'Weather' or not to call medics

[x635 4,066]

'Weather' or not to call medics

Local officials must vote on proposed change in ambulance-dispatch procedure.

By TOM JOYCE

For The Evening Sun

Posted: 04/14/2009 01:00:00 AM EDT

It happens often during snowstorms, according to Cindy Dietz, director of York County 911.

A driver will spot a car that apparently went off the road and call 911 to report an accident.

Maybe the driver of that spun-out car is injured and is in dire need of treatment. Or maybe all he needs is a tow truck.

What's the best way to handle it?

FULL STORY: http://www.eveningsun.com/ci_12133446?IADI....eveningsun.com

[v85 212]

Do they use "medic" to mean ALS or to mean ambulance?

I know in Orange County on the highways a reported crash brings State Police, Fire Department (if they respond to medical calls, or if there is a reported fire or fluid leak), and BLS.

If the accident is reported as head-on, rollover, or into a pole, tree, or guardrail; FD is automatically dispatched and ALS is as well.

I'm not sure if winter makes a difference

[ckroll 101]

This goes back to the idea of tiered response and how one makes the decision on what resources to send. The object is to get the appropriate resources to most of the jobs most of the time. If the standard is every job, every time, then towns have to overstaff most of the time to be able to handle high call situations.

What isn't done that might be useful would be an incident alert, short of sending EMS. If an investigative vehicle is responding to a scene with unknown injuries, advise EMS or ALS so that those units can perhaps start assembling or moving into position, non emergency. If ALS is rolling towards a potential scene and something more significant drops, it can be diverted. A key concept is getting someone who can make the call on scene in a timely manner.

Back in the day...SP would not dispatch fire or ambulance in our town to Parkway calls until they confirmed it was needed. There were patient reports of hour long waits for assistance and in one case of a car wrapped around a tree, the engine compartment split open, the engine was cold when we arrived, so that car and that patient had been sitting for way too long.

Obviously we don't send a helicopter to every job because that would be silly. A paramedic, while less silly, may still be too much, and even BLS response as an emergency with airhorns howling seems to me to be too much for AA's with unconfirmed PI. But someone able to make a decision needs to get there. One way to bridge the gap could be non emergency EMS response of some kind that either stages in the vicinity if police are minutes out or does a drive by if police are detained.

[helicopper 1,050]

During inclement weather, when response and turn-around times are going to be longer anyway, EMS agencies should assemble crews in quarters and staff all the available vehicles they have. It does seem a waste to send fire and EMS to every car off the road during a snow storm but perhaps putting a couple of fire and EMS people in a 4WD vehicle and having them respond with PD "to investigate" these jobs and serve as first responders when someone is actually injured would be a prudent and effective idea.

While many will argue this, most trauma calls are BLS and can be treated and transported without a medic and suffer no adverse affects. So the issue of sending medics on every car accident call shouldn't be that big a deal. The few medic units that we have should be strategically located to be available for as many calls as possible. In severe weather, they shouldn't be pulled to one side of their response area or another on calls that can go BLS. When the really serious job pops up they're available and can do the most good for the most critical patient.

[v85 212]

I know during the storm two years ago, I believe that is what they did. All VAC's along route 17 went on standby, and each corps would send someone up and down their area of 17 to look for MVA's.

You could also have your PD officers cross-trained as EMT's. I know of at least one department in Orange County that does, and they have a health dept. number as a non-transporting EMS agency. This way if there is something they can provide some care before the rigs get there.

[Guest]

For those that do this for free I think it is a huge disservice to them to require them to stay at the quarters of their agency. Of course it helps response times, but how about the fact that these people have their own things to do. Turn around should be lightening fast for both volunteer fire depts and ambulance services, the labor is not getting paid to be there, why have them stand around!

[helicopper 1,050]

For those that do this for free I think it is a huge disservice to them to require them to stay at the quarters of their agency. Of course it helps response times, but how about the fact that these people have their own things to do. Turn around should be lightening fast for both volunteer fire depts and ambulance services, the labor is not getting paid to be there, why have them stand around!

I'm sure that the victims of the MVA's we're talking about are really worried about inconveniencing the crews of the ambulance that they need to get them to the hosptial. If people don't want to do the job required of them - and sometimes that's "standing around" (in a building with heat, food, water, cable TV, internet, and other amenities) - then they should rethink their commitment to the job. EMS is not a hobby and our treating as one is a major reason why it is so screwed up. I am a strong advocate of volunteer EMS but am tired of excuses from the volunteers that the training takes too long, the calls take to long, or whatever else is the complaint du jour. Either do the job or don't. If an agency can't do it with volunteers, then they should hire the people necessary to do the job right. If more volunteer agencies rostered full crews instead of hoping that they can cover calls when the tones go off, there would be less discontent because you'd know when you're expected to be immediately available and rigs should get out faster.

As someone else said in another post, "you volunteer once when you join - after that it's a commitment".

[Guest]

For those that do this for free I think it is a huge disservice to them to require them to stay at the quarters of their agency. Of course it helps response times, but how about the fact that these people have their own things to do. Turn around should be lightening fast for both volunteer fire depts and ambulance services, the labor is not getting paid to be there, why have them stand around!

There are plenty of departments that don't have home response, you have to be in the station (and close to the rigs) to make the call... I've never heard anyone complain.

[Guest]

I think this could be something for another thread. These people do it for FREE. Chris, you get paid, I do not see your profile as saying you do it for free, and the other poster has just started. I have been involved in this for free for 15 years and for a job almost 8. I find it strange that while at work we are back and forth from a BS run in about 15 minutes, when no one is getting paid, almost 45. You look at the information about how many man hours are used and its such a waste. Nothing going on, let the people go home! Commitment is not to giving up part of your life for something, it is about giving up part of yourself.

