WHO SHOULD BE DISPATCHED, CLOSEST AVAILABLE OR DESIGNATED SERVICE FOR THAT AREA?

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Permalink Reply by Jason on March 26, 2009 at 5:47pm

Here is Kidder Twp, Carbon County there is three ambulance services working a 72 square mile area. My service covers the North, central, east and southern territories as BLS. An in county ALS service covers the south and eastern part as ALS with our BLS.

A unit from neighboring Luzerne county which is another EMS region all together might I add provides primary ALS/BLS coverage to the Northwestern territory along with primary ALS to all of the North and Central territories with my service as BLS.

So we have managed to work things out and cross the county lines, along with the regional lines of care to get to the patient's faster.

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Permalink Reply by Adrian S Brandau on April 3, 2009 at 6:11pm

Skip, the 800 MHz system is pretty much a joke. The MACOMM units are in the hospitals and county offices only, with no one at the street level actively participating in training or using those units. In fact, even the people in the hospital don't know exactly what the unit is for or how to use it. I've taken the online training course offered through the state EMS Con-Ed website, but that's as far as I've been able to get to even touching a unit. In the event of an MCI, I doubt anyone would be familiar enough with the base stations or portables (wherever they are) to adequately use the system.

At the county level, some services aren't permitted to use other counties frequencies. Our ALS unit responds primary and second due to parts of Lycoming county, and they denied our request to add their frequency into our radio. So I have no contact with on scene personnel prior to arriving on scene. Again, political issues.

In general, I'm a bit of a socialist when it comes to EMS. Like many have already said, the closest EMS unit should be dispatched and respond. When it comes to volunteer services, step up the mutual aid dispatching to simultaneous if you have to. And certainly, at no time should ALS care be delayed because Unit X is the designated provider while Unit Y is closer.

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Permalink Reply by Jeff Gaudio on June 10, 2009 at 1:23am

Well, you can't send a closer unit to another services jurisdiction and not the primary service. A dual response makes the most logical sense.

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Permalink Reply by Don Lynch on June 13, 2009 at 9:15am

Dispatch should always be for patient safety and care but all too often the politicians get involved in their support base.

If the station that is 12 minutes away is a volunteer company but has a crew on at all times which is what we did when I lived in VA we were required to pull a certain amount of crew each month. Then the one 12 minutes away will get on the road faster and could arrive earlier than the one a few minutes away that could arrive if they are getting a crew together from home.
Another thing to look at if you want the nearest to be dispatched at all times is GPS monitors on all trucks that comes up at the dispatch. That was if an ambulance is on the street coming back from a call they can respond and get the care there faster than either one of the two.

Another thing to look at is what about the second due?

In my neck of the woods we have a primary ambulance company that has been having some problems which we all have at times. The powers that be have a problem with another local department less than a mile from their station which has a paid BLS staff on days and that hasn't scratched on a call in years.

I have sit at home and heard Station X dispatched to a call and it has gone to second due. You would think that Station Y less than a mile away would be dispatched. No they aren't they have a volunteer ambulance from 6 miles away dispatched, when they scratched the next due was from an ambulance 7 mile away this one has a paid crew on too, if they are busy and can't respond the nest due is 10 miles away.

I have heard it going to the second and third due more times than I would like too. I had a niece how had a medical problem her father called the ambulance and when it took so long to get on scene he transported her to the hospital himself not a good idea but better than waiting.

When I ask why Station Y wasn't dispatched I was told that the two stations don't like each other and that the current chief officer have problems with each other.

I have a son with Muscular dystrophy and god forbid that anything happens to him do I want to wait till second or third due get to my house when I know there is an ambulance a mile from my house that is sitting there and not getting dispatched.

The Department of Health needs to step in and at least dictate that second due be the next closest, not who the individual chief wants because he has a problem with the next closest. It shouldn't be let's teach them a lesson, let them sit there and we will go around them. Patient care should be first and

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Permalink Reply by Seth Heller on July 17, 2009 at 11:54am

personallyi believe for the sake of the pt that the closest available should be dispached. territorial boundiers are a huge problem. i mean if the closest can be dispached along with the company whos territory it is it would work better for the pt. mainly because he wont have to wait for an ambulance. i have had personal expirence with being the closest and not being dispached. my shift was in station when a motorcycle accident occurred. we were 2 miles away and never got a beep on the pager or even an over-radio dispach. instead they called the ambulance companies territory it was in and the company was 6 miles away. the end result was the victim ended up dieing on the street while the ambulance was in route.

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Permalink Reply by antonio craig on November 1, 2009 at 8:23pm

I think it should be closet unit and also make clear what type of service is needed (bls or als).

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