EMS Response Times

[ONEEYEDMIC 68]

Are you losing it man?  I NEVER SAID that it is the fault of the PD that the Ambulance does not get out.  That is a membership issue. I DID say that the PD is responsible for us taking longer to get on scene because on many occassions they DELAY DISPATCH in one way or another.

Nor, did I say that we do not want the PD there.  I just said that it would be nice to dispatch those that have to drive across town to pick up the rig BEFORE sending the Patrol Car.

Start my own Company, if was was prosperous then that would be fine.  But the fact remains that many (not all) PD's answering the 911 calls in westchester are not trained to handle the medical emergencies they receive.  Do you disagree OneEye?  I doubt it.

And I, too, see many many EMS people more concerned about thier clipboards then patient care.  That isn't the point of my rant.  And I DO HOPE my PD reads this, and every complaint that I and other members have made here and on "official" basis in the past few years, because they need to know that they are jeopardizing the well-being and health of our community.

GOOD JOB!

The subject was response times - and I voiced my opinion, which, apparently, hit a nerve of yours.  If you can tell me that I am wrong and that SOME POLICE DEPARTMENTS are awful at dispatching, then I would love to hear how I am wrong.

I don't know you, or what PD you work for.  But I am referring to the ones I have PERSONAL experience with.

Oh, and if you lose respect for me that's a shame, I am sure I will lose sleep over it tonight.

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Do you really think that the 20 seconds it takes a dispatcher to dispatch a Patrol car to the scene makes a difference? The bottom line is, VOLUNTEERS should be in the building when the call comes in. NOT Coming from across town to get to the building. That is the problem with RESPONSE TIMES.

Maybe where you are they delay dispatching you. I don't know the total, but I am sure most PD's that field 911 calls aren't medically trained. Where does it say that they have to medically trained? Now, if I am answering the phones, I will help in any way that I can. I am not EMD certified, but I have been a MEDIC for a LONG TIME. I like to think that I can handle anything on the phone or in person. It also depends on who is calling. Just trying to calm someone down on the phone can be the hardest thing.

Of course some PD's are bad at dispatching, just like SOME VAC's and VFD's suck at helping people and putting out fires.

I'm not going to lose sleep over this either. It just sounds like you need to move where you are going to get better EMS/FIRE response.

[Eagle24 2]

If the EMT is part of the ambulance than the rig times are recorded with notation that the EMT was on scene prior to.  If it was a FR group that sent an EMT to ride on another ambulance than the EMT makes out the PCR and hands a copy to the ambulance agency for their records.

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thanks for clearing that up

[CAM502 6]

Do you really think that the 20 seconds it takes a dispatcher to dispatch a Patrol car to the scene makes a difference? The bottom line is, VOLUNTEERS should be in the building when the call comes in. NOT Coming from across town to get to the building. That is the problem with RESPONSE TIMES.

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While I do agree that there should be a duty crew, I think you are wrong about the 20 seconds. Yes it could make a difference, and do you really think it just takes 20 seconds? CarXXX come in....CarXXX come in....CarXXX take in an aided at XXX....CarXXX 10-4. Now they turn to the VAC radio, turn up the volume, check the address again, proceed to hit the tones...and the process begins. Now unless CarXXX is a EMT or medic with supplies, you just wasted a lot of time for nothing.

[Guest]

Yes blame the PD's. I can tell you right now that most PD's in this area or anywhere else for that matter would just assume have nothing to do with dispatching vollie EMS units. Perhaps you can attempt to initiate your own EMS reporting system for your area so you have only yourselves to blame when things don't go as planned.

Maybe the officers of said dept don't want to be bothered with dipsatching, but those that make the decisions will fight tooth and nail to hold onto that control.

I can't see it being the PD's problem. Other things do and are going on when an EMS call comes in. I know for one, that the first thing that I do is dispatch the Patrol unit and MEDIC at the same time. Next is the either setting off the tones, calling another PD, or Calling 60 Control. I would rather have a Patrol unit or Medic on scene first, then to be waiting for the AMB.

We don't even give the location or nature over the pager. When they call in, we give that information. We have found that if they know what or where the call is, they pick and choose whether or not to go.

There is no non-emergency BLS call. When a call comes in and the person states that they need and AMB, we ask for the nature. How am I supposed to know if the person is telling the truth or not. That is why we send a Patrol Unit and the Medic. The Medic can determine if it is BLS and turn over care only when AN AMB gets on scene.

