toastycookies
Member
I understand and I just joke. Stop paging the ambulance and start paging the crew!
Ambulance Not Answering Dispatch
- Thread starter pinballwiz86
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I understand and I just joke. Stop paging the ambulance and start paging the crew!
D
DaveNF2G
Guest
If your municipality is covered by a commercial ambulance service, that service probably has no backup. Any other commercial service is a competitor, so unless there is a statute that requires them to respond, they may just simply decline any requests. Volunteer services in some areas resent paid companies, so they won't come either.
I experienced this most acutely one evening as the dispatcher for National Ambulance in Rochester, NY.
National owned 16 ambulances at the time. On that evening, one was unavailable in the paint bay. The city contract called for 6 or 8 (I forget the exact number, and it changed late in the evening) rigs to be operating during my shift. Rochester got so busy that night that we ended up with all 15 rigs staffed (one by the president of the company driving) and I was still holding multiple emergency calls.
Fortunately, relations between National and our competitor, Monroe Ambulance, were good at the time, and we even had a Monroe mobile transceiver wired into our base station. For a few hours, I was dispatching my own rigs on my channel and tossing what calls I could to Monroe on their channel. So we deployed a combined total of more than 20 ambulances and were still backed up.
For a short time, I tried to get mutual aid from county volunteer ambulances for some of the border area calls. Long story short, the vollies refused to respond into the city. In one case, it was a volunteer fire chief who ordered his ambulance crew to stand down after they had accepted the mutual aid call. I suggested to the 9-1-1 fire dispatcher that they contact the city's fire chief about the refusal to honor the mutual aid agreement, but I doubt that ever happened.
Some people (and the fire companies that first responded on the calls) waited the better part of an hour for an ambulance in a municipality where typical response times were under 8 minutes about 90% of the time (which was what the contract called for).
EDIT: I was also begging for the emergency departments to release ambulance crews from both companies, but when we get backed up, so do they.
I experienced this most acutely one evening as the dispatcher for National Ambulance in Rochester, NY.
National owned 16 ambulances at the time. On that evening, one was unavailable in the paint bay. The city contract called for 6 or 8 (I forget the exact number, and it changed late in the evening) rigs to be operating during my shift. Rochester got so busy that night that we ended up with all 15 rigs staffed (one by the president of the company driving) and I was still holding multiple emergency calls.
Fortunately, relations between National and our competitor, Monroe Ambulance, were good at the time, and we even had a Monroe mobile transceiver wired into our base station. For a few hours, I was dispatching my own rigs on my channel and tossing what calls I could to Monroe on their channel. So we deployed a combined total of more than 20 ambulances and were still backed up.
For a short time, I tried to get mutual aid from county volunteer ambulances for some of the border area calls. Long story short, the vollies refused to respond into the city. In one case, it was a volunteer fire chief who ordered his ambulance crew to stand down after they had accepted the mutual aid call. I suggested to the 9-1-1 fire dispatcher that they contact the city's fire chief about the refusal to honor the mutual aid agreement, but I doubt that ever happened.
Some people (and the fire companies that first responded on the calls) waited the better part of an hour for an ambulance in a municipality where typical response times were under 8 minutes about 90% of the time (which was what the contract called for).
EDIT: I was also begging for the emergency departments to release ambulance crews from both companies, but when we get backed up, so do they.
So what happens if a caller lives in an area that does not charge for EMS calls, but the call is referred to mutual aid and the responding agency does charge?
Does the caller pay?
Does the requesting agency pay?
Does the caller pay?
Does the requesting agency pay?
No single answer for that. Around here, the patient or insurance is billed. I've heard of agreements where the host agency pays, but not recently.
The caller would not get billed unless the caller is the patient.
The national trend is billing. Free ambulance service is on the wane due mostly to rising costs and the gradual decline of the volunteer pool
TANSTAAFL!
Let me add some more to the conversation.
Even all volunteer ambulance squads are moving to billing. The costs of equipment, vehicles, supplies, and training are spiraling higher all the time. Here in New York, the cost of a basic EMT course is approaching $1,000. Paramedic is a lot more.
Larger volunteer squads have been forced to hire EMTs and Paramedics because of increasing call volumes. Once you start paying staff, billing follows if it's not already in place.
There's a tiny town north of us that runs about 100 calls a year. One of their few EMTs is going out for surgery soon. The town is considering paying an EMT from a commercial service for coverage. They don't have a lot of choices up there in the central Adirondacks. Neighboring squads are 1/2 hour or further away and dealing with their own volunteer shortages. It's almost a no-win situation.
