EMS Refusing a Standby

[Guest problEMS]

Did I just hear correctly...an EMS agency to remain nameless...was responding to the fire in the Town of Mamaroneck and when they were advised of their role in the incident, they refused to standby and cover the district.

FYI it sounded as if there was ambulances from every area remotely close to the scene of the fire. When pulling up it sounded as if there were people out of every window, even reports of someone trapped on the fire escape in the back.

Interesting...I wonder how this agency would react if roles were reversed

[LTNRFD 266]

If the agency will remain nameless, can you say what type it was? Municipal, volunteer or commercial?

[notch138 7]

If the agency will remain nameless, can you say what type it was? Municipal, volunteer or commercial?

I dont think that it matters what type of agency this was. The big picture is they neglected to do there duty and acted and a most unprofessional matter just by refuseing a call after finding out the details. Would they of done the same thing if it was a tramatic arrest, or an MCI. The fire department is not only A: Required to have an ambulance stand-by at all structure fire's (at least thats my understanding). and B: Count on EMS being readily available on scene in the event that something (God Forbid) happens to one of it's members.

I hope that the agency that these people work with have/are takeing action on this, along with reporting to the state EMS Bureau.

Edited October 10, 2010 by notch138

[Bnechis 3,961]

I hope that the agency that these people work with have/are takeing action on this, along with reporting to the state EMS Bureau.

Since not every EMS agency has signed the county mutual aid plan, those agencies are not required to provide mutual aid. There are also not legally entitled to recieve it. The state EMS Bureau will do nothing about it. But the county has the legal ability to deal with (them not being a signatory to the plan) it if they wanted to.

Does the agency have a policy that they will respond to a call, but not a standby? What if they have no one to cover their district? Does that change it?

[LTNRFD 266]

As BNechis stated not all agencies are on board with the mutual aid pact. If it was a commercial ambulance that was not going to be able to bill a patient and decided there was no money in a stand by so they refused. Or is it someone trying to make a statement about having enough EMS units or not standing by at a VAC????

This wasn't an abuse of the system situation, it was an M.C.I. (potential) situation.

[NJMedic 96]

Perhaps they knew they would not have the resources in town to handle other emergencies if they send a truck out on mutual aid. I tend to doubt it but that would be avalid excuse in my eyes

[helicopper 1,050]

I think the type of agency is relevant. Commercial ambulance services are just that - commercial and they don't want to see their limited resources tied up at a stand-by. (I'm not saying I agree, I'm just considering the commercial perspective.)

As for the EMS needs of this incident...

How many ambulances were on scene already standing by?

How many injured were they attending to? How many people were being evacuated from the building?

Is it correct that the stand-by that was refused was to cover the district not respond to the scene of the fire?

I ask these questions only to get a better sense of what the morning was like. Thanks to anyone who can shed more light on the situation.

[StOpGoBlUE 11]

Could it be that the agency that was called was extremely busy covering there first due response area???... A lot could have played factor in this... Glad everyone was safe though great job done by all

[Bnechis 3,961]

I think the type of agency is relevant. Commercial ambulance services are just that - commercial and they don't want to see their limited resources tied up at a stand-by. (I'm not saying I agree, I'm just considering the commercial perspective.)

The two commercial services inthe southern part of the county (Empress & Transcare)have always done standbyes.

As for the EMS needs of this incident...

How many ambulances were on scene already standing by?

How many injured were they attending to? How many people were being evacuated from the building?

NRFD has a policy that at least one officer (in addition to those assigned to the MA rigs)is assigned when we go out of town. This is ussually either myself or the dept. Safety officer. When this call came in Car 2302 advised me that he would cover and the safety officer would back-up. I continued to monitor, but did not respond. I heard Bat 15 request a total of 5 (not including L/M Vac) for 2-4 patients. At least 2 pts transported. Red Cross was requested for 20 families and since things were still confusing, requesting 5-6 ambulances was very reasonable, even if some might be put into stagging.

