EMS call coverage

[PFDRes47cue 653]

There are so many vollie agencies in Westchester County because EMS is still a very young field when compared to Law Enforcement and the Fire Service, and paid services were obselete for a very long time in Westchester. EMS still is not a priority to a lot a communities in Westchester. As long as an ambulance shows up from somewhere, I personally don't believe that the politicians in a lot of these towns and villages really care how their own EMS system is doing. Especially now that the whole county has ALS level service available, any agency can look good in the eyes of the public when a paramedic unit arrives on scene before an ambulance and initiates care.

Whatever it takes to get the patient the care he/she needs and to get them to the hospital. I don't think it matters whether the provider receives a check of some amount (low in EMS field) every week or what ever the pay period be.

[JJB531 652]

Whatever it takes to get the patient the care he/she needs and to get them to the hospital. I don't think it matters whether the provider receives a check of some amount (low in EMS field) every week or what ever the pay period be.

At no point did I say it matters whether the provider receives a check or not. It's easy to say whatever it takes to get the patient the care he/she needs and get them to the hospital, but it has to be said with some level of accountability or performance standards for EMS agencies (volunteer and career), which there currently is a lack of in Westchester.

[PFDRes47cue 653]

At no point did I say it matters whether the provider receives a check or not. It's easy to say whatever it takes to get the patient the care he/she needs and get them to the hospital, but it has to be said with some level of accountability or performance standards for EMS agencies (volunteer and career), which there currently is a lack of in Westchester.

I think it is a lack country wide... I agree that it is bad in Westchester especially however some agencies are doing things to make the EMS system work. Other agencies paid or vollie should switch up their ways and see if new efforts prove better.

[JJB531 652]

I think it is a lack country wide... I agree that it is bad in Westchester especially however some agencies are doing things to make the EMS system work. Other agencies paid or vollie should switch up their ways and see if new efforts prove better.

Some agencies are doing things to make the system work within their own community. Some agencies are supplementing personnel with per-diem EMT's such as Hawthorne and Valhalla. Some agencies are establishing tax districts and hiring full time EMT's and Paramedics, such as Ossining. The only reason the system works countywide though is because we have been able to adapt to the fact that there is no real countywide system. Things may work fine at certain local levels, but overall the "system" is non-existent countywide with the exception of countywide unit designations.

A lack country-wide... in certain areas, yes, there is lack, but overall other parts of the country are considerably more advanced when it comes to prehospital emergency medical care and EMS systems when you compare them to the Northeast, especially here in the NY Metro area.

[PFDRes47cue 653]

Well on the scanner up at school (upstate NY) I just heard it take 1 hour and 5 minutes from the time the call came in to the time an ALS intercept was completed. I often here calls (EMS) up here that take 30 to 40 minutes for someone to get to the scene...often times this is just a CFR. Don't here those numbers to often in Westchester. I once remember hearing a unit stay on scene for almost and hour and a half. I believe the call was for a hip injury but don't quote me on that. If you wanna see some real f'up ems...come up to SLC!

Edited February 13, 2010 by PFDRes47cue

[JJB531 652]

Well on the scanner up at school (upstate NY) I just heard it take 1 hour and 5 minutes from the time the call came in to the time an ALS intercept was completed. I often here calls (EMS) up here that take 30 to 40 minutes for someone to get to the scene...often times this is just a CFR. Don't here those numbers to often in Westchester. I once remember hearing a unit stay on scene for almost and hour and a half. I believe the call was for a hip injury but don't quote me on that. If you wanna see some real f'up ems...come up to SLC!

I've been involved in plenty of disastrous EMS situations right here in Westchester. Waiting 45 minutes for an ambulance when I can see the EMS building from the patients house. Waiting until the dispatching agency was 3 or 4 agencies down in the mutual aid list before an ambulance would respond. Showing up at the scene of a reported pin job to find that everyone ran to the fire engines and rescues and no one bothered to staff the ambulance, and then having to wait for a mutual aid ambulance. Ask any paramedic who has worked a fly car system in Westchester and the overwhelming majority will have disaster stories for you about waiting on scene for an ambulance. You can't compare Westchester County with certain areas upstate, where you have significantly more rural communities where response times are extended simply because of the geographical layout of these areas. What type of area are you referring upstate?

Once you have experienced different EMS systems systems here in Westchester over 10 years or so, then you will understand that EMS in Westchester can be just as bad as your experiences upstate at school.

