Why not just send an ambulance?

[paramedicmike]

I saw this article referenced in another forum and thought I'd share it here.

Mesa FD response article

I'm not sure where they came up with the dollar amounts they cite. But why not use the savings to buy additional ambulances?

*****DISCLAIMER*****

Despite how this may appear, I am NOT attempting to start yet another us versus them argument. I merely found it interesting that a FD was finding it too expensive to send an engine out on medical calls so they opted to send out a non-transporting response unit with a paramedic and EMT.

If your intent is to fan the flames of discontent and turn this into an interservice bash fest, exit this thread now. If you have insight as to costs and why the FD would move this way, then by all means, join in.

Thank you for your cooperation.

-be safe

[AZCEP]

Just a guess based on what little I know about the situation.

Mesa FD has more stations and has shorter response times than the ambulance provider they work with, Southwest Ambulance.

They are able to respond a QRV with full ALS quicker than they can send a fully staffed engine company cheaper than buying out the contract and certificate of necessity that Southwest currently holds.

This way, they are still serving their tax base with ALS providers, and are not placed in a greater position of liability that would come from providing ambulance transport.

[Andrewtx]

I'm a little bit confused by a couple points in this article. Maybe someone can clarify.

The goal is to handle non-emergency, social service 911 calls such as rides to a hospital or falls in the most cost-effective way, Tucson Fire Deputy Chief Todd Pearson said.

I'm not sure exactly what they mean by this. Are they planning on transporting patients in these SUV units in cases where they can sit upright and buckled in? Or did the article just mean to refer to elderly RMAs where someone just needs a hand?

They are staffed with one paramedic and one emergency medical technician. If the call requires only basic life-support skills, they will cancel the engine or ladder, leaving it available for the next call.

If these units are already staffed with a paramedic, then why would they require an additional engine or ladder on scene for an ALS call? Needing an ambulance, obviously, I understand -- or an ALS engine if the hybrid unit is BLS. :?

[Just Plain Ruff]

I find this a good use of resources. How often is it that you actually need 4 firefighters on scene along with 2 from the ambulance?

I think it's a good utilization of resources. Free up the engines to fight fires and rescue calls and put the smaller fast response vehicles on the streets. The public is still getting their money's worth.

I've been on several calls where a full engine complement was on scene wiht me. I was unable to release one of the firefighters due to patient condition. That took the engine out of service for one patient. There were many times that that engine could have been the first arriving unit on a structure fire yet they were out of service working a medical call. It also meant a longer response time for other pumpers and a bigger fire.

I agree with this whole heartedly.

In the city of merriam Kansas, they have bls ambulances that respond with the als crews. This frees up the fire engines to run what they were designed to run - fires and rescues.

I think in the end everyone will benefit.

Great article.

[paramedicmike]

Ok...Knowing that transport units belonged to a different organization altogether would be good knowledge to have with regards to this type set up. The way the article was presented gave me the idea Fire and EMS were combined.

But then there's the concern with overtime versus serving the tax base. If you eliminate medical responses from the FD will this help reduce OT costs? In theory I suppose it could. Is there pressure on the company providing ALS transport services to increase the number of vehicles on the road?

I realize the focus of the article is on this new practice of the FD. But there are larger issues at play. Just thinking out loud.

-be safe

[Richard B the EMT]

(In case the article gets moved from availability from the newspaper...)

Mesa tests light emergency crews

But finances prevent continued use of 2-person units

Senta Scarborough

The Arizona Republic

Feb. 26, 2007 12:00 AM

Mesa is among several cities rethinking the way they respond to emergency calls in an effort to cut response times while remaining cost-effective.

Other fire departments including Glendale, Tucson and Phoenix have either tested or are using smaller, less expensive units staffed with two-person crews to handle certain types of emergency calls.

Mesa ran a 60-day pilot program last summer after City Manager Chris Brady challenged the Fire Department to come up with alternatives to handle medical calls and reduce response times. Medical calls make up 76 percent of fire calls there.

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The city used two-person crews of a paramedic and an emergency medical technician driving a light-duty truck on calls when a four-person crew on an engine would have responded in the past. The crew worked out of Station 203 in west Mesa, one of the nation's busiest.