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I found out the hard way when our ALS ambulance was dispatched for a lift assist. The women needed a lift assist because she had a pulse of 30 and unconscious and the care taker didn't realize the nature of the problem. Now every call is treated as serious( ALS) until i see for myself. You are right that someone who calls may not preceive the seriousness of a medical or trauma situation.

[ONEEYEDMIC 68]

While I do agree that there should be a duty crew, I think you are wrong about the 20 seconds.  Yes it could make a difference, and do you really think it just takes 20 seconds?  CarXXX come in....CarXXX come in....CarXXX take in an aided at XXX....CarXXX 10-4.  Now they turn to the VAC radio, turn up the volume, check the address again, proceed to hit the tones...and the process begins.  Now unless CarXXX is a EMT or medic with supplies, you just wasted a lot of time for nothing.

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I may have been a little crazy when I said 20 sec. SO here is the scenario. Call comes in for an AIDED. While I am on the phone, I am dispatching the Patrol unit and the MEDIC. When I hang up the phone, I dispatch the Necessary AMB. If you read back to old posts, We dispatch 1 AMB Corp. For the other 2 we either have to call another PD or 60 Control. I can't do that while taking Info on the original call. Now most of the time, we have a Civilian Dispatcher and either one of us takes one of the other duties. So I guess where we are, THE AMB is dispatched at the same time. Now, if I am alone, I hang up the phone and call the next appropriate agency that needs to dispatch the AMB. What they do with that, is on them. It is out of my hands. On some occasions, we talk to the VAC that was disp by the PD. Not when 60 Control dispatches them though. So there is going to be a lag, but because of me.

I can't say this for all of our PD dispatchers, but it is very close to that scenario.

[Guest]

It seems like the issue of response times is definitely heated. It would make sense to have one centralized area to oversee where resources are. I know from my town that when the PD desk gets busy its hard to maintain EMS dispatching. They are not certified EMD and my guess is that the certification will help you more effectively handle the call. Is it routine to send ALSFR out on all calls in the county? If we had a county wide 911 for EMS how do you decide the # of transporting vehicles and would your goal be to have most ambulances with one EMT and one medic? would ALSFR be used? I would guess that the #s of EMS providers would be based on meeting certain response times?

[firemoose827 324]

I think we need to start a post on dispatch procedures!!

Whoever said that the VOLUNTEERS need to be in the building instead of responding from home has no life...I have a wife pregnant with our first and a house to take care of, if our agency wants us to stay in quarters than start paying me, or atleast buy me pizza! That is why its called VOLUNTEER, we respond when we are available.

[Guest KFD236]

Katonah-Bedford Hills Volunteer Ambulance Corps. Has a fantastic response time and They are dispatched by PD too. I give them both a lot of credit they do a great job.

[Guest]

I think we need to start a post on dispatch procedures!!

Whoever said that the VOLUNTEERS need to be in the building instead of responding from home has no life...I have a wife pregnant with our first and a house to take care of, if our agency wants us to stay in quarters than start paying me, or atleast buy me pizza!   That is why its called VOLUNTEER, we respond when we are available.

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Thats where problems arise.

[roeems87 0]

not all volunteer agencies respond from home...

[Remember585 815]

Our PD strikes again!

Last night (4/4 around 0100) we got dispatched for an EMS call on the south end of the Village for a party with difficulty breathing.

I heard the call, got dressed and made my way across town. As I was driving towards the scene, I realized that I hadn't heard the Ambulance nor a second dispatch.

It took me 8 minutes to get to the firehouse, and I was suprised to see the rig still in quarters and nobody there. At first I thought that the call was cancelled, but I was wrong. I radioed the PD desk and asked, "Any personnel on scene?" The reply was no, so I asked, "Can you tone out again since it hasn't been done yet?" The desk did so, now 11 minutes into the call. While sitting in the rig awaiting a crew, I heard the on scene Patrol car ask "have you heard from the Ambulance yet?" to which the Sgt. replied, "No." At this point the Medic, rightfully, requested Mutual Aid.

Another 2 minutes later, my Asst. Chief called and said to respond, as he would fill out the crew. Afterwards, the Chief told me that he thought the call was covered, because it was "a long time" before a 2nd dispatch was made.

