DOH:EMS and their skillset

[cameroncray03]

So, with the addition of DOH getting an Ambulance and FlyCar there have been some issues arising.
To start, most of the time we have DOH online, SCFD isn’t. And with the way everything is, DOH can only practice to EMT-B when the medic or FlyCar is staffed. With the increase of ALS calls that are being shown in the county, this poses a threat to the welfare to the public of Firestone when we have fully trained and certified EMT-I’s, EMT-P’s, and even a few CCEMT-'S that are restricted to a very limited selection of equipment and materials.

I propose to allow the FlyCar to stock up to CCEMT-P, but leave the BLS ambulance as it is. The reason for this logic is the FlyCar can only be driven by a PiC (Paramedic In Charge), CCEMT-P (A PiC currently), MDs (Medical Doctors), and DOH General Staff. This would cut back on the number of people on DOH providing ALS care unless the FlyCar is on scene. Which, is about 2-4 times a week for hours on end.

Here is the SCFD demographic of the call load that was run, and what SCFD determines an ALS call.

ALS Call Criteria;

A call should be treated as an ALS Medical if any of the following are present:
Seriously abnormal vital signs.
Chest Pain
Anaphylaxis or Allergic Reactions
Any heart or breathing complaint
Any problem with airway
Weak and Dizzy (if everything is okay after your assessment, you can turf it off as BLS if stable)
Altered Mental Status or Unconscious (unless it’s their baseline mental status)
Any seizure patient (if known history of seizures you can probably treat and release if stable)
Any patient who appears to be seriously ill or unstable.
Any patient with a toxic ingestion
Patients needing medications or ALS interventions (severe pain, patients who are combative, etc)

And the SCFD Call demographics;
I’m aware these show mostly fires and MVA’s, but patients that come out of these are 97% going to be an ALS call.

Cameroncray03, MED02 Paramedic In Charge, Shift 1 DOH
1FDP84/SAR2, Rescue 1 SCFD

Should DOH:EMS be able to stock and provide up to their scope level if the FlyCar is on scene?

• Yes
• No

[AestheticallyHappy]

@cameroncray03

I propose to allow the FlyCar to stock up to CCEMT-P,

env said no, hes the one that locked DOH to bls

[AestheticallyHappy]

shouldve included this in the main message however;

you’re in SCFD, SCFD provides ALS/critical care, you are on DOH 90% of the time you are in county locking yourself to EMT-B as your max scope. if you get a call that comes in that you 100% need als/critical care, switch to the department that you are in that allows you to provide that level of care.

i understand that DOH has it’s own quota, but for the times that i’ve been in county and you’ve, and other SCFD members, have been on DOH and being unable to assist me on calls because they are either; a.) in the flycar when i specifically need a vehicle to transport and made it clear in the radio transmission or b.) on the bls ambulance when they have the ability to get on SCFD and staff an ALS engine/ambulance to the ALS emergency that has arisen while me and other members on SCFD are busy with our own situations has been too many.

this is not a callout post towards the DOH:EMS division or any member of it, im stating things as i see it from an SCFD standpoint.

[DevilNode]

just callout 9th med, we’re built different

[tow23er]

This is because the SCFD chief did not want DoH to have ALS capabilities, so DoH got locked to BLS by the co-founder. That’s not a controversial statement, that’s just a fact. DoH would be fully capable of providing ALS if allowed to. They were even willing to compromise down to just an ALS fly car and a BLS ambulance, but that wasn’t enough apparently. I just don’t understand the logic behind it. SCFD can have an ALS engine or tower, but DoH can’t have even one ALS command vehicle, nevertheless an ambulance?

Just a little disclaimer, this isn’t an attempt to bash anyone or to disrespect the co-founder. I was not the one who brought this to the public light, I’m just giving my take on it.

[SeanCityNavy]

9th Medical Battalion

“We’re Built Different”

[Francisco_Mango]

@cameroncray03

DOH can only practice to EMT-B when the medic or FlyCar is staffed.

