EMT Fly Car - Would It Help?

[RWC130 594]

EMT Fly Car

by EMS Zones

Before I begin let me just start by saying this is an idea I have

based on years of experience in EMS and also just by listening to a

Radio/Scanner.

It's no secret here in Westchester that a lot of VAC's (Volunteer Ambulance Corps)

have staffing issues. Let's do something about it!

I am NOT here to bash ANY agency, this is an idea and I would like YOUR feedback.

Mutual Aid...... When does it become abuse?

Should one VAC have to cover calls for another on a regular basis?

When does it end?

"Hey John, we covered 3 calls today for ________ VAC they suck,

they can't get out for anything"

DO YOU AS CAPTAIN WANNA HEAR THAT?

Why not put our heads together and try to come up with a plan?

I will use Westchester County EMS Zone 7 for example.

(Again, this is for example purposes only)

Zone 7

City, Town, or Village:

Village of Buchanan

Village of Croton

Town of Cortlandt

City of Peekskill

Town of Yorktown

Covered By:

Cortlandt Community VAC

Croton Fire Dept.

Peekskill VAC

Mohegan VAC

Verplanck Fire Dept.

Yorktown VAC

You have 6 Ambulance agencies covering the area.

How many Ambulances is that? Approx. 15-16?

Why not utilize those 6 agencies in this zone to staff an EMT Fly Car

24/7 with an EMT ??

The EMT Fly Car would respond as needed and assist with

filling a crew or supply additional manpower at an incident.

If needed the Rig could roll w/ Driver Only!

Think of how great it would be for an EMT to gain experience in a BLS Fly Car.

Is it worth a try?

If this happened how many of you would Volunteer one shift a week on this EMT Fly Car

if one was put in your area?

Next time you wanna buy that "Officers Vehicle" how about using it

as the EMT Fly Car to help out?

(EXAMPLE STAFFING)

Monday = Cortlandt VAC's day to staff the Fly Car

Tuesday = Croton FD's day to staff the Fly Car

Wednesday = Peekskill VAC's day to staff the Fly Car

Thursday = Mohegan VAC's day to staff the Fly Car

Friday = Verplanck FD's day to staff the Fly Car

Saturday = Yorktown VAC's day to staff the Fly Car

Sunday = Open / Rotation of 2nd Day

FEEDBACK?

[Guest partyrock]

Since you're using zone 7 we'll stick with it. How many calls a day does zone 7 handle? How often are there multiple calls out in the zone? I know you're not expecting to cover every call with the fly car, but if a full 50% of the time there are multiple calls out and 50% of those are three or more then the EMT flycar isn't going to be very effective. If you are able to cover the majority of your calls with the flycar, why not work the same schedule with a fully staffed bus. The two most effective tools an EMT has are oxygen and wheels. An EMT on scene without a bus is good for a whole lot of air and stare. It's pretty much what I get stuck doing on most EMS runs.

[ny10570 745]

I've gotta agree with partyrock. If you can get the fly car out, why not just get a bus staffed. You can really set an interesting precedent in Westchester with that kind of service.

[RWC130 594]

Yes, absolutely a fully staffed Ambulance would be best.

No doubt about that.

This idea is to assist the many VAC's that can't get the ambulance out the door.

Paid Crews is an option that some VAC's have put in place and some are looking into.

When you call in Mutal Aid on a regular basis to cover your own calls now that VAC

coming in is down (1) Ambulance and crew. In several areas Mutual Aid is abused.

VAC's that are taking steps to solve this problem I give A LOT of credit!

Maybe a COUNTY of WESTCHESTER run EMS would be an answer?

I appreciate the feedback... Keep it coming!

[ONEEYEDMIC 68]

How about you put 2 EMT's in the fly car with 2 sets of gear like RPS does. That way when there is multiple calls going out the fly car could go to the other scene. I think you have to see how many times Mutual Aid goes out. How many times crews can't get out and so fourth. That is also a big area to cover with just one fly car. How about just merging all the Ambulance to one big CORP and centralizing it.

[Goose 188]

Sounds nice, but i'm not a supporter. I think VACs should be looking very seriously toward the future. Consolidation and bringing in paid personnel is the answer.

