Responding to calls

[Dondestro 9]

I've been off for a week and have been around the scanner alot, it seems like more and more ems calls are having to go mutual aid. Pirmarly in putnum county. is this normal or just a phase, seems like every call has to be toned out to 1-2 sometimes 3 or 4 departments before a full crew is gathered.

it seems liek more departments should go to a piad day crew and leave the vol's responsable for the night calls.

I'm not bashing anyone just an observation.

[Goose 188]

It's been going on for years everywhere, nothing new here champ. It's unlikely to change - too much "pride" and politics involved. It is what it is...until someone dies.

[helicopper 1,050]

It's been going on for years everywhere, nothing new here champ. It's unlikely to change - too much "pride" and politics involved. It is what it is...until someone dies.

True enough - but it's been getting progressively worse in Putnam. The practice of using ALS to cover agencies that couldn't field their own BLS crew also worked against the development of an effective ALS system (again in Putnam). The call volume and geography works against Putnam - there's no easy way to get from one side of the county to another and most agencies (most, not all) don't have the volume to support the salaries of paid personnel.

It is pathetic when you hear about 25-30 minute response times in 2007 but that's not all that uncommon unfortunately.

Anyone have any suggestions for improving it?

[Guest]

It's been going on for years everywhere, nothing new here champ. It's unlikely to change - too much "pride" and politics involved. It is what it is...until someone dies.

Happened this pass sunday in PA 2 young folks were killed in house fire cause they couldnt get mutual aid to respond in time, all the near by depts even my station went to a house fire in PA just before that one came in so they couldnt get anyone to respond there fast enough

[texastom791 31]

no it's not really a new thing during the day not alot of people are around but the medics cover the call before going mutual aid from like 9-5 monday through friday

Edited November 21, 2007 by texastom791

[Goose 188]

no it's not really a new thing during the day not alot of people are around but the medics cover the call before going mutual aid from like 9-5 monday through friday

Just for clarification, as far as Putnam County is concerned:

Monday through Friday from 6am - 6p Medics 4 and 3 (covering the east side of the County) are staffed in an ambulance with a medic and EMT. If, a job drops and the respective volly agency does not get out within the alloted 3 dispatches (5-10 minutes i think) the transport is handled by the contracted ambulance. After 6pm the EMTs are off shift and the ambulance becomes a "fly ambulance." Medics 2 and 1 are still fly cars only. Philipstown ambulance staffs a full truck from 7a - 4p with its own EMTs and then with 1 EMT from 4p - 7a (staffed by their own hired EMTs).

Despite this, problems still exist, as with everything.

Edited November 21, 2007 by Goose

[texastom791 31]

yeah i didn't really know the specifics but i knew it was something like that the dispatches are one every minute for three minutes before mutual aid i think

Edited November 22, 2007 by texastom791

[helicopper 1,050]

Just for clarification, as far as Putnam County is concerned:

Monday through Friday from 6am - 6p Medics 4 and 3 (covering the east side of the County) are staffed in an ambulance with a medic and EMT. If, a job drops and the respective volly agency does not get out within the alloted 3 dispatches (5-10 minutes i think) the transport is handled by the contracted ambulance. After 6pm the EMTs are off shift and the ambulance becomes a "fly ambulance." Medics 2 and 1 are still fly cars only. Philipstown ambulance staffs a full truck from 7a - 4p with its own EMTs and then with 1 EMT from 4p - 7a (staffed by their own hired EMTs).

Despite this, problems still exist, as with everything.

So Putnam still takes away 25% of it's available ALS resources when (not if) a BLS crew can't be fielded by the agencies that have been plagued with daytime staffing problems for years. That is PATHETIC! The ambulance is not a bad idea but I'd still rather see the EMT's in the ambulances and the paramedics remaining available to pick up the next job - especially if EMD says it should receive ALS. It's also time to start conserving the resource and not sending them on clearly BLS jobs (isolated extremity trauma with no LOC, etc.).

Given the shortage of EMS resources in the County, I'd actually prefer a two medic fly-car in the central part of the County so the other medic units can remain in their primary areas rather than relocate all day (burning gas) and covering the busy parts of the County. Not unlike the way RPS operates in Rockland County. Two medics, one truck, double the coverage.

At least Philipstown accepts responsibility for their staffing shortage and addresses it - at their own expense not everyone elses!

