Chester Co. EMS-How many vehicles?

[policefreak]

I notice that when Chester County dispatches EMS to a life threat incident, they dispatch an ambulance, a medic, and a QRS. My question is are the medics on board the ambulance, or is the QRS a team that boards the ambulance, or is each thing in a separate vehicle?

 

[ChrisRupert]

I'm not sure of the EMS System in Chester County perse. Usually, the paramedic is on the MICU
(Mobile Intensive Care Unit) which is basically a paramedic ambulance. Other times, the paramedic responds in another vehicle. A QRS unit which is a Quick Response Unit is usually a fire department vehicle where First Responders and EMT's respond in areas where it takes time for an ambulance to get there. QRS carries the AED (Automated External Defibrillator), Oxygen, and other basic life support supplies.

 

[ctrabs74]

I notice that when Chester County dispatches EMS to a life threat incident, they dispatch an ambulance, a medic, and a QRS. My question is are the medics on board the ambulance, or is the QRS a team that boards the ambulance, or is each thing in a separate vehicle?

It depends on which EMS squad is dispatched and where in the county the call is.

There are only a handful of EMS squads which run MICU ambulances (EMT and medic on board).

MICU units - 25 (Longwood), 67/167 (Phoenixville), and 87-6 (Uwchlan's rig at Station 6 between 0700-1900).

In most parts of the county, the medic responds in a separate vehicle from the BLS ambulance.

ALS Chase Cars - 2 (Berwyn), 4 (Malvern), 46 (Downingtown), 87 (Uwchlan, save for MICU 87-6 example above), 91 (Chester Co Hospital), 93 (Brandywine Hospital), 94 (Southern CC EMS).

A few areas have Quick Response Service (QRS) units, which can either be a separate chase car, or in some cases a fire engine. These units are occasionally referred to as Squad xx or QRS xx.

QRS providers in Chester County - 26 (Atlgen - fairly new, they usually respond in Engine 26-3), 27 (Cochranville), 31 (Sadsburyville), 38 (Thorndale), 41/43 (Coatesville FD/typically respond when 41 EMS is committed on a call elsewhere), 48 (Glenmoore), 49 (East Brandywine), 58 (West Chester University), 61 (Kimberton), 73 (Ludwig's Corner), 74 (Upper Uwchlan).

Some BLS companies with a single ambulance will respond in a TAC or Squad unit when that rig is out of service (such as 5 - East Whiteland or 44 - Westwood).

A typical dispatch for BLS, ALS, and QRS:

Ambulance 89 (Elverson), Medic 87 (Uwchlan), and QRS 48 (Glenmoore) dispatched to an ALS call in Wallace Township. The call is in 48's first due fire territory, which is closer to the 48 house than 89, in Elverson Borough (near the Berks County border). Even if 89's bus gets out a couple minutes before Tac 48, responding as the QRS, Tac 48 is closer and is capable of providing BLS care until the ambulance arrives.

That explains Chester County EMS in a nutshell.

 

[Q-ball]

I was just about to ask what "QRS" means, quick response service huh, woulda never guessed......but wait, arent all ambulances considered quick responding vehicles?...and why dont all ambulance stations have a QRS squad, is it a budegt thing? or are they strategically located?

oh yea, and what does ALS and BLS stand for?

 

[rcvmo]

it is a budegt thing

QRS or Echo Unit, ya don't don't need one at every station.
Maybe one per district at the most if district is made up of multiple stations. More like a Unit that rides around the county or district and can get there faster than the ALS unit.

I've seen in rural areas in Mi. where the Echo Unit is parked at a MDOT Park & Ride lot. When the page goes out, VFD or medics on call respond to the PNR lot. I thought kinda strange unless the medics on call bring the drug box with them.

rcvmo

 

[Q-ball]

does anyone know for sure how it works in montco county pa?..im really curious now...id assume since only parts of montgomery cty. are rural, like worcester and skippack and the neighboring municipalities....like the salfords and parts of limerick..i guess only those types of areas need them, but even still, when the call goes out and the ambulance leaves the station, i still think its moving fast enuff with lights and sirenes that additional units would be unnecessary....

