Rural Scene Times

[Arctickat]

Why didn't you just transport?

[Guest ~~~]

Not sure if that comment was towards me or not, I will take it as it was. I work for the Sussex County EMS, we're a non-transporting agency. ( due to there's a vol. fire department that offers ems services every ten or fifteen miles down the road.) The problem with them is that they take so long to respond. So we come in as a rapid response, we have eight als utility trucks, usually rolled out, driving and waiting or stationed and ready to respond on a moments notice. (not all eight) If there's a call they are out of the door and gone within a minute (maybe two at most) we also have two division management cars for assistance to units out or if we are closer to the scene we will also respond with one of the als units, or if there's a big enough fire/accident we will respond to those.

[Arctickat]

Hmm, how do you feel about this response model? To me it doesn't seem to be in the best interest of the patient. Are these ambulances ALS agencies as well? Does your agency accompany the patient to the hospital with the ambulance or do you turn care over to them and return to your base?

I'm not trying to harass you or anything like that, I'm genuinly curious and trying to get a firm understanding of the concept. Up here we have jurisdictional areas assigned to us, it's pretty much impossible for an ambulance to beat another one inside their own jurisdictional boundary.

Edited September 6, 2012 by Arctickat

[Guest ~~~]

Personally I do not like the way it is set up. One of our paramedics will update the arriving emt's, and then will ride on the ambulance and the other will drive the truck behind the ambulance to the hospital. They will both bring in the patient, along with the other emts/fire fighters and have their own paperwork to do. If a division manager is called to the scene or he or she will also go to the hospital, along with a police officer if the injury was associated with a criminal activity. The ambulances are BLS, though our paramedics are on board most of the time.

- one more thing I'd like to add. Sure I don't like the idea of a ambulance not arriving on scene before other ems personnel that can not transport the pt. But it's much better than the pt waiting, if we can get there within eight minutes and start treatment when the fire/rescue dept. is just pulling out has better turnout statistics for the pt - just one of the problems living in a rural area.

Edited September 6, 2012 by PattonEMT

[Richard B the EMT]

PattonEMT, quick question. As a field Paramedic with your county EMS, if first in, did you have transport capability, or are you in a "Fly Car/First Responder" unit, and have to wait for someone with transport capability?

As I am not familier with your local system, do all EMS agencies in your service area, with the obvious exception of FD engine and truck companies, have transport capabilities?

[Arctickat]

I just don't like the position this puts you in Patton, for several reasons.

• I assume the medic is alone in an SUV or something of that nature. This leaves you with no support if you're attacked.
  
• If the patient needs to be moved you'll need help.
  
• Doing ALS treatments is typically a two person job. Sure, one can do it, but it takes much longer.
  
• If your company can get there sooner it could transport sooner if it had this capability
  

Like Richard says, we're not familiar with the way your system works and I may be way off base. With 2 exceptions I've never seen a valid purpose for an ALS fly car. Either it provides extra hands for an ALS unit already on scene, or it can meet a BLS unit enroute to the hospital. It makes no sense to delay BLS transport to wait for an ALS provider and it makes less sense to have an ALS provider stuck on scene all alone, unable to transport. This sounds like a system set up on that TV show "EMERGENCY!" but at least Johnny and Roy worked together.

Looking over your website it looks like your organisation is well equipped and well funded, it seems the only reason that your organisation doesn't transport is to avoid pissing off the IAFF. To me, that's a poor reason when patient care is the priority.

http://www.sussexcountyde.gov/dept/ems/

Edited September 6, 2012 by Arctickat

[Guest ~~~]

In each utility there is two paramedics, they are usually the first on scene. If they need assistance they will radio me in. Its not so common that I am the first on - though a good amount of times. Im in a SUV alone. As far as attacks go if the pt does not seem safely stable they will request police assistance and its up to the paramedics if they wish to arrive on scene before police arrives. In assistance calls they police usually hauls as fast as possible. Our paramedics 98% of the time on scene. our agency does not have any transport vehicles, we rely on the fire depts and private ambulance companies - like the vfw for example. But they take their time and the fire departments don't like them arriving on their scene anyway unless requested for asst. Like I said per truck there is two paramedics and one division manager per sub (there's two of those).

I think there was just a misinterpretation

I don't mess with their website, they do so poorly at keeping it updated. Two paramedics on there have left the agency and they are still on there and they lack to include me and another paramedic - but that's a whole different story (more like rant) - but they should explain how the shifts and units work

[Arctickat]

lol,@ the website comment. I understand better now. So you have 2 medics per response vehicle, which is a utility box on a truck. That addresses all the concerns I had with the exception of the quicker transport time. In my experience though, a few minutes likely won't make a lot of difference.

Who pays for your services? Is it all through county taxes or is there a user fee? If two ambulances or an ambulance and a fly car are sent to a scene from two different agencies, then there are two bills for the client to pay.

[Guest ~~~]

The fire department ambulances do not charge - they run primarily off town taxes and donations, or rarely funding from the USFA. We work off county taxes, donations, and sometimes we will receive money from the state at times.

Which I suppose counts as a donation

[Arctickat]

So people are donating to duplication of services...in a sense. An ALS response service and a BLS transport service. Has no one discussed amalgamation?

Edited September 6, 2012 by Arctickat