My county is 3 volunteer services and one commercial service. Two of the volunteer services moved to billing several years and hired staff for at least part of the day. The 3rd volunteer squad doesn't bill and relies primarily on one paramedic for much of its coverage. There are several others in the squad, but they aren't able to cover many calls due to work commitments. If that one paramedic retires or resigns, that squad will have to make some major changes to survive. They either have to find the resources to pay staff or fold and let the commercial service cover the area. It they move to paid staff, they're certain to begin billing.
If a volunteer squad can't at least answer the radio, even if just to say they can't cover the call, they are already in serious crisis. Thanks to television and the movies, the public has come to believe that an ambulance rolls as soon as you call 911. It's not the case much of the time and leads us to a very false sense of security. When I was injured in June, it certainly took at least 20 minutes before an ambulance actually left the garage and headed my way. I don't agree with the "page 3 times 5 minutes apart" procedure, but that is the local squad's option. But given the additional travel time for the mutual aid ambulance, it does not skew the total response time that much.
My point to all this is that there is no single plan to EMS here in the US. What they do in one place, they may not do in another. And you are not guaranteed that a paramedic will treat you. It might be an EMT who has limited treatment options compared to a paramedic. If it is a short ride to the hospital and/or you're not seriously ill or injured, that might not matter very much, but if you're in deep trouble and/or it's a long trip to the hospital, having a paramedic with additional medications and treatment skills and equipment might well mean the difference between life and death.
And much of it hinges on money or the availability of manpower.
Want fast service, pay up.
Where I live we pay taxes to have crews ready to go. I will say it is amazing how fast from a call to them showing up at the scene.
I understand. But most likely, it isn't the norm for those paid crews to work an entire shift at the station, or a couple of shifts in a row, without going on a call. Some lightly-populated communities need ambulance service, but the call volume is low. Their only realistic choices may be to have volunteers in the community, or wait on a paid crew from a bigger town that might be 30 or 40 minutes away.
902
Member
Long but relevant on rural EMS and volunteerism...
I lived this, having moved from very urban Northeastern NJ (which, at the time, was also plagued by volunteer issues) to the rural Midwest. I lived on the edge of my county and the service was a 100% paid ALS system with two paramedics on each ambulance. There were several areas with paid-on-call EMTs and paramedics, but mine wasn't one of them. My closest ambulance response was about 16 driving miles and, with multiple responses into the area, timed at an average 38 minutes (if they were available - longer if it came from another station). That was partly because of road conditions, partly because many crews didn't want to "go all the way down there" and dogged the response if it was anything less than a high priority medical or trauma call.
I had a volunteer ambulance about a mile and a half away, but because of a complex mix of politics, them being outside of the county, and labor issues, they were rarely called into the area. Their direct policy was, though, "if you call us, we'll go," so their dispatch 800 number was labeled on each phone handset.
Being in the rural area didn't just limit us to ambulance problems. We also had a very long response time for law enforcement. The sheriff's deputies would often respond from the populated areas, across a wildlife preserve braving deer, poorly plowed roadways, and other hazards, to get to where we were. The only "good" response was from the volunteer fire department because many of the members owned or were employed by local businesses. They dropped what they were doing and took the call. They were usually pretty quick. They also began to provide on-scene BLS to help offset transport response times.
At some point, we realized that we needed to be self-sufficient. I'm a former paramedic, all expired. A few times, I recerted as a paramedic and, one time, I became an EMT in the state I was living in, as well as National Registry, but let that go, too, as I wasn't working in the field. Keeping CEUs up and finding relevant classes you need is a full-time job in and of itself when your work is doing something else. I was lucky, as my work was somewhat supportive.
I built a well-stocked BLS kit and worked with my wife (a former EMT) and the kids to learn how to use it. I also bought an AED once they were made available (I was the likely candidate). We picked up a bunch of fire extinguishers and Indian cans, and we bought firearms, learned safety, and spent a bunch of time at the range. After a while, we could take care of ourselves until the resources we had arrived. Eventually, the district built a station 1/3 of the distance away, and their response time improved, Thankfully, my family never needed to call for an ambulance.
I always took issue with the mileage fees and was very critical about it. The board of governance made decisions on where to put stations and they put them in highly populated areas, some that had duplication with a municipal ALS ambulance. My challenge was that their choice in service area placed my family at a disadvantage and failed to meet the regional standard of care considering my taxes were as high as those who were served within higher population density - but did not get double banged with a high response time and mileage. Got to love local politics, especially in the hinterlands. Anyway, I wasn't the only one critical of the issue, and enough statistics were presented to justify building something closer.