First, I blame our own members for not responding in a timely fashion. But, I further blame the PD for not paying attention to us. Even after 6 minutes when we had nobody, assuming the Desk Sgt. was paying attention, they could have had Mutual Aid coming sooner. This call further enhances my dismay with our current system. Anyone else feel like I do?

[ONEEYEDMIC 68]

Our PD strikes again!

Last night (4/4 around 0100) we got dispatched for an EMS call on the south end of the Village for a party with difficulty breathing.

I heard the call, got dressed and made my way across town.  As I was driving towards the scene, I realized that I hadn't heard the Ambulance nor a second dispatch.

It took me 8 minutes to get to the firehouse, and I was suprised to see the rig still in quarters and nobody there.  At first I thought that the call was cancelled, but I was wrong.  I radioed the PD desk and asked, "Any personnel on scene?"  The reply was no, so I asked, "Can you tone out again since it hasn't been done yet?"  The desk did so, now 11 minutes into the call.  While sitting in the rig awaiting a crew, I heard the on scene Patrol car ask "have you heard from the Ambulance yet?" to which the Sgt. replied, "No."  At this point the Medic, rightfully, requested Mutual Aid.

Another 2 minutes later, my Asst. Chief called and said to respond, as he would fill out the crew.  Afterwards, the Chief told me that he thought the call was covered, because it was "a long time" before a 2nd dispatch was made.

First, I blame our own members for not responding in a timely fashion.  But, I further blame the PD for not paying attention to us.  Even after 6 minutes when we had nobody, assuming the Desk Sgt. was paying attention, they could have had Mutual Aid coming sooner.  This call further enhances my dismay with our current system.  Anyone else feel like I do?

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Sounds like something your CHief and the CHief of PD has to discuss.

[firemoose827 324]

Thats where problems arise.

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What problems have arisen from my post? Enlighten me.

[4truck48 25]

Waiting 10 to 15 minutes for an ambulance, what year is this 1966? NO IT'S 2006 it's about time everybody woke up. If you cant get help there in a reasonable amount of time then CHANGE your system. YOU GET WHAT YOU PAY FOR.

[GAW6 66]

Can I ask a question - why is everyone always bashing EMS response times? Has anyone ever questioned FD response times? I guess if your house and property, something that most people work hard all their lives for, is burning down is not as important? Aren't FDs also having their share of problems getting people out, especially drivers, during the day? Most volly FDs do not stay "in quarters" and are responding from home or jobs.

[ny10570 745]

The FD's absolutely have their own problems but there are a few major differences. First, when FD's say they are comming up short, most are still getting that first rig or two on the road. They can still begin an effective initial attack while mutual aid is activated. If your average VAC comes up short one member on an alarm you may not be able to respond at all. Second, on a daily basis FD's do not have as much of a direct impact on a people's lives as EMS does. How many actual emergencies does the average FD respond to that require their intervention to mitigate threats to life? How many people were pulled from a fire, rescued from a collapse ,or extricated from a collision? The vast majority of the time the FD is responsible for property, not lives. In EMS every time you are called it is becase there is a percieved or actual threat to someone's life. That is why there is a greater emphasis on time.

[Jason762 2]

The FD's absolutely have their own problems but there are a few major differences.  First, when FD's say they are comming up short, most are still getting that first rig or two on the road.  They can still begin an effective initial attack while mutual aid is activated.  If your average VAC comes up short one member on an alarm you may not be able to respond at all.  Second, on a daily basis FD's do not have as much of a direct impact on a people's lives as EMS does.  How many actual emergencies does the average FD respond to that require their intervention to mitigate threats to life?  How many people were pulled from a fire, rescued from a collapse ,or extricated from a collision?  The vast majority of the time the FD is responsible for property, not lives.  In EMS every time you are called it is becase there is a percieved or actual threat to someone's life.  That is why there is a greater emphasis on time.

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Maybe I shouldn't get involved in this thread because I believe you are just talking about VFD's in Westchester (with which I have no experience), but I do take exception to the statement of "How many actual emergencies does the average FD respond to that require their intervention to mitigate threats to life?" The FD I work for responds to many actual emergencies everyday. We run as first responders to any life-threatening EMS call in the city as well as our fair share of fires and rescues. Maybe we are not an "average FD" as you stated but you seem to be downplaying the importance of the FD in emergency response. And I'm not sure what you meant by "How many people were pulled from a fire, rescued from a collapse ,or extricated from a collision?". Did you mean how many today, last week, or ever? Plenty of peoples lives have been saved by actions taken by FD's. DO NOT downplay the importance of the FD. We are all a vital service to the community. It is also untrue that "In EMS every time you are called it is becase there is a percieved or actual threat to someone's life". I can't tell you how many times I have seen the wasted resources of EMS having to respond to a bloody nose or to pick up another drunk or a broken toe, etc. I am not downplaying the importance of EMS at all, but every call you go on is not the end all, be all, of emergency response. Lets face it we are all important agencies and response time is key in all facets of emergency response, FD, PD, and EMS. If the system isn't working then lets work together and find one that does.

