Emergency Response (Lights and Siren) for EMS Calls

[helicopper 1,050]

The threads about lights and emergency vehicle operations got me thinking and while looking online for something else I came across an article by Doug Wolfberg that is just as timely now as when it was published in 1996.

http://www.emergency...nliability1.htm

Some interesting excerpts from the article:

I'm going to begin this column by stating a bias up front: I believe that lights and sirens are overused by EMS providers. I also believe that light-and-siren use probably causes more deaths and injuries than it saves or prevents. Moreover, light-and-siren use leads to careless driving by overexcited drivers and is one of the most insidious contributors to EMS liability. In this month's column, I am going to construct an argument for the serious curtailment, if not complete abandonment, of light-and-siren use by EMS vehicle operators. This argument will be based on scientific literature, case law and personal observations.

In 1995 study published in the Annals of Emergency Medicine (1), researchers concluded that transport time from the scene to the hospital in a small city was 43.5 seconds faster with lights and sirens than without. While this difference in transport time was found to be statistically significant, it was not clinically significant. That is, the ambulance may get to the emergency department 43.5 seconds faster by using lights and sirens, but there is nothing the ED staff can do with that extra 43.5 seconds to improve the patient's outcome.

In fact, among volunteer EMS organizations insured by Glatfelter, for every medical malpractice claim against an EMS provider, there are 25 claims for automobile liability arising from ambulance crashes.

The article also lists some interesting recommendations that people should look at for an honest self-assessment.

School's Open - Drive Carefully.

[Alpinerunner 61]

Very interesting article. And it has implications on the fire side too. Do you need code 3 response for CO alarm when the house is evacuated? Probably not. Do you need code 3 for tree down? Probably not. What about for the 2nd and 3rd due apparatus for an automatic alarm? That is a tough question and can only be answered by careful statistics. You would need to look at the number of apparatus accidents vs. number of stops on fires found by alarms, then compare the damage cause by those accidents vs. the damage of burning an extra room.

Then you look at the fact that you can't put a price on a life. Is that a life of someone hit by a fire truck, or the price of a life taken by fire. A complicated subject indeed.

[JM15 386]

Maybe in terms of EMS priority dispatch could help decide appropriate response levels? Anyone use priority dispatch?

[INIT915 1,119]

Very interesting article. And it has implications on the fire side too. Do you need code 3 response for CO alarm when the house is evacuated? Probably not. Do you need code 3 for tree down? Probably not. What about for the 2nd and 3rd due apparatus for an automatic alarm? That is a tough question and can only be answered by careful statistics. You would need to look at the number of apparatus accidents vs. number of stops on fires found by alarms, then compare the damage cause by those accidents vs. the damage of burning an extra room.

Then you look at the fact that you can't put a price on a life. Is that a life of someone hit by a fire truck, or the price of a life taken by fire. A complicated subject indeed.

2nd or 3rd? What about the 1st due? Given the frequency of false alarms, are the risks of RLS outweighed by the potential of an actual incident?

Look at (most) law enforcement agencies. No responding units use RLS. The potential of a legitimate alarm is statistically insignificant (hypothesis here) when compared to sending 2, 3, 4+ units with RLS, creating a risk of accidents/incidents to the general public and to ourselves.

[PFDRes47cue 653]

Very interesting article. And it has implications on the fire side too. Do you need code 3 response for CO alarm when the house is evacuated? Probably not. Do you need code 3 for tree down? Probably not. What about for the 2nd and 3rd due apparatus for an automatic alarm? That is a tough question and can only be answered by careful statistics. You would need to look at the number of apparatus accidents vs. number of stops on fires found by alarms, then compare the damage cause by those accidents vs. the damage of burning an extra room.

Then you look at the fact that you can't put a price on a life. Is that a life of someone hit by a fire truck, or the price of a life taken by fire. A complicated subject indeed.

Very good point. My department is very good about only running lights and sirens when needed? We often are told to respond in non-emergency mode (no lights or sirens) right when we call in responding? This of course increases safety but I have noticed a negative impact from the publics point of view. I have often been asked, "Why do you guys never use lights or sirens?" or "I hear the horn go off and then the trucks leave with no lights or siren..." could constantly responding non-emergency for "minor" alarms hurt our public image or make the public question our seriousness or level of effort? as far as CO alarms for example. The Chief(s) on scene have CO detectors in their chief cars...do they need a rig with personnel to call it a malfunction? Can the chief make that distinction by investigating himself and instead of having trucks on the roads without lights or sirens, have them remain in quarters? Also, for my curiosity, is a department held more liable for rig accidents when responding code or not code to alarms. In my opinion I feel the department would be more "screwed" if a rig is involved in an accident going to a alarm in non-emergency mode. Other parties involved and their attorneys may ask, "If there was no rush on apparatus getting there, why be responding at all?) Rant over...

