The best service in the country

[Ridryder 911]

Okay the main point would be there are bad, fair and even good systems. Some that are better than others. Size, and location is irrelevant... what some lack other may provide ..vice versa. The main point is to provide the best patient care possible and treat employees with respect and provide safe, and effective equipment and comparable wages and benefits.

R/r 911

[emtbyker]

As for KE5EHI, I'm not attacking, but why in the world would you put System Status Management (SSM) as if it is a good thing? SSM has been proven to be ineffective for several reasons, back problems sitting in rig, poor crew rest and how do you guess where the next call will be? If SSM is so effective why don't fire departments and other EMS agencies do it? It's different to move units during a major incident to cover an area, but to just move units to move units is just plane dumb. SSM belongs in the trash can, your back will thank you for it.

There's a lot of EMS agencies doing SSM. As for Fire. It seems like it would be kinda nasty moving entire engine companies around all over the place. Moving one rig and a couple of folks around is easier. Fire response times increase when there are multiple incidents in the same area. Make that three+ and everything goes to pot! The good news, multiple fire incidents don't happen in the same areas with the incredible regularity that multiple EMS incidents do.

Case in point: Riggs Station 31 (Atwater, CA) has SSM stats that show that when one call goes down there's a high likelyhood that another will go down shortly thereafter before the next station can meet response times. It's spooky but it's true. So Riggs tries to keep two Riggs at the station, even though they may go hours without a call. When one happens, another very, very, often does.

EMSA uses System Status stats to change the posting model to meet historic load requirments.

As for stress on the crews...

At Riggs where I used to work they mixed SSM and 24-hour stations and it's a major nightmare. Getting toned up at 0200 because the status dropped and you needed to go cover a post along the side of a highway for 5 hours.

Now, take SSM and mixed it with HPEMS & 12-hour shifts it makes sense. It works for AMR ALCO. It works here too. Sure, we get crazy busy sometimes, at the moment more often then not. Even though I've been here only a couple of months, and my street time at this point is limited, there's a rhythm to it. Sometimes you get into a posting loop, but most of the time you run about a call an hour. EMSA East gives us 20 minute drop times and with the Medusa Tablets it isn't hard to make that.

I'd much rather run 12 calls in 12 hours then 10 in 24 hours. Back problems? We're often not in the trucks enough to worry about it!

I like to run calls, always have. I was wrecked during most of my 24-hour shifts at Riggs. The 12-hour shifts sucked because they were either near or after a 24-hour shift.

Sure, I'm still a tater, but I'm already happy with my choice to come to work here. EMSA East is something special. I left California to come here. We're staffing up to increase the number of trucks on the street too. P+ really seems to take retention seriously and they know that staffing up is key to doing that.

I finished that academy last week. There's a reason why EMSA folks have an attitude, we're trained well and given great equipment and protocols to get our jobs done. The academy was kind of like Paramedic graduate school. It wasn't as much about following protocols, we did that in the first 2 weeks. It was about thinking, feeling and knowing what to do. I thanked the folks that put it together. I think that every service that uses 12-lead and ETCO2 cap should be trained the way we are. Of the paramedics I know that have 12-lead in their protocols I know very few that really know how to read them and don't just read the top. Before everyone jumps down my throat I know there's a lot of folks out there that know how to really read 12-leads, but how many services in the US really take the time to train their folks on 12-lead and ETCO2 cap. A handful at best. EMSA is one of that handful.

--- Nancy

[Dustdevil]

Before everyone jumps down my throat I know there's a lot of folks out there that know how to really read 12-leads, but how many services in the US really take the time to train their folks on 12-lead and ETCO2 cap. A handful at best. EMSA is one of that handful.

It's a sad, sad state of affairs when an employer has to teach any medic to do something that they should have been one-hundred percent proficient at before graduation. It is also a sad, sad state of affairs when they have to put on a class to teach something that can be learned from a book in one weekend of independent study. And it is a sad, sad state of affairs that so many certified medics are really just too stupid to grasp 12-leads, no matter how it is taught.

Nobody is saying EMSA sucks. In fact, we've all acknowledged that EMSA does some great things. But anybody who thinks they are "the best" obviously has very little EMS experience. And just because a lot of systems use SSM does not make it a good thing. There are lots of things used in EMS that suck, and SSM is one of them.

[emtbyker]

Nobody is saying EMSA sucks. In fact, we've all acknowledged that EMSA does some great things. But anybody who thinks they are "the best" obviously has very little EMS experience. And just because a lot of systems use SSM does not make it a good thing. There are lots of things used in EMS that suck, and SSM is one of them.

I hope you're not saying that I have very little EMS experience. I've worked in two of the larger systems in the country and worked in several urban ERs (and one smaller EMS system).

As for SSM, I agree that it has problems, but, from a deployment angle what would work better for busy urban EMS?