[firemoose827 324]

Yes, there needs to be a system in place to put paid crews on during the day...but the problem I see doesnt lie in too much pride to switch. My entire squad, except a few, want to get help during daytime hours but the VILLAGE wont agree its justified. They refuse to pay a crew or hire a service to cover the area and it jeopardises lives. Something needs to happen in a local goverrnment level to impliment the change. And if there are still squad members out ther who feel you shouldnt change over, than they forgot why we are here....the PATIENT. And we should do everything we can to provide a FAST, reliable service to them when their lives are in jeopardy. Too many people are thinking stats instead of Helping People.

Its a shame that someones pride causes someone else to loose their life.

[MPACE2-299 0]

In Putnam if a call comes in Monday through Friday from 6am - 6p, the original agency only gets a driver and the call is BLS, the Empire EMT will take in the call with that agency leaving the medic in service if another ALS call drops.

[Dondestro 9]

my concern is 10 min is a very long time when it comes to a emergency we all know this. I am not bashing putnum i just used them a san example. we here in new fairfield welcome the paid crew during the day greatly, we know we can't do it....its a life possibly in danger so come-on-in. all i am trying to say is i have heard putnum tone out three departments at one time...multiple timesin a row for a single call. i am talking 3-4-5 times it being paged out.

[smwells 7]

Several departments in Putnam have worked to minimize calls going mutual aid by hiring EMTs, unfortunately others that have seen an increase in coverage issues, have not.

This has forced the county to have Empire State Ambulance supply an ambulance instead of a fly car in Medic 3 and 4's territory on the East side of Putnam County. The Medic 1 and 2 areas on the west side still maintains the use of flycars, with the area volunteer agencies covering thier calls consistently.

[ckroll 101]

For another perspective, Putnam County can't make good decisions on resource allocation without good data. A huge issue for us is the inability to get reliable data from the CAD system. It's been years and it either can't or won't provide meaningful data.

Some in Putnam, [i was one of at least 2], felt a system based on 4 flycars and one or two EMT staffed ambulances to assist all local corps, not just the chosen towns east of the Taconic would provide better, more uniform coverage. That said, Putnam County management says no and they sit on all the data that could prove or disprove the practicality of such a system. Yes, a significant amount of the time one or two paramedics is/are acting as a driver for BLS transports. And at that, towns west of the Taconic are not offered access to a contract ambulance if they fail to cover a call.

In the county's defense, the effort is to assist agencies that need it most and to position resources to serve the most county residents. That means some residents get more than others. The farther up the trough you dine, the better you like the current system. Balance has to be struck between cost and service and where one draws the line is hot for debate.

I think a good case could be made, [if cost is the heavily weighted consideration] that any ALS is of limited additional value, certainly when it is used for BLS transport [ the 'no value' condition] . A better case can be made that cost per capita [ roughly 1 million dollars now for 100,000 residents or $ 10 per resident] is the cheapest insurance/ service the county can provide. If a system could be designed that actually got EMS transport to all county residents and ALS to all residents at 9/90 [within 9 minutes, 90% of the time] that it could be worth twice what we are paying now.

That said, the other hot debate is who should be paying. Should the county be involved in financing EMS at all? Should the county be subsidizing the towns to provide BLS service? Should/Can it subsidize some towns and not others? If cost is the crystallizing issue, as it seems to be at the moment, one has to ask "Whose cost?". Argument can be made that the county can save itself a lot of money if it takes the position that BLS should be the responsibility of the town and that ALS, probably too expensive on a town by town basis, is better funded at the county level. Of course, that means towns pay more. That makes sense to me.

If there were obvious, good answers, I think there are large enough hearts and brains [if not wallets] in Putnam that we would have found them by now. Compromises are a necessity... which is why we need good data and clear vision.

[helicopper 1,050]

In Putnam if a call comes in Monday through Friday from 6am - 6p, the original agency only gets a driver and the call is BLS, the Empire EMT will take in the call with that agency leaving the medic in service if another ALS call drops.

And when the agency doesn't get out at all, the ALS unit becomes a BLS ambulance, right?

Yes, there needs to be a system in place to put paid crews on during the day...but the problem I see doesnt lie in too much pride to switch. My entire squad, except a few, want to get help during daytime hours but the VILLAGE wont agree its justified. They refuse to pay a crew or hire a service to cover the area and it jeopardises lives. Something needs to happen in a local goverrnment level to impliment the change. And if there are still squad members out ther who feel you shouldnt change over, than they forgot why we are here....the PATIENT. And we should do everything we can to provide a FAST, reliable service to them when their lives are in jeopardy. Too many people are thinking stats instead of Helping People.