[helicopper 1,050]

How about you put 2 EMT's in the fly car with 2 sets of gear like RPS does. That way when there is multiple calls going out the fly car could go to the other scene. I think you have to see how many times Mutual Aid goes out. How many times crews can't get out and so fourth. That is also a big area to cover with just one fly car. How about just merging all the Ambulance to one big CORP and centralizing it.

But you still have the issue of transportation. I gotta agree with NY and Goose - the need is an AMBULANCE! The fly-car will be a novelty that will eventually wear off and you'll wind up having trouble staffing that too! Or you'll have people buffing on the fly-car and never riding the ambulance. What'll happen in some areas - you'll get PD (BLS FR), FD (BLS FR), Medic Unit (ALS FR) and now a VAC "fly-car" (BLS FR) - four emergency vehicles and no means of transportation. That's no solution!

How about rostering a crew in quarters using personnel from all the Zone 7 (keeping with this example) ambulance services and then taking calls for the entire area as opposed to single territories?

I agree that we have to look at the big picture and stop limiting ourselves to this little town or village but unfortunately I don't think BLS fly-cars is the answer.

[Oswegowind 17]

This is a great "plan B". It is an idea that can work. Goose, I volunteered for years and worked for years in both types of systems...just happened to have volunteered in this zone as a member of Peekskill and Cortlandt VACs and a fully paid system is not the answer, sorry. If the originating agency gets a crew on the first or second tone, then the EMT Fly Car is not dispatched, however if only 1 person from the originating agency assembles, EMT/Driver or Driver only, then that person takes the ambulance to the scene and the on duty Zone Wide EMT responds as the 2nd member of the crew. While the Paramedic is also responding. Where as in the past we have rode with the medics as a partner, certain crews not always available, and I personally have ridden in BLS calls for other jurisdictions, including Croton and Mohegan on their ambulances while operating with the Medic in the Fly Car, The ALS fly car system has sinced changed thus this is not the answer anymore, as well there are 3 paramedic agencies that cover this zone. By having the EMT avail, the medic does not get stuck on a job he is not required for and keeps this very important resource available to additional calls. Paramedics have had to ride in jobs for some time due to a lack of qualified staff responding to jobs. I believe that the EMT fly car would best be suited to be staged either at Peekskill VAC or at Hudson Valley Hospital, and this could become a paid position where the EMT also has duties in the ER such as assisting during down time or can remain 100% volunteer, where as the volunteer would have to stay within the zone limits while on duty but could attend to personal business during down time. In fact if I can manage to find the time to take an EMT course soon, I would even help to staff this vehicle as best I could around my work and personal schedule.

On a side note, I also believe that Croton should become a member of the Zone wide system and that CRP should become their ALS agency since they are a part of the Town of Cortlandt. Ossining does a fantastic job there, but they are an incorporated village in the Town. JMO!

Ambulance Resources:

CCVAC 88b1, b2, b3, rehab unit, officers unit

PCVAC 75b1, b2, b3, officers unit

VFD 83b1

Croton FD 55b1, b2

LMFDVAC 69b1, b2, b3, injury prevention unit

YVAC 86b1, b2, b3

CRP 35m1, 35m2

PFD 39m1, 39m2

YVAC 34m1, m2(day time)

OVAC (i got no idea)

I am sure I am missing something, though. Would like to see current membership numbers.

[Goose 188]

I never said a 100% paid solution is the answer. I said look towards consolidations so we don't have 5 VACs serving a 5 x 5 mile chunk of land AND look at hiring personnel to mitigate your manpower issues. I'm speaking of the larger issue, not this particular section of Westchester.

[Guest alsfirefighter]

A few points of my own:

Why do agencies not communicate better to maximize whatever staffing is available across all agencies? There are times where agency A has a driver...call goes mutual aid. Agency B can only get an EMT....another agency gets called. Why not roll the ambulance from agency A and have the EMT come and cover their call? Putnam at one time and someone would have to confirm if they still do, used an EMT "sharing" system. Then again except for one agency listed in zone 7 by RWC all are dispatched by 60 Control and that could be easily coordinated amongst them. In zone 7 that was stated, except for the agencies covering the southern end of Cortlandt there is BLSFR coverage available. IN MOST CASES....I'll leave the rest of that comment alone for right now. There are enough vehicles there as Chris said and often no ambulance.