I’m 99.9% sure we can practice up to EMT-I on BLS-1.

[DevilNode]

ok coast guard detachment

[SwagGermanFighter]

battalion*

[anon54114525]

DOH was locked to BLS on their vehicles because DOH should not be the primary emergency services provider. They are expected to staff the Medical Center and not their ambulances. SCFD is an emergency service provider and are responsible for handing patients over at SCMC. If DOH had the same capabilities as SCFD, everyone would instead join DOH for EMS as well as hospital care and that would not only kill off SCFD, but will also kill off SCMC, disregarding the fact that they are only staffed during “shift hours.”

[cameroncray03]

I understand and respect your reasoning on your decision. But, the flaw with it is; if SCFD only has a firefighter/EMT-B online and the server is full. Then their is only BLS across the county. And with paging a Paramedic or FireMedic, I’ve seen it take upwards of 30-40 minutes of queuing for one to get in. As for my other reasoning, when SCFD is stacked on ALS calls with limited staffing (Like there was a few days ago when we had both SCFD ambulances and DOH vehicles staffed running calls) and we have multiple cardiac or major trauma calls. There’s equipment that’s needed that’s tied up. And with current regulations, we are to stabilize certain cases before transporting. That’s why I had suggested only the fly car of DOH be equipped to a CC or EMT-P level. It’s restricted to pretty much 5 people in the entirety of DOH already so there isn’t a major issue of doh being a primary ambulance service, especially when it comes to ALS. I’m thinking of DOH was atleast given the chance (Like 2 week trial then reevaluate) of their FlyCar having CC/EMT-P equipment on board, instead of automatically assuming worse case scenario. We wouldn’t notice as bad as a department trend I feel some people assume would arise.

[Toastee_RBLX]

However, one could argue a simple fix to this would be to add benefits based off position within both.

By having a private vs state system (Though technically SCMC is a public hospital, for the sake of this lets think of it as private), you breed a direct competition. This could be seen through: response time, reliability, and “one-up-manship” - essentially besting the other wherever you can.

You could for instance give a pay raise to SCFD paramedics, however, DOH may say their paramedics may only need to log fewer hours, or vice versa. You can control human behaviour based off of responses to many external factors, so if you want to control them effectively, see how they act without any limitations.

DOH should’ve had a period where their ambulances were considered ALS equipped to see how it would work with SCFD. If there was a significant issue that arose then yes lock them to BLS, or do the required remedy. But, by going guns blazing and assuming it’d kill of SCFD and then SCMC, you haven’t been able to see:

A. If it was the only issue
B. If it was even an issue
C. If your assumption was wrong

But look, I’m personally used to a system where ambulances in my country will leave their ambulance station to start their day, but usually end it by sitting outside a hospital for hours while they handle patient transfer and support. A system where SCMC crews are ALS equipped along with SCFD may mean that across the county we’ll see faster response times, and more active/capable crews for any situation.

But look, it’s Firestone, and at the end of the day anyone in the FF/Medical sector is usually at a loss in most decisions. I don’t know how true this statement is of DoH and SCFD as of current, but during my time in SCFD it sure felt true enough.

[anon54114525]

They were locked to BLS after I let their fly-car be ALS and they wanted more and started bashing at mrzip in the most toxic way possible. No thanks.

[cameroncray03]

You realize, there’s probably a reason behind the bashing (Do I agree this should’ve happened, no. Did it already happen, yes). As for the wanting more, isn’t that literally every department in Firestone? And at the time of the stuff being added. We didn’t have the command structure we have. Droxy is doing a good job managing and controlling the EMS side of DOH as the chief. And there’s a lot of people in DOH who are both SCFD/DOH.

[anon54114525]

@cameroncray03

there’s probably a reason behind the bashing

no thanks. no “reason” justifies it at all.

[SwagGermanFighter]

i don’t get why doh hired so many people in one intake anyways