The Way We Dispatch Paramedics in This County Needs To Change

[x635 4,066]

Over the course of several years on this forum, there has been discussion over the allotment of Paramedic resources in Westchester.

 

As a former Paramedic, Firefighter, 911 Dispatcher, and scanner enthusiast, I'm tired of hearing ALS being dispatched to cut-and-dry BLS calls.  I believe the issue is deeper seated.

 

The way we currently do it is to send a Medic on everything no if, ands, or buts. But that has far reaching implications. We are going to face a Paramedic shortage at some point. Paramedic school is getting longer and more intense, and the people who want to put up with it and the low pay they get when they graduate is getting lower, while the cost to live around here is getting higher. Burning out Paramedics by having to go on these runs constantly is a real threat. Then there is the case of making the medic ride it in because BLS could only get a driver. We should not use this as a factor when dispatching Paramedics. 

 

Not to mention all the money that fuel costs and the wear and tear placed on the vehicles and equipment going to an 89 year old female who routinely pulls out her catheter. Some of money saved could be used to give Paramedics raises, which gives more incentive to be a Paramedic.

 

If EMD was properly used, and our dispatchers trained and trusted, we could utilize our resources better, saving them from the problems above.

[SECTMB 612]

All you have to do is look within your own departments and see that the number of active members, and I mean real actual active members, is not as many as a couple of years ago, less than a few years ago, even less than a decade ago.  For all the reasons that have been identified within these forums the ranks of volunteers is dwindling.  Certainly the way departments are dispatched affects this.  

 

How many times can you drop what you are doing to respond to an automatic alarm that turns out to be caused by steam from a shower or dust from construction workers? Or to be cancelled before you even get off the ramp?

 

And, everything now requires an ambulance.  The public has been over educated to dial 9-1-1 for even the most minor maladies.  It seems nobody gets to the hospital under their own steam these days. 

 

Eventually it will have to become all paid.  Since I left Westchester I have lived in three Southern counties that provided paid fire/EMS-Paramedic services.  Palm Beach County has some pretty pricey areas like Westchester but the other two were/are not nearly as wealthy as Westchester.  If they all can provide paid fire/EMS to their citizens, so can Westchester.  

 

And for those who keep bringing up that laws and fire districts and all that prevent changes, well, change the laws for the benefit of the people.  That's what legislatures and legislators are for.

 

 

[Bnechis 3,961]

The first step is admitting one has a problem, and since agencies can't or won't do that even after the 3rd or 4th tone out.

 

the leadership in most agencies do not want change! 

[FFEMT84 2]

The way calls come in to dispatch and what they actually are can be very differ rant and need als. To say a medic shouldn't be send to a so called cut and dry bls call and it goes bad then it has a trickle effect just saying 

[wedgeclose 59]

The abuse of "assisted living" complexes in calling for 911 response for falls and other minor occurances has taken its toll on the system.  In the case of Croton and Briarcliff the contract for ALS requires response by the Tri Village fly car on every call.  Many of those calls are then deferred to OVAC ambulance 2 BLS unit because not all shifts are covered by per diems in those villages.  It is an overload.  In years gone by it was not uncommon for an entire 12 hour tour to go call free...now in a 12 hour tour there can be 12 or more calls.  Abuse of the system?  It's going to catch up with us and there will be a real problem one day.

 

[Dinosaur 844]

On 3/11/2016 at 11:31 PM, x635 said:

Over the course of several years on this forum, there has been discussion over the allotment of Paramedic resources in Westchester.

 

As a former Paramedic, Firefighter, 911 Dispatcher, and scanner enthusiast, I'm tired of hearing ALS being dispatched to cut-and-dry BLS calls.  I believe the issue is deeper seated.

 

The way we currently do it is to send a Medic on everything no if, ands, or buts. But that has far reaching implications. We are going to face a Paramedic shortage at some point. Paramedic school is getting longer and more intense, and the people who want to put up with it and the low pay they get when they graduate is getting lower, while the cost to live around here is getting higher. Burning out Paramedics by having to go on these runs constantly is a real threat. Then there is the case of making the medic ride it in because BLS could only get a driver. We should not use this as a factor when dispatching Paramedics. 

 

Not to mention all the money that fuel costs and the wear and tear placed on the vehicles and equipment going to an 89 year old female who routinely pulls out her catheter. Some of money saved could be used to give Paramedics raises, which gives more incentive to be a Paramedic.

 

If EMD was properly used, and our dispatchers trained and trusted, we could utilize our resources better, saving them from the problems above.

 

 

There's no allotment of paramedics in Westchester.  Every little town, village, city, district chooses whether or not they will provide ALS and to what level.  Further, they dictate the response policies that will be followed. 

To not have a comprehensive EMS system in 2016 in one of the wealthiest counties in the nation is pathetic and we have nobody to blame but ourselves.  I could add the same about the fire service but that's for another thread!

 

 

[antiquefirelt 994]

I would think full implementation of any EMD protocols would be a great start. We have state mandated EMD, but they stopped short of mandating each town designate how medics are dispatched when they don't have any available. Our calls are triaged by dispatch (not infallible) and we send the appropriate resource per the dispatch code. Others will hold off calling a medic util they arrive to ensure the medic is needed, saving them money on needless requests, but costing precious time when they are. I wish I could report our EMD protocols were stellar, but we find that we now have a few issues that result in medic being sent too often for BLS type calls.

[amr6334 16]

I as well listen to the scanner in my neck of the woods.  Lodi Ohio.  We have our own Emergency Department and travel time is minimal.  From when crew gets on scene is a 5-8 mins transport to ED.  There is no need for ALS unless they are going with the crew.  Some of the outlying areas where its 15-20 mins or maybe longer maybe ALS could be needed.  I worked for Alamo EMS (RIP), Beacon VAC and Marlborough VAC (also RIP) where the magic powers were have ALS meet enroute to the hospital.  Is that something that could be done???   EMD protocols are only as good as the caller. 

 

CALLER Im having chest pain with pain radiating to my arm

 

Sometimes stands for "I shouldn't have had that taco earlier

 

A pulled foley catheter should never need ALS. 

[Remember585 815]

On 4/1/2016 at 5:16 PM, wedgeclose said:

The abuse of "assisted living" complexes in calling for 911 response for falls and other minor occurances has taken its toll on the system.  In the case of Croton and Briarcliff the contract for ALS requires response by the Tri Village fly car on every call.  Many of those calls are then deferred to OVAC ambulance 2 BLS unit because not all shifts are covered by per diems in those villages.  It is an overload.  In years gone by it was not uncommon for an entire 12 hour tour to go call free...now in a 12 hour tour there can be 12 or more calls.  Abuse of the system?  It's going to catch up with us and there will be a real problem one day.

 

 

Actually, your information is incorrect.  The Tri-Community ALS Unit (36M1) is only dispatched to ALS calls and, based on EMD, only certain BLS calls.  The contract - as far as I know in Croton, anyway - has not changed and the ALS unit is not sent to all EMS calls.