Secondly...Oswego we're friends so this isn't direct to you just your comment and is offered to all. Why isn't paid services the answer. You want to make the "full paid" argument fine. But it seems there is plenty of billing going on which are getting back fairly decent reimbursement and there certainly are plenty of fancy vehicles going around, along with coats, shirts, sweatshirts etc. I'm all for having memebers having the ability to look professional, but lets get calls under wraps also.

Any argument can be made...but when you are the one sitting on scene at a call when a 4th and 5th agency can't even get one person together...that is a problem. Or the dependance that seems to occur that if we don't cover the call ALS will ride it in, another ridiculous problem or sometimes you know you have no choice but to ride it in, lose an ALS unit because another medic has been sitting for 30 minutes waiting for an ambulance and you know you aren't going to be any luckier. Who IMO often makes the "paid service isn't necessary or costs to much" argument. Those in an agency, particulary the one discussing it or being discussed about and those whom have never had to wait for an ambulance with a significantly or critically injured or ill patient or one who never has had to do everything but dance a jig while waiting and trying to explain why one isn't there. Or they themselves haven't had a close experience themselves or with a loved one that had to wait. Would you wait if your house was being broken into? Would you want to wait (and some of you may) if your house was on fire? Then why is it ok to wait for medical?

If your billing to me it should be hard and quite embarrassing to justify and call drop rate greater than 10%. And I think I'm being liberal and even tossing out calls dropped if multiple calls go out or you need multiple ambulances to an incident. Show me any other types of professions or businesses that are run or allowed to be run like many emergency services are.

[Guest Orpi442]

This is great that you are out there looking at a possible fix for a on going problem that is effecting everywhere.

A possible ideas that might be thought of. One a flycar, yes a fully staffed ambulance is the best. Lets you the ambulance as the flycar, with yes another emt on board. You now have a fully staffed ambulance. Okay I know this really sound stupid but I am getting to the point. How about a shared EMT program? A EMT from one agency & a EMT from another on a scheduled shared ambulance. Putnam had this started, but it kind a went to the side. I can tell you that it has worked with Philipstown & Garrison Vacs. A driver or EMT from one will respond with a bus & a EMT or a driver from the other will respond & do the call together. If its ALS the medic works it and the other EMT or driver is still available. Also may I note that Philipstown is going double paid staff during the day. My hat is off to a VAC with a limited amount of calls making such a bold move. I also like to say Thank You to Peekskill for there responce to a call I had in Garrison. Guys, You Done Great.

[Guest DADAY]

But there is the age old aurgument, The bus may not go inservice without an EMT, but without a driver the bus can't even get out of the garage? Its like the chicken and the egg.

[Skooter92 7]

In Columbia County, the VACs got together and decided that weekdays, each VAC would staff a BLS bus in rotation that would serve as a "Tac" unit. If Westchester did something similar by zone or other geographic particular, it might be useful in decreasing volunteer stress and response time. Note, I am NOT stating HOW/BY WHOM it should be staffed-work that out amongst yerselves.

[Guest]

Many good ideas and suggestions have been brought forward here. Having been a past V.A.C. Captain, I'll say this. Between volunteer agencies, exists great deal of annymosity. One thinks they're better than the other. The other is tired of doing mutual aid for the 3rd time that day to their neighbor's. The Vollie/EMT fly car, in theory, is a good choice. But then comes in, who runs control of it. Name to me two orginizations that will allow equal control/jusrisdiction of that vehicle/operation?

I believe I read, having and EMT is good, but one that just sits around waiting for a bus to show up is stupid (I wasn't quoting verbatum). THat's neither here, nor there. The other thing I read was about a paid staff. That's a great idea, providing the agency has funds for it, and if they're willing to accept such a need for it.

What it boils down to is this, you'll never know what should be done until it's you or one of your family sitting and waiting for a bus to show up for up to half an hour. The fact that the county (and all their lack of infinite wisdom) hasn't even chime in and offered ideas/assisstance in this matter.