[helicopper 1,050]

I think this could be something for another thread. These people do it for FREE. Chris, you get paid, I do not see your profile as saying you do it for free, and the other poster has just started. I have been involved in this for free for 15 years and for a job almost 8. I find it strange that while at work we are back and forth from a BS run in about 15 minutes, when no one is getting paid, almost 45. You look at the information about how many man hours are used and its such a waste. Nothing going on, let the people go home! Commitment is not to giving up part of your life for something, it is about giving up part of yourself.

This might be fodder for another thread but it fits just as well here. First off, not all "volunteers" do it for free - if they receive LOSAP or other inducements/benefits it is not free. I will assume that for our purposes we're discussing those who are actually doing this in the spirit of volunteering and are not receiving any form of compensation. As for me personally, well this isn't about me nor is it necessary for me (or any other member) to defend my opinion but since you asked: my job in law enforcement is paid, yes, but I have been involved in volunteer fire and EMS (way more EMS) as a unpaid volunteer for decades so I might just have something to contribute to the discussion.

Back to the topic. NO, commitment isn't giving up part of your life but it does require giving up some of your time - for training and to do the job. If you're able to clear an EMS job in 15 minutes I'm going to speculate that you're working in a community with a hospital. That makes a big difference on turn around time. When you've got a 15-20 minute ride to the hospital in good weather, it only stands to reason that it will take longer in inclement weather. The same can be said of response times. If it takes 5 minutes to get to the ambulance and another 5 minutes to get to the scene and another 5 minutes to actually reach the patient in good weather and double that in bad weather what happened to the victim's viability? There are response time standards for EMS and doing it for free doesn't give you carte blanche to ignore standards or regulations or pick and choose your calls. Too many people in the volunteer sector feel that they should receive special consideration because they volunteer. The illness or injury doesn't care who's treating it and all the patient wants is a competent professional to take care of them. They don't discriminate based on paychecks.

I find it ridiculous that people who assert that they are "EMS professionals" won't staff an ambulance for a shift or two instead of just being on-call. I've heard FD's tone out to staff the apparatus during inclement weather and all I've suggested in this thread is that EMS considering doing the same thing.

If that's what is required to do the job right, then do it. If a volunteer isn't willing to do the job right, I'd rather they didn't do it at all. But hey I'm a paid cop what do I know.

[Guest]

I would hardly call getting 400 dollars in 35 years pay or compensation, especially when if I put 20 bucks in an account for each time I was sitting there for 20 minutes waiting for the 'sheet' to come back cause heaven forbid that we need to keep it to one sheet cause it is so difficult to scan it with the barcode reader.

The point is I volunteer for the community, just like everyone else. Socializing is fine, but when I turn out, I want to come back as soon as possible. If I wanted to hang out I would hang out, but because the Chief wants to BS with the Trooper or get involved in something that is NOT our responsibility we all have to suffer?

It keeps a lot of people from responding, especially at night.

I also do not work in EMS so 15 mins for a turnaround on an EMS run would be like just dumping them and running. I have no idea how long those runs take.

[WAS967 97]

Sounds like you need to find a different line of volunteering.

[helicopper 1,050]

I would hardly call getting 400 dollars in 35 years pay or compensation, especially when if I put 20 bucks in an account for each time I was sitting there for 20 minutes waiting for the 'sheet' to come back cause heaven forbid that we need to keep it to one sheet cause it is so difficult to scan it with the barcode reader.

The point is I volunteer for the community, just like everyone else. Socializing is fine, but when I turn out, I want to come back as soon as possible. If I wanted to hang out I would hang out, but because the Chief wants to BS with the Trooper or get involved in something that is NOT our responsibility we all have to suffer?

It keeps a lot of people from responding, especially at night.

I also do not work in EMS so 15 mins for a turnaround on an EMS run would be like just dumping them and running. I have no idea how long those runs take.

The IRS considers it compensation and I think most taxpayers will consider it compensation.

We're not talking about socializing or hanging out at a scene - we're talking about making EMS resources available in a timely fashion when adverse weather conditions will impact response times. If you're not in EMS then this argument is really moot anyway. The fact is that time matters and if EMS providers want to be professionals they'll make sure the ambulances are staffed when they need to be, including sometimes on stand-by.

As for your discontent about sheets and barcodes or officers and troopers, perhaps you should address that within your agency as it is clearly not the subject of this thread.

[Guest]

It works for both EMS and FD runs. You just dont get it. these people are here for free! it should be as fast as possible. If you let them go and you need them again just call em back.

Edited April 20, 2009 by roofsopen

[helicopper 1,050]

It works for both EMS and FD runs. You just dont get it. these people are here for free! it should be as fast as possible. If you let them go and you need them again just call em back.

I get it, believe me. I get that you want to show up and get your job done as quickly as possible so you can go home. But I think we're just on opposite sides of the issue. I think there are plenty of people who would rather give up four hours in one shot than respond to random pager calls (sometimes only to find out the call is covered before they get there). And I know that I'd rather do four calls consecutively without leaving and returning, leaving and returning, etc.

Rostering may be inconvenient to some but the reality is that more people are inconvenienced by pager calls. With a roster (whether in-house or not) only 2-3 people need to respond for a call. Without a roster many have to drop what they're doing to cover a call and still only 2-3 are needed.

We don't have to agree and we probably won't. That's OK.

[Guest]

That I agree with! I am not really questioning the staffing of EMS facilities at all, but to require it is kind of unfair especially when we all have other requirements. Things should be fast! But you and I probably do not think like everyone else. I want to do what needs to be done and return, to the Station, what ever, just get me out of there, unless of course its at a all girls college, then Ill stick around :-)