24/48 hour shift

[Generic]

I am not sure why this wasn't posted in the post above. I even edited it and this text showed up but I am not seeing it posted in my last answer.

[QUOTE="Jim37F, post: 620350, member: 18895]I'm not even aware of any LA Co stations with multiple squads (though there's at least one or two I can think of that could use an extra ha)[/QUOTE]

I am not sure why they don't do that. It may be partly do to a lack of space at stations that need it. They did add squad 130 to help pick up the slack of squad 33 which ran over 10,000 calls last year. It's unusual that they put a squad at a neighboring station but with that call volume, it's understandable. Usually it's every other or 2 stations. (West Hollywood is a special case).

 

[ExpatMedic0]

I have never been on that exact schedule. However, I have worked day shift fulltime for years and night shift fulltime for years. Once you get a rythem on the same shift its not so bad. The worst was rotating shifts. The last couple contracts where terrible. First one was 2, 12 hour day shifts, followed by 2, 12 hour night shifts. The last on was one week of night shifts, followed by one week of days shifts. When you switch back and forth like that over months and years its not only terrible for your physical health, but your mental health as well. The worst of the worst was by far the day and night shifts in the same week. I use "black out curtains" a night mask and ear plugs when I get home.

 

[CALEMT]

FS7 was the busiest last year with over 5,600 calls. FS37 is up there though.

Now thats interesting, while I'm a east end guy I would've figured that 25 or 27 would be the busiest. Always hearing those stations pop off.

 

[WolfmanHarris]

Just curious Wolfman, what does fire typically respond to in Ontario Canada?

Each service sets their own tiered response agreements with their local FD. Generally in areas served by paid FD they would respond to cardiac arrest, unconscious, chest pain, SOB and obviously MVC/rescues. Areas served by volly FD about the same though some do less due to demands on volunteers. FF's only trained to FR or EMR.

Where it gets interesting is in a few major centres services are provided advocating for more evidence based tiering which has dropped FD response way down in my area. We send two transport Ambulances to every cardiac arrest. No FD response to LTC or other medical facilities. We've also stopped FD response to CP and SOB unless altered LOA. We have liberal policies for back-up and lift assist and aggressive RRU deployment during peak hours so I can get additional Paramedic help quickly.

**Edit: fixed some big thumb related issues. Sorry on my phone.

 

[CALEMT]

Each service sets their own tiered response agreements with their local FD. Generally in areas served by paid FD they would respond to cardiac arrest, unconscious, chest pain, SOB and obviously MVC/rescues. Areas served by volly FD about the same though some do less due to demands on volunteers. FF's only trained to FR or EMR.

Where it gets interesting is in a few major centres services are provided advocating for more evidence based tiering which has dropped FD response way down in my area. We send two transport Ambulances to every cardiac arrest. No FD response to LTC or other medical facilities. We've also stopped FD response to CP and SOB unless altered LOA. We have liberal policies for back-up and lift assist and aggressive RRU deployment during peak hours so I can get additional Paramedic help quickly.

**Edit: fixed some big thumb related issues. Sorry on my phone.

So just out of curiosity a typical medical aid where I'm at in So Cal gets a fire engine and a ambulance. Full arrests get 2 engines and a ambulance. Traffic collisions depending on if its a cut and rescue or how many vehicles involved can get just a engine and ambulance. If its multiple vehicles you can get 2+ engines and more than 1 ambulance (depending on how many people are injured). A cut and rescue traffic collision gets a truck, 2 engines, battalion chief, and depending on number of patients 1 or more ambulances.

Is your typical medical aid response just a ambulance and you utilize fire for the more "serious" calls i.e. full arrests, tc's, etc?

 

[WolfmanHarris]

Is your typical medical aid response just a ambulance and you utilize fire for the more "serious" calls i.e. full arrests, tc's, etc?

All calls receive a Paramedic ambulance. During peak times (0600-2400) in higher density areas a RRU will also be sent if the call is in its zone. If FD is tiered they are often cancelled before scene or shortly after; or response times are similar throughout our region.

If the call is clinically high acuity or dynamic and I want hands I will either take the RRU medic with me in the back or call for back-up. There are guidelines for when/how but essentially at my discretion.

If the call is operationally challenging (MVC, MCI, rescue, etc) than a Captain or Superintendent will attend the scene to take operational command. They rarely provide any patient care. Depending on resource requirements we have pre planned responses that could include our Multi-Patient Unit (bus), Emergency Support Unit, (truck full of spare gear, scene lighting and command post), Special Response Units (single medic, tactical w/ additional lighting, spare bags, rescue support) and any additional Ambulances and RRU as necessary to manage the call.

The Incident Management Support Centre may be staffed at HQ to oversee system level issues like calling in/holding over staff, media inquiries, managing the usual call volume that's still coming in, mutual aid, etc.

In my system FD is primarily used in non patient care roles even on the calls they do attend. If I haven't cancelled them they're likely running equipment to and from the truck for me, facilitating extrication from the house, etc while Paramedics handle patient care, even on cardiac arrests.

 

[CALEMT]

Interesting. Also excuse my ignorance but RRU is what exactly?

 

[Flying]

Interesting. Also excuse my ignorance but RRU is what exactly?

