So most ALS intercepts in NJ are ALS ambulances? Interesting.
No..... back in the day, only New Brunswick, Newark and Jersey City were "legally" allowed to transport in an ALS ambulance; the justification for this was in those cities, both the ALS and BLS were ran by the same hospital based agency. So in those three cities, and only those three cities, you would find paramedics riding in ambulances. The theory was, both an ALS and BLS truck showed up; if the patient required ALS, the paramedic truck transported and BLS went back in service, and if the patient did not require ALS, the EMT truck transported and ALS went back in service. and if the patient was really sick, the patient was usually transported in the BLS truck, with both medics in the back, and the EMTs drove both vehicles to the hospital.
In the rest of the state, ALS is in a flycar (usually some type of SUV), from a hospital based regional system, while the BLS was ran by the municipality. So if the patient is BLS, the paramedics go available, and if the patient is ALS, one medic treats while the other follows in the SUV, while the BLS ambulance transports. This was a political decision that started before I became involved in EMS.
10-15 years ago (maybe it's closer to 25 years now), some hospital based systems (which had previously only ran ALS units) added CCT units, and added BLS divisions. This allowed them to create non-emergency divisions to get in on the lucrative hospital discharge and inter-facility market, as well as bid on 911 contracts for municipalities. They staffed their CCT unit with an RN, a Paramedic, and an EMT, so if the CCT unit wasn't on a CCT run, they could be sent on ALS requests when the primary unit was tied up. In theory, the CCT unit could transports, but legally they were only able to transport with the BLS unit. So agencies could apply for waivers to the "only BLS can transport" if they chose too, and it was up the the dept of health to approve or deny it.
I have heard people say that the ALS agency for Bullet's area had such a waiver, but I have also heard that they were told a waiver exists, but no one has actually seen it. So they are pretty much going on "well, since those guys could do it based on their criteria, and we meet the same criteria, then so will we, and we can beg for forgiveness if we get caught." and last I heard others were following their trend. It's a political headache that predates me.
I heard RWJUH/NB have moved their paramedics out of ambulances, and moved them to SUVs to save money (well, for RWJ they had 6 medic trucks; they all used to be in ambulances, located throughout the county; now only the ones stationed in New Brunswick are still in an ambulance, but the out stations are in SUVs).
Do they carry two sets of ALS gear in the event that the ALS ambulance is diverted to another call while their partner rides in with the other (BLS) ambulance?
yes and no. Some trucks will carry two sets of gear. two monitors, two drug bags, two airway bags etc, so if they needed to split up (all paramedic units in NJ are dual ALS provider by state law) and each take an ALS patient to the hospital in a separate ambulance, they could. But no, once they are assigned to an assignment, unless some weird thing happens, they are committed to that assignment until the crew turns over patient care.
a BLS ambulance (typically based in the municipality) is sent to EVERY request for an ambulance that comes through the 911 system. ALS are only sent on calls that meet ALS criteria per EMD guidelines. In theory, ALS should only be treating and transporting patient that meet ALS criteria. At least that's how the system is set up to function.