What upsets me more is that very few agencies can come together and mutually storm up a plan without causing a holy war.

[Guest partyrock]

A couple of people here have mentioned here and in other threads about the paid or volunteer on duty emt standing by between calls. We happily pay Fire and PD to be there for the just in case and what ifs. We buy 3/4 of million dollar rescues and TL's, boats, etc that will be called into service to save a life how often? Look at your town...when was the last time that your specialty piece of equipment was directly involved in saving someone's life? I'm not saying these apparatus are not necessary and should be eliminated, but lets look at priorities and get some reliable BLS transport in service.

[Remember585 815]

Most of the EMS, and this is speaking of my area, isn't run as tightly as it should be. Period, end of point. I am still a member of two EMS agencies, one FD based the other a VAC. Both have stronger points then the other, but equal if not more weaker points. I have been in EMS whether paid or volunteer for almost 14 years. I became a CFR at 16, back when our Ambulances weren't DOH certified so I played Crew Chief many times. I have been an EMT since 1996 and I can tell you there's been one HUGE change I've seen that has affected the whole thing.

M O R A L E.

How can you be expected to keep personnel interested in giving up their time when it seems like nobody cares?

Here's a scenario that plays out too often for me and I am sure others can relate.

You are home, basically doing nothing when the pager goes off. You decide to go to the call (feeling guilty that the last two went Mutual Aid). You get in your car and head to the Rig. On your way there, you hear someone else call in that you really don't like working with, oh well. You hear an update from PD asking for you to "step it up" but no reason is given. You get in the rig and go. You get on location and it is a house up a hill with like, 200 steps, all of which are broken and uneven. The ALS Fly Car is on location trying to convince you (before seeing the patient) to make it a BLS call so they can get some sleep because they have been working 3 days straight. You lug your crap upstairs to your patient. As soon as you get in the door, a neighbor starts asking you to move the rig because they really need to get out. (Golf match?) You now walk back downstairs and move the rig. You then go back upstairs and inside. The patient is stable and they family is asking you to transport to a hospital not so near-by. The Medics and Cops all say "it shouldn't be a problem" (because they aren't going) but you politely tell the family and patient that you can't for some logical reason others will question anyway. You lug your patient down the never-ending staircase into your rig to realize the AC is hardly working. You try to hook the patient up to the onboard O2 and realize it is low. (Thanks, last crew.) You transport to the nearest hospital to an awaiting team of grouchy nurses asking why you didn't go to another facility. Out of spite, they take their time finding a bed for your patient. You finally roll out of the ER and start heading home but you can't. The pricks on the call (actually, 3 calls ago, two went Mutual Aid) didn't fuel up so now you have to. You get your fuel, go back to quarters, replace the O2 tank and go home. Total time - about two hours.

So, you take this and throw in the usual in-fighting of most agenices, the ever-rampant micro-managing of most Officer(-types) and add in the fact that while you were on this call you passed about 3 other members of your agency who you know weren't doing anything else and you take into consideration how many of your members have moved out of the area because it COSTS WAY TOO MUCH and you ask yourself WHY? Why the hell do I still do this crap?

The answer, because you still care, despite all of the BS. It isn't as easy to throw down what you're doing to go, but you still do your best to cover as much as you can. Sadly, not enough people care to look beyond all the little crap to do what it best for the agency and more importantly, the community.

Will a BLS Fly-Car work? Don't know for sure, but I know if you begin to depend on it like many depend on ALS to cover calls, it will only be a matter of time before you're at the next "What should we do?" If you take an EMT from my FD and put them in a car covering from Croton to Peekskill, chances are most of the day they won't be available to us in Croton because the CVAC and PVAC call volumes are much greater then ours. And we will then have to call Mutual Aid, as we have to do so often now.

[ONEEYEDMIC 68]

Remember, that was an AWESOME POST. I closed my eyes after reading it and was reliving most of my EMS nightmares.

[Guest alsfirefighter]

Thanks bro...now I want to go jump off a bridge or something.

And let the record reflect I've never done the "make it a BLS call" to ya. lol.

