Replies to This Discussion

Permalink Reply by Clint Gorball on October 26, 2008 at 11:51pm

My department just began providing EMS Transport service at the ALS level just over 1 year ago. Of course our call volume has increased greatly however the service we provide and the revenue generated has also greatly increased. The goal of starting a transport service was to provide "better" service to our community. The hospital-based service that previously covered our community left a lot to be desired. We are now sponsored by a nearby, but not local, hospital that provides us with more progress protocols than the local hospital (they sponsor the previously covering EMS service) could have offered us. I know it has only been 1 year but to date, it has been a great success.

Permalink Reply by Sarah Turner on October 27, 2008 at 7:19pm

We do not have ambulances here in Charleston. Charleston county EMS runs our EMS. In Ohio we ran EMS, and although it isn't my favorite thing to do, It did make the day go faster. I must say, working in a department without ambulances has however allowed me to increase my training substantially. That is all due to the extra time.
I would go back to running EMS and fire because I prefer to run alot of calls, and that is how I began in the fire service.

You guys need to study various different ways EMS is ran and write up justification to present to your mayor on why your having EMS is necessary. That is, if you want to keep it.

Permalink Reply by Don Crooks on November 14, 2008 at 2:37pm

Hello Nita, the dept. I am with now has their own rescues, and I have been with this dept for a year and a half, and to me, the rescues are awesome, I have no problem pulling shifts on them. I've spent just about all of my 21 years of public service on rescues/ambulances and I see your point clearly. I was full time with private ambulances for 14 years providing service to fire departments that didn't have their own and I am here to say it was no fun, antique equipment, low pay/benefits, no respect from fire dept personel, and the minimum amount of units to "just meet requirements of the fire depts" leading to punishing shifts with little to no sleep or time to eat. Now, I am with a dept that provides rescues and it is the difference between night and day, the number of rescues in service is based on service and not profit, if call volume increases and response time starts to fall, more rescues are put in service. And because we are aloud to bill for rescue service it is a large part of our budget because like your dept, it is greater than 80% of what we do. I see similarities in our dept, the younger guys think that being on the rescue, affectionatly known as the "box", is a burden and that they are destined to be on "Big Red" I can only reassure them that one day they will be on Big Red and our rescues are a big part of why and how we have a full time dept. I am a huge supporter of Fire based EMS, I believe getting help to you quickly in the publics time of need far outways the name of your insurance carrier and profit margins. I wish I had some incredible statement you could pass along to your mayor that would change his mind. As far as your brothers and sisters that feel that without rescues you would have less to do! I can't argue that because it is true, did they really get in this business to do nothing? There is little room for error in this line of work, whether it is fire or EMS, and the only way to truly be good at what you are doing and minimize error is to train and perform. I hope I have put a little light on the subject for you, Be safe and enjoy your ride home after every shift, Fraternally yours

Permalink Reply by FF Matt Mullen on November 17, 2008 at 10:30pm

My department used to provide BLS transports service only, with a Hospital Based ALS intercept service. About 8 years ago, the fire department began their own Paramedic Transport service and that is how it is today. We are also in the process of developing our Engine companies into Medic Engines. Having a fire-based medic service provides a higher level of response the town's people, engines on scene first are medics. It also provides more man power to the fire side. If it wasn't for my department having medics, we would lose at least 8 people (out 90 or so employees). More importantly these additional medics have roles on the fire scene because they are cross-trained as firefighters.

Permalink Reply by Chris Gaylord on December 15, 2008 at 10:42pm

In our county, none of the departments (paid or volunteer) do transports...everything's done by AMR on county contract. Most departments do run at least some ALS engines though. A few departments also have transport-capable rescues that they use to respond in, but they only transport if we get into an MCI type situation (hasn't happened since I've been here). They are identified in our MCI plan for that purpose.

When I was down in SoCal, however, almost every FD provided ALS transport. The notable exception isLA County, which still runs the "Squad 51" type rescue squads and uses private ambulances for transport. A couple other departments use this same model, but most run their own ambulances.

Permalink Reply by Little Gary on December 16, 2008 at 10:17am

We operate 4 ambulances and 3 ALS chase vehicles, The private services DO NOT LAST, our rigs serve the city and also run out into the county. Keep up the good fight

Permalink Reply by David Zarker on December 20, 2008 at 8:31pm

Our department has always done emergency responce and transports in the county. EMS accounts for about 85% of our 18,000 calls a year.

Permalink Reply by matt-man24 on March 2, 2009 at 10:46pm

My department on the west side of Indy has 4 full time ALS ambulances and 1 tack bus staffed by IAFF civilian personnel since Jan. 2000. Our EMS crews are very professional and patient care and advocacy is of the our main objective. I have been an IAFF firefighter/emt, eventually paramedic since 1996 and have seen the lack of qualitity in both care and personnel in private service. I believe fire/based ems is the only way to go with 911 transport. These people care about their patients because this is their career, where they want to be, and respect this profession. Feel free to contact me for more info and proof.

Permalink Reply by Rick Westerman on March 5, 2009 at 8:04pm

Nita, I do work for a fire Dept. that staffs our own ambo's, fire based EMS continues the same level of care that was initiated by the crew that makes first contact. That's not to say privates are not capable, it means that likewise trained team members with the same medical direction start and finish care without a transfer to another agency. This fact also comes into play when policies and procedures differ between private and government providers. Government agencies have to follow strict guidelines from OSHA and NFPA some privates do not have to, they see them as suggestions rather than the rule. The closeness, and the bonds formed between fire/ems crews is important in the communication arena as well. Operating and understanding your city specific radio traffic can become critical to patient and crew safety. When it comes to operating under stressful situations, with patient outcomes at stake, nobody call deliver better service than crews that live, learn and train together. For my Dept. it has been a model for other surrounding departments to evaluate and consider doing the same. One organization with one common goal.

Fraternally,
Rick westerman

Permalink Reply by Bruce M Chapman on October 2, 2009 at 10:49am

Yes my dept does transport, it is a really good sorce of revenue to off set our budget, we bill all pt insurance and the monies go directly to our budget in a seperate line Item.this monie helps pay for our new busses and equipment,along with fire apparatus.

Permalink Reply by Kevin Hatfield on August 27, 2010 at 11:58pm

Strathcona is also a fully integrated department, we also transport patients to the Hospital. The only down side is the sitting in a hospital hallway, and you end up missing a structure fire :(

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