[PFDRes47cue 653]

I've been involved in plenty of disastrous EMS situations right here in Westchester. Waiting 45 minutes for an ambulance when I can see the EMS building from the patients house. Waiting until the dispatching agency was 3 or 4 agencies down in the mutual aid list before an ambulance would respond. Showing up at the scene of a reported pin job to find that everyone ran to the fire engines and rescues and no one bothered to staff the ambulance, and then having to wait for a mutual aid ambulance. Ask any paramedic who has worked a fly car system in Westchester and the overwhelming majority will have disaster stories for you about waiting on scene for an ambulance. You can't compare Westchester County with certain areas upstate, where you have significantly more rural communities where response times are extended simply because of the geographical layout of these areas. What type of area are you referring upstate?

Once you have experienced different EMS systems systems here in Westchester over 10 years or so, then you will understand that EMS in Westchester can be just as bad as your experiences upstate at school.

I was trying to avoid naming exact places but St. Lawrence County... I was not comparing St. Lawrence county to Westchester...I do not think I mention comparing them. I simply said if you want to see bad EMS look here. Also having "plenty" of bad experiences and being able to name some is unavoidable...however, my point was that up here it is almost every call (in certain jurisdictions)

[JJB531 652]

I was trying to avoid naming exact places but St. Lawrence County... I was not comparing St. Lawrence county to Westchester...I do not think I mention comparing them. I simply said if you want to see bad EMS look here. Also having "plenty" of bad experiences and being able to name some is unavoidable...however, my point was that up here it is almost every call (in certain jurisdictions)

Having bad experiences like waiting 45 minutes for ambulances here in Westchester is 100% avoidable outside of extingent circumstances. Even one situation where a patient has to wait 45 minutes for an ambulance, once again, outside of extingent circumstances, is completely unacceptable here in Westchester.

[PFDRes47cue 653]

Having bad experiences like waiting 45 minutes for ambulances here in Westchester is 100% avoidable outside of extingent circumstances. Even one situation where a patient has to wait 45 minutes for an ambulance, once again, outside of extingent circumstances, is completely unacceptable here in Westchester.

Agreed, it is unacceptable. However, there will always be those situations that for some reason it happens (extingent circumstance). Therefore it is 100% unavoidable, nothing is 100% avoidable. No matter what you prepare for a circumstance will come up that messes up the system and delays response times, paid or vol.

Edited February 13, 2010 by PFDRes47cue

[LTNRFD 266]

There has got to be some reason why there are so many vollie agencies in the county...something must be working or must have worked in the past or something. I would sure like to think about all the people who have been helped by the vollies!

One of the reasons is way back before many of you were born, there was full time paid/career EMS in Westchester County. It was a hospital based system. I believe that many hospitals in lower Westchester, with emergency rooms ran ambulances. They could not provide a quick response to their primary response areas and cost too much to operate. There would be 45-60 minute responses on average. This prompted many areas to form the own EMS. Many police department ran stretcher cars or had ambulances available. If the patient could not go by RMP or stretcher car the ambulanca was sent. This ment calling in a car and taking an officer off the road to drive the ambulance. Depending on the manpower, the patient may have had someone ride with them in the back. Many times the patient was alone in the back of the ambulance. Then there were the VACs that started up. A ten minute response was up to 6 times faster than was the norm.

[PFDRes47cue 653]

One of the reasons is way back before many of you were born, there was full time paid/career EMS in Westchester County. It was a hospital based system. I believe that many hospitals in lower Westchester, with emergency rooms ran ambulances. They could not provide a quick response to their primary response areas and cost too much to operate. There would be 45-60 minute responses on average. This prompted many areas to form the own EMS. Many police department ran stretcher cars or had ambulances available. If the patient could not go by RMP or stretcher car the ambulanca was sent. This ment calling in a car and taking an officer off the road to drive the ambulance. Depending on the manpower, the patient may have had someone ride with them in the back. Many times the patient was alone in the back of the ambulance. Then there were the VACs that started up. A ten minute response was up to 6 times faster than was the norm.

Very interesting. I know that in Pleasantville for example EMS was at one point run by the funeral parlor. Sounds like a conflict of interest to me!!! HA

[dmc2007 17]

Agreed, it is unacceptable. However, there will always be those situations that for some reason it happens (extingent circumstance). Therefore it is 100% unavoidable, nothing is 100% avoidable. No matter what you prepare for a circumstance will come up that messes up the system and delays response times, paid or vol.

