What was your first 911 call?

Chris EMT J

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My first call after being fully certified? Terrorist Attack. A bus exploded and I treated the driver alone. He had a partial amputation of the lower leg. Don't recommend it for a first pt.

On another track, I don't understand what you mean by working but only having 2 911 calls. In the US are all ambulances not controlled by 911? Do you have emergency calls that come from somewhere else?
In the US we have 911 service ambulances, private ambulance service for like dialysis treatments, and some can call the private service for a transfer to the hospital and it could be a emergency.
 

Jim37F

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On another track, I don't understand what you mean by working but only having 2 911 calls. In the US are all ambulances not controlled by 911? Do you have emergency calls that come from somewhere else?
A lot (most even?) US ambulances aren't a part of the 911 System. They solely do IFT (Inter Facility Transport). Things like ER discharge to Nursing homes, transfers from Nursing homes to the hospital, transports between the various tertiary care facilities (cancer clinics, stand alone MRI offices, etc).

Usually non-emergency, often pre scheduled, though a lot are "call and they'll send a unit".
There are emergent transfers, CCT (Critical Care Transport, often staffed with a Nurse and/or Repiratory Therapist alongside the EMTs, I've even seen CCT with an MD...) are usually all considered IFT.

Dialysis transports alone are a huge chunk of the IFT business, and that keeps a lot of private ambulance companies in business just doing these transports.
 

IsraelEMS

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Interesting. So how does 911 decide which ambulane to send? Are there ambulances that only do 911 calls? Does this differ by state?
 

Chris EMT J

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Interesting. So how does 911 decide which ambulane to send? Are there ambulances that only do 911 calls? Does this differ by state?
Yes there are some ambulances that only do 911 calls. Also some companies are mix and take some 911s and IFT
 

IsraelEMS

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Does 911 dispatch you directly?

In Israel there is only 1 national dispatch that answers 101 (our version of 911 calls) and dispatches ambulances. Its a national ambulance service so no different companies. Also, all of our dispatches are also field medics. This helps in getting the right info from callers or walking callers through cpr. Do the people who answr 911 calls also have ems training? Can the dispatch the closest ambulance across state lines (like if the caller is in Nevada and the closest ambulance is in California)? So curious how it works there.
 

Chris EMT J

Forum Lieutenant
124
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Does 911 dispatch you directly?

In Israel there is only 1 national dispatch that answers 101 (our version of 911 calls) and dispatches ambulances. Its a national ambulance service so no different companies. Also, all of our dispatches are also field medics. This helps in getting the right info from callers or walking callers through cpr. Do the people who answr 911 calls also have ems training? Can the dispatch the closest ambulance across state lines (like if the caller is in Nevada and the closest ambulance is in California)? So curious how it works there.
Yes essentially 911 only companies. We get direct if close enough if not they will find someone else.
 

Jim37F

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So there's no single central 911 system. But the phone system is designed to route a 911 call to the appropriate local 911 center . It may be regional in rural areas, or cities like LA may have a dozen different ones. They have their 911 providers (either the Govt provided Third Service EMS or Fire Dept ambulance or they call the contracted private company who dispatches their unit)

Otherwise the non 911 IFT calls, the hospital or whoever calls the ambulance dispatch directly. Some facilities will "shop around" and call different companies
 

jjyi24

Forum Probie
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First call was for an ankle fracture at a soccer game. First real call was an aortic dissection. Couldn't wrap my boot-brain around how it wasn't a CVA for the whole call.
 

DrParasite

The fire extinguisher is not just for show
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Does 911 dispatch you directly?
most of the time, yes... sort of. almost all 911 systems have some type of emergency ambulance system. Sometimes the 911 center dispatches the ambulances directly; other times they will pass the call information (and often caller) to the ambulance dispatch center with an automatic computer transfer and/or a one touch phone transfer, who handles all communication between the 911 center and the ambulance. Smaller towns have 911 dispatching directly, larger cities have dedicated police, fire, and EMS dispatchers.
In Israel there is only 1 national dispatch that answers 101 (our version of 911 calls) and dispatches ambulances. Its a national ambulance service so no different companies.
That's not how it is in the US. Each town or county has their own Ambulance service, or contacts out with a private service or 3rd party non-profit company to provide EMS services to the area. Some places have multiple EMS agencies providing EMS services to a give town, city or county. In theory, all standards are similar.
Also, all of our dispatches are also field medics. This helps in getting the right info from callers or walking callers through cpr. Do the people who answr 911 calls also have ems training?
Sometimes... but not always. Some dispatchers are former field providers, and some are EMTs. However, there is not requirement to have EMS training, aside from Emergency Medical Dispatcher training (and even that isn't required in every state). Some EMS dispatcher centers require dispatchers to also be EMTs, but not every 911 call taker has EMS training
Can the dispatch the closest ambulance across state lines (like if the caller is in Nevada and the closest ambulance is in California)? So curious how it works there.
As a general rule, ambulances don't cross state lines, even if they are closer. In some areas, they won't cross county or municipal lines either, unless requested. There are historical reasons, funding reasons and political reasons for this, as well as regulatory reasons.

You also need to remember that Israel is the size of NJ, so it's not exactly a fair comparison. For example, MDA handles 2.7 million requests for service a year, and that's for the entire country; in NYC, the FDNY EMS system handled 1.7 million request for service in 2018, and that's just for one (albeit very large) city. I know of cities that handle 75,000 calls for services just within their city limits. I'm not saying NYC's EMS system is anything to admire (in fact, I've ranted about it on this website), but there are certain quirks about the US system that make it an apples to pineapples comparison to how other countries do things (not saying its right or wrong, just different and hard to replicate)
 

IsraelEMS

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So how do your dispatches determine what's an emergency and what's not? Can you see a difference in the calls dispatched with people who have EMS training and those who don't (or do you have limited interaction with the dispatchers? What happens if someone calls 911 for something that is not an emergency (like a transport request)?

@DrParasite I'm not really comparing the US with Israel. Aside from size there are so many other differences that it would be impossible. I am simply trying to understand the differences and since all my experience is here I guess that's the only frame of reference I have.
 

Jim37F

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There's always specific protocols and lines of questioning and what not the Dispatchers (whether EMD or not) have to follow. Generally speaking if they request an ambulance, they're going to dispatch an ambulance.
 

EMTrook

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Trying to keep a diary of runs I make as Im just starting out (volunteering).

My limited experience so far... I've done 2 ED shifts and 3 ride alongs. Not much excitement on first shift - notably standing around in bullet proof vest for 2.5 hrs (was 90 degrees outside and who knows what it was in the house) while police tried to talk an AMS patient out from barricaded room. Second/Third ride alongs - 2 codes - my first real CPR scenario and an elderly patient fall - skull fracture.

A few more a bit less notable (minor car accident, syncope episode), but all great learning experiences. So much to learn, but lucky to have been along side super competent and experienced EMTs and Paramedics who patiently and professionally helped guide me through, providing feedback after each call was over.
 
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