Rolling apparatus on EMS calls . . .

[doug_e 0]

We've recently begun rolling E92 on westside EMS calls and R37 on eastside calls. We're improving our SOG for this as we go along.

Does your department do this?

What are your experiences?

What are your thoughts?

[LCFD994 8]

I know in Lake Carmel we dont send apparatus to an EMS call unless extra help is needed, or the incident is on the Highway. For ALL PIAA's you get apparatus dispatched as well.

I think this holds true for most if not all of Putnam County.

I work in a system in Westchester where you do get apparatus dispatched to every EMS call, it is nice to have the extra set of hands on the scene with you. The only problem that we have ever run into is where they leave the apparatus. Sometimes they block the street and sometimes they block the residence that your going to. But, I have also known PD's that have done that as well. In both cases it has been few and far in between, and a great working realtionship has been developed among all departments involved.

[SHAC7301 0]

Doug....what"s the reason behind the change?

[doug_e 0]

For lift assistance and traffic control on scene.

[Guest alsfirefighter]

Traffic control? For all EMS calls? I understand MVA's and such but for all other EMS calls I don't see where traffic control really comes into play, if the term "for increased patient care" or "to better serve our customers" isn't in the reason, perhaps you need to reevaluate why exactly its being done.

With that said, I do think its great:

Another side note, as a EMS provider, a FD based one at that, and as one that works in several systems I think its always great to have BLSFR. If that is what you are providing. Having the extra hands is great if they are trained. If you are going to run I highly suggest that only EMS certified personnel be allowed to respond unless there is a need for lifting. Nothing is more aggravating then having too many hands and for your patients too many people mulling around as they are in what for some is a very private needing moment. Additionally what I have seen happen, is often because of our fire based ego's, you will have firefighters whom think they know it better, even when they aren't EMS certified or will want to do things their way or figure they can force their way onto EMS providers. You are going to have to immediately get that under control if that occurs. Also keep in mind that it is poor PR and customer service if a crew all arrives, no one is EMS and no treatment is being done. I certainly don't want a bunch of guys in my living room when I can't breath hoping the ambulance arrives soon, or just 1 person out of the bunch treating me while I have strangers staring at me.

994 hit it on the head, if you get out before the ambulance, the front of the house isn't yours, it should be the amublances. Also remember that they called for an ambulance so when a fire apparatus shows up you may need to explain why your doing it.

Just remember if you are going to do it, do it right or don't do it at all.

[doug_e 0]

That's why I posted the thread. We want to do it right and hearing added input is invaluable when building this enhanced service level.

The BMFD provides EMS for the village already drawing EMS members from the FD ranks. There is already an EMS mindset in the department.

We've been clear that the apparatus follows the ambulance to the scene. That no non-EMS trained personnel are to enter the premesis without orders.

Our primary reason to roll is to provide lift assist and get it there early rather than waiting an additional 10 minutes for it to arrive. Most of the time we are returned or do not respond at all. Apparatus placement at the scene provides a block for patient loading.

It's going to require some work but I believe it's a workable program and has quite a bit of positive PR potential. Granted there is always the risk of a PR nightmare, but we're mitigating that as much as we can.

Thanksto everyone, so far for their input.

[ex-commish 490]

Doug,

Just like you....we are a fire-ems agency. When 60-control bangs us out for an mva you are getting an ambulance and our rescue pumper. Even if the pumper isnt used it is a good means to block the scene, especialy on the highways in which we cover many of them.

Andy Mancusi

Asst. Chief

Hawthorne FD

[Guest alsfirefighter]

Doug,

So if the ambulance doesn't get out, the apparatus sits there? I'm just asking being you stated the apparatus follows the ambulance.

Also, again, I would be more geared to saying its a BLSFR program then to say for lifting, or blocking the scene for patient loading. On PIAA's and pedestrian struck and other roadway incidents ok. But I've never had a problem anywhere loading a patient for routine medical calls, especially those in Briarcliff.

It definately sounds like your on the right track. I know PD is sent on all calls when they are available as well. But I would definately run it as a BLSFR program and respond regardless who gets out first, apparatus or the ambulance. Good luck with it, and you definately have the right mindset, especially how you keep mentioning you guys reevaluate and adapt as needed. I'm sure I'll see you out there sooner or later.

[doug_e 0]

Andy,

Thanks for your input. Running a rig on an MVA is a neccessity these days. As I said at the start of this thread we are now running apparatus on all Briarcliff ambulance calls. We don't send apparatus to mutual aid, only in town.

ALSFF,

I believe we'll move toward the BLSFR as we grow into this. Until then we've decided to keep the apparatus in quarters until the ambulance is staffed and responding. This way we don't have a rig with medically untrained FF's sitting at the foot of the driveway while the s**t hits the fan inside (very bad PR). If we can't get the bus out we'll send the apparatus to help the mutual aid company.

As for the the blocking, we figure that while we're there we might as well position the apparatus such that it provides a secure patient loading area.

We've already had a few calls turn into "goat rodeos" so we've really locking down the operations.

Thanks for yor input as well...

[Guest]

In Larchmont We Send One Engine Normally Engine 33 To All Ems Calls As A First Responder.

[LCFD968 10]

I think if we did this we would never get the ambulance out. There are alot of times the rescue will sit filled with ff's and the ambulance sits with nobody or just an EMT. The officer would have to pull somebody off the rescue to go on to the ambulance. So, I could just imagine what would happen on ever EMS call.