Thing is, an extingnt circumstance is one that can't be prevented by reasonable effort. Something that can be prevented by a complete controllable factor (having adequate staffing) is not. That's a failure of the system which shouldn't be accepted.

[Bnechis 3,961]

I was trying to avoid naming exact places but St. Lawrence County... I was not comparing St. Lawrence county to Westchester...I do not think I mention comparing them. I simply said if you want to see bad EMS look here. Also having "plenty" of bad experiences and being able to name some is unavoidable...however, my point was that up here it is almost every call (in certain jurisdictions)

They have only 12% of the population of Westchester but 600% more land to cover. It is not a big surprise that EMS response times are poor. They only have 3 hospitals in an area that is 4 square miles larger than Westchester, Putnam, Dutchess, Rockland, Orange, The Bronx, Manhattan, Queens and Brooklyn combined

[PFDRes47cue 653]

They have only 12% of the population of Westchester but 600% more land to cover. It is not a big surprise that EMS response times are poor. They only have 3 hospitals in an area that is 4 square miles larger than Westchester, Putnam, Dutchess, Rockland, Orange, The Bronx, Manhattan, Queens and Brooklyn combined

Luckily I'm only 2 minutes from a hospital!!!

[Goose 188]

Thanks JJB531.

[x635 4,066]

As screwed up as EMS in Westchester is, if there was a disaster, Westchester could pull it together and handle it.....textbook, maybe not but the job would get done.

60 Control dispatchers are excellent, and could coordinate the largest disaster if they had to.

And, if we really needed it, god forbid, we would have more ambulances and providers then we knew what to do with.

Every system could use improvement, and Westchester in my opinion has one of the worst operationally in the Country. However, to say that people would die in a disaster because of volunteers is a very arrogant and insulting remark to all those involved in EMS in Westchester.

[PFDRes47cue 653]

As screwed up as EMS in Westchester is, if there was a disaster, Westchester could pull it together and handle it.....textbook, maybe not but the job would get done.

60 Control dispatchers are excellent, and could coordinate the largest disaster if they had to.

And, if we really needed it, god forbid, we would have more ambulances and providers then we knew what to do with.

Every system could use improvement, and Westchester in my opinion has one of the worst operationally in the Country. However, to say that people would die in a disaster because of volunteers is a very arrogant and insulting remark to all those involved in EMS in Westchester.

AGREED! Well said.

[Bnechis 3,961]

As screwed up as EMS in Westchester is, if there was a disaster, Westchester could pull it together and handle it.....textbook, maybe not but the job would get done.

"pulling it together" at the last minute is not good enough. Most EMT classes spend less than 1 hour teaching triage, ICS and disaster managment. When I've evaluated MCI drills in Westchester it has taken hours to get the 1st patient transported and at actual incidents I've seen crews grab one patient cause they looked bad and left without triaging anybody else. EMS needs training, planning and a command presence to have a chance of pulling it off. To EMS "getting the job done" often means transporting everyone, which I have no doubt they will get it done, but transfering the disaster to the ER does not solve anything.

60 Control dispatchers are excellent, and could coordinate the largest disaster if they had to.

The problem is not the dispatchers, its the fact that to get 20 ambulances they need to make dozens of calls, you cant coordinate if every service requires a seperate phone call and then having to call MA to cover when that 1st (2nd or 3rd) agency can't get out.

And, if we really needed it, god forbid, we would have more ambulances and providers then we knew what to do with.

Are you talking about Westchester County NY? Maybe there is a Westchester in Tx. We keep having issues with getting 1 or 2 ambulances on the road and you think some how these issues will resolve itself at the moment of a disaster.

I always teach that you need to practice the way you are going to play. We do not practice for disasters and we can't get enough players on the field for a scrimage so how are we going to shine during the "big game"?

[PFDRes47cue 653]

[quote name='Bnechis' date='13 February 2010 - 08:55 PM' timestamp='1266112555' post='204225'

I always teach that you need to practice the way you are going to play. We do not practice for disasters and we can't get enough players on the field for a scrimage so how are we going to shine during the "big game"?

We all know just how may people show up for the "Big Game" Especially in the FD. You can have a residential alarm and have 7 people show up then get a fire 20 minutes later and have 40 people show up..."Big Games" draw big crowds.

Edited February 14, 2010 by PFDRes47cue

[Raz 14]

We all know just how may people show up for the "Big Game" Especially in the FD. You can have a residential alarm and have 7 people show up then get a fire 20 minutes later and have 40 people show up..."Big Games" draw big crowds.

