Not enough ambulances?

Mercalyn

Mercalyn

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I was curious if too many personnel were called out at one time, what would the dispatchers do if they ran out of ambulances / personnel to cover that next call? Outsource to another county or something?
 
That's usually what most places do.

In the counties I work in, there is one ambulance company that exclusively respond to 911 calls. If they are low or have no units available, they'll start calling ambulance companies that usually do interfacility transport (do not usually respond to 911 calls, but are ambulance with at least two EMTs on it). After that, they'll start calling ambulance companies from surrounding counties.
 
Thanks for the reply. So there isn't licensing issues with that? Sending IFT-only EMTs to go respond to emergencies?
 
They all hold the same certification. The IFT companies will usually have contracts with the city/county/company to provide back-up 911.

Another term is mutual aid, generally for fire-based EMS, requesting help from another department for 911 calls or a fire.

We don't really have anyone to get mutual aid from, all about 45 minutes away lights and sirens, they start pressuring units in the system to clear from the hospitals quickly and if it gets bad enough they will send out an "all call" page requesting all available off duty personnel to report to staff extra units. If there's inclement weather forecasted they will staff an extra unit or two.
 
As a private service we often ran mutual aid calls for busy departments. We had both 911 contracts and IFT contracts. When we were short of units we'd call other privates in the area. When they were busy dispatch would calls providers in surrounding counties.

I responded to calls where a city calls us and another service and the first one to arrive got the call.

A licensed provider/unit is a licensed unit. Most of my colleagues at the private service I worked for also worked for municipal agencies or volunteer services.
 
Mercalyn said:
Thanks for the reply. So there isn't licensing issues with that? Sending IFT-only EMTs to go respond to emergencies?
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Depends. In many states, there are no different "IFT" standards. A CCT truck may even carry more than a 911 rig.

In the end, most places have mutual aid agreements that sort this sort of question out ahead of time.

Some places (usually big cities) just won't call for help, and will hold calls instead. That's BS, IMHO.
 
Our District is divided up into about 10 zones (I don't remember the exact number). For each zone, obviously all of our units are listed first, but then we start listing trucks from other agencies based on how close they are. Similarly, we are listed somewhere down the line on the list on other agencies' lists.

Each of these lists is called a "run card" and they are thought out in advanced. Most of these are just reciprocity agreements--I'll cover you on this card and you'll cover me on this card--but some of them are one way and may involve the exchange of money or other compensation/consideration.

With the advent of computer dispatching, run cards have gotten as specific as having a run card for each address. So the computer dispatching system can pull up the run card for a given emergency at a given location in a matter of milliseconds. In the rural area where I am, we still have just the 10 or so cards that we own and then about 15 cards that other people own sitting in a binder.
 
WuLabsWuTecH said:
Our District is divided up into about 10 zones (I don't remember the exact number). For each zone, obviously all of our units are listed first, but then we start listing trucks from other agencies based on how close they are. Similarly, we are listed somewhere down the line on the list on other agencies' lists.

Each of these lists is called a "run card" and they are thought out in advanced. Most of these are just reciprocity agreements--I'll cover you on this card and you'll cover me on this card--but some of them are one way and may involve the exchange of money or other compensation/consideration.

With the advent of computer dispatching, run cards have gotten as specific as having a run card for each address. So the computer dispatching system can pull up the run card for a given emergency at a given location in a matter of milliseconds. In the rural area where I am, we still have just the 10 or so cards that we own and then about 15 cards that other people own sitting in a binder.
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We have this, which works very well. Borrowed from the fire department that we are contracted to, so there is no issue with working with neighbors who have fire based ambulances.

The towns without fulltime ambulance service have "line boxes," so if you live at the edge of one of these towns, a neighboring town's fulltime ambulance will respond to you, likely beating the POC crew.
 
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Well, we're assigned to posts when coverage drops. If need be there are BLS rigs that are available to provide coverage. They typically respond with a supervisor or respond as an additional unit to transport BLS and in certain cases ALS patients.
 
Wow I got a lot of responses overnight~

I think that answered it pretty well. Thanks all.
 
Mercalyn, some systems operationally will never mutual-aid (they think it looks bad, or their contracts are written so they get fined if they mutual-aid more than if they simply hold the call). Alternatively, there's simply no one available.

When this happens, you go on hold.
 
We mutual aid with a bigger company in the city next to us. We more often then not are covering them.
 
We have zero mutual aid. Once the system runs out, you're screwed until an ambulance is available. This isn't a weekend night/weather/mass gathering/holiday thing, either(they usually staff extra units in anticipation). It could be Tuesday morning, 11am, and there's no ambulances available.
It's asinine.
 
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Trashtruck said:
We have zero mutual aid. Once the system runs out, you're screwed until an ambulance is available. This isn't a weekend night/weather/mass gathering/holiday thing, either(they usually staff extra units in anticipation). It could be Tuesday morning, 11am, and there's no ambulances available.
It's asinine.
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We are zero mutual aid for all BLS calls... we do call mutual aid for ALS calls (depending on where in the city the call is). I have heard of times when we are holding 10 calls over the span of several hours, and one of two times when we were holding as much as 30 calls during a busy weekday.

For every place I have worked, we NEVER called an private IFT unit to take one of our calls. many private IFT companies won't take them because there is no guaranteed revenue for them. We usually request a neighboring 911 service respond into our area to cover the call.

the other issue is despite we all having the same EMT and CPR cards, and even the same equipment, IFT crews aren't trained the same. they don't have same supplemental certifications, nor are they as experienced in the 911 system, know the city as well as our crews do, have direct contact with 911 dispatch, nor we have any way to hold them accountable. my former agency had an IFT division, so we would send them on 911 jobs if the primary 911 trucks were unavailable, but we would NEVER send a private IFT ambulance on a 911 call. the exception, might be an MCI where we had 50-100 patients and needed ambulances, but those are very very rare.

many volunteer agencies will attempt to recall off duty personnel to staff an additional ambulance. Sometimes they get one, othertimes, not so.
 
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