AMR takes over Fire Dept. EMS

[zzyzx]

http://www.stocktongov.com/news/pr2010-8-31fireparamedicsorderedstopals.cfm

[HERBIE1]

The article does not mention WHY the change in service. It must be political. Too many questions. Like- who was originally responsible for the transports?

I'm not a fan of most fire based EMS services, but if the FD never provided the transport to begin with, why would you deny the fire paramedics the chance to render care until the ambulance arrives? This sounds incredibly stupid and a lawsuit waiting to happen. I highly doubt this will last for very long.

[CBEMT]

I'm not a fan of most fire based EMS services, but if the FD never provided the transport to begin with, why would you deny the fire paramedics the chance to render care until the ambulance arrives?

Because of the costs and risks associated with ALS first response that can not be countered with any corresponding decrease in mortality?

[PamelaAnn]

As a medic who works in San Joaquin County (including Stockton), AMR has had the transport contract for some time now. Stockton FD has been an ALS service for years, and at one time did transport as well, but after AMR won the RFP for this county in 2005, AMR took over sole transport in Stockton, Lodi and Tracy. Until September 1st of this year, Stockton FD still performed ALS services except for transport. We shall see what the future brings.

[DartmouthDave]

Hello,

From my point of view it seems like an awkward system to have the FD arrive start treatment and they had over transport to a 3rd party such as AMR.

How dose this work? Dose the FD medic go with the AMR crew all the time, sometimes or never?

I think a call could get congested. There could be a log jam of fire trucks and ambulances at each call. What dose the FD respond in? An ambulance? A Fire Truck? Chase Car? How many people? A full crew of four fire fighters?

Also, the AMR crew may not agree with the treatment rendered. But, despite this you have to haul them to the ED. Or, catch flack if things went poorly.

Lastly, I think, it would be sweet deal for the FD. Respond. Treat. Leave. While (for most calls I assume) the AMR crew drives to the ED, dealing with triage and possible sits and waits for a bed.

IMHO.

Cheers

Edited September 16, 2010 by DartmouthDave

[HERBIE1]

Because of the costs and risks associated with ALS first response that can not be countered with any corresponding decrease in mortality?

Well, obviously there would need to be numbers to back up such a statement, but since the majority of first response is about PR, even the appearance of "qualified" help is enough to appease most people. Most people have no idea if someone is qualified, if they have the right resources and/or training or not, unless they make a major screw up.

Hello,

From my point of view it seems like an awkward system to have the FD arrive start treatment and they had over transport to a 3rd party such as AMR.

How dose this work? Dose the FD medic go with the AMR crew all the time, sometimes or never?

I think a call could get congested. There could be a log jam of fire trucks and ambulances at each call. What dose the FD respond in? An ambulance? A Fire Truck? Chase Car? How many people? A full crew of four fire fighters?

Also, the AMR crew may not agree with the treatment rendered. But, despite this you have to haul them to the ED. Or, catch flack if things went poorly.

Lastly, I think, it would be sweet deal for the FD. Respond. Treat. Leave. While (for most calls I assume) the AMR crew drives to the ED, dealing with triage and possible sits and waits for a bed.

IMHO.

Cheers

In many areas, EMS calls indeed look like a disaster response. Tons of people, although many are standing around with hands in pockets- quite impressive. A first responder fire apparatus, an ALS equipped apparatus, an FD or other transport unit, maybe a supervisor, maybe PD, etc. It's all about appearances, but some folks do wonder why they ask for an ambulance and get fire trucks. Even if the care received from the FD is top notch, they still need a way to get to the hospital, and there are NEVER enough ambulances- FD or 3rd service. The dirty little secret of EMS is that the transport component of a medical response is ALWAYS the limiting factor, and one that is usually overlooked.

[CBEMT]

Lastly, I think, it would be sweet deal for the FD. Respond. Treat. Leave.

Of course. The only thing they have to do to "prove" their value in the EMS system is to get there before the ambulance. In many systems, the fire dispatcher takes the 911 call, dispatches a fire company, THEN notifies the ambulance company dispatcher. The protocol is designed from the ground up to make sure the ambulance is running second.

Well, obviously there would need to be numbers to back up such a statement

Pretty much my point- anyone wanting to maintain a system like Stockton's should be able to prove that ALS first response changes outcomes for the better. It won't happen.

[Kiwiology]

Well its lesser of the two evils anyway,

[Richard B the EMT]

As to FD based EMS systems, transport or not, I am on record here, admittedly unsupported by any documentation, that FDs that ASK to do EMS work, are usually more successful, or at least happier, than FDs that are ORDERED by the local political scene, to do EMS work.

[HERBIE1]

Pretty much my point- anyone wanting to maintain a system like Stockton's should be able to prove that ALS first response changes outcomes for the better. It won't happen.

Assuming there is no other behind the scenes drama going on, the only numbers that matter are dollars and cents. If the city can provide the service cheaper, that is the direction they will go. I would bet it's also a pissing contest between the city and the FD. Traditionally, public service is the sacred cow(as it should be)- the last to be affected by budget issues, the last to endure lay offs, etc. I would bet that the FD overplayed their hand, and failed to take into account just how bad the economy is right now. Departments are seeing cutbacks, fire houses are closing, members are being laid off- it's unheard of in the business, but these are desperate times. Are they in the middle of contract negotiations? Did someone on the FD commit a major screw up recently? Is someone on the department running for public office, or speaking out against the city lately?

Again- there's more to the story- the city simply did not decid to yank the services of the paramedics for no reason.