Ambulance - Half A Crew

[x635 4,066]

Several VAC's in Westchester (and Putnam and Dutchess too?) have an paid EMT to help cover calls. I've been listening to my scanner, and several agencies still have trouble getting crews. Why not just hire another paid EMT so you have a full crew? What is the point of one EMT when you have to page multiple times for another EMT or Driver and not get one?

[STAT213 332]

All 'bout the Benjamin's.

[Jybehofd 85]

Yup trying to save the buck not a life

[SECTMB 612]

I don't believe it is common, widespread, public information when a person dies after a prolonged (two or three to mutual aid) response. Perhaps if there was more information on the relationship between dispatch, response and outcome it would prompt, if necessary, some changes.

[Jybehofd 85]

You don't want to see some of the times up here

[Bnechis 3,961]

Several VAC's in Westchester (and Putnam and Dutchess too?) have an paid EMT to help cover calls. I've been listening to my scanner, and several agencies still have trouble getting crews. Why not just hire another paid EMT so you have a full crew? What is the point of one EMT when you have to page multiple times for another EMT or Driver and not get one?

And the 4 or so other VAC's in the same town(s) are doing the same. It would be much better to take those 2 one manned ambulances and CONSOLIDATE into 1 two manned unit so response times would be reasonable.

Each of these agencies is paying 1 EMT to do 1 or 2 calls in 12 hours. Most city ambulances are doing 8-12 calls in that time.

Big waste of $$$ and the response times still stink.

[RES24CUE 168]

Plus EMTs are a dime a dozen...you can hire some pimply faced high school kid with a buff belt for like $9.00 an hour part time so that you don't have to pay for benefits. These losers will line up for the job tenting in their EMS pants at the $9.00 rate!

[Jybehofd 85]

or better yet in an area where a paid agency is the volunteers could all agree that after the third tones they go mutal aid to the paid agency. and to make sure they can support at least one bls unit in the area all calls from MD offices, Nursing homes and other frequent callers can go to the paid ambulance first to support it. So the truck could run 7am-7pm 7am-5pm monday thru friday. but i think such an agreement would have to have a pro-active group of people that would be willing to say there is a problem and this might help that problem. it would unfortunately take months to negotiated all the details out but in the long wrong it should almost cover itself. There would be a lose though with some days being slower then others. So from the paid agency side an upfront compensation may have to be established evenly or a more complex formula can be used to calculate that if a volunteer agency "X" had more mutal aid responses there over all percentage of total cost would be less at the end of the year or moneys could be returned from those said transports preformed by a paid crew. Thus the paid agency would have to bill the patients they transport, so since the ambulance was already covered for, the money the ambulance would bill for could thus eventually go back into the volunteer "X" operating budget or town. depending on who pays the cost. Im roughly guessing a BLS ambulance could run 300k a year give or take a few factors such as OT and all insurances. If that was split 10 ways for example it would cost about 30k a year per participant. on the high end it could be 50k-60k It would take some time to iron out how all the financials would properly work. But its just a thought and nothing more then that I have had for a few years.

[wcr20 17]

So by waiting for AFTER the 3rd tone failure, your response time is already 9-15 minutes and the patient is dead.

[Jybehofd 85]

Mmmm. Yeah that's about an average response time and you might bet the medic there depending on the call volume and location. And to tell the truth it's a good chance you might if your at the 9 minute mark. Things are backwards here

[wcr20 17]

Well - when I lived/worked up there - 99% of the areas that now have independent Medic response (ie: N Westchester, Putnam, etc.) did not

so the patient waited thru multiple tone outs to get anybody at all

[Billy 68]

Several VAC's in Westchester (and Putnam and Dutchess too?) have an paid EMT to help cover calls. I've been listening to my scanner, and several agencies still have trouble getting crews. Why not just hire another paid EMT so you have a full crew? What is the point of one EMT when you have to page multiple times for another EMT or Driver and not get one?

I agree with you Seth. I hear the same thing all the time with calls not being covered and I find it very scary the response times for many agencies. Something needs to be changed but as we all know, change is hard if not impossible in these parts.

[Billy 68]

I don't believe it is common, widespread, public information when a person dies after a prolonged (two or three to mutual aid) response. Perhaps if there was more information on the relationship between dispatch, response and outcome it would prompt, if necessary, some changes.

Thats an interesting thought. If the Lohud or Snooze12 did a story it might stir up some controversy. Unfortunately it will probably take some high profile tragic incident for that to happen and maybe get politicians involved.

[calhobs 110]

I remember a certain VAC Capitan telling me a 20 min response time is very acceptable.

[Bnechis 3,961]

I remember a certain VAC Capitan telling me a 20 min response time is very acceptable.

It is very respectable, but only when you consider that some agencies on some days take 60-90 to get a call covered.