[LCFD994 8]

In Larchmont We Send One Engine Normally Engine 33 To All Ems Calls As A First Responder.

Shawn, there sending out one or two of the Paid firefighters to every EMS call, unless obviously they are tied up doing another call. On the serious calls you get the Engine and Tower Ladder to the scene until LVAC gets there. Its to put more manpower on the scene if needed. It works pretty well, and I think the reason they bring the ladder is if they should get another call , nobody has to run back to get the ladder truck.

Its much different down there then up in putnam.

[BFD1054 1,552]

In Buchanan we run on EMS assists with Cortlandt VAC. We are toned out during daytime hours (usually 7am-4pm or whenever requested) & usually only on life-threatening calls. The policy seems to change every few years though lol. At one time, we responded to all EMS calls within the village 24/7. Then we responded to all EMS calls between 7am & 5pm. Now we only respond on life-threatening calls between 7am & 4pm as i stated before. Our 1st due EMS rig is our Rescue, which carries a BLS bag, AED, back-boards, collars, stokes & some other equipment. When the Rescue is OOS or tied up, we'll respond with our Rescue/Pumper which carries basically the same equipment minus the AED. If the Rescue is OOS, we will place the AED on the engine. I think its a pretty good system for us because as we all know, it can be hard to get a crew during the daytime, especially if the EMS agency is already on a run & you have to get a 2nd crew. We require that our active members have at least CPR/AED to ride on EMS assist's & all non-qualified members stay back at the firehouse, unless lift-assistance is requested. We have 9 or so EMT's in our company & the majority of them are pretty active. 4 out of our 7 officers are EMT's which is also helpful. We've been averaging 1 or 2 EMT's on each EMS assist lately which is a big help. The Rescue will roll with a minimum of 2 members (if they have the minimum requirements) & the only members allowed to respond to the scene are our officers. I happen to be an officer & an EMT, so if i don't make it to the rig, i will head to the scene to assist. Some of our members are also members of Cortlandt VAC, so they know the layout of their rigs & where their equipment is located, which is also helpful. We are also in the process of setting up in-house training with my company & Cortlandt VAC. We want Cortlandt VAC to come to our HQ with a rig & show our guys where things are located & also discuss what is expected of us & how we can further help them on EMS runs. Like i said, all in all i believe that it is a good system & has worked very well for us. Good luck Briarcliff with your new EMS response plan, it definately won't hurt, thats for sure! Your FD runs your EMS, you should use that to your advantage! Try to get the FF's & EMS personnel together & do some drills so that the FF's aren't just standing around being useless on calls! Anyway, good luck again & same to any other department that may start a similar program. As we all know, EMS has really started to become a big part of the firefighting world, so take in as much as you can learn!

Lt/EMT Michael Swankie

Buchanan FD

[JBE 328]

I think it depends on the situation. I can think of a few instances where we either had everyone on the Rescue and nobody on the bus, like Shawn said. Another time we had to wait like 6 to 8 minutes for the Rescue to respond to give us a hand with an obese patient in cardiac arrest. Another situation is if you don't have the manpower to roll the bus, roll something with some EMS equipment and get some aid there to help out before the mutual aid bus shows up.

[DMA327 12]

Quick Question...

You roll an engine out the door to help the mutual aid bus. You say you should have medically trained personnel on the engine...BUT, when the people requesting EMS ask why there's an EMT on the fire truck and why cant the guy driving a fire truck drive an ambulance...whats the answer gonna be?

[JBE 328]

I was looking at it from the CFR-D point of view. Better to have something than nothing.

[DMA327 12]

From a CFR stand point great idea to get the ball rollin if you have guys in quarters and someone needs immediate assistance. But what if you have EMT's on the rig who don't wanna ride, then what? Someone aint gonna be happy

[JBJ1202 27]

I am looking for more information on standard operating guidelines for those departments that assist ems on a regular basis. More importantly if it is really beneficial and worth starting such a system in departments that dont do it. I am particularly interested in local volunteer departments that do it.

[bmfd231 3]

In Briarcliff we send an apparatus with the ambulance to each in town call, either R37 for the east side and E92 for the west. We look to minimize crews to no more than 4.

For each ambulance call the appropriate truck is also paged. One important note is that the assisting truck is not to leave the firehouse before the ambulance. It is to communicate with the ambulance to make sure that its arrival coincides with them. The personnel on board the assisting apparatus are trained on the various ambulance features to actually be of assistance. Once they finish there task, they return to the fh. It works very well.

[ajsbear 11]

In re-reading this thread I will say as for going on all EMS call? Tom, I agree if you have too many people just standing around doing nothing or getting in the way it makes no sense. Plus it may make the paitient or family nervous. We all know everyone runs to make the rig and not everyone is EMS trained in any way. As for MVA's, the other day we were returning from wires down and GVAC was dispatched for an MVA with minor injuries but we were not. Our chief called Putnam and told them we too were going to respond. Good thing we did. There was smoke coming from the cars electrical system. Had we not gotten there and attended to that we could have ended up with a car fire on a flatbed. I think any time EMS rolls on an MVA it should be a joint EMS/FD response and only to MVA's should it be automatic. Other EMS calls, let the on scene medic deside if he/she needs FD assistance.