Assistant Fire Chief Dan Stubbs said the program would be a cost-effective, temporary fix to reduce response times and relieve busier stations until more are built. Fire Chief Harry Beck said Mesa is four fire stations behind, and crews are stretched as the city grows.

Mesa firefighters have seen response times spike 27 seconds over the past two years. Mesa reached a scene in less than four minutes in 61 percent of calls; the national standard is 90 percent.

Mesa's program was modeled after a Tucson program that uses a half-ton truck called the Alpha unit, named after lowest-level calls.

The goal is to handle non-emergency, social service 911 calls such as rides to a hospital or falls in the most cost-effective way, Tucson Fire Deputy Chief Todd Pearson said.

Pearson estimated the cost at 50 cents per call for the Alpha units compared with the price of an engine responding at $2 to $3 per call or a ladder truck at $4 to $5 per response.

Three years ago, Glendale firefighters began using two-person, medic-roving units driving ambulances called "clock stoppers" to provide support for engine and ladder trucks during peak call times, Glendale Assistant Fire Chief Tom Shannon said. Now, they have three units.

They are staffed with one paramedic and one emergency medical technician. If the call requires only basic life-support skills, they will cancel the engine or ladder, leaving it available for the next call.

Mesa conducted the first 30 days of its program during the 12-hour peak call time from 7 a.m. to 7 p.m. and crews responded to 30 calls. The next 30 days were staffed 24 hours and the crews responded to 80 calls.

Despite the apparent advantages, Mesa says it can't afford to keep the program going this fiscal year.

Three weeks ago, Stubbs and Mesa Fire Chief Harry Beck asked for $246,000 in overtime from the city manager's office to fund a 24-hour, two-member Transitional Response Vehicle team and planned to launch it March 1, according to records obtained by The Republic.

They also asked for an additional $1.1 million for staff, equipment and vehicles for two units for next fiscal year, starting July 1.

But Brady turned down the request for the current fiscal year, saying there is no money. He added that the fire department is already $1 million over budget in overtime this year.

"I asked for it, pushed it forward, and I think it has a lot of merit and can work," Brady said Thursday. "Spending even more (overtime) didn't feel appropriate to do at this time."

Fire Deputy Chief Mike Dunn said funding for minimum staffing has not increased in several years, leading to the increase in overtime.

[FormerEMSLT297]

A couple of reasons why this is a good idea.

1. Smaller truck (as stated) keeps operating costs down.

2. Many Fire dept's keep their engines for 5, 10 even 15 years or more. This program greatly reduces the wear and tear on the engines, and trucks, which in turn keeps maintenance costs down, fuel costs, down, etc.

3. a lot of times as stated you don't need 4 or 5 FF at the scene.

4. The smaller trucks 4x4's suburbans, tahoes, whatever are more maneuverable and can get thru traffic faster, better and safer.

4. And one of the BEST reasons, keep the engines in service to fight fires.

[Dustdevil]

But seriously folks, can this really be about keeping costs down? I ain't no mathmagician, but I am pretty sure that simply providing enough ambos and paramedics to meet the demand for medical services is, in the long run, much cheaper than what it costs the FD to run this dual role nonsense.

It's not about saving money. It's about milking money and glory for the fire department because really, they aren't worth what they are getting as it is, much less if all they did was supression.

[Niftymedi911]

=D>

Well put Dust, I give you +15 for that one

[zippyRN]

But seriously folks, can this really be about keeping costs down? I ain't no mathmagician, but I am pretty sure that simply providing enough ambos and paramedics to meet the demand for medical services is, in the long run, much cheaper than what it costs the FD to run this dual role nonsense.

It's not about saving money. It's about milking money and glory for the fire department because really, they aren't worth what they are getting as it is, much less if all they did was supression.

RRV = 30 k gbp vehicle+ kit

Ambulance = 50 -120 k gbp vehicle and kit ( depending on ALS/ BLS and coachbult or van body)

Full sized fire appliance = 250k gbp upwards

single man staff your RRV and you save further ...

reduces the use of appliances and the 'cost per call' because the none Paramedic trumptons are standign around at the call tasked but not actually doing anything ...