And yes, I know this is an EMS Run thread...the same can be applied to EMS non-emergency responses.

Edited September 8, 2010 by PFDRes47cue

[191SH 4]

So Ems abuses the lights and sirens I think they are forced to abuse it when someone dials 911 and states their illness is worse than it is Ems believes it to be life threating and its a stumped toe that is abuse, but the Police officers. How many times do I see cops especially in Yonkers put their light bars on just to pass a red light so lets look at both sides here.

[Alpinerunner 61]

So Ems abuses the lights and sirens I think they are forced to abuse it when someone dials 911 and states their illness is worse than it is Ems believes it to be life threating and its a stumped toe that is abuse, but the Police officers. How many times do I see cops especially in Yonkers put their light bars on just to pass a red light so lets look at both sides here.

That is a response code. I believe it's usually called code 2, expedited response. It's used for not quite emergency, not quite "nothing". I don't know any further from that... but I don't believe the cops are abusing their lights when they do this. I used to see this in Raleigh and though the same thing, then I learned about Code 2.

[Alpinerunner 61]

2nd or 3rd? What about the 1st due? Given the frequency of false alarms, are the risks of RLS outweighed by the potential of an actual incident?

That's my speculation. I believe 1st due should always go Code 3 to an alarm. Too much damage can be done by a fire in a short time. The 2nd and 3rd due are debatable, and I don't quite have an opinion myself. I would say just drive more carefully. And no one should ever be "busting" red lights. Treat them as stop signs.

[FFFORD 27]

When I drive an ambulance for my Volunteer corps I will actually go no lights no sirens even if dispatched priority 1 (lights/siren). all depending on the dispatch. If I am dispatched to something like impending/possible MIs, respiratory arrests, MVCs, drownings, and a few others I will go priority 1. I also take into account the distance to the scene. if its a short trip, I'm not going priority 1. if its long, (up to 15 minutes in my town) I will usually use lights if I am in higher traffic areas, and then shut down if not in high traffic. I also have a lot of old country roads in my town which I would not travel any different in speed. I always get the, "dude its priority 1, what are you doing?" and I usually just have to explain to them my thoughts. all about driving with "due regard."

[STAT213 332]

We have drastically reduced our lights and siren useage here. We almost never transport with lights and sirens. In addition, we have adopted the pro qa system which assigns one of six levels of priority to each ems call, ranging from minor (alpha) to life treatening (echo) and other (omega - lift assists, etc.) The calls are coded by the statewide 911 center and we now respond with traffic to all alpha and bravo coded calls.

We also send only the first due engine with lights and sirens to alarm activations, and service calls are 99% of the time responded to with traffic as well. Alarm activations for us have a standard response of two engines, the duty chief and a truck or tanker depending on the district and hazard.

[FFBlaser 24]

Maybe in terms of EMS priority dispatch could help decide appropriate response levels? Anyone use priority dispatch?

We Do, Alpha being low, Delta being High.

We usually only Roll code 3 on Charlie calls and up, but occasionally the dispatcher will relay mid run that the patient is no longer breathing and than it becomes a Delta Response and we light it up

[minivac 0]

In My Corps, We Go Lights and sirens to every call (unless specified by the patient that they do not want to have a lights and sirens approach to their house). I like this policy becuase you can never rely on the dipatch information (not criticizing dispachers, I really apprechiate all you guys do) but it has been my experiance that what we get called out for is very different than what we have to deal with on scene, and you never know when a "diabetic emergancy" will turn into a cardiac arrest. (yes this has happened) We have lights and sirens for a reason, so use them, just not excessively

[Just a guy 493]

So Ems abuses the lights and sirens I think they are forced to abuse it when someone dials 911 and states their illness is worse than it is Ems believes it to be life threating and its a stumped toe that is abuse, but the Police officers. How many times do I see cops especially in Yonkers put their light bars on just to pass a red light so lets look at both sides here.