[ny10570 745]

The FD I work for responds to many actual emergencies everyday.  We run as first responders to any life-threatening EMS

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I am referring more to traditional roles and definition of duties. An FD's EMS response is still an EMS matter and would be better served by an ambulance than a fire truck. If you're having a medical emergency, anyone would rather have an ambulance over a fire truck, its just that in many cases the FD can get there faster.

And I'm not sure what you meant by "How many people were pulled from a fire, rescued from a collapse ,or extricated from a collision?".  Did you mean how many today, last week, or ever?  Plenty of peoples lives have been saved by actions taken by FD's.  DO NOT downplay the importance of the FD.  We are all a vital service to the community. 

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Make it a day a month a year or ever. You many pull hundreds of people out of fires and extricate another 1000 from crashes and collapses, but EMS is responding to more life threatening emergencies in that same time period.

  It is also untrue that "In EMS every time you are called it is becase there is a percieved or actual threat to someone's life".  I can't tell you how many times I have seen the wasted resources of EMS having to respond to a bloody nose or to pick up another drunk or a broken toe, etc. 

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And yes everytime was an overstatement but the vast majority of the time you are responding to what someone has percieved as an emergency. Yeah, a bloody nose may not be an emergency, but more often than not the majority of those that call believe they are in a crisis.

EMS and ifre are essential. I am just addressing the reasons why I believe EMS seems suffer more scruitny for their response times.

[shac 7313 0]

they do if they respon to the bldg from 1 block away ! ! ! ?

[ONEEYEDMIC 68]

GAW, I believe that I said something in a previous post about FD response times. If my house was on fire, I would want a quick response and if somebody in my family was sick, I would want a quick response. So I guess what I am trying to say, is RESPOND QUICKER FOR EVERYONE.

[Guest]

I think we need to start a post on dispatch procedures!!

Whoever said that the VOLUNTEERS need to be in the building instead of responding from home has no life...I have a wife pregnant with our first and a house to take care of, if our agency wants us to stay in quarters than start paying me, or atleast buy me pizza!   That is why its called VOLUNTEER, we respond when we are available.

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I thought the reason to volunteer in EMs is patient care. if we truly care responding from quarters could decrease response times by 50%. This is not done to make us feel good the primary goal is to help those in need in a timely way.

[roeems87 0]

I think a key point is being missed here. In busier systems, this is not a problem. EMS is readily available because either (1) they are paid and on duty, or (2) they are volunteer, but staffed in quarters or on the ambulance. In those same places, mutual aid is generally not that far away. And when someone doesn't sign on, there is a corps/dept. officer or paramedic requesting mutual aid immediately for whatever reason they are unavailable at the time. The problem with response times is not necessarily a "problem," but an aspect of a system that only does 1 call a day--or even one call a week. Sure, we would all be benefited by having EMS, Fire, PD, whoever around the corner and ready at a moment's notice to respond to whatever emergency you are having. That's not always possible, or quite frankly efficient. With slower (meaning the 1 call type places I'm talking about above), having members responding from home, is perhaps the most efficient use of their time. Before you jump down my throat on that one... let's realize the response times of paid agencies as well--that is to say because they are staffed and "readily" available, the paid factor has nothing to do with my point. Except for those paid locations who are accepting of mutual aid, you could wait 15-20 minutes for an ambulance in a paid system. I live in a larger city in Westchester (figure that one out) and it took 23 minutes to get an ambulance to my neighbors house when she was having difficulty breathing. Sure, we had an engine in 3 minutes, but until we're putting stretchers on the hose bed, it's not much use.

So what's my point? The response times are all a part of the system, flaw or not. If you have a system that doesn't require 24/7 paid and staffed service, then you don't have it. The point stands for fire, EMS, and in some places PD. Currently going to school in upstate NY, many towns are covered by the state police, or ambulances from the county. Your response times could be 30 minutes with them responding from quarters. Tack on the extra 10-15 if they are voly's... even more for voly FDs... (There is no such thing as a staffed VAC here without being paid.) It's all part of the way things are. Not to say that can't be improved, but until there is a greater need, there may not be much difference...