[RWC130 594]

alsfirefighter,

Hey bro, if you need a ride to the bridge let me know.

I'd be glad to help!

LOL!

[NYMedic37 22]

Maybe each zone should have a paid (career EMS) EMT flycar to insure that at least 2 professional EMT's are on duty at all times. The crew can be paid thru the VAC's revenue recovery program (with the expense shared by each VAC in the zone).

[helicopper 1,050]

Why a fly-car and not an ambulance? The zone coverage with a full crew is a great idea - at least you know you can put one ambulance on the road immediately. I just don't understand why we're pushing the fly-car idea when the problem is not being able to get a crew for an ambulance.

And on the subject, is the Westchester County Regional EMS Council involved in this issue? They have more authority than the County as they're tasked with medical control and other operational issues in accordance with Article 30.

[RWC130 594]

Maybe each zone should have a paid (career EMS) EMT flycar to insure that at least 2 professional EMT's are on duty at all times. The crew can be paid thru the VAC's revenue recovery program (with the expense shared by each VAC in the zone).

I LIKE THAT IDEA!

Breaking up the costs to run it (shared) by a few agencies would really bring the cost down

for everyone involved. I think in the end you would really benefit getting the calls covered.

This might also help with Volunteer EMT burnout!

Someone will argue why not staff a BLS bus?

Then why not staff an ALS bus? ALL good points!

Any VAC Officers reading this that would consider some various levels of EMT Fly Car coverage?

[NYMedic37 22]

Why a fly-car and not an ambulance? The zone coverage with a full crew is a great idea - at least you know you can put one ambulance on the road immediately. I just don't understand why we're pushing the fly-car idea when the problem is not being able to get a crew for an ambulance.

And on the subject, is the Westchester County Regional EMS Council involved in this issue? They have more authority than the County as they're tasked with medical control and other operational issues in accordance with Article 30.

Chris192...Excellant idea! Assign a career EMS Ambulance to each zone. Have each VAC pay for it thru revenue recovery, shared by each VAC. That way an ambulance is always available for calls instead of rolling the dice to see if vollies will show up for calls.

[RWC130 594]

Chris192,

And on the subject, is the Westchester County Regional EMS Council involved in this issue? They have more authority than the County as they're tasked with medical control and other operational issues in accordance with Article 30.

You make good points about staffing a Bus, no doubt!

This was just a little vision of RWC130 seeing the problems.

If the Westchester County Regional EMS Council is reading this GREAT!

I'd love more input!

[firemoose827 324]

Many good ideas and suggestions have been brought forward here. Having been a past V.A.C. Captain, I'll say this. Between volunteer agencies, exists great deal of annymosity. One thinks they're better than the other. The other is tired of doing mutual aid for the 3rd time that day to their neighbor's. The Vollie/EMT fly car, in theory, is a good choice. But then comes in, who runs control of it. Name to me two orginizations that will allow equal control/jusrisdiction of that vehicle/operation?

I believe I read, having and EMT is good, but one that just sits around waiting for a bus to show up is stupid (I wasn't quoting verbatum). THat's neither here, nor there. The other thing I read was about a paid staff. That's a great idea, providing the agency has funds for it, and if they're willing to accept such a need for it.

What it boils down to is this, you'll never know what should be done until it's you or one of your family sitting and waiting for a bus to show up for up to half an hour. The fact that the county (and all their lack of infinite wisdom) hasn't even chime in and offered ideas/assisstance in this matter.

What upsets me more is that very few agencies can come together and mutually storm up a plan without causing a holy war.

OK, I got into this discussion late and did not read the rest of the posts so if I duplicate anything......too bad. Im glad you brought this up REDOKTBR, as far as the "control" of the fly car. In our county of Schoharie we have EMS Coordinators, 4 of em, 2 are paid FT medics equiped with fly cars and equipment (county owned) and 2 are volly that fill in for the FT when not available. They get issued radios. My question is couldnt this "BLS Fly car" be run in the same fashion? Just add on 2 more deputy coordinators and have them be BLS, issue them radios and they can respond as EMT for those agencies that are unable to field a full crew.