I was going to leave this alone but now feel compelled to reply due to the fact that it always seems that no matter what the thread is about, this one happens to be about EMS, someone has to drag the PD into it.

First i will say that Empress has some pretty terrible drivers - hold on I didn't say all, I said some !! There have been MANY times when you see them fly through an intersection lights and sirens and just avoid an accident barely.

I had an incident with them 6 or 7 years ago, it was 7 AM and we had a voluntary EDP that was going to St. Joe's for a psych eval. We were in a parking lot behind the carpet shops on nepperhan avenue and all of a sudden you could hear the siren and here comes this BLS bus flying into the parking lot lights and siren and didnt shut the siren off unit they put the bus in park.. you know how much traffic there is in the empty parking lots at 7 am.

As far as the cops putting their lights on to go through red lights, you have no clue where those guys are going or what type of job they are going to. They could be going after someone or trying to get to an area where a plain clothes cop is doing a surveillance and they need to get there quickly but quietly.

The other problem is that when people in yonkers (and probably other areas also) see an emergency vehicle with lights and sirens on they just stop where they are, no attempt to pull over and it only makes getting to a scene that much harder. So when you approach an intersection many times putting your lights on as you approach an intersection sometimes is the best way to get through it.

[INIT915 1,119]

So Ems abuses the lights and sirens I think they are forced to abuse it when someone dials 911 and states their illness is worse than it is Ems believes it to be life threating and its a stumped toe that is abuse, but the Police officers. How many times do I see cops especially in Yonkers put their light bars on just to pass a red light so lets look at both sides here.

Your grammar aside, your way off base. As crimecop points out, there are lots of instances PD needs to get somewhere quickly, yet quietly. Using lights and sirens as you approach a scene may not be the best approach, whereas that is less of an issue for FD/EMS.

You are however right, the public does abuse 911. That goes without saying. If you then transport that "stumped toe" RLS to the ER, you are just contributing to the problem.

[helicopper 1,050]

So Ems abuses the lights and sirens I think they are forced to abuse it when someone dials 911 and states their illness is worse than it is Ems believes it to be life threating and its a stumped toe that is abuse, but the Police officers. How many times do I see cops especially in Yonkers put their light bars on just to pass a red light so lets look at both sides here.

This post highlights the issue in the article. "So EMS abuses the lights and siren" is an unacceptable position. We have a mandate to everyone in our community, not just the person who dialed 911, so when we broadside someone in an intersection or have any other emergency vehicle accident, we're not fulfilling our mission and we're failing our consituents.

"Forced to abuse it"? Again, the system is failing and we're making no effort to correct it. If we have a proactive EMD system and respond based on reasonably obtained info, fine. When we use the rationale that any call could be another call we're setting ourselves up for a problem.

Finally, getting to the call is only one part of the problem. As pointed out, going to the hospital with lights and siren is inappropriate 99% of the time and yet time and time again we see it.

[antiquefirelt 994]

In My Corps, We Go Lights and sirens to every call (unless specified by the patient that they do not want to have a lights and sirens approach to their house). I like this policy becuase you can never rely on the dipatch information (not criticizing dispachers, I really apprechiate all you guys do) but it has been my experiance that what we get called out for is very different than what we have to deal with on scene, and you never know when a "diabetic emergancy" will turn into a cardiac arrest. (yes this has happened) We have lights and sirens for a reason, so use them, just not excessively

Those who drive can be and have been held liable in accidents where they were travelling lights and sirens to a non life or limb call. There are some compelling arguements to not driving lights and sirens to all calls and few for it.

Our SOPs require EMS drivers to drive lights and sirens when it is a life or limb threatening call, and to respond "non-emergency to all calls that do not rise to that level. In 15 years of this I can recall only 1 incident of the 1500-1800 annual EMS runs where we "got bit" by bad info. A reported cut on the hand turned out to be a hand in a snowblower! Given the distance and number of lighted intersections I doubt we'd have gained more than 30 seconds, but the family rightly was upset hat we hadn't taken the call as serious as it was.

[50-65 205]

Just from my point of view... I work EMS for a commercial agency. Generally, dispatch will tell us if it is an Alpha (with traffic) response. Otherwise, it is assumed to be Code 3. That said, I will often go alpha depending on traffic conditions, time of day, distance, etc. Code 3 while transporting is rare and often extremely hazardous if family follows. That is generally reserved for the CPR in progress or other critical pt.

