I work for a volunteer/paid-on-call department and I am a lieutenant in charge of medical and split with one of the captains with doing training. The capt ask what about using squads (or whatever term u want to use) to running medical calls. The idea has come up in the past, but met tons of resistance. Now we have a new chief and are in the rebuilding process with hiring new guys. I was wondering if any departments out there do this and how do they have it setup. Also if anyone has anything to add on this topic it would be great to hear your ideas/opinions.

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We used to but stopped with the beginning of automatic aid. Auto aid requires a minimal staffing of 3. If your on your way back from an EMS run and catch a fire what do you do?

Here in Indy we run 2man squads. 1 FF/EMT &1FF/Paramedic. Right now we have 5 squads in the city all but 1 are at a TAC house. On a fire the squad acts as a truck crew. Here 1 man is the driver/engineer & the other is a Lt. Or Capt. One or both ff are a paramedic. The squads take a big load off the engines. I am at a single engine house we will hit 4,000 runs this yr. The squad in our battalion will hit close to 7,000. The Engine at there house doesn't do much ems.
If are rescue is full (3-4) we will stop by the station drop off 2-3 guys to grab the engine and/or tanker. The rescue has 1 pack on it for someone. The other waits for a pack from from first arriving engine. At least with the rescue truck first arriving to a fire we can get a scene size up and mutual aid coming. We don't have automatic aid right now with neighboring departments d/t not being able to offer the personnel needed during the day when most personnel are working their regular jobs.
To add some background info. My department runs approx 600 calls in a rural area with call increase over the last few years. I and my captain know of some departments in our area that have done this. One department had the department split in half and each squad would cover every other week for medical calls. Then if needed call additional manpower for the second squad. For structure fires everyone would respond.


  A dept that I used to run with housed 1 of each rescue,ladder and engine. For ems runs we almost always took the squad or utility to keep the big trucks available. In PA once I make patient contact I am not allowed to leave until care is transferred or the patient signs a refusal form. Several times a year we did have overlapping calls where the squad was on an ems run and we got knocked for a fire response.  If we ran ems off the engine we would be out of luck for fire response. We did have more drivers for the big trucks than emt's for medical calls so it made sense to leave the big trucks. Add in the fact that it is much cheaper to run their squad (chevy tahoe) and it made sense at the time. Figure about 6mpg for the big truck vs 15 mpg or better for the squad, oil changes and other maint cost and its not a small amount of money you save. There were exceptions like daylight driver training, since we only had a handful of members that were able to answer daylight calls, the engine handled everything.  

Just some back ground on the department: 300 fire calls, 500 ems calls annually with about 40 volunteers from 1 station covering about 15 square miles. The use 1- 100ft ladder, 1- 2000gpm engine, 1-heavy rescue  (certified to PA DOH requirements for heavy rescue and QRS), 1- Squad (certified to PA DOH requirements for QRS), 1- brush truck, 1- utility pick up and 1-technical rescue trailer. Their equipment may have changed a bit since I left in 2009 but not much.

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