NY towns want to change ambulance transport law

[DrParasite]

NY towns want to change ambulance transport law
The law prohibits a certified first responder from transporting a patient in an ambulance to a hospital without the presence of an EMT

some highlights:

NIAGARA COUNTY, N.Y. — If you’re in need of immediate medical attention in New York state and a less qualified first responder appears on your doorstep, you may have to wait for someone more qualified to transport you to the hospital.

But there are some people in Niagara County — and elsewhere in the state — who are trying to change that.

Jennifer Bieber, the soon-to-be former town supervisor in Royalton, said the required course necessary to become a “certified first responder” may not be as lengthy, “but they can do almost anything an EMT can do.”

“If there’s no EMT available, why not let that person (a certified first responder) jump on that ambulance and get that person to the hospital,” Bieber said.

“It is great to have those higher levels of care. But they’re getting fewer and fewer,” Godfrey said. “And the whole idea of the ambulance service is time, meaning getting them to a hospital as quickly and safely as possible. The better care we can get them in the back of an ambulance, the better chance the person has.”

So much wrong with what these towns want done.......

Read the rest here: https://www.ems1.com/ambulances-eme...city-wants-to-change-ambulance-transport-law/

 

[DesertMedic66]

Sounds like it’s time to either contract out for EMS or start a paid company/department

 

[VFlutter]

Why even have a first responder? Call an Uber

 

[NysEms2117]

thats an area of the state that is not very populated, if im not mistaken the whole county has <150,000 people. agree with both points.

 

[hometownmedic5]

At that point, drive yourself, have a nearby human of whatever qualifications drive you in their car, call a taxi/uber, whatever.

I truly dont understand people who want to receive no medical care call an ambulance. I see this at least once a week. "(gender neutral human pronoun) I'm going to put you on the monitor, start an IV, check your blood sugar etc. " i dont need all that, just take me to the hospital" why did you even call me....

 

[DesertMedic66]

At that point, drive yourself, have a nearby human of whatever qualifications drive you in their car, call a taxi/uber, whatever.

I truly dont understand people who want to receive no medical care call an ambulance. I see this at least once a week. "(gender neutral human pronoun) I'm going to put you on the monitor, start an IV, check your blood sugar etc. " i dont need all that, just take me to the hospital" why did you even call me....

I’ve been known to point to the patients car and say “is that not working? I can take a look for you so you can drive yourself”

 

[hometownmedic5]

I’ve been known to point to the patients car and say “is that not working? I can take a look for you so you can drive yourself”

I've wanted to so so many times, but I would outright lose my job if I did and it got back to my bosses.

I have to remind myself at least once a day that if people only called us in a true life or death dire emergency, 80% of us would be unemployed or otherwise employed. We say stupidity is job security. That extends much past people doing stupid things to end up needing us into people calling us when they dont need us. sad, but true...

 

[rescue1]

I started EMS in a farm county of 20,000 people and we still had several paid medics and eventually a paid BLS ambulance, in addition to the volunteers. The counties next to us (all of them with less than 70,000 people) staffed a full county ALS ambulance service with 5-6 units in service. I refuse to believe a county of 215,000 people cannot adequately staff multiple ALS and BLS ambulances/chase units with professionals, as opposed to volunteer first responders for any other reason than refusal to adapt to the times.

 

[vc85]

Bad idea. CFRs only have around 1/2 of the training of an EMT and are designed to be a stopgap until higher trained personnel arrive

CFRs don't have the same assessment and base knowledge as an EMT and can't perform skills that could be needed on longer transports like administer most medicines, reduce certain orthopedic injuries or do "blind" EKG transmission. (All of which an appropriately trained EMT-B can under the collaborative protocol)

(Of course most patients don't need an ambulance to begin with but that is for another thread)

 

[NysEms2117]

I’ve been known to point to the patients car and say “is that not working? I can take a look for you so you can drive yourself”

Lol! thats my dream to do one day.... but generally CC stuff requires transport

 

[NysEms2117]

Bad idea. CFRs only have around 1/2 of the training of an EMT and are designed to be a stopgap until higher trained personnel arrive

CFRs don't have the same assessment and base knowledge as an EMT and can't perform skills that could be needed on longer transports like administer most medicines, reduce certain orthopedic injuries or do "blind" EKG transmission. (All of which an appropriately trained EMT-B can under the collaborative protocol)

(Of course most patients don't need an ambulance to begin with but that is for another thread)

have no fear, NYS EMT-B cannot do any of those things.

 

[EpiEMS]

So much wrong with what these towns want done.......

So much wrong - absolutely. The important thing to keep in mind is the context - as @NysEms2117 said, that area of the state is not very populous (~210k people), and most of the communities (if not most of the population) are predominantly served by small volunteer fire departments or ambulance services (there are 12 BLS non-transporting agencies, 3 ALS non-transporting agencies, 8 BLS transporting agencies, and 11 ALS transporting agencies), organizations that function both a public service function & a social function. These are not, in my conversations with affected people, folks who are going to want to see full or partial professionalization, increased requirements, and/or spend more money on upgrading services/personnel. Heck, look at the issue in Lockport...

By way of credibility, I lived in Erie County (due south of Niagara County) and spent a bunch of time in Niagara County (still do, for the record).