On the same note its criminal that the homeless in every city get an ambulance in 8 minutes or less and a high end taxpayer gets a hope and a prayer.

[x635 4,066]

On the same note its criminal that the homeless in every city get an ambulance in 8 minutes or less and a high end taxpayer gets a hope and a prayer.

I don't want to hijack the topic, but I had to respond the above.

I was homeless for a period recently. Literally living on the streets homeless in Los Angeles. I was treated MUCH differently then someone who is a "high end taxpayer"....especially when you consider those "high end taxpayers" were living just a few miles away in Beverly Hills. I walked..no at that point dragged myself.....several miles to a hospital, making my condition/injuries significantly worse, because I was embarrassed and worried of the EMS stigma of homeless people abusing the system. I've paid both income and properties taxes for many years.....but unfortunately, I was down on my luck for a period of time....why should response times be any different for me when I was homeless then a "high end taxpayer"? Shouldn't response times be the same for EVERY human being, despite whatever stigma blankets a group of people? And maybe if we are worried about the "homeless drunks" abusing the system stereotype....maybe we should blame our healthcare and social services system....or even sadder, our VA system. Or, maybe our EMS systems not interfacing with a social service system to get people long term help. It's not as easy as you think for a homeless person to get the consistent long term help him/her needs. </rant>

[Bnechis 3,961]

I don't want to hijack the topic, but I had to respond the above.

I was homeless for a period recently. Literally living on the streets homeless in Los Angeles. I was treated MUCH differently then someone who is a "high end taxpayer"....especially when you consider those "high end taxpayers" were living just a few miles away in Beverly Hills. I walked..no at that point dragged myself.....several miles to a hospital, making my condition/injuries significantly worse, because I was embarrassed and worried of the EMS stigma of homeless people abusing the system. I've paid both income and properties taxes for many years.....but unfortunately, I was down on my luck for a period of time....why should response times be any different for me when I was homeless then a "high end taxpayer"? Shouldn't response times be the same for EVERY human being, despite whatever stigma blankets a group of people? And maybe if we are worried about the "homeless drunks" abusing the system stereotype....maybe we should blame our healthcare and social services system....or even sadder, our VA system. Or, maybe our EMS systems not interfacing with a social service system to get people long term help. It's not as easy as you think for a homeless person to get the consistent long term help him/her needs. </rant>

Seth I understand your experience and perspective on this is different than most. But it still does not change the fact that in Westchester the poor residence of many communities got ALS 25 years before the tax payers in many communities. We had agencies in Northern Westchester that were against ALS, even if it was free. The services provided and the response times in the worst neighborhoods in NYS, Newark, Yonkers Mt Vernon, etc. are vastly better than those in communities where the property taxes alone start at 50k.

[paratrooper75 41]

Several VAC's in Westchester (and Putnam and Dutchess too?) have an paid EMT to help cover calls. I've been listening to my scanner, and several agencies still have trouble getting crews. Why not just hire another paid EMT so you have a full crew? What is the point of one EMT when you have to page multiple times for another EMT or Driver and not get one?

My favorite is when two neighboring VAC's each have one EMT/driver on and get toned out and neither can get a full crew! Why not consolidate and rotate departments with a full crew? These two VAC's have a very low call volume so one full crew would be much more beneficial then two incomplete crews. The phrase "take it with the medic" is common place now.

[AFS1970 504]

How long are departments waiting before the second or third tones?

Way back in the dark days when I started in Dispatch we had 2 of our ambulances that were staffed like this at night. We had a policy that if they did not sign on within a minute we toned again, and if they did not sign on in 30 seconds after that we toned out the other ambulance. Now in practice this was too short a time because it could take the other half of the crew more than 90 seconds to get out of his driveway. In most cases there were designated crew members who could be at home but would take a radio with them and sign on to let us know they were wither going to the station or the scene, or even to call their partner for an intercept if the ambulance had to pass their house on the way to the call.

I have friends who volunteer in NJ and when they get toned out, even if they have signed up to cover for the shift, they call in either by radio (officers) or phone to tell the dispatcher they are responding. They only go to a second tone if no one calls in. I am not sure how long they wait but I think it is less than 5 minutes.

It seems to me that since mutual aid is by definition coming from a greater distance, waiting 12-15 minutes to even call them is too long.

[RWC130 594]

What VAC's in Westchester County have paid staff?

One EMT or Two?

[JM15 386]

Somers FD has two paid EMT's that are on the first ambulance out the door.

[x635 4,066]

My favorite is when two neighboring VAC's each have one EMT/driver on and get toned out and neither can get a full crew! Why not consolidate and rotate departments with a full crew? These two VAC's have a very low call volume so one full crew would be much more beneficial then two incomplete crews. The phrase "take it with the medic" is common place now.

Exactly!