I got into EMS and became a volunteer firefighter because of my childhood hobby listening to scanners. In fact, when I was in high school, I heard them setting off the Plectron numerous times to get someone to respond two blocks away from my home. Two times. Three times. I couldn't take it anymore. I rode out there on a bike and offered to help. I was 16. Instead of telling me to leave or be threatened to with getting locked up, as seems to be the prevailing philosophy these days, I was told to go to the meeting location on Monday night where I was given a form to fill out. After being checked out, I got a pager, a jacket and jumpsuit, and was given "my" riding night. And, if I was available during the days, I could help out, too. That was 37 years ago and I've been doing something that involved EMS, fire, or communications ever since.
EMS is severely in need of being recognized as the professional discipline it is. I have a lot of friends and former co-workers in "professional" EMS who come down on squadies for failing to develop proficiency. And I've seen volley squads that were foundations of their respective communities 37 years ago fold. I feel sorry that a 16 year-old today doesn't (or can't) look at an ambulance or a fire truck - or even a police car - and and say, "I have a role here, I can help people, and I can turn this into MY profession."
I lived this, having moved from very urban Northeastern NJ (which, at the time, was also plagued by volunteer issues) to the rural Midwest. I lived on the edge of my county and the service was a 100% paid ALS system with two paramedics on each ambulance. There were several areas with paid-on-call EMTs and paramedics, but mine wasn't one of them. My closest ambulance response was about 16 driving miles and, with multiple responses into the area, timed at an average 38 minutes (if they were available - longer if it came from another station). That was partly because of road conditions, partly because many crews didn't want to "go all the way down there" and dogged the response if it was anything less than a high priority medical or trauma call.
I had a volunteer ambulance about a mile and a half away, but because of a complex mix of politics, them being outside of the county, and labor issues, they were rarely called into the area. Their direct policy was, though, "if you call us, we'll go," so their dispatch 800 number was labeled on each phone handset.
Being in the rural area didn't just limit us to ambulance problems. We also had a very long response time for law enforcement. The sheriff's deputies would often respond from the populated areas, across a wildlife preserve braving deer, poorly plowed roadways, and other hazards, to get to where we were. The only "good" response was from the volunteer fire department because many of the members owned or were employed by local businesses. They dropped what they were doing and took the call. They were usually pretty quick. They also began to provide on-scene BLS to help offset transport response times.
At some point, we realized that we needed to be self-sufficient. I'm a former paramedic, all expired. A few times, I recerted as a paramedic and, one time, I became an EMT in the state I was living in, as well as National Registry, but let that go, too, as I wasn't working in the field. Keeping CEUs up and finding relevant classes you need is a full-time job in and of itself when your work is doing something else. I was lucky, as my work was somewhat supportive.
I built a well-stocked BLS kit and worked with my wife (a former EMT) and the kids to learn how to use it. I also bought an AED once they were made available (I was the likely candidate). We picked up a bunch of fire extinguishers and Indian cans, and we bought firearms, learned safety, and spent a bunch of time at the range. After a while, we could take care of ourselves until the resources we had arrived. Eventually, the district built a station 1/3 of the distance away, and their response time improved, Thankfully, my family never needed to call for an ambulance.
I always took issue with the mileage fees and was very critical about it. The board of governance made decisions on where to put stations and they put them in highly populated areas, some that had duplication with a municipal ALS ambulance. My challenge was that their choice in service area placed my family at a disadvantage and failed to meet the regional standard of care considering my taxes were as high as those who were served within higher population density - but did not get double banged with a high response time and mileage. Got to love local politics, especially in the hinterlands. Anyway, I wasn't the only one critical of the issue, and enough statistics were presented to justify building something closer.
I got into EMS and became a volunteer firefighter because of my childhood hobby listening to scanners. In fact, when I was in high school, I heard them setting off the Plectron numerous times to get someone to respond two blocks away from my home. Two times. Three times. I couldn't take it anymore. I rode out there on a bike and offered to help. I was 16. Instead of telling me to leave or be threatened to with getting locked up, as seems to be the prevailing philosophy these days, I was told to go to the meeting location on Monday night where I was given a form to fill out. After being checked out, I got a pager, a jacket and jumpsuit, and was given "my" riding night. And, if I was available during the days, I could help out, too. That was 37 years ago and I've been doing something that involved EMS, fire, or communications ever since.
EMS is severely in need of being recognized as the professional discipline it is. I have a lot of friends and former co-workers in "professional" EMS who come down on squadies for failing to develop proficiency. And I've seen volley squads that were foundations of their respective communities 37 years ago fold. I feel sorry that a 16 year-old today doesn't (or can't) look at an ambulance or a fire truck - or even a police car - and and say, "I have a role here, I can help people, and I can turn this into MY profession."
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