Is it correct that the stand-by that was refused was to cover the district not respond to the scene of the fire?

I do not know, but....L/M VACs building is only 4/10 (2,100 feet) of a mile from the fire scene, so staging there either to cover the town or the fire would have been a reasonable location.

[helicopper 1,050]

Just to clarify, I'm asking questions to get more information and a sense of what the job was like. Not to criticize.

It is entirely reasonable to have 5 ambulances standing by at a fire of this magnitude even with no patients produced yet. I remember a fire in another nearby community that had even more staging so whether 5 or 15, that was the IC's call and I'm not saying it was wrong.

To those who may have interpreted my questions as criticism, I hope this clarifies things. If it doesn't, feel free to PM me and we can discuss it further.

Thanks again to those who have added insight to the thread.

[Goose 188]

Can someone possibly clarify what exactly the obligations of the mutual aid agreement are? I'm curious to know if an agency (ie: any agency that is signed onto this plan) is obligated to send a bus even if that would leave their primary response area without an ambulance.

Stripping one's primary response area - which may be busy already - as some suggest, may have been a concern last night. I think we can all understand that and i think its a fair concern. I know many fire departments have pre existing plans in place for call back of members to staff reserve apparatus, do these departments strip their respective municipalities prior to called back members arriving or is a minimum contingent maintained until reserve apparatus can be staffed?

Because i have no first hand knowledge of what occurred, i think this may serve as an interesting talking point. When i worked in dutchess county, one of the things they did extremely well was pre planning. I know this has always been a fire department thing (something that FDs seem to do fairly well, generally speaking) but if i recall properly there were established MCI levels within the county. Every level dictated the number of ALS & BLS and where they were coming from. Naturally as you went up in incident severity more resources were sent but always sent in and rearranged in such a way that no one particular area was left without ambulance to respond on normal call volume.

It seems like establishing something similar to the dutchess system would avoid refusals and confusion in the future.

Either way, glad to see everyone was safe and got treated but sad to see something like these become an issue...

[Ga-Lin 86]

I'm a little confused, not living in Westchester cty. and up on all events, the issue for me would this.... when was the refusal to respond given. I don't think that commercial vs volunteer is relevant. While it is true that commercial services don't usually respond to stand - bys (if you don't transport you don't get paid), it also depends on their relationship with the agencies they serve/work with, contracts and, as in 9/11 where a commercial service responded & members of that EMS only organization also gave their lives at ground zero, responding on their own because they believed their services were needed. (Unfortunately, we know now that this was not to be the case, either you walked away or didn't).

Volunteers are often quoted as saying "I'm a volunteer but I'm also a professional". Well if the crew (or organization) refused to respond after being informed what their role was to be ("the hell with that, I'm not going to sit on my A** while others are at the scene") this is the height of unprofessional behavior. Unfortunately I've witnessed this behavior many times when everyone & his brother turn out for "the hot jobs" Cardiac arrests or big trauma jobs that get the adrenaline flowing, but takes multiple tones to assemble a crew for the sick old lady vomiting up in a bucket because she just went through 6 wks of chemo & radiation.

I also don't by "leaving our district uncovered" excuse either. If you're part of the mutual aid system, after responding you call the next agency to cover & so on as everyone cascades in. Even not being part of a cty plan, every agency faces times where events overwhelm resources & outside help is needed. I would hate to be the agency (weather part of mutual aid system or not) when asked for help, refused & were then the ones overwhelmed the next week asking for help.

I'm guessing, at 2am, that this was an individual crew decision, in which case they do need to be spanked and the organization needs to do a little "begging your pardon" to their neighbors.

That's my view.

Edited October 11, 2010 by Ga-Lin

[Bnechis 3,961]

Can someone possibly clarify what exactly the obligations of the mutual aid agreement are? I'm curious to know if an agency (ie: any agency that is signed onto this plan) is obligated to send a bus even if that would leave their primary response area without an ambulance.