Staff up 24-hour stations like fire, everywhere? SFFD tried it and they're moving towards 12-hour shifts now. It looks like in the end they will move to SSM.

How do you meet sub-10 minute response times? Saying that you don't need to respond that fast doesn't cut it. Also how do you cost effectively blanket an urban area with enough trucks to handle volume without being able to move them?

I'm not trying to sit here and say SSM is the be all end all. I just haven't seen anyone in this string of posts (and others) say what would be better. There any many Fire based EMS systems in the country that have moved away from station based EMS to SSM or brought a private service into or back intro their response area.

PLEASE... point me at some web site that has a study that shows a really workable, proven, model for urban EMS response.

I'll be completely honest. I worked as an executive in the computer industry before I came to EMS. Unlike many field medics I do think about the bottomline.

To sum up my opinion (and it's just that), SSM is often misused. In smaller urban or urban/rural systems the difference in number of trucks needed is maybe 10%-20% (in many cases another 2-3 trucks would mean no need for SSM). But, to move off SSM in a system like EMSA Tulsa wouldn't we really be faced with needing to add more like close to 50%-100%? Even then, you might still run into response time issues.

Willing to be educated...

--- Nancy

[mediccjh]

I think that anyone who works for a service and loves it there and is happy is going to (maybe wrongfully) guess that it would be that way for anyone who worked there. Maybe to them IT IS the bestest place in the world. But, everyone is entitled to their opinion, and I am sharing mine.

You are a wise medic student, and hit the nail right on the head.

A lot of people bash the place I work at full-time. Yeah, it has its problems, but I am happy there, and in my opinion, it is only my happiness I care about.

[etfink]

I hope you're not saying that I have very little EMS experience. I've worked in two of the larger systems in the country and worked in several urban ERs (and one smaller EMS system).

As for SSM, I agree that it has problems, but, from a deployment angle what would work better for busy urban EMS?

Staff up 24-hour stations like fire, everywhere? SFFD tried it and they're moving towards 12-hour shifts now. It looks like in the end they will move to SSM.

How do you meet sub-10 minute response times? Saying that you don't need to respond that fast doesn't cut it. Also how do you cost effectively blanket an urban area with enough trucks to handle volume without being able to move them?

That is exactly what we do in metro phoenix with SW Ambulance, have stations either out of firehouses our our own. We have a 1min mark to go enroute and a 10min response time. We just move when the toner goes off. I love it! I work 10 days a month. I would never go to a system with 12s. For those that like them great I mean no disrespect I am just very firm in my prefrence.

[Dustdevil]

I work 10 days a month. I would never go to a system with 12s. For those that like them great I mean no disrespect I am just very firm in my prefrence.

Do you have any intention of ever going to college?

Good luck!

[etfink]

Do you have any intention of ever going to college?

Good luck!

If you are refering to my spelling error of "preference"? If so wow great job! You can cut people down not just for their level of certifaction but for a spelling error. If not and this is an actual question please ignore my sarcasim. I have gone to college, and a have a BS in Nuclear Engineering.

I don't mean to start any problems Dust and a 8 yr vet. I thank you for your continued service and wish you the best.

Stay safe,

Eric

[Dustdevil]

If you are refering to my spelling error of "preference"? If so wow great job! You can cut people down not just for their level of certifaction but for a spelling error. If not and this is an actual question please ignore my sarcasim. I have gone to college, and a have a BS in Nuclear Engineering.

Sorry for the misunderstanding. No, it wasn't a cut down. It wasn't a shot at you at all. I didn't even notice your spelling errors. But, now that you mention it, there were three in your reply too. Spell check is fast, easy, free, and reflects positively on your professionalism.

My comment was specifically relevant to your firm preference for 24 hours shifts. Think back to your college days. Could you have attended a M-W-F or T-TH class while working 24 hour shifts? Very doubtful. If you were by some miracle able to pull it off, you would be giving up a lot of study time, as well as missing quite a few classes. My only point was to let you know about the biggest drawback to 24 hour shifts that you might not have been aware of.

If you are going to make a serious career of this, you still have a lot of college ahead of you. And it is extremely hard to do on your beloved 24 hour shifts. That's why they suck. Of course, most medics don't care because they are too big a loser to go to college anyhow. :roll:

You gotta remember, unlike yourself, a great many medics didn't get into EMS because they were interested in higher education. They got in because they were too stupid for higher education, and they can play with the siren with only a month of school.

[etfink]

Those are good points about college and I am sorry for getting so fired up. I am lucky, in my system we are large and diverse enough that people can work rotating 24s, static 24s, or 12s. Looking at it from a broader point of view I can see how other agencies would not be able to support that kind of flexibility.

Hopefully there will be more formal EMS education ie college that I will have the chance to attend in the future. You an I are in strong agreement that that is what our profession needs to be thought of as true professionals.