On the fire side however, I have argued with the powers that be to no avail about response procedures. In my opinion, for AFA's, the chief officer and 1st due engine should respond code 3. 1st due truck and/or rescue should respond code 1. All 2nd due apparatus should remain manned in quarters. You can always step up response if needed, and it creates a lot less confusion for the public if you are cancelled and returned.

[Guest]

I was going to leave this alone but now feel compelled to reply due to the fact that it always seems that no matter what the thread is about, this one happens to be about EMS, someone has to drag the PD into it.

First i will say that Empress has some pretty terrible drivers - hold on I didn't say all, I said some !! There have been MANY times when you see them fly through an intersection lights and sirens and just avoid an accident barely.

I had an incident with them 6 or 7 years ago, it was 7 AM and we had a voluntary EDP that was going to St. Joe's for a psych eval. We were in a parking lot behind the carpet shops on nepperhan avenue and all of a sudden you could hear the siren and here comes this BLS bus flying into the parking lot lights and siren and didnt shut the siren off unit they put the bus in park.. you know how much traffic there is in the empty parking lots at 7 am.

As far as the cops putting their lights on to go through red lights, you have no clue where those guys are going or what type of job they are going to. They could be going after someone or trying to get to an area where a plain clothes cop is doing a surveillance and they need to get there quickly but quietly.

The other problem is that when people in yonkers (and probably other areas also) see an emergency vehicle with lights and sirens on they just stop where they are, no attempt to pull over and it only makes getting to a scene that much harder. So when you approach an intersection many times putting your lights on as you approach an intersection sometimes is the best way to get through it.

I agree completly. I know in the Bronx, I never used used the lights or siren unless I was going to a 13. We had maybe 5 cars for the midnight and I don't know anyone who abused the warning devices. The new guys usually got it out of their system in a few months and if they didn't, the older guys would usually pull them aside. I know it's a cliche but you can't help anybody if you don't get there yourself.

[FiftyOnePride 100]

A priority system based on a sequence of standard questions and adding any other pertinent info to decide the response seems to work up here. Granted I've been to life threatening and fatal priority 3's and 4's (NLS side of the scale), and been to very minor almost "laughable" for better lack of an appropriate term priority 1's. From my time spent behind the wheel of an ambulance, in our rural setting, RLS for the majority of transports results in minimal time gained. Not that I am denying their credibility in the ease of transport, but it is just something to think about.

[minivac 0]

While I understand that every call we go on may not be a life or death situation, they are always emergencies, otherwise it wouldn't be called EMERGENCY medical services... While the ultimate topic of this thread is about lights and sirens, I believe this is more a conversation about the individual drivers and how they drive on each call. You must always use common sense on a call and do whatever nessicary to keep the crew and the patient safe. So lights and sirens or not, just get the job done and stay safe.

[Just a guy 493]

While I understand that every call we go on may not be a life or death situation, they are always emergencies, otherwise it wouldn't be called EMERGENCY medical services... While the ultimate topic of this thread is about lights and sirens, I believe this is more a conversation about the individual drivers and how they drive on each call. You must always use common sense on a call and do whatever nessicary to keep the crew and the patient safe. So lights and sirens or not, just get the job done and stay safe.

While I agree that you need to always keep your crew and patient safe I completely disagree that EMS calls are always an emergency... maybe where you live people only call for an ambulance when needed but in Yonkers, people in the hood call for stomach aches, bloody noses, vomiting, back pain or the ever popular "I've drank too much and want to go sleep it off at the hospital so come get me" . People are under the impression that A. They don't have to pay for an ambulance and B. If you come to the ER by ambulance that you will be seen right away, obviously both falsehoods. Just because it's called the emergency medical services DOES NOT MEAN it's an emergency

[helicopper 1,050]

While I understand that every call we go on may not be a life or death situation, they are always emergencies, otherwise it wouldn't be called EMERGENCY medical services... While the ultimate topic of this thread is about lights and sirens, I believe this is more a conversation about the individual drivers and how they drive on each call. You must always use common sense on a call and do whatever nessicary to keep the crew and the patient safe. So lights and sirens or not, just get the job done and stay safe.

Yes, we are called that but the reality is that the overwhelming majority of our work is not, in fact, an "emergency". It may be perceived as one by the caller, someone may be out of control and need us to help restore control to them in a situation that overwhelms them, but don't for a minute think that everything we do is an emergency. The sooner you embrace that notion the more rewarding you'll find your career.

