than yet another thread on Fire based EMS on this website, to keep it focused on FS9 and Skid Row's particular challenges, imagine either Skid Row magically got transported into your district (or your service, be it Hall, or AMR wherever, ATCEMS, MEDIC, etc took over exclusive EMS operations for that particular district, besides simply adding more ambulances to the area, what are some other options or solutions that could be looked at?
Aside from what's already been mentioned, less costly tactics such as PSA's, billboards, and town hall meetings could work wonders.

In fact, I'd go so far as to say they'd make for an excellent "test-market" strategy to see how well said community responds to such services.

At best, they're receptive and the next step to actually rolling out a CP program would be that much smoother; at least, you'll have formed community relations, and provided a service that may effect even just one persons thought process.

One more person educated, is one more person enlightened.
 

SpecialK

Forum Captain
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I've been to Los Angeles, specifically past Skid Row and it's disgusting, it's like the after-effect of a nuclear war or something. I've never seen anything like it, I can't understand how these folk aren't somehow you know, in subsidised housing or being looked after by some sort of agency. If we had homeless people wandering the streets like that man, it'd be some sort of huge political scandal and probably cost the Government the next parliamentary election!

I found the local LAFD station and had a look around with the crew on duty ... some of them were Paramedics. They weren't that interesting to talk to, all they wanted to do is show off their flash red vehicles and talk about how "cool" they were, like very hyper-aggressive at promoting themselves but had absolutely no interest in discussing anything of substance so I left after a little bit.
 

NomadicMedic

Pot or Kettle? Unsure.
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Didn't but I just read an article about an agency that embedded medics IN a homeless shelter?
That sounds like a solution for some of this.

As does a non emergent transport vehicle and alternative transport locations.

But change takes times. After all, we still respond lights and sirens to EVERYTHING and transport working codes. :)
 
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DrParasite

DrParasite

The fire extinguisher is not just for show
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I believe you are right: they have 2 ALS and 2 BLS ambulances, along with 2 ALS engines and a BLS ladder, in an areas where "ninety-five percent of the station’s calls are medical." While not the preferably solution, I would absolutely shut down the second engine, and maybe even the ladder, and replace them with 4 more ambulances (maybe relocate the ladder, instead of shutting it down, as I know it covers more than just skid row).

This is a great example of a city that uses suppression units to bandaid an under staffed EMS system. the sick people don't need a non-transport first responder, they need (more often than not), a ride to the hospital. Or as Ventmokey said, a proactive system where practitioners and social workers could check on people before they called 911, and prevent the issues prior to 911 being calls.

As rough as the engine guys have it (and based on the article, it seems that only the engine guys are running their butts off), the EMS units are probably getting hit harder... and guarantee they suck in many more EMS units than the ones assigned to station 9.

the focus of the article could have been on the overworked EMS crews and the lack of EMS support for the people on Skid row, and how they need better funding to help the people in their district... alas, those poor overworked heroes who ride the engines really deserve a kudos for all the hard work they do.
 

VentMonkey

Family Guy
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Sort of on topic, but if anyone knows who Nathaniel Ayers is, and/ or has seen "The Soloist" know not all are lost causes. Sort of like John Nash, they put schizophrenia into perspective.

Bakersfield does have a similar situation with our local mission, which is right next to one of our city fire stations. I'm pretty good friends with one of their more seasoned captains so him and I will talk in passing from time to time. He's been there as long as I can remember, and enjoys it overall, though admittedly Bakersfield is maybe an eighth the size of Los Angeles (the city itself).

I still think a community-involved approach is the best way to go about any of this. If you make it a joint agency venture you're also ensuring that both (EMS are fire) departments go in with an equal understanding of what it is that needs to be done, from clinic, to routinely following up with people, and anything in between. Involving LE, and assigning them specific tasks will only enhance such an approach.
 

medicsb

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How busy this station is also has to do with how they count the numbers. LAFD noted the station responded to 17,434 incidents in 2015, the article mentions a call volume of 27,338 for the same year. They're busy, for sure. But, when you break it down on a per ambulance or per apparatus basis, they're definitely not the busiest in the country. A quick search showed something like 84% of LAFD's call volume is EMS and 60% are ALS. So that comes out to about 4400 runs per ALS ambulance and BLS doing just under 3000 each. Sure, that's busy. But, they are not setting any records. Neither are the fire apparatus. Definitely brutal (and unsafe) for 24 hour shifts.
 

EpiEMS

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60% ALS, what's your source? Just curious because I'd like to see if those are ALS responses or ALS transports.


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NPO

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I don't envy station 9. While I think this article is silly and only glorifies the work they do, it doesn't fix or identify any problems. Everyone knows the calls there Re predominantly abuse. It's not like they are running true medical emergencies that often. While the article likes to paint a pretty picture, I've heard some stories from that area about some pretty erroneous misconduct.
60% ALS, what's your source? Just curious because I'd like to see if those are ALS responses or ALS transports.


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That doesn't seem off to me. But I have no numbers in front of me. Just by guess, if you put as many paramedics on as much apparatus as LAFD does, you're going to get a lot of ALS transports.

Maybe they count ALS transports as transports with a paramedic, not with ALS interventions.

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EpiEMS

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That doesn't seem off to me. But I have no numbers in front of me. Just by guess, if you put as many paramedics on as much apparatus as LAFD does, you're going to get a lot of ALS transports.

Maybe they count ALS transports as transports with a paramedic, not with ALS interventions.

Interesting point! Not to mention, if you throw a medic on board, I am given to understand that Medicaid pays at the ALS rate, assuming the complaint was deserving of an ALS response in nature per the area's dispatching protocol.
 

NomadicMedic

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Interesting point! Not to mention, if you throw a medic on board, I am given to understand that Medicaid pays at the ALS rate, assuming the complaint was deserving of an ALS response in nature per the area's dispatching protocol.

Not quite. The billing is pretty specific. Just having a medic on a BLS call doesn't automatically allow you to bill as an ALS call. However, you CAN bill the call as ALS 1 if you perform an ALS intervention or perform an ALS assessment. (Which every medic should do, and document as such.)

ALS 2 is when you perform 3 separate medication admins or perform an advanced procedure such as electrical therapy, advanced airway or the like.
 

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