You see, our coordinators run county training, coordinate mutual aid and obviously provide ALS fly car services, lately these services have been abused by agencies who are unable to get an EMT. They just ask if the coordinator can assist, which than takes one county medic out of the loop for 25-45 minutes, depending on where they transport. I think this would stop the misuse of county medics and provide a better service to the communities we serve. Maybe even down the road these "BLS Flycars" can become additional paid county staff, provide BLS flycar services, be Instructors for EMT classes, and assist with mutual aid at MCI's. (Just a few additional job responsibilities to justify the paid positions.)

I believe what the original post is saying is that the BLS FLycars would "link up" with another ambulance and ride as EMT/Crewchief, and not necessarily respond to the scene and wait for an ambulance to arrive.

This is an issue that needs to be addressed, and the petty bickering about whos call it is and who fields the most calls in the fastest time needs to stop. We should all, AS A WHOLE, be concerned about getting an ambulance to someone who needs it in a decent amount of time, not who gets there. I dont think it matters if you get an EMT from ABC squad and an ambulance from DEF squad with a medic from GHI squad responding to a call in JKL's district. Shouldnt we all be concerned with the fact that the person who calls an ambulance GETS an ambulance in a timely fashion? Do you think the Pt is saying, "Oh thank god, its a full crew from Sleepy Hollow and not those bastards from Gotham City.....FEW!" I think not...if we do our job righ they are saying "Man, they were fast and professional, and they were nice to my relative too...."

I think PT care has taken a back seat to pride in most of our State....should be the other way around.

Moose

[Guest partyrock]

Can we get away from the BLS flycar. It works for ALS in conjunction with a BLS ambulance only because many ALS interventions can be done on scene and ALS can significantly increase the window of opportunity for many emergent conditions. The best thing BLS can do for a patient is get them quickly and safely into the hands of the appropriate facility. A BLS flycar is useless without an ambulance, so why not just get rid of the flycar all together.

[helicopper 1,050]

Can we get away from the BLS flycar. It works for ALS in conjunction with a BLS ambulance only because many ALS interventions can be done on scene and ALS can significantly increase the window of opportunity for many emergent conditions. The best thing BLS can do for a patient is get them quickly and safely into the hands of the appropriate facility. A BLS flycar is useless without an ambulance, so why not just get rid of the flycar all together.

All of the above plus not all calls are ALS whereas almost all calls require transportation. Well said, Party!

[RWC130 594]

It's been over a year since this thread was started.

Thank you to all who gave input on this.

Recently I was speaking to Remember585 about EMS issues,

Over a year has passed and NOTHING has changed!

The tones still sound and sound and sound.

We "Roll the Dice" on who and when an Ambulance will respond.

Sometimes an EMS call will go from one VAC to Mutual Aid VAC X 2, 3, 4, and yes every

now and then a 5th M/A EMS agency. 15, 25, 35 + minues to be transported to the ER!

Would this be acceptable if YOU were the 911 caller and Mom or Dad was

having a Heart Attack?

Do YOU think having a Volunteer EMT Fly Car that could be staffed by local VAC's

to help cover calls is a good idea? (I say this only because most VAC's can get a Driver)

In other words sharing of VAC EMT's to cover this Fly Car

If every VAC kicked in some $$$ it can and would help cover calls in your area.

I realize (as mentioned) having a Commercial Ambulance staffed with EMT's might be the BEST option to

guarantee coverage, I do however feel strongly an EMT Fly Car could work.

Do you think it's worth a shot?

THOUGHTS?

[NWFDMedic 58]

This is an interesting topic; anything that would promote agencies working together is a good thing. In Ulster County, there are 4 departments that are part of a cooperative mutual aid for BLS during the day. If one agency can get a driver and another an EMT, they can get together and make a crew. I imagine that this would require some cross-training of EMT's to the operation in the back of the other service's ambulances, but that is a small obstacle. Anyone here from Wallkill, Modena, Shawangunk Valley or Gardiner that can tell us how this works and how effective it has been?

[sr71 1]

Darien Post 53 Ems runs I.L.S fly cars...known as the 50 unit..that runs with the ambulance or before it.