It has never ceased to amaze me when a 22 year old claims to be "burned out" in EMS. I know 40 and 50 year olds who still love their job in EMS. Why? Because they have realistic expectations and understand that what we do isn't an emergency FOR US!

If your profile is correct and you're really just starting out please try to remember this - and remember the guidance from other people who love the job - because if you go down the adrenaline junkie road you're bound for disappointment.

[Bnechis 3,961]

What about for the 2nd and 3rd due apparatus for an automatic alarm? That is a tough question and can only be answered by careful statistics. You would need to look at the number of apparatus accidents vs. number of stops on fires found by alarms, then compare the damage cause by those accidents vs. the damage of burning an extra room.

2nd or 3rd? What about the 1st due? Given the frequency of false alarms, are the risks of RLS outweighed by the potential of an actual incident?

That's my speculation. I believe 1st due should always go Code 3 to an alarm. Too much damage can be done by a fire in a short time. The 2nd and 3rd due are debatable, and I don't quite have an opinion myself.

About 2 years ago I did a stitistical review of our automatic alarms going back 21 years. We did more than 35,000 automatic alarms during that time. Approximatly a dozen (that did not also have an additional call to 911) turned out to be working fires. Statistically, we documented more working fires that were discovered when the rig drove down the road and spotted it (out training, inspecting even going to the store, etc.) Makes it tough to not take into accounty the potential accidents that saving 1 minute on 34,988 calls creates.

This of course increases safety but I have noticed a negative impact from the publics point of view. I have often been asked, "Why do you guys never use lights or sirens?" or "I hear the horn go off and then the trucks leave with no lights or siren..." could constantly responding non-emergency for "minor" alarms hurt our public image or make the public question our seriousness or level of effort?

Interesting, most of the time the public thinks we abuse RLS, if they even notice us at all.

as far as CO alarms for example. The Chief(s) on scene have CO detectors in their chief cars...do they need a rig with personnel to call it a malfunction? Can the chief make that distinction by investigating himself and instead of having trucks on the roads without lights or sirens, have them remain in quarters?

If you believe this, then why send rigs on any calls, just send the chief, or better yet; have PD check and advise. Look how much we could save if we dont need the rigs anymore. Maybe just the chief and a check book...at workers he can just write a check to the owner.

Also, for my curiosity, is a department held more liable for rig accidents when responding code or not code to alarms. In my opinion I feel the department would be more "screwed" if a rig is involved in an accident going to a alarm in non-emergency mode. Other parties involved and their attorneys may ask, "If there was no rush on apparatus getting there, why be responding at all?) Rant over...

I guess your rigs never leave the station for anything other than calls. No maintenance trips, no training, no reason your rig would ever be on the street? Since the law says that you must use due care with RLS, if in an accident & RLS, its your fault. If driving for any reason its who is mostly responsible by the situation. A number of years ago my wifes car was struck at a red light. she was stopped waiting for the light to change and a car ran the light hit her and a wall. The insurance companies (hers and the other guys) said it was 20% her fault because: "she got up that morning"

In My Corps, We Go Lights and sirens to every call (unless specified by the patient that they do not want to have a lights and sirens approach to their house). I like this policy becuase you can never rely on the dipatch information (not criticizing dispachers, I really apprechiate all you guys do) but it has been my experiance that what we get called out for is very different than what we have to deal with on scene, and you never know when a "diabetic emergancy" will turn into a cardiac arrest. (yes this has happened) We have lights and sirens for a reason, so use them, just not excessively

So you cant trust the trained dispatcher who may not know what the call is, but you trust the caller to know you dont need RLS? Many times I've seen people will let there loved one die or the house burn down before the embarrisment of RLS showing up in front of the house.

[INIT915 1,119]

While I understand that every call we go on may not be a life or death situation, they are always emergencies, otherwise it wouldn't be called EMERGENCY medical services... While the ultimate topic of this thread is about lights and sirens, I believe this is more a conversation about the individual drivers and how they drive on each call. You must always use common sense on a call and do whatever nessicary to keep the crew and the patient safe. So lights and sirens or not, just get the job done and stay safe.

Unfortunately, and as you will see as you have more time in the field, not every call we get is an emergency. In fact, quite a number of the calls made for "E"MS are not emergencies at all.

