How many on a call

[explcdt8]

This is sort of a follow-up to the question about corps being unable to crew during the day. How many members do you usually get per call?

In our town:

1 ALS Rig -- 2 to 3 members (For-Profit Private Company)
1 BLS Rig -- 3 Members Minimum, Most Likely 4, Good Percentage of time 5 (including JR. Corps Observer/Assistant) (At least one member is EMT on every call) (All Volunteer)

On life-threatning calls you usually get all of the above, plus 1 vol. member to scene in POV, plus 1 or 2 PD officers, who are CFR/CPR/AED/o2 certified.

[noelchabanel]

We handle ALS and BLS calls on the same truck and always have at least two licensed on all calls (which is the legal requirement to transport), and often also have a driver. However, at MVA's just about the whole department shows up, since we usually need more help, and they are the more exciting calls. If someone is really crashing, we usually don't have trouble getting a third licensed person in the back if we know beforehand it is a bad situation. We are an all volunteer service. If we are "lucky" the patient who is crashing was in an MVA and we have extra licensed help all over the place :D

[MDEMT280]

Too many variables to answer that properly. What type of call? What area (paid or volunteer coverage)? What time of day, for volunteers?

Minimum is two licensed/certified providers for any transport unit. BLS = 2 EMT-Bs. ALS = At least one EMT-I or EMT-P.

IMHO, running with 5 on a box is too much. :eek: Call for a manpower assist if you need that much help.

[explcdt8]

I guess on a standard call say (Shortness of Breath or Unconcious but Breathing) NOT MVA or CPR in Progress or anything like that.

MDEMT: It was not an assist, that is what they crew with.:eek: I don't know how they fit them all in, I'm told there is enough seats for everyone. It is the new Horton. The one where there is a small opening between cab and back. It also has the feature that when you shift into park the lights automatically cut out to just flashing cube lights (Sorry, can't describe it better, I am looking for pics now.)

Yesterday for an abdominal pains w/ poss. pregnancy related two rigs showed. ALS carried 3, BLS carried the full 5.


I found a video of our rig, PM if you want to see it

[MDEMT280]

A standard medical call would get an ALS unit or a BLS unit as determined by EMD, with a minimum of two crew at the staffing levels I mentioned earlier.

Volunteer units frequently run with more, perhaps three, perhaps four if they've got a trainee or they know the manpower will be needed (known heavy patient, etc.). Paid units very rarely run with more than two -- typically, only when they have a recruit doing field training.

The district supervisor may respond as well, depending on the call (one paramedic in a car).

A manpower unit would respond for forced entry, known heavy patient, major calls (unconscious, cardiac arrest, etc.), as a first responder for transport units with extended ETAs, and when requested by units on scene.

As you can see, it starts to get complicated. That's the problem describing a county-wide system that integrates volunteer and paid stations, with each volunteer station also setting their own staffing policies (so long as they meet county minimums).

And I'm sorry, but 5 in a box is just a clown car. Regardless of how many SEATS there are -- yes, you can seat five on the bench, captain's chair and CPR seat if so equipped -- you can only have so many people working on a patient at one time.

And I'm also sorry about this, but you said at least ONE member of that five person crew is an EMT? What are the other four people?

I guess on a standard call say (Shortness of Breath or Unconcious but Breathing) NOT MVA or CPR in Progress or anything like that.

MDEMT: It was not an assist, that is what they crew with.:eek: I don't know how they fit them all in, I'm told there is enough seats for everyone. It is the new Horton. The one where there is a small opening between cab and back. It also has the feature that when you shift into park the lights automatically cut out to just flashing cube lights (Sorry, can't describe it better, I am looking for pics now.)

Yesterday for an abdominal pains w/ poss. pregnancy related two rigs showed. ALS carried 3, BLS carried the full 5.


I found a video of our rig, PM if you want to see it

[explcdt8]

At least one is an EMT

The other are Certified First Responders.

This is on the volunteer rig, and it meets state standards for a BLS unit.

On an ALS Rig you have 2 EMT's and 1 Paramedic

[MDEMT280]

OK. I was afraid for a second you'd say the EMT was the only medically-trained person on the unit. :eek:

I've seen issues with non-medical crew on an EMS unit, and it ain't pretty.

