Closest ambulance goes?

[CentralCalEMT]

directed to you and any other county based, so if you have an area on the county line, will you only pull from your county, or will your dispatch center call the next county over and say "I have a call in town on the county line, do you have a closer unit?"

It depends on the system. In Central CA, in Tulare County, there are areas where Kern County EMS units are closer 99% of the time due to the fact Kern County has a couple of towns with 2-3 ALS units each (Delano, Kernville) right on their side of the county line and the closest Tulare County resource might be 30 min away. For those calls (easily a couple of hundred a year) mutual aid/auto aid is requested. However, the Kern County units follow their own Kern County protocols and transport to Kern County hospitals which are closer to those areas.

 

[MaxExam]

The closest(sometimes) & or if not coexisting, the most appropriate for the indicated MOI/NOI Level.

 

[DrParasite]

I