I'm interested to hear what others think about the positives and negatives of fire based ALS first response. Discuss pt outcomes, response times (how that affects pt outcomes), the financials regarding staffing and deployment, the FD doing both first response and txp, or only first response with a county third service EMS, or private provider doing the transports.
My dept has 37 paramedic staffed engines, the same number of ALS ambulances, 14 of which are double medic, a few squads that have medics, and four BLS buses. Due to our EMD, and how the OMD has tweaked it, many calls are categorized as ALS. Engines get diapatched on most ALS calls, and all MVA's. The county wants at least two medics onscene for every ALS call. If no engine is available, an EMS Capt. can be the second medic, and if it's a double medic PTU, a BLS ambulance will be dispatched instead of the engine, or perhaps a truck or squad, depending on who's closest.
My dept has 37 paramedic staffed engines, the same number of ALS ambulances, 14 of which are double medic, a few squads that have medics, and four BLS buses. Due to our EMD, and how the OMD has tweaked it, many calls are categorized as ALS. Engines get diapatched on most ALS calls, and all MVA's. The county wants at least two medics onscene for every ALS call. If no engine is available, an EMS Capt. can be the second medic, and if it's a double medic PTU, a BLS ambulance will be dispatched instead of the engine, or perhaps a truck or squad, depending on who's closest.
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