"Section 6: OBLIGATION TO RESPOND

Each participating EMS agency must forthwith respond to any call for assistance from another EMS agency pursuant to the provisions of this plan, through the coordination of the county Emergency Services Communications Center. This obligation to respond does not include unavoidable circumstances, such as maintenance problems, shortage of manpower, or if the agency already involved in an emergency or other call."

Yes, you if you are able to respond (but it would strip your area) then you are obligated to respond. This was debated at length, but the issue became what is the responsibility to respond if you only own 1 ambulance (so any mutual aid out would strip your district) and everyone agreed that if you dont give mutual aid, you are not entitled to recieve it.

[huzzie59 75]

WESTCHESTER COUNTY EMS MUTUAL AID PLAN 2003

http://www.westchestergov.com/emergserv/ems/PDF_Files/MutualAidPlanDec03-v5.pdf

[NYMedic37 22]

I'm a little confused, not living in Westchester cty. and up on all events, the issue for me would this.... when was the refusal to respond given. I don't think that commercial vs volunteer is relevant. While it is true that commercial services don't usually respond to stand - bys (if you don't transport you don't get paid), it also depends on their relationship with the agencies they serve/work with, contracts and, as in 9/11 where a commercial service responded & members of that EMS only organization also gave their lives at ground zero, responding on their own because they believed their services were needed. (Unfortunately, we know now that this was not to be the case, either you walked away or didn't).

Volunteers are often quoted as saying "I'm a volunteer but I'm also a professional". Well if the crew (or organization) refused to respond after being informed what their role was to be ("the hell with that, I'm not going to sit on my A** while others are at the scene") this is the height of unprofessional behavior. Unfortunately I've witnessed this behavior many times when everyone & his brother turn out for "the hot jobs" Cardiac arrests or big trauma jobs that get the adrenaline flowing, but takes multiple tones to assemble a crew for the sick old lady vomiting up in a bucket because she just went through 6 wks of chemo & radiation.

I also don't by "leaving our district uncovered" excuse either. If you're part of the mutual aid system, after responding you call the next agency to cover & so on as everyone cascades in. Even not being part of a cty plan, every agency faces times where events overwhelm resources & outside help is needed. I would hate to be the agency (weather part of mutual aid system or not) when asked for help, refused & were then the ones overwhelmed the next week asking for help.

I'm guessing, at 2am, that this was an individual crew decision, in which case they do need to be spanked and the organization needs to do a little "begging your pardon" to their neighbors.

That's my view.

I have to agree strongly with this post. I have seen this type of unprofessional behavior before. Especially the multiple tone outs for the "Non" hot jobs. Its actually disgraceful that some EMT's would be selective as to who they will respond to and who they will not respond to. No integrity.

[Truck4 48]

Two things from what I know: Transcare (NRFD) responded with 30A1 and transported (1) civilian to Sound Shore. Empress was requested for an M/A bus to cover Mamaroneck Village, Town and Larchmont.

[StOpGoBlUE 11]

Who are you to degrade any service.... And how do you know it wasn't busy in **** and they couldn't send any units ? Do you know the facts? And reasoning why they couldn't send an ambulance...????

Edited October 11, 2010 by helicopper
Reference to specific agency/territory removed.

[GAW6 66]

I have to agree strongly with this post. I have seen this type of unprofessional behavior before. Especially the multiple tone outs for the "Non" hot jobs. Its actually disgraceful that some EMT's would be selective as to who they will respond to and who they will not respond to. No integrity.

I have also witnessed this behavior and think it is absolutely disgusting! That is why all EMS agencies need to do scheduling. This way there is no "picking and choosing" the types of call or the facility that the call is at. Like I say to my members "just think if it was YOUR family member waiting for the ambulance". As far as I am concerned, WHOEVER the agency was, they were paged out and have an obligation to respond.