It evens happens in busier VAC's too. Then usually after the mutual aid musical chairs is finally settled, another call always comes in and the game is started again.

[Bnechis 3,961]

This is all because to many agencies have forgot the only reason for existing is the patient and not for the organization or the members.

ITS ALL ABOUT THE PATIENT!

I wish the State DOH would start to question agencies that have a pattern of failing to respond or major delays in responding as to why should they be allowed to maintain their C.O.N.

[Brayidur 0]

I don't usually post but this one I feel I can at least chip in. In Dutchess county with the exception of the Big 3 career departments, at least a few of the volunteer agencies do roster their ambulance, on the over night, when most commercial ALS agencies will be coming out of the City of Poughkeepsie, or up in Red Hook. However many departments are now going to also having at least 12 hour dedicated ALS units, that work when the majority of the Volunteers are at work. But beyond that, it comes down to the crew, we have crews that stay at the fire house on their nights, and get off the floor sometimes before county is done dispatching, but there are also crews that take 2nd, 3rd dispatch to call out Driver/EMT alone, let alone get the rig off the floor.

[GAW6 66]

Mmmm. Yeah that's about an average response time and you might bet the medic there depending on the call volume and location. And to tell the truth it's a good chance you might if your at the 9 minute mark. Things are backwards here

Your profile states you are from Pleasantville. Is this the area you are speaking about? If so, where did you get your information / documentation from?

[velcroMedic1987 330]

There's no such thing as "half a crew". Either you have a crew or you don't. Paging for drivers, EMT's, or one of my favorites "attendant" is just compounding the delays. You should have to have a crew on duty (and I would argue that they have to be with the ambulance) so you can actually arrive in time to save a life.

If there has already been a 20 minute delay between the 911 call and the ambulance responding, turn the damn lights and siren off. You're no better than a pizza delivery guy at that point.

[sueg 77]

It may be besides the point, or maybe not, but one has to keep in mind that many of the calls are not always to save a life, but to help people who are sick, or cannot get up by themselves, or who are injured but not in danger of dying, or having a psychological emergency or episode or are drunk, or who had the flu for three days and call when everyone is now sleeping even if they do happen to be staffing inside the firehouse. Yes, we should get out as promptly as possible, and absolutely ASAP for the more serious calls and emergencies in which the patient is in extreme distress. But not everyone is going to die if we pass 9 minutes. Although I can understand the point of getting out faster, and wish it were always possible, especially for the patient's sake and comfort.

[Dinosaur 844]

It may be besides the point, or maybe not, but one has to keep in mind that many of the calls are not always to save a life, but to help people who are sick, or cannot get up by themselves, or who are injured but not in danger of dying, or having a psychological emergency or episode or are drunk, or who had the flu for three days and call when everyone is now sleeping even if they do happen to be staffing inside the firehouse. Yes, we should get out as promptly as possible, and absolutely ASAP for the more serious calls and emergencies in which the patient is in extreme distress. But not everyone is going to die if we pass 9 minutes. Although I can understand the point of getting out faster, and wish it were always possible, especially for the patient's sake and comfort.

That's like saying not all automatic alarms are fire calls. My question is how do you know when the actual fire or true medical emergency where minutes do count is going to occur? If we knew when that was going to happen we could all save a fortune by only staffing appropriately during those times.

Is this any different than fire apparatus responding with one or two guys on it?

[sueg 77]

Absolutely no difference, because you cannot tell just from what the caller told Dispatch whether the person who "fell" is really in cardiac arrest or just planking for fun; or the diff breather is a CHF patient about to drown or someone just having an anxiety attack; or the repeat AFA is really a structure fire or someone forgetting their code again; or the CO detector is a bad battery or the real deal until you physically get someone there to investigate and maybe pass the word back to the other responders. Which is why we try to get a full crew for both the ambulances and the apparatus as soon as possible so we can get there and do our job promptly with enough people to mitigate the situation whenever possible.

Unfortunately, some people do go by the intial Dispatch and think it is not worth their time to respond [AKA "not enough of a glory call"], or the trucks rush to be the first to respond without a sufficient crew to do so properly [AKA "Look at our great response time, but gosh, can't do a darn thing yet" or "Ooops, we took the wrong truck for the job" (or used the ambulance to get people there to helpbut do not have a crew to transport")]. Thank God for the core group of people who do take what we do seriously, and here's hoping it rubs off on the newer ones coming in down the line,

[v85 212]

I think the money plays a pretty big role in it.

For example, what is a small ambulance corps to do that doesn't have enough volunteers to cover a call, but doesn't have the population or volume to pay for 2 paid EMTs every day?

I know the answer in that case is really consolidation, but until that happens, isn't it better to at least have 1 trained responder to assess and start treatment before the crew arrives than to have nothing, or farming the task off on another service (like PD)