[explcdt8]

How do you have an non-medical crew on an emergency MEDICAL unit?


The absoulute lowest trained people are Standard First Aid+CPR for Professional Rescuer+AED; and those are the Jr. Corps Observers(official title, they do a little more than observe, but I am not sure how much, I mainly know about the PD not the EMS or FD)

[MDEMT280]

Eh, I should clarify, by "non-medical crew," I mean there are crew members who are not EMS providers, not that there wasn't a single EMS provider on the crew.

Some places think that the driver is just driving, so he doesn't need to be an EMS provider, he just needs CPR training. Only the person in the back needs to be an EMS provider.

It sucks, big time, to think your ambulance crew actually knows what they're doing, or knows what bag to grab, or how to operate a stretcher, when in reality all they've been told and all they think they need to know is how to drive the vehicle.

Unfortunately, some places, all you need to be a legal crew is one certified EMT to be with the patient. Volunteer companies may not be able to get two EMTs, but they've got Joe the retiree who lives next door to the fire station and he'll show up and drive if they get one EMT.

It's hard times for recruitment and retention all over in the volunteer world. If it comes down to it, do you put the crew with only one EMT on the street, or do you let your citizens suffer?

[explcdt8]

I see. That has been a problem in neighboring towns I believe but never in ours.

[CACBAND]

Around here for any medical call one engine (FD) and one ambulance is dispatched. The engine has a crew of 4 (at least one EMT-P) the others are EMT-Bs though one or two are EMT-Is right now. The Ambulance (Southwest) has a crew of 2 (EMT-P and EMT-B) for 911 calls. The medic from the engine also generally rides in with the ambulance. In the event that the call volume exceeds the number of engines available the fire department does have one ambulance but Southwest still transports nearly always.

[AnthonyM83]

If it comes down to it, do you put the crew with only one EMT on the street, or do you let your citizens suffer?

Would they really suffer? I imagine if the city council realized they literally had NO EMS, they'd be finding funds for a real EMS system pretty quick.

You wouldn't want to rely on a volunteer PD where some shifts may or may not be covered, right? Well, don't rely on volunteer EMS. Demand full-time professionals (not only would they have high passion for it since it's their career, they'd also have time to keep up to date with latest medical developments and trainings).

[MDEMT280]

Tell a town of 1,000 that they need an ALS transport service, 24/7/365, and I'm sure they'd love the idea. Tell that town how much it'll cost, and they'll tell you exactly where you can go, and how you can get there.

Full-time, paid services are great, but they're not practical in many areas of the country.

And by the way, whether or not you get a paycheck doesn't dictate how much passion you have for a job. I can show you plenty of working joes out there who punch a time clock every day, 9-5, doing stuff they hate, who walk out of work and put on a reserve LEO uniform or volunteer fire/EMS uniform and do that job for free because they love it. And yes, I can also show you plenty of paid "professionals" who are half-assing it all the way to retirement, not because it's something they love doing, but because it's a government job with benefits.

[noelchabanel]

Tell a town of 1,000 that they need an ALS transport service, 24/7/365, and I'm sure they'd love the idea. Tell that town how much it'll cost, and they'll tell you exactly where you can go, and how you can get there.

Full-time, paid services are great, but they're not practical in many areas of the country.

And by the way, whether or not you get a paycheck doesn't dictate how much passion you have for a job. I can show you plenty of working joes out there who punch a time clock every day, 9-5, doing stuff they hate, who walk out of work and put on a reserve LEO uniform or volunteer fire/EMS uniform and do that job for free because they love it. And yes, I can also show you plenty of paid "professionals" who are half-assing it all the way to retirement, not because it's something they love doing, but because it's a government job with benefits.

Excellent post.

[AnthonyM83]

And by the way, whether or not you get a paycheck doesn't dictate how much passion you have for a job.

Would a town without any EMS system whatsoever receive assistance from county or state government?

And no, paycheck doesn't dictate passion, but ability to devote one's career to it can allow you to immerse yourself in it. I never claimed full-time EMS by nature was better or had more devotion, rather it allowed it.

I can match your examples with examples of poor EMS volunteers as far as professionalism and reliability and motivation for doing the job (being a health professional versus having a fun lights/sirens job), but that doesn't mean all/most volunteers are like that and no one claimed so.