Priority dispatch

[oklahomamedic]

I know the larger systems have it, but what do the smaller companies do, say 2-6 units? My supervisor is constantly getting on my case for responding no L&S on B.S. calls, because we are level 1 or 0.

We were on our 5th call after midnight and dispatched to displaced peg tube. Both of us were exhausted and had no business driving C3. He never said anything, but I could tell it in his voice when I said, "we will be enroute C1."

Some people complain about transporting dead bodies C3 for no reason. What about the number of unecessary C3 responses we make? Dispatched to urgent care for DKA and find the patient with a sugar of 115. Obviously they did not make the effort to check on their own.

[spenac]

Lights and sirens are the death of way to many. Honestly the few seconds saved probably make no difference 99.999999999999999999% of the time.

[Christopher.Collins]

Im not sure what system our dispatch uses but whatever they determine its either, "respond hot" or, "respond cold." They are usually pretty well about determining priority level also. Aside from here and the private service I once worked for they are the only two agencies Ive been with that tell us how to respond. All other agencies just dispatch the call and typically (unless told otherwise i;e "with the flow of traffic" or "step up response per new complaints of___") the driver will determine response level.

Im sure its probably universal nationwide and maybe in other countries... but here in Connecticut while responding you are not considered a legal emergency vehicle unless your lights and siren are operated simultaneously. That being said if Im using one, I am almost always using both. There is enough responsability and liability on us as is in event of an accident that I wont take a chance. If some blind guy happens to be walking down a dark road and I hit him with just my lights running because its 0200, Im already at fault but regardless of my not knowing hes blind Im sure the prosecuter will be sure to prove I did not do everything in my power to warn him of my presence. Then on the flip side that same prosecuter will probably be the guy fighting for noise complaints at 0200 made by emergency traffic. Frankly, if Im responding to a legitimate emergency and someone makes a noise complaint, I dont really care... Im doing my job and that job is to help someone who has a little more trouble than sleeping at night.

Now... Im sorry if any of that comes off making me sound wreckless. Yes there are alot of calls we are dispatched to on a priority basis that do not warrant an emergency response, but untill we arrive we have only the word of the dispatcher who has the word of the (sometimes overly panicked) people on the other line. We can not diagnose a patient at our skill level so we can not determine en-route if some calls are not an emergency.

Instead of going balls to the wall though I will always exercise due regard. Yes I go the speed limit and stop at traffic lights and stop signs to clear the intersection before I proceed. During the day time I will always use my siren, unless your passing by a store front you cant tell if your lights are working, and people may not nessecarilly see your lights anyways. When I come to an intersection I usually select the most obnoxious sounding siren (usually the phaser) and keep it on all the way through along with my air horn. At night time, particularlly very late night or early morning I will run my lights only but regardless of where I am (a residential zone for instance) I will whail my siren and air horn at intersections, blind turns and blind driveways. On the highway, unless we are slow moving and there is alot of traffic I dont get on the siren alot... because of the doppler effect at certain speeds no one will hear it anyways. But yea, the highway is one place I never ever act like an idiot when driving. If anything I will go around 5mph under the limit.

As far as transporting codes... I leave that to the disgresion of the most senior person is in back. That person diserves just as much a chance to live as any other patient regardless of survival statistics, but as spenac says the few seconds you save usually make no difference.

[spenac]

As far as transporting codes... I leave that to the disgresion of the most senior person is in back. That person diserves just as much a chance to live as any other patient regardless of survival statistics, but as spenac says the few seconds you save usually make no difference.

Actually AHA guidelines say not to transport.

[CBEMT]

I know the larger systems have it, but what do the smaller companies do, say 2-6 units? My supervisor is constantly getting on my case for responding no L&S on B.S. calls, because we are level 1 or 0.

It would help to know what that means.

[JPINFV]

Based on the context, I'm assuming that level 1 and level 0 is having 1 unit available and having no available units respectively.

[toutdoors]

When working the ambulance, we are dispatched and our response mode is determined by the medics. If we are going to a 911 call that has fire EMS dispatched as well, it is emergent. On the fire side of the issue, we are getting better at calling the medic unit and telling them they can slow down but continue because there will be a transport, but there is no immediate threat to life. Such as the broken arms, cuts that will need stitches, and they want to go by ambulance rather than have the wife drive them in type of deal.

What I really love is when you get the transfer call from nursing home to hospital. So you get in the rig and go enroute, now when the dispatcher tells you you are going for chest pain, or lethargic/unresponsive hypotensive pt that has been this way for the past half hour, then we step it up and ask for fire EMS to be sent as well. There have been several snide remarks from the administrators at some of our beautiful (sarcasm) nursing homes that say we didn't need all these people here, but hey I don't mind putting a burr in some saddles so I don't care what they think. Then again, the whole nursing home scenarios could be dedicated to it's own post entirely.

At one time, when dispatch for the ambulance was still done "in house" and there were EMT's or medics working the dispatch, then the response mode was given during dispatch, ie: respond code 3, or code 1 type of thing. Now the city/county comm center does the dispatch for the ambulance, so it is kind of up to us in the street to determine our response mode, to a certain extent.

[crotchitymedic1986]

Take all the emotion and drama out of the scenario, and just deal with facts:

You are resonding to a call that is 10 miles away or 52,800 feet:

If you travel at 40 mph (.666 miles per minute),with no stops, you will arrive in : 15 minutes

If you travel at 50 (.83 miles per minute),with no stops, you will arrive in: 12 minutes

If you travel at 60 (1 mile per minute) with no stops, you will arrive in: 10 minutes

But we all know the faster you drive, the more likely you will be to make frequent stops and starts. Several scientific studies have proven that driving L&S only shaves a minute or two off of your call. Which is about the same amount of time that is wasted in the dispatch center. You are far better off to have a sufficient amount of ambulances, staffed by crews who know their territory.

P.S. Your boss probably has you responding to non-emergent calls L&S, so that you will not have to get the Physicians Certificate signed for medicare/medicaid.

[Arizonaffcep]

P.S. Your boss probably has you responding to non-emergent calls L&S, so that you will not have to get the Physicians Certificate signed for medicare/medicaid.

How you respond doesn't negate the need to get the Physician Certification filled out. Medicare doesn't care if you respond L&S or not. So...it still needs to get filled out. It could, however be an attpemt to keep a good response time for CON (at least here is AZ...CON=certificate of necesity, State's sanctioned monopoly for response, and is time guided by the applicant for the CON).

[crotchitymedic1986]

Guess things have change, I only had to get Phys Cert statement for non-emergencies.