Not gonna go there about volunteers but...

[scratrat]

[web:b00cc58f57]http://www.hudsonreporter.com/site/news.cfm?BRD=1291&dept_id=523585&newsid=18389834&PAG=461&rfi=9[/web:b00cc58f57]

[Dustdevil]

Luckily for you, you don't even have to discuss the volunteer aspect to find so many things wrong with this scenario.

When somebody proposed having a separate forum for each state here at EMT City, I was opposed. But I am seriously starting to think that Jersey needs its own forum. :?

[scratrat]

Sounds like a good idea...

[Yummymedic05]

I don't always feel you can blame 100% of issues on the volunteers. In the county I worked in, the county only had to cover with volunteer BLS units....no ALS HAD to be here, but the hospital ran the ALS units. All the county was volunteer (except for one city that had ALS), and lots of the volunteers didn't answer calls. So sometimes people had to wait 20 minutes for an ambulance. If residents would learn about these issues BEFORE moving into an area some of these issues wouldn't occur in my opinion.

[medic001918]

So sometimes people had to wait 20 minutes for an ambulance. If residents would learn about these issues BEFORE moving into an area some of these issues wouldn't occur in my opinion.

Well I agree that people moving to an area should research the available resources, there is also a responsibility of a service that's already in place to provide reliable, time effecient responses. And I'd be willing to bet that somewhere on paper there's an agreed upon response time between the service and the town. It's a question of how much that repsonse time requirement is enforced. To blame the person for living in an area that provides unprofessional and poor services under the banner of being a licensed emergency service is very much out of line. Maybe the town should recognize the problem and step up and address the matter. That might be a better thing to have happen than to have the potential resident have to figure it all out on their own prior to moving there.

Shane

NREMT-P

[ghurty]

The time onscene for the first responder (the police officer) was crazy.

In the NJ town that I am in we have a multi-tiered system that seems to work quite well.

First of all, during the day (when there are less vollys around) we have a paid squad that runs out of the police dept.

But in any 911 call, the call goes directly to our local PD dispatch, they will simultaneously dispatch EMS (based on the protocl, they also decide whether our not to request a mdeic unit). as well as a police unit.

All our Police officers are Certified First Responders, and some of them are EMT's as well. In any serious call, the PD will be there quite fast, I have heard them being given orders to break off from a different call (like a traffic stop) in order to get to a cardiac call.

So usually less then 3 minutes after the call goes out, emergency care is already started.

Also, we have three squads in town that cover different areas, for a serious call, it goes out automatically to all three squads, so there is no wait time to see if the squads whose area it is in is able to cover.

Our dispatchers also are pretty easy on letting medics transport (even though NJ state law says that they can only do it as a last resort), usually the dispatchers would give permission for medics to transport after it goes out 4 alerts (at 7 minute intervals) depending on the call.

So while the whole volunteer system is going to eventually fall apart, I think overall there are some stopgap measures towns can do to stop incidents like this from happening.

[JakeEMTP]

Our dispatchers also are pretty easy on letting medics transport (even though NJ state law says that they can only do it as a last resort), usually the dispatchers would give permission for medics to transport after it goes out 4 alerts (at 7 minute intervals) depending on the call.

Am I reading this correctly? It is possible for a pt. to wait 28 min before medics are allowed to transport?

Remind me never to visit NJ if this is true. :shock:

[Chief1C]

Urban volunteering? No, that should have gone out decades ago. I would have understood, partly, if they had all of their ambulances out already. However, I haven't seen many cities that do not have more than one ambulance service. Hell, if our town was out, there would be three more rigs jumping to get in just for bragging rights. Someone on your ass, jumping the call, because you were slow, etc. What happens when all of their ambulances are out? Isn't there another service in the city? That seems like a civil liability, the city may rely on these folks with out various problems, usually. But there should be a back up plan.

I could understand waiting 21 minutes for an ambulance, if you were in a rural area, and lived that far from an ambulance.. We live about 50 from the nearest ALS unit. Snaps his fingers.. Uhh.. Waiter? DNR please?

[scratrat]

The time onscene for the first responder (the police officer) was crazy.

All our Police officers are Certified First Responders, and some of them are EMT's as well. In any serious call, the PD will be there quite fast, I have heard them being given orders to break off from a different call (like a traffic stop) in order to get to a cardiac call.

So usually less then 3 minutes after the call goes out, emergency care is already started.

Our dispatchers also are pretty easy on letting medics transport (even though NJ state law says that they can only do it as a last resort), usually the dispatchers would give permission for medics to transport after it goes out 4 alerts (at 7 minute intervals) depending on the call.

All I can say is wow. This is exactly the mentality that forced me to leave New Jersey. Amongst a few other reasons.

So, less than 3 minutes and emergency care is started? By whom? A first responder? A police officer who is also an EMT? Without getting into an argument about who's better than who, what may I ask is a first responder going to do for a sudden onset stroke? How about an acute MI?

Oxygen. Thats it. And while that is important, the pt will be dead if not gotten to definitive care immediately. I don't care if it's by BLS or ALS. That's another debate. But the fact remains, that even if medics are on scene, if they can't transport in a timely fashion, then that's a seriously flawed system. If my family member waits, by your own admission, 28 minutes while suffering from an acute MI, and then dies, rest assured I'd own your little town. I'm not sue happy, but there comes a point that a hostage must be shot. And in this case, the hostage would be your service. Or whichever service failed to respond.

Somewhere, on paper, by law, there is a written agreement, that any squad will respond to a call within XYZ timeframe. Problem is, no one enforces it. I think it should be the State's job. Whenever a crew is not RESPONDING with a FULL CREW, not just one EMT and a first responder, then that service gets fined. After XYZ number of fines, the squad gets shut down, disbanded, and a someone else takes it over. Whether it be a PAID service through the state, county, city, whatever. I may be wrong, but I haven't found ONE county thus far in Florida that does not have at least one 24 hour service covering them. If one state can do it, so can everyone else.

[emtannie]

The problems in this scenario are too numerous to mention....but... the blame does not lie completely with the volunteers....

The municipality should be ashamed of themselves for having a volly service when it appears that they have an adequate base to support a full time paid service. The administration of the existing services should abe ashamed of themselves for screwing up the scheduling....

I guess is that until there are enough lawsuits in the region this occurred in, that the municipality won't bother really reviewing the situation and making changes....

To blame the volunteers themselves is focussing blame on only part of the situation. This problem is much bigger and needs to be addressed that way.

There are areas in every county that are remote, and response times to those areas are bound to be longer... and yes, people moving to those areas may not always take that into consideration. But, as emergency services, part of our duty is to educate our communities not only on what we do (we are not just "ambulance drivers") but what they can do for themselves.... Education, or the lack thereof, plays a big part in all the issues in this scenario....