 

[policefreak]

Q-Ball, it really depends on where they're going. Just found a list of EMS identifiers for montgomery county and noticed that station 10 (Upper Moreland) has a QRS unit, Station 33 has a QRS, station 80 Upper Gwynedd fire has a QRS. and so does station 82 fire. It appears that West Chester Univ. and Phoenixville Hospital have QRS chase cars. Although I don't live in Montgomery county, I would have to guess that most of the time medics are on board the ambulance but the QRS are usually fire engines. We do the same thing here in jersey in camden and burlington counties in some municipalities. In stations that have paid firefighters we don't call them QRS but we assign an engine or rescue company to life threat EMS calls where BLS and ALS are dispatched. The reason why is that there are likely more fire engines than medic units in each given municipality. So the engine may be closer and get to the emergency quicker than the medic or ambulance, especially in high-traffic areas like Cherry Hill, Mt. Laurel, Deptford, and Cinnaminson.
Oh, BLS= Basic Life support (usually in the form of an ambulance)
ALS= Advanced Life Support (Medic-usually only dispatched to life threatening emergencies like cardiac, respiratory, and some MVA's)

 

[ctrabs74]

Q-Ball, it really depends on where they're going. Just found a list of EMS identifiers for montgomery county and noticed that station 10 (Upper Moreland) has a QRS unit, Station 33 has a QRS, station 80 Upper Gwynedd fire has a QRS. and so does station 82 fire. It appears that West Chester Univ. and Phoenixville Hospital have QRS chase cars.

Phoenixville Hospital used to have an ALS chase car - Medic 95. They disbanded a few years ago; ALS in Phoenixville area is provided by MICU 67 (Phxville West End Fire Co. ambulance).

WCU shouldn't even have been listed in Montgomery County; everyone knows that WCU is in Chester Co.

 

[Q-ball]

Allthese years growing up, i thought that the individuals in the ambulances were actual medics, hence the name emergency medical technician(emt)...and now it is being said that they are not, they are just more like transporters?...

 

[rcvmo]

and now it is being said that they are not, they are just more like transporters?...


Gives a new meaning to "Load and Code".

Here in Mi., last I read, anyone who provides transport, run echo-unit had to be an EMT-Paramedic or above. The last I heard a Bravo ( basic Life support) on the HEAR was probably a good ten years ago. There are a few, but usually an out-county, or out state transport coming in to the U-M.
rcvmo

 

[clifford1]

Pennsylvania EMS:

First Responder (FR) - basic level of traning to provide care at the scene of an emergency.

Emergency Medical Technician - Basic (EMT-B) - basic EMT tranining to provide care at the scene and during transport.

Emergency Medical Technician - Defibrillator (EMT-D) - basic EMT traning including use of an Automated External Defibrillator (AED). (pretty much all EMT's nowadays)

Emergency Medical Technican - Paramedic (EMT-P) - basic EMT plus advance life support (ALS) training including airway, IV, and medications. EMT-P's are often refered to as "medics".

Pre-Hosptial Registered Nurse (PHRN) - Licensed RN with additional training in pre-hospital ALS.

Vehicles:

Quick Response Service (QRS) - usually certified First Responders or EMTs. Has basic equipment.

Basic Life Support (BLS) Ambulance - at least one EMT and one driver (many run with 2 EMTs). Has basic equipment and can transport.

ALS Ambulance - sometimes referred to as a Mobile Intensive Care Unit (MICU) - at least one EMT-P or PHRN, plus an EMT. Has basic and advanced equipment and can transport.

ALS Chase/Responders - one or two EMT-P/PHRNs in a non-transport vehicle (sedan or SUV usually). Has advanced equipment but cannot transport (usually).

These components are part of what is called a "tiered response" system, meaning that at a typical emergency, the QRS will arrive first, followed by the MICU, or the BLS and ALS chase. Each community/region will have some combination of these vehicles depending on their needs/geography/resources. Whatever way they arrive, the goal is to get someone at the scene as soon as possible and have an ALS provider with the patient during transport to the hospital.

Hope this helps!

Chris C.

