Flagstaff examines two-tier response system

[CBEMT]

2-tiered response defended

http://www.azdailysun.com/news/local/article_c81c2d05-9d2d-536c-9ed9-b109e7fd0ac1.html

It's a scene that can be witnessed every day in Flagstaff.

A call goes out of a man down behind some bushes near some businesses on North Fourth Street.

A few minutes later, a Flagstaff Fire Department engine arrives with three firefighters on board. The crew begins administering medical assistance to the unconscious man.

A short time after the fire crew arrived, a Guardian Medical Transport ambulance arrives with two crewmembers aboard.

Once the man down has been stabilized, the fire crew helps the ambulance crew put the man in the ambulance. Then, the fire crew hands the man off to the ambulance crew for transport to Flagstaff Medical Center.

Every emergency medical call in Flagstaff receives a "two-tiered" response of fire and ambulance crews.

While some jurisdictions in the country consider the two-tiered response a wasteful duplication of service, local emergency responders laud the system in northern Arizona, calling it a "model" service. Local emergency responders contend the two-tiered system aids with efficiency and provides the quickest, best service for patients in northern Arizona.

The first responders: Who are they?

http://azdailysun.com/news/local/article_729ac850-7d7b-5b3f-bf57-953416a61797.html.

Each fire station in the city is staffed with three certified personnel -- captains, engineers and firefighters.

"Think of a ship," said Deputy Chief Jerry Bills of the fire department.

Give two-tiered medical responses closer look

[This one's an editorial, posted a week after the other two articles. -CB]

http://www.azdailysun.com/news/opinion/editorial/article_a7fbb924-7362-5ba8-8224-94e351df254d.html

At any given time in the city of Flagstaff, there are three different agencies waiting to respond to calls that might involve a medical issue -- from traffic accidents to street alcoholics bumping their heads on the curbs.

Police officers, firefighters and Guardian EMTs all rush to the scene, driving squad cars, fire trucks and ambulances.

On paper, this level of response in a city of 60,000 seems excessive, and more than a few residents have wondered over the years whether it is medically necessary and financially sustainable.

But in practice, just sorting out how the overlap has developed and why can be difficult, much less determining whether the system can be made more efficient.

Edited April 13, 2010 by CBEMT

[Dustdevil]

[HERBIE1]

As we have discussed ad nauseum, each city has different needs and there are many variables which make direct comparisons between systems difficult at best. What works(or does not work) in a city like Flagstaff may not work in a larger city or in a rural area. A hospital based service may work well, but if they are owned and operated by the hospital, they are also not as dependent on turning a profit as a free standing entity. The hospital, for example, can absorb costs within their overall operating budget so their stated profits/losses/costs/expenses can be misleading.

[Just Plain Ruff]

why can't we go back to the good ole days of bringing them to Ole Doc Baker on the back of a horse drawn trailer. I'm sure the patients didn't suffer any more than the little girl in DC did, the reporter in DC did, nor the guy in the snowstorm.

As a matter of Fact, I'll bet good ole Doc Baker would have made his way out in that snowstorm and performed life saving surgery on the guy in his living room by candlelight.

Oh the good ole days.