Collier County, FL; The battle is on

[WolfmanHarris]

Sorry Dust I should have been more clear. I understand why someone would want to dump the routine calls on someone else in lieu of glory and excitment. I see that crap in school everyday with the trauma junkies who tolerate the calls that involve more compassion and less toys and that barely. There's more than enough medics with this same attitude, they just don't get out transport when they drive an ambulance.

The main thrust of my question is how does any organization get approval for an ALS program that sees Paramedics arrive in a non-transport unit, extend their scene time while a transport unit waits outside and then sometimes not even put a medic in the back handing off to a BLS unit. Even more senseless, having an engine and ALS ambulance respond and have the transporting medics wait. I mean someone has to approve this system at a government level and while I don't vouch for the intelligence of any elected official, I can't see how this could pass muster.

So... how do these system sell this? What's their pitch?

[VentMedic]

So... how do these system sell this? What's their pitch?

Through fear. Florida citizens defeated one bad tax move earlier this year because the FFs didn't count on the public being educated enough to read a financial sheet. But, the majority of Florida already has FDs with all Paramedic FFs on ALS engines and ALS ladders.

California is also a huge state for these tactics. Here's some of their ads they are are running for this election:

Berkeley: Vote for a medic on every fire engine.

http://yesongg.org/index.cfm?Section=10&PageNum=78

Alameda: small island - They usually spend their day grocery shopping and hanging at the coffee houses or just driving their equipment around town. Yes, they do get the occasional fire and medical call but it is still a small town.

http://www.savealamedafirehouses.com/

Let's not forget the power of the unions on a city government. Vallejo, CA was a great example of that.

http://www.sfgate.com/webdb/vallejo/?appSe...n=7441898916846

Put Fire Dept in the box and come up with almost 100 names that earned well over $100,000, some over $200,000. And, this is not even San Francisco.

[WolfmanHarris]

Thanks for the links there was some excellent insight in there. Up here very few FD's have made an active effort to take on EMS. Some services have a combined admin with two divisions but that seems to be working okay at the local level. City of Kawartha Lakes was an amalgamation of a bunch of small rural towns around the medium sized town of Lindsay. When they amalgamated all the VFD's and EMS were brought under CKL Emergency Services, of which EMS is one of two divisions. From what I understand it's worked well for a few reasons. The townships no longer have to pay for duplicate administration for each VFD. The FF's are volunteer and seem quite happy to stay that way. The Chief of the EMS Division isn't an FF and the overall chief lets him run his own show.

Once again, here's what I don't understand (nor do I expect to). I read the Berkley site right through and read their justification for PMD/FF's and how it was based on strategic placement of Fire trucks and response time. My first thought was, couldn't an ALS transport ambulance be placed at each of these same stations, have the same response time and much quicker to hospital time? I know, it seems almost too easy.

I've said it before, I like Firefighters. I like cops too. Ditto for nurses and doc's. Heck the garbage-man and my mailman are both quite friendly. It's not about knocking the waterfairies, it's about knocking the people who make the decisions and try to feed these lines of BS to us on behalf of them. And about those FF's who buy the line hook line and sinker. I can at least grudgingly respect those who know they're only doing it to protect they're jobs.

[CBEMT]

Damn.... this guy has big brass ones! Go Doc!

[firedoc5]

There are Rescue/Pumpers. During my FD career we converted a couple of new pumpers we got, few and far between, but they seemed to have worked out nicely. And we did have one "rescue truck" that was actually a type III ambulance that we could transport if it were in dire need. A few times we did deem it necessary to transport, including myself at least four times that I can think of. Talk about the flack flying over that. But say if you're in a hostile situation with a serious/critical pt., and transport had 10 min. ETA, are you going to just hang around? I don't think so.

It's a long story but I'll keep it short. When the city FD decided to go into EMS there was already a private ambulance service in business. They were in business before EMT's were known as EMT's. But for one reason or the other, whether it was for more state monies, increase in population, the Johnny & Roy Syndrome, the FD was wanting EMS. The owner of the ambulance service was furious to say the least. And he had some major political pull, more or less he had a lot of low friends in high places. But they did finally come to the agreement that FD, in the city only, responded to all EMS calls for treatment. But so did the ambulance serv. for transport and assistance. Yes, it took a few years to get things worked out. Luckily by '84 when I started working for that ambulance serv. things had been ironed out and the cooperation worked very well. Of course as with any "mutual agreement" there are bumps in the road.

Those in the city were not charged for EMS treatment from the FD or city. Totally tax supported. The private service was able to bill for the transportation. But come to find out, they started charging for ALS services. They were charging for the use of a monitor, when it was the FD's, etc. But then they started itemizing. They charged if a spine board was used, c-collars, etc. no matter what agency's equipment was used. And if there were ALS personnel that responded on the ambulance, even though their main duty was just for transport, they charged for that too. That was a BIG bump for a while. But by the time they got that ironed out I'd already got on the FD full time, along with at least three others from the same ambulance serv.

I know some of this may sound piddly, it was a town of just shy 20,000 residents at the time. But our call volume was high per population. So it was like a small city with bigger city problems at times.

[pguy280]

[Just Plain Ruff]

What will end up happening, they will replace the medical director with someone who is more flexible towards the fire departments.

[jbanagas]

It all goes back to the prime point being made here, which is that FDs traditionally want all the money and glory that comes with EMS, but don't want to commit fully to it. They only want the sexy patients. They're too good to deal with the routine. They want to scream to the scene, save the day, get on the news, and then be back in their recliner chair before the patient even arrives at the hospital. Typical fire service selfishness. It's never about the patients. It's all about the firemonkeys.

Ironic how the group of people who most often beats the altruism drum in this country has become the most selfish and narcissistic.

I take it you been reject once or twice from being hire with an FD. This great nation should just go back to Johnny and Roy, why fix it if it ain't broke.

[JPINFV]

This great nation should just go back to Johnny and Roy, why fix it if it ain't broke.

You've got to be joking. Anyone who thinks that LA and Orange County EMS setup is progressive has no clue what they are talking about. Fire based EMS: Where the expectations are so low that they aren't even expected to interpret a 12 lead.

[jbanagas]

You've got to be joking. Anyone who thinks that LA and Orange County EMS setup is progressive has no clue what they are talking about. Fire based EMS: Where the expectations are so low that they aren't even expected to interpret a 12 lead.

Yeah, but at least you can make up to 100k a year with little OT.