 

[Septa3371CSX1]

Just about every county or municipality that dispatches emergancy services uses a computer aided dispatch (CAD) system. This CAD system is used to determine what unit(s) will respond to a particular location. If a volunteer unit who is dispatched to the call is unable to respond, the CAD will go to the next due until a unit is enroute. The next due is also dispatched when the unit whose first due the call is in is not available or out of service. As an example I'll use the EMS response order for my town, Lansdowne Borough in Delaware County.

The reponse order for transport (BLS, some are ALS) units is as follows:

East of Lansdowne Avenue

1st Due: 19-7 (Lansdowne FC, partially staffed by Fitz EMTs)
2nd Due: Medic 16-7 (Yeadon FC, staffed by Fitz medics)
3rd Due: 03-7 (Clifton Heights)

West of Lansdowne Avenue

1st Due: 19-7
2nd Due: 03-7
3rd Due: Medic 16-7

A transport unit is dispatched to all ambulance calls in the local. When the call requires an ALS unit, one is dispatched along with the transport unit (exception of 2nd call on the eastside where Medic 16-7 does both transport and ALS service). The response order for ALS units is as follows for the entire borough.

1st Due: Medic 105 (Fitz ALS Chase unit, usually staffed by 1 medic)
2nd Due: Medic 16-7 (Yeadon FC / Fitz ALS Transport unit)
3rd Due: Medic 04-7A (Darby FC #1 / Fitz ALS Transport Unit)

Up until last year Fitz had a QRS unit staffed with 1 EMT that responded to calls in the area where a vollie ambulance was only able to respond with a driver. QRS 105 has since disbanded and the members now staff ambulance 19.

When the dispatched unit(s) arrive on location, they begin patient assement and pre hospital treatment. The need for a medic is established and once ready, they transport the patient to a local hospital. If assistance is needed an additional ambulance or a fire truck is dispatched. In some cases the additional unit(s) will go with the transport unit to the hospital to assist there.

Hopefully this explains some of the questions here.

 

[ocguard]

Allthese years growing up, i thought that the individuals in the ambulances were actual medics, hence the name emergency medical technician(emt)...and now it is being said that they are not, they are just more like transporters?...

As others have explained, regarding levels of training for EMS providers, EMTs provide basic life support. It could be considered an insult to say that ambulances staffed with EMTs (no paramedics) are "transporters" as EMTs are highly trained, and in many cases take their jobs very seriously and are true professionals. The fact is, MOST ambulance responses are basic life support calls that can be handled start to finish by an EMT. And EMTs can very effectively stabilize most any patient, including those who are critically ill or injured. Many seasoned paramedics would tell you that they would much rather have an experienced EMT as a partner than a rookie paramedic.

It should be closely noted that in many areas ambulances are in fact "paramedic ambulances" and are staffed with a BLS and an ALS provider. As mentioned, most PA EMS services identify these types of units as MICUs (mobile intensive care units) but many other areas of the country would simply call them medic or paramedic units.

 

[CommJunkie]

Pennsylvania EMS:

First Responder (FR) - basic level of traning to provide care at the scene of an emergency.
NOTE: FIRST RESPONDERS ARE NOT TRAINED IN COMPLEX MEDICAL SITUATIONS. THEY BASICALLY PROVIDE BANDAGING AND OXYGEN.

Emergency Medical Technician - Basic (EMT-B) - basic EMT tranining to provide care at the scene and during transport.
FYI: MOST PEOPLE ON AN AMBULANCE ARE EMT-B's. IT IS (EXCEPT FR) THE FIRST STEP IN MEDICAL TRAINING, AND EMT-B's ARE TRAINED TO HANDLE AND RECOGNIZE SOME COMPLEX SITUATIONS.

Emergency Medical Technician - Defibrillator (EMT-D) - basic EMT traning including use of an Automated External Defibrillator (AED). (pretty much all EMT's nowadays)
THIS LEVEL WAS DONE AWAY WITH A FEW YEARS AGO WHEN AED'S BECAME MUCH MORE COMMON. AED IS NOW PART OF CPR TRAINING, THUS MAKING EMT-D UNNECESSARY.