I never understood how people can say this out loud and think that it sounds like a logical argument in defense of their position. I'd rather be without the extra yahoos that show up for the "big game" as they generally tend to:

-Get in the way of people who are properly trained and practiced.

-Make the situation worse by making the wrong decisions.

-Use resources that would be put to better use in more capable hands.

-Complicate the chain and scope of command.

I'm not denying that big games draw big crowds, but to hear people put that forth as a positive thing is ridiculous. Give me a small army over a large armed mob anyday.

[PFDRes47cue 653]

I never understood how people can say this out loud and think that it sounds like a logical argument in defense of their position. I'd rather be without the extra yahoos that show up for the "big game" as they generally tend to:

-Get in the way of people who are properly trained and practiced.

-Make the situation worse by making the wrong decisions.

-Use resources that would be put to better use in more capable hands.

-Complicate the chain and scope of command.

I'm not denying that big games draw big crowds, but to hear people put that forth as a positive thing is ridiculous. Give me a small army over a large armed mob anyday.

I did not say it is a good thing. I was simply replying to BNECHIS post. He said that we do not get enough players for scrimmages how can we expect to for the "Big Game". I said that we do get a lot of players for the "Big Game". I did not mention anything about these being great players or just bench players. Neither did BNECHIS. I too would much rather have a small competent army than a big one full of dead weight. I was not trying to defend my "position" and I do not think it is logical, it is simply fact. People show up for the big one. Think before you attack...makes for a better thread.

[Raz 14]

Think before you attack...makes for a better thread.

Not editing your posts after the fact also makes for a better thread.

[INIT915 1,119]

Not editing your posts after the fact also makes for a better thread.

I'll bite. What was changed? Since you quoted his post in your, they appear identical.

[Guest alsfirefighter]

This is a tale of 2 agencies. Both who have a lot of members who say "we don't do that bad." One at least tries with having a paid emt/driver in house for 12 hours during the day tour...the other still doesn't get it. They both bill...and the one that doesn't get it...gets a higher return on their billing then the one that pays someone.

Between the 2 agencies I answered 9 calls for service. Out of those 9...I got a full ambulance crew on a whopping 1 of them. But no..their aren't any problems...and oh yeah..the one that doesn't get it..has BLSFR via paid firefighter/emt's...but yet don't use them to cover calls when all they can is drum up a driver..so instead they go mutual aid. To agencies that are hurting themselves.

What number of calls dropped to mutual aid would you have to say there is a problem and we need to take a look at it? Also throw in how many calls that are BLS that some medics cover and ride in for you. Would say 400 come close?

[PFDRes47cue 653]

Not editing your posts after the fact also makes for a better thread.

That is not what I edited...I edited a spelling error...come of us care about that. I'll say again, think before you attack...makes for a better thread.

[PFDRes47cue 653]

Not editing your posts after the fact also makes for a better thread.

RAZ, wouldn't an edited post make for a better thread. I mean a fixed a spelling error others may fix grammatical errors. I know you completed at least 10th grade(state law?)...didn't your papers and homework get better grades when they were edited after the first draft??? This almost pertains to EMS call coverage...

Edited February 14, 2010 by PFDRes47cue

[bfxfd 8]

RAZ, wouldn't an edited post make for a better thread. I mean a fixed a spelling error others ma fix grammatical errors. I know you completed at least 10th grade(state law?)...didn't your papers and homework get better grades when they were edited after the first draft??? This almost pertains to EMS call coverage...

I find it ironic that there are spelling errors in a post criticizing spelling errors.

[PFDRes47cue 653]

I find it ironic that there are spelling errors in a post criticizing spelling errors.

It is ironic...guess it needs to be edited again!

[flyboy14295 4]

I never understood how people can say this out loud and think that it sounds like a logical argument in defense of their position. I'd rather be without the extra yahoos that show up for the "big game" as they generally tend to:

-Get in the way of people who are properly trained and practiced.

-Make the situation worse by making the wrong decisions.

-Use resources that would be put to better use in more capable hands.

-Complicate the chain and scope of command.

I'm not denying that big games draw big crowds, but to hear people put that forth as a positive thing is ridiculous. Give me a small army over a large armed mob anyday.

Well said!!

[16fire5 693]

PFDRes47cue the point Bnechis is making is there are plenty of places with lower population densities than Westchester (we'll leave out St. Lawerence County) in NY that do a better job getting ambulances out and I might add staff them to an advanced level.