Sounds like it’s time to either contract out for EMS or start a paid company/department

Agreed - but I don't think they want to. They have a county sheriff, so I don't think county EMS would be unreasonable (like Albany has and Dutchess County is considering).

Why even have a first responder? Call an Uber

Interestingly enough, Uber wasn't legally permitted to operate upstate until the end of June 2017.

 

[GMCmedic]

Geeze. We have ~60,000 people in 400 sq miles, with 8 volunteer fire departments, 1 combination fire department, and 5 ALS ambulances with paid staff.


Seriously.

Sent from my SAMSUNG-SM-G920A using Tapatalk

 

[EpiEMS]

Geeze. We have ~60,000 people in 400 sq miles, with 8 volunteer fire departments, 1 combination fire department, and 5 ALS ambulances with paid staff.

Hey, I think that's a much more reasonable setup. Not sure why folks aren't willing to have...well, professional emergency services.

 

[vc85]

have no fear, NYS EMT-B cannot do any of those things.

My agency can do all except for the blind ekg. The new collaborative protocols are great

 

[Carlos Danger]

Royalton is actually surrounded on all sides by paid paramedic-level EMS services - both municipal and private - and there are several commercial services in the region who would probably be more than happy to cover Royalton full time. They already cover a handful of other towns nearby.

What you need to understand is that EMS in Niagara County is about as backwards as you can get. The reason they want to change the law has nothing at all to do with lack of availability of more highly trained personnel. It is all about the volunteer services keeping the commercial EMS agencies from gaining any kind of control whatsoever. There is a very strong tradition of volunteer fire and EMS in that region, and though they have no choice but to rely on the commercial agencies to a fair degree, the paid agencies are 100% under the control of the volunteer services when they are working in the "out in the county", as they say there.

A common type of arrangement in this region is for one of these small towns to make an agreement with a commercial agency for the commercial agency to keep a paramedic ambulance nearby (but definitely not IN the town) to respond only when the town can't get a volunteer crew together. Even when a 911 call comes in for a clearly emergent request, you'll sit in your station listening to them tone out over and over again. Eventually their dispatch will admit that they can't get a crew together and will request the closest unit from one of the commercial agencies. If that commercial ambulance happens to be on another transport already, it might be weeks before Niagara County will call that particular service again. They'll punish the service for not being available by requesting mutual aid from another service, even if they are much farther away.

I used to occasionally staff a fly car based out of Lockport that covered pretty much all of Niagara County. If a request came in that was clearly paramedic level and dispatch knew they only had BLS personnel available, they MIGHT ask you to respond to the area. But don't dare actually go to the scene until the BLS vollies get there and actually request you to the scene.

The bottom line is that in rural western NYS, the public safety community would literally rather have their citizens transported by volunteer CFR's who take forever to respond than by paid paramedics sitting around the corner. I witnessed that mindset first hand countless times.

 

[rescue1]

Royalton is actually surrounded on all sides by paid paramedic-level EMS services - both municipal and private - and there are several commercial services in the region who would probably be more than happy cover Royalton full time. They already cover a handful of other towns nearby.

What you need to understand is that EMS in Niagara County is about as backwards as you can get. The reason they want to change the law has nothing at all to do with lack of availability of more highly trained personnel. It is all about the volunteer services keeping the commercial EMS agencies from gaining any kind of control whatsoever. There is a very strong tradition of volunteer fire and EMS in that region, and though they have no choice but to rely on the commercial agencies to a fair degree, the paid agencies are 100% under the control of the volunteer services when they are working in the "out in the county", as they say there.

A common type of arrangement in this region is for one of these small towns to make an agreement with a commercial agency for the commercial agency to keep a paramedic ambulance nearby (but definitely not IN the town) to respond only when the town can't get a volunteer crew together. Even when a 911 call comes in for a clearly emergent request, you'll sit in your station listening to them tone out over and over again. Eventually their dispatch will admit that they can't get a crew together and will request the closest unit from one of the commercial agencies. If that commercial ambulance happens to be on another transport already, it might be weeks before Niagara County will call that particular service again. They'll punish the service for not being available by requesting mutual aid from another service, even if they are much farther away.

I used to occasionally staff a fly car based out of Lockport that covered pretty much all of Niagara County. If a request came in that was clearly paramedic level and dispatch knew they only had BLS personnel available, they MIGHT ask you to respond to the area. But don't dare actually go to the scene until the BLS vollies get there and actually request you to the scene.

The bottom line is that in rural western NYS, the public safety community would literally rather have their citizens transported by volunteer CFR's who take forever to respond than by paid paramedics sitting around the corner. I witnessed that mindset first hand countless times.

This is giving me flashbacks to my first volunteer gig (which went paid 24/7, thank god), where you had to sit on the pad in the ambulance until there were at least 3 personal, or the county response checked you at 8 minutes (exceptions were made for cardiac arrests). The reason being that "if we responded too quickly, the further away volunteers would stop showing up". At least the county ALS chase cars were paid and technically had control of the scene.

I got written up a lot there, but this place sounds way worse.

 

[EpiEMS]

I used to occasionally staff a fly car based out of Lockport that covered pretty much all of Niagara County.

Twin City Ambulance?

 

[Carlos Danger]

Twin City Ambulance?

Yep. I cut my teeth working for TCA in Buffalo and Niagara county, and a little later flying with Mercy Flight.