Emergency Medical Technican - Paramedic (EMT-P) - basic EMT plus advance life support (ALS) training including airway, IV, and medications. EMT-P's are often refered to as "medics".
EMT-P's (ALSO COMMONLY CALLED MEDICS) CAN HANDLE THE MOST COMPLEX MEDICAL EMERGENCIES. THEY ARE TRAINED TO GIVE MEDICATION VIA IV, DEFIBRILLATE, INTUBATE, AMONG OTHER THINGS. THEY ARE USUALLY SENT TO COMMONLY LIFE-THREATENING CALLS, SUCH AS CHEST PAIN, CARDIAC SYMPTOMS, RESPIRATORY PROBLEMS, ETC.

Pre-Hosptial Registered Nurse (PHRN) - Licensed RN with additional training in pre-hospital ALS.
LICENSED RN AND LICENSED EMT-P. YOU WILL FIND THESE ON THE MEDICAL HELICOPTERS ALOT, AS THEIR PRIMARY FUNCTION IS TO ADMINISTER MEDICATIONS NOT ALLOWED BY EMT-P LAWS.

Just a little clarification.

 

[Q-ball]

i can't thank you all enuff for that great info, but still, im not sure it's been said how it is determined which areas/twps. get QRS units and which don't...there has to be some reason why all ambulance stations dont have QRS units?...and are they really necessary since ambulances are emergency vehicles and have lights and sirens, it may arrive only 2-3 seconds behind a chase car or maybe even the same time,, so whats the point?...i can see if its a rural area, but much of montgomery cty. pa is not rural, a very small percentage is.

 

[ChrisRupert]

QRS units were designated for areas where a BLS Ambulance is greater than a 10 minute response time. Not to be sure, but I believe it is now based on milage rather than response time due to paid staff. Local Fire Departments and such have to make the local EMS Council aware of intent to begin a QRS unit and they either accept or deny the request. Granted, in the more urban areas QRS units are not as needed as in the rural areas. In the rural areas, QRS units have been very beneficial and have saved lives.

 

[ocguard]

In many cases, fire departments operate QRS units, not ambulance services. In some cases, this is a method for a fire department to boost call volume and increase their presence in the communities. In other parts of the country, fire departments respond on all EMS calls as first responder/medical assist. Many PA departments use the QRS as a way to emulate this trend, and stay progressive, as the role of the fire department is ever changing and moving more and more toward EMS.

And some QRS units are stationed in the same house as an ambulance, but will not respond unless that ambulance is on another call, and a second due ambulance must respond. Other QRS services respond on certain calls regardless of how far away the ambulance/medic unit is. It's really up to th eindividual service's protocol, or county dispatch procedure. There is no concrete method to how QRS units are dispatched and utilized.

 

[Septa3371CSX1]

Delaware County QRS 71 is a good example of a QRS unit that responds no matter what. It is staffed by volunteer First Responders and EMTs at Station 71 (Chester Heights Fire Company). It responds to all EMS calls in the borough of Chester Heights. Ambulance service for the borough is provided by Medic 59-7A (Concordville FC / Riddle Memorial Hospital paramedic unit) for the northern half of the town and Medic 72-7 (Aston Beechwood FC / Crozer Memorial Hospital paramedic unit) for the southern half. Middletown Fire Company (Station 50) has a utility that is a certified QRS unit but it is only utilized when needed (i.e. other units are busy) Green Ridge Fire Company (Station 63) has a QRS unit that responds to some EMS calls in Aston Township with Medic 72-7 but not all calls.

 

[Q-ball]

lafaayete ambulance(317) covers my area, and i noticed on their webpage, it shows two ambulances, one being ALS and one being BLS...and another vehicle between them, a chevy suburban, now, i know from residing here that we do not have a QRS unit, so who the heck is responsing in that other vehicle? that actual paramedic?...if th actual medic is responing i the suburban, then that means the ones in the ambulances are simply emt's right?....this twp, does not have a QRS unit. check out their site.

 

[Q-ball]

i think the vehicle is just a supervisor vehicle, which leads me to wonder why a supervisor vehicle has to go out on a ambulance call...especially if its not a QRS unit and what exactly do they have to supervise? unless the supervisor is just another name for QRS.