Rapid Response Unit?

 

[VentMonkey]

**Edit: fixed some big thumb related issues. Sorry on my phone.

No worries, I suffer the same affliction.

Very neat, cutting sounding system, btw, so thanks for that.

 

[WolfmanHarris]

Rapid Response Unit?

Yep. We staff 5 from 0600 to 1800 and another 4 that come on from 1200-2400. They cover an area of a few square kilometres in areas that are both high density for calls and due to traffic have higher than average response times. Single Primary Care Paramedic (BLS) that stay mobile in their zone (our Ambulances are all station based).

Beyond that we have one Captain or Superintendent in a response unit per district and one SRU (tactical) per district that can jump calls.

I'm extremely lucky to work in a system that is not only very well resourced (though we can always use more units) but has excellent professional leadership and is very progressive. Ontario has terrible directives and scope of practise compared to elsewhere, but within those provincial limits we're as evidence driven and patient centred as possible.

I realize I've hijacked this thread a bit; sorry about that.

 

[VentMonkey]

Yep. We staff 5 from 0600 to 1800 and another 4 that come on from 1200-2400. They cover an area of a few square kilometres in areas that are both high density for calls and due to traffic have higher than average response times. Single Primary Care Paramedic (BLS) that stay mobile in their zone (our Ambulances are all station based).

Beyond that we have one Captain or Superintendent in a response unit per district and one SRU (tactical) per district that can jump calls.

I'm extremely lucky to work in a system that is not only very well resourced (though we can always use more units) but has excellent professional leadership and is very progressive. Ontario has terrible directives and scope of practise compared to elsewhere, but within those provincial limits we're as evidence driven and patient centred as possible.

I realize I've hijacked this thread a bit; sorry about that.

Not at all. I think it's safe to say I'm not the only one on here interested in learning how prehospital practitioners function in other parts of the world, and outside of the U.S.

 

[CALEMT]

Not at all. I think it's safe to say I'm not the only one on here interested in learning how prehospital practitioners function in other parts of the world, and outside of the U.S.

I'm always intrigued by how other people especially our neighbors north of the border do things.

 

[VentMonkey]

I'm always intrigued by how other people especially our neighbors north of the border do things.

...the most efficient way

 

[dutemplar]

Not at all. I think it's safe to say I'm not the only one on here interested in learning how prehospital practitioners function in other parts of the world, and outside of the U.S.

2 12 hour days, flip to 2 12 hour nights. "Four" off, but the first day is wasted recovering and all. Overall, most providers don't like that and would much prefer to do straight days or straight nights, and flip weekly or every other week.. instead of in the middle of each rotation. 16 shifts per month, so extras and OT are tossed in. But it makes scheduling easier. Somehow.

Every call gets an Alpha (two EMT-Is) started hot, may be calmed down as info comes in.
Step up gets a Delta, area EMT-I supervisor who's been here a while and can coordinate.
Next steup up gets a Charlie, (one EMT-I, one Critical Care Paramedic).
"Oh schnikies" may get an Oscar (Operations supervisor/manager, usually a CCP, they've been here a while)

Incident command system is styled off of the London Ambulance Service,... (sigh)

Remote areas will get a Lifeflight helicopter, and outside of the city may get a Lifeflight if there it's judged a better option than a ground Charlie to respond.

Sadly, they use a US based system so it tends to overdispatch severely where the the tiers were designed for BLS cold, BLS hot, ALS as compared to Intermediate cold or hot, Intermediate and supervisor, Intermediate plus Supervisor and CCP. But hey, it works. Lucas on just about every unit (Deltas, Charlies, Oscars,...) so any priority call already starts with 5 providers.

 

[ExpatMedic0]

2 12 hour days, flip to 2 12 hour nights. "Four" off, but the first day is wasted recovering and all. Overall, most providers don't like that and would much prefer to do straight days or straight nights, and flip weekly or every other week.. instead of in the middle of each rotation. 16 shifts per month, so extras and OT are tossed in. But it makes scheduling easier. Somehow.

I absolutely hate this, Its defiantly the Brits and South Africans that love doing this.

 

[NomadicMedic]

I absolutely hate this, Its defiantly the Brits and South Africans that love doing this.

It's the Sussex county schedule too

 

[ExpatMedic0]

It's the Sussex county schedule too

WOW! I actually had never seen a place do it in the U.S. ( on the west coast anyway). That's a bummer

 

[DrParasite]

WOW! I actually had never seen a place do it in the U.S. ( on the west coast anyway). That's a bummer

When I was in Central NY, all the fire departments did it. I never could understand it, switching from days to nights on a regular basis sucks.

 

[NomadicMedic]

4 platoons, 2 12 hour days. 2 12 hour nights. 4 days off. I actually didn't mind it until the second night. That was always bad.

 

[WolfmanHarris]

I love our schedule. PD is on the 2D-2N-4Off and they always look wiped by the end. We're on 4N-4Off-3D-3N-4off-4D-6off. The split can be a challenge, but the 6 in a row off each month and the predictability of having two out of every four weekends off is nice. Plus using 48hrs vacation or lieu usually results in 2 weeks off. Thanks to some careful saving of my time I just took all of September off.