Its a shame that someones pride causes someone else to loose their life.

The local government (Village in your case, Jonesy) is ultimately accountable to you! Make it a campaign issue and send people to every debate, public appearance, etc. to make sure the public knows its a problem and the elected officials learn that they will be held accountable for it. The 2008 election is going to be a BIG one and it will be a great time to get important issues such as this on the table for debate and discussion. Send them official correspondence requesting the change and if they fail to act, go public.

For another perspective, Putnam County can't make good decisions on resource allocation without good data. A huge issue for us is the inability to get reliable data from the CAD system. It's been years and it either can't or won't provide meaningful data.

Some in Putnam, [i was one of at least 2], felt a system based on 4 flycars and one or two EMT staffed ambulances to assist all local corps, not just the chosen towns east of the Taconic would provide better, more uniform coverage. That said, Putnam County management says no and they sit on all the data that could prove or disprove the practicality of such a system. Yes, a significant amount of the time one or two paramedics is/are acting as a driver for BLS transports. And at that, towns west of the Taconic are not offered access to a contract ambulance if they fail to cover a call.

In the county's defense, the effort is to assist agencies that need it most and to position resources to serve the most county residents. That means some residents get more than others. The farther up the trough you dine, the better you like the current system. Balance has to be struck between cost and service and where one draws the line is hot for debate.

I think a good case could be made, [if cost is the heavily weighted consideration] that any ALS is of limited additional value, certainly when it is used for BLS transport [ the 'no value' condition] . A better case can be made that cost per capita [ roughly 1 million dollars now for 100,000 residents or $ 10 per resident] is the cheapest insurance/ service the county can provide. If a system could be designed that actually got EMS transport to all county residents and ALS to all residents at 9/90 [within 9 minutes, 90% of the time] that it could be worth twice what we are paying now.

That said, the other hot debate is who should be paying. Should the county be involved in financing EMS at all? Should the county be subsidizing the towns to provide BLS service? Should/Can it subsidize some towns and not others? If cost is the crystallizing issue, as it seems to be at the moment, one has to ask "Whose cost?". Argument can be made that the county can save itself a lot of money if it takes the position that BLS should be the responsibility of the town and that ALS, probably too expensive on a town by town basis, is better funded at the county level. Of course, that means towns pay more. That makes sense to me.

If there were obvious, good answers, I think there are large enough hearts and brains [if not wallets] in Putnam that we would have found them by now. Compromises are a necessity... which is why we need good data and clear vision.

Excellent points! Has the County resisted a FOIL request for CAD data or are they just stonewalling in the traditional local government manner? It's time that governments including Putnam start acting responsibly with our tax money and I don't think the inequity of EMS service is responsible. We are subsidizing agencies who fail to meet their mandate and can't even get a rig on the road for a call - for a parade yes but a call no. That's a shame!

ckroll, maybe you should run for CE!!!

[ckroll 101]

[ Has the County resisted a FOIL request for CAD data or are they just stonewalling in the traditional local government manner?

I don't think it's malicious at all. The managers can't manipulate the programs to spit out informative data sets. The county might be well served to find a consultant that does not have emotional, financial, or political ties to the county to help us find strategies and set goals. Towns or their agencies might be more cooperative if the harder choices were outlined by impartial individuals. We might consider a proactive approach, asking ourselves where we want to be in say, 10 years, getting consensus on a long term plan, and then looking at the possibly unpopular intermediate steps it will take us to get there.

Proud as I am to be a volunteer for almost 20 years, if we look at how much money is spent countywide on ALS and BLS, it is a vast sum of money. If we are spending close to 2 million on BLS and 1 million ALS, that should buy a lot of service, though maybe not service as it looks now.

[helicopper 1,050]

[ Has the County resisted a FOIL request for CAD data or are they just stonewalling in the traditional local government manner?

I don't think it's malicious at all. The managers can't manipulate the programs to spit out informative data sets. The county might be well served to find a consultant that does not have emotional, financial, or political ties to the county to help us find strategies and set goals. Towns or their agencies might be more cooperative if the harder choices were outlined by impartial individuals. We might consider a proactive approach, asking ourselves where we want to be in say, 10 years, getting consensus on a long term plan, and then looking at the possibly unpopular intermediate steps it will take us to get there.

