a Question for starting fire-based EMS

[codeblue81]

I was wanting to get a few opinions on what would work best for a lowbudget FD. A transporting BLS ambulance, or a non-transport BLS rescue Squad. The only ambulance around is an ALS rig 15 min away. In the case of medical or trauma calls it would be best to have rapid response. Which would be better. Any ideas welcome.

code_blue81 :D

[SilverCity4]

Well, there are lots of factors. What are you calling "low budget" and what's your estimated run volume?

There are much fewer standards to meet by running non-transport BLS Rescue. But, you aren't going to get any revenue from running non-transport BLS.

Now, run a transport BLS unit, and you can bill for services. However, you're going to have the State Department of Health (or it's equivilent) watching over you, and it's going to cost more to maintain the program.

[Firemedic 61]

IF YOUR ALS UNIT IS THAT FAR AWAY YOU SHOULD CHECK ON OPERATING AN ALS QUIK RESPONCE UNIT. THIS IS THE BEST WAY TO PROVIDE RAPID ALS INTERVENTION TO YOUR COMMUNITY AND IT IS ONE MORE THING TO BOAST TO THE CITIZENS WHEN YOU NEED BUGET INCREASES. IF YOU TRANSPORT YOU CAN COLLECT MONEY FOR THE RIDES BUT YOU HAVE TO CHECK WITH YOUR STATES DEPT. OF HEALTH. ALSO TO IAFF HAS A PERSON DEDICATED TO HELPING FIRE DEPARTMENTS START EMS. CHECK IT OUT ON THE IAFF WEB SITE. IAFFONLINE.COM. HOPE THIS HELPS.

[bfcf623]

I think the Intermediate EMT May be your answer. My information is old (it's based on 1996). You would need backing from your Units Medical Director, and the Illinois dept. of Public Health (it would not hurt if the community and members of the state legislature were on your side either). If you can show the need for advanced care sooner (review run reports)and document everything that was als in nature you might be able to get a intermediate course. Intermediates once trained (56 hour minimum) and certified can administer IV solutions, medications by local protocal, trauma care and other authorized techniques for life threatening conditions under the direction of a physician. Also I would consider having a ambulance just incase the other service is going to be delayed so you can head to the hospital if the patient is in bad shape or meet the paramedic unit while enroute. This would also require approval from the same sources. I would check around your state and see if anyone else is providing intermediate care in a situation similar to yours as well.

[ALSfirefighter]

Code,

There are several factors, many which have already been mentioned, that you must take into account. First, as you stated was your budget restrictions. However, if you start up your program you may be able to get some more money in your budget if you gain the publics eye and understanding. Also, as Silver stated, you cannot be reimbursed as a non-transporting agency. However, you may be able to reach a agreement with the transporting agency to receive part of their payment for your use. Depending on your relationship, that may not be easy.<br />Secondly, you have to look at your manpower issues. I do not know if you are career or volunteer, but either way you will need to have adequate personnel. Do you now have enough members to staff a BLS ambulance, will you continue to have enough, and what are your response goals. 100% of calls, 80%? Once you commit, you may lose face if you cannot maintain it and have to give it up. Again, it also depends on your call volume also. Is 1 ambulance enough? Also how much more will your insurance coverage cost? You will have to look at adding some insurance for malpractice/negligence.

My idea that I can give you, is why not start up as a non-transporting provider. You can get your basics that you need (according to your DOH guidelines). And get your feet wet. If it looks like its going good, and I don't mean for a couple months,(everything new looks good for a few months)then you can begin the process of upgrading to a transporting agency from there. By the time you spec out and purchase an ambulance you can get all the remaining equipment you need.

-----------------------------------------------<br />The above is my opinion only and doesn't reflect that of any dept/agency I work for, deal with, or am a member of. <img src="biggrin.gif" border="0">

[MOBrian]

Right away I would like to tell you to jump into at least ALS first response, it is truely the best thing that you can do for your community. You could do ALS repsonse with the ALS rig 15 minutes away to assist. If you can recall an ALS rig 15 minutes away does very little life saving and a lot of calling the ME. Get your department to go ALS, it is a lot of work and time but the best thing possible for the community in which you serve