Collier fire-EMS merger may get resuscitated Monday

[crotchitymedic1986]

I am sorry, in the fire department example I gave, EMS was county but seperate from Fire (I should have said that). But with that being said, when the budget dried up the also merged with Fire. Whats funny is that all those years when EMS was seperate, the medics were begging for the day they would go under Fire, now that they are there, they are singing a different tune.

PS: and the funding difference is that not every US citizen has insurance, and most americans are not willing to be taxed at the rate necessary to provide the level of EMS you propose. Compound that with EMS decisions being based on a county by county process, its no wonder it is screwed up.

[WolfmanHarris]

Okay that makes a bit more sense. Otherwise I'm going to leave this be. I'm already getting five types of deja vu from this discussion.

[FormerEMSLT297]

Although this is obviously an attempt to grow union jobs, sending a fire truck first is not always a bad thing. ...edited for length .

I thnik what i saw was that they do not always send a transport unit.. I understand the the fire truck may be closer, and therefor go first,, what i do not understnad is the delay in sending transport for 3,4,5 minutes to wait till the engine gets to the scene......

The whole Sheriffs thing is born out of the Broward .... www.sheriff.org having taken over all Emergency service units in that county... Fire, EMS, LE, Jail, and helo ops... It was a power play by Ken Jenne, , a few years ago....

Youd have to ask someone for South FLA if it is working out or not....

[crotchitymedic1986]

I agree with you on priority 1 --- life threatening calls, but on a non-lifethreatening call, why send an ALS ambulance when you can reasonably assume that transport is not needed (roach in ear, cut finger, etc) and can send a BLS or ALS fire truck ?

Even if the ambulance is only tied up for 20 minutes, a priority 1 call could come out where that ambulance was, just a few minutes after being dispatched to the lower acuity call. Keep the ambulances available for real calls.

[WolfmanHarris]

Because you can never assume transport is not needed.

See DCFD. I would way rather see an Ambulance with proper staffing on scene able to say "Nah this needs to go to the hospital" and go, then have one medic and four guys with their thumbs up their buts and nothing to do saying the same thing and starting a response from a cold start.

[crotchitymedic1986]

Well that would be a nice world, one with more ambulances than you need. But it isnt today's reality in most large urban centers. So you do have to triage your calls, to keep transport units 10-8. Which isnt to say that you couldnt have some EMS ALS first responders who went to low acuity calls to keep the transport units available. And although anything is possible, a roach in the ear or a cut finger (even if amputated) does not require a 6 minute response from a transport unit. And the vast majority of calls on any given day, are not life-threatening calls that require that response. Like I said, a priority one call should get an ALS transport unit response, but there are many calls that can be handled be a BLS unit.

I am glad that you work in an area where this is not a problem, but in most major cities, this is the way it is done.

[WolfmanHarris]

Right these non-life threatening calls need a dedicated single role provider with the education and clinical judgement not to cock up the minor call either. WHOA! Deja vu all over again.

Personally I'm really excited that the service of my choice put out their long term budget recently that calls for huge expansion in facilities and units on the road. York Region EMS is planning to replace 15 ambulances and place 13 new units on top of that on the road between now and 2015. $11 million for a new operations centre/station in one town. Upgrades to stations current shared with VFD's and another new station out in the boonies. Why? Because current services weren't keeping pace with increases population and call volume.

There's recognizing a crappy reality and there's accepting it as unchangeable. Recognizing is good, accepting is not.