[INIT915 1,119]

About 2 years ago I did a stitistical review of our automatic alarms going back 21 years. We did more than 35,000 automatic alarms during that time. Approximatly a dozen (that did not also have an additional call to 911) turned out to be working fires. Statistically, we documented more working fires that were discovered when the rig drove down the road and spotted it (out training, inspecting even going to the store, etc.) Makes it tough to not take into accounty the potential accidents that saving 1 minute on 34,988 calls creates.

Capt. That was my point exactly, although admittedly mostly a hunch and from personal experiance, as I didn't have any data to work off of, but your research completely validates my hypothesis.

From a "cost/benefit" perspective, many of us misprioritize.

[RNEMT26 40]

I think sometimes the drivers of some rigs don't really understand what is going on. In my district there are people who are strictly just drivers and they think that they should go code 3 to everything. I think anyone who has been in EMS for a while (and as a couple people have said) knows that most of the stuff we do isn't a true emergency, so whats the sense in putting you or someone else at risk? I really dont think it's worth it. And to be honest, I hate going RLS unless it's an absolute necessity. The only txp I'll do RLS is an arrest or something that is evolving and getting worse. I don't need to have the injury or death of someone on my conscious, and esp if the call turns out to be a bunch of nonsense, and try explaining that to a judge. "Oh well your honor we thought it was a bad call because it was a P1/2 response" Yea that's not gonna help you. And as "minivac" said "you should use common sense," well hate to tell you guy but common sense aint all that common, stick around in this business long enough and you'll learn it realllllllll fast. When the adrenaline is pumping common sense for alot of people goes out the window and what you think might be the right thing to do is the farthest from it.

As far as solutions, you could do more training and awareness on the meaning of the priority system for those who don't have it. But when people hear a call "possible MI" i think the adrenaline is gonna hit and the sense of "i gotta get there ASAP" takes over. So I don't think education would have an effect. You could just scare people straight and find cases of people that were killed and/or seriously injured in accidents with vehicles going code 3 and maybe those images stick with people. You could pump out all the numbers n stats that you want, but i think what will take people to think twice about if they really need to be doing 90 MPH to a call or not... is an unfortunate tragedy. And don't get me wrong, I don't wanna see anyone get hurt or die doing this job, but people don't learn unless it's a significant or life altering event. And even after that some people might STILLLLLL not learn, so I just hope nothing bad like that ever happens to me or anyone else.

Edited September 9, 2010 by RNEMT26

[WAS967 97]

It pretty sad that here in Westchester there is no priority system for dispatching ambulances and medics to calls. The fact that I have to go RLS to every call I get dispatched to is kinda ludicrous.

[Bnechis 3,961]

It pretty sad that here in Westchester there is no priority system for dispatching ambulances and medics to calls. The fact that I have to go RLS to every call I get dispatched to is kinda ludicrous.

Thats not completele correct. We have a partial system based on priority dispatch thru 60 Control. Which currently only looks at type and number of resources and can implement the other if depts request. The problem is they can only do this if they get proper info from the caller and 70% of the time the local PD does not transfer the call to them.

[helicopper 1,050]

I think sometimes the drivers of some rigs don't really understand what is going on.

= Failure of management to properly train and supervise.

In my district there are people who are strictly just drivers and they think that they should go code 3 to everything.

= Failure of management to properly train and supervise.

The only txp I'll do RLS is an arrest or something that is evolving and getting worse.

Many of us will argue that there is no need to go lights and siren to the hospital with an arrest. It is difficult enough to properly perform CPR in an ambulance without being bounced around in the back by someone sailing to the hospital like that. With ALS on board there is very little else that the hospital can do to improve the outcome so it really isn't necessary.

When the adrenaline is pumping common sense for alot of people goes out the window and what you think might be the right thing to do is the farthest from it.

= Failure of management to properly train and supervise.

We need more leadership and direction within our EMS organizations. Management needs to be just that, management. You can't keep the marginal driver "because he's available on days" or allow below standard performance "because we're volunteers". There are some agencies who have excellent leadership and proactive training (both initial and ongoing) but they're not the ones we read about...

[helicopper 1,050]

Thats not completele correct. We have a partial system based on priority dispatch thru 60 Control. Which currently only looks at type and number of resources and can implement the other if depts request. The problem is they can only do this if they get proper info from the caller and 70% of the time the local PD does not transfer the call to them.

Ahhh, the problem of 40+ PSAP's in a county of less than 1 million people.