[ny10570 745]

roeems87, you make an several excellent points. There certainly trade offs associated with the various types of service you are willing to pay for. Ideally we would all have an ambulance waiting for us, but that isn't cost effective. In my opinion, times have changed and quick access to pre hospital and hospital care can now do more than ever before to save lives. Combine that with a decrease in volunteerism and we need to do more and provide a better service with less. Sadly, that is not reasonable to expect adn usually not possible. Once we can no longer provide the best care available for a reasonable price, it is time to start looking at other options.

[firemoose827 324]

I thought the reason to volunteer in EMs is patient care.  if we truly care responding from quarters could decrease response times by 50%.  This is not done to make us feel good the primary goal is to help those in need in a timely way.

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I guess we are a little behind in times. I am reading all of these posts seeing how many of you vollies post in quarters and there isnt a FD or VAC anywhere around me that do that. EMS is changing everyday. I wish I had the time to sit in quarters, believe me, anywhere would be better than getting the crap beat out of you by a preg. wife!! And our FD has a day room with TV, weights, and pool table so I dont know why more of us dont stay at qtrs.

I do agree that PT care is priority but we obviously arent as busy as you guys are where it warrants stayin in quarters. What dept are you from and do you have the rec facilities? What is your call volume like? Just curious. Thanks for the input and stay safe.

Jonesy

[Guest]

I guess we are a little behind in times.   I am reading all of these posts seeing how many of you vollies post in quarters and there isnt a FD or VAC anywhere around me that do that.  EMS is changing everyday.  I wish I had the time to sit in quarters, believe me, anywhere would be better than getting the crap beat out of you by a preg. wife!!  And our FD has a day room with TV, weights, and pool table so I dont know why more of us dont stay at qtrs. 

I do agree that PT care is priority but we obviously arent as busy as you guys are where it warrants stayin in quarters.  What dept are you from and do you have the rec facilities?  What is your call volume like?  Just curious.  Thanks for the input and stay safe.

Jonesy

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We don't have to stay in quarters and our call volume is about 500 and we don't have much in HQs. However I would bring paperwork down with me or use the ambulance to run errands like we do where I work if it became a requirement. To just say you volunteer isn't enough. You have to do whats in the interest of patient care. If you had an asthma attack, seizure or an allergic reaction how long would you want to wait till you had your problem attended to? What if it was your kid and you knew help was not coming for at least 10 mins or more but if you lived in a town a couple of miles away you would have ALS in 2-5 mins?

[firemoose827 324]

We don't have to stay in quarters and our call volume is about 500 and we don't have much in HQs.  However I would bring paperwork down with me or use the ambulance to run errands like we do where I work if it became a requirement.  To just say you volunteer isn't enough.  You have to do whats in the interest of patient care.  If you had an asthma attack, seizure or an allergic reaction how long would you want to wait till you had your problem attended to?  What if it was your kid and you knew help was not coming for at least 10 mins or more but if you lived in a town a couple of miles away you would have ALS in 2-5 mins?

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Well, we do 800 a year, an avge of 70 a month, and we respond from home, and our avge time to get a rig enroute with atleast a crew of 3 is 5 minutes. We run two rigs with ALS coming from county medics who are both paid and provided with fly-cars that respond from different parts of the county. Their avg response time is 3 minutes. So I guess we do pretty well than.

[Guest]

Can I ask a question - why is everyone always bashing EMS response times?  Has anyone ever questioned FD response times?  I guess if your house and property, something that most people work hard all their lives for, is burning down is not as important?  Aren't FDs also having their share of problems getting people out, especially drivers, during the day?  Most volly FDs do not stay "in quarters" and are responding from home or jobs.

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My house I can replace...I am insured. People can't be replaced. I want fast response when I call 911 for both but especially when I need medical attention.

[Guest]

It seems that when you call 911 you get the local PD. If they don't dispatch ALS then it would go to 60 control in Westchester. Why is there reluctance to have everyone in EMS dispatched by 60 control? Does anyone have the actual total number of medics for all of Dutchess County? And if I have this correct Putnam has 4 for the entire County....800 sq miles? If correct that sounds like a problem?