Proud as I am to be a volunteer for almost 20 years, if we look at how much money is spent countywide on ALS and BLS, it is a vast sum of money. If we are spending close to 2 million on BLS and 1 million ALS, that should buy a lot of service, though maybe not service as it looks now.

I don't think it is malicious either. It is as you said emotional, political, and to an extent financial.

Great plan - have you tried to sell it to anyone at the County or your home agency so they could try???

[Remember585 815]

Westchester has their share of problems covering EMS calls too. I almost feel like it is a crap shoot when toning out certain agencies as to whether or not they're going to come out and play.

I guess as long as the person in need doesn't mind waiting 30, 60 or even 90 minutes for an ambulance to transport them, then there's nothing to worry about.

I say the next time an ambulance is dispatched to a call you simultaneously order a pizza delivery and see who shows up first.

My money says you can snarf down two slices before your ambulance shows up.

[/sarcasm]

As a member of the EMS community for nearly half my life I can say this - WE AREN'T DOING THE JOB AS WELL AS WE SHOULD! Agencies not getting out, Mutual Aid and ETAs over 30 minutes are common practice and it isn't right. I don't get it, what is so hard about covering an EMS call - in most cases it only requires a response of TWO PEOPLE! Most Fire Departments can get five times that around the clock for NON-EMERGENCY CALLS. Why aren't people waking up, showing up and covering calls?! Afraid to tech? Personality conflicts? Calls take too long? I've heard and used all the excuses (except the first) myself, but enough is enough. Those agencies having the greatest difficulties covering calls need to do a serious self-assessment and come up with a solution - not a band-aid - a solution - to this problem. We all have friends and more importantly, FAMILY that is depending on these services so let's all "man up" and figure out what to do - even if it means paying people to ensure an ambulance shows up in a reasonable time!

[Goose 188]

Westchester has their share of problems covering EMS calls too. I almost feel like it is a crap shoot when toning out certain agencies as to whether or not they're going to come out and play.

I guess as long as the person in need doesn't mind waiting 30, 60 or even 90 minutes for an ambulance to transport them, then there's nothing to worry about.

I say the next time an ambulance is dispatched to a call you simultaneously order a pizza delivery and see who shows up first.

My money says you can snarf down two slices before your ambulance shows up.

[/sarcasm]

As a member of the EMS community for nearly half my life I can say this - WE AREN'T DOING THE JOB AS WELL AS WE SHOULD! Agencies not getting out, Mutual Aid and ETAs over 30 minutes are common practice and it isn't right. I don't get it, what is so hard about covering an EMS call - in most cases it only requires a response of TWO PEOPLE! Most Fire Departments can get five times that around the clock for NON-EMERGENCY CALLS. Why aren't people waking up, showing up and covering calls?! Afraid to tech? Personality conflicts? Calls take too long? I've heard and used all the excuses (except the first) myself, but enough is enough. Those agencies having the greatest difficulties covering calls need to do a serious self-assessment and come up with a solution - not a band-aid - a solution - to this problem. We all have friends and more importantly, FAMILY that is depending on these services so let's all "man up" and figure out what to do - even if it means paying people to ensure an ambulance shows up in a reasonable time!

Don't lump me into that category, I'm responding to and on scene at the majority of my assignments in under 5 minutes. It's the volunteers who aren't holding up their end of the bargain and all too often have too much "pride" to admit it. Cut the bull, enter into the 21st Century, get the truck out or pay someone to.

[Remember585 815]

get the truck out or pay someone to.

Truck - you mean "Ambulance," right?

[DOC22 1]

Truck - you mean "Ambulance," right?

He probably means Engine, Truck, Rescue AND Ambulance!

[NWFDMedic 58]

The Putnam County system hasn't worked since I worked down there in 2001 and probably long before that. The same problems we're all used to hearing about in the volunteer service have made the problems even worse. The county itself is set up poorly for a countywide system and in a lot of places politics makes it worse because the county line might as well be the Great Wall of China. The addition of the daytime ambulance from the ALS provider I'm sure has helped, but it's kind of like putting lipstick on a pig ... you still have a pig. (Not bashing the provider with this comment, any provider in the PC system would be poised to fail).

What PC needs is to have the important people realize that this is a problem. If you can't make the politicians on the county level realize the problem, get on your town officials and inform the residents. There are plenty of people who have ideas and maybe some brainstorming can result in a better system. However, as long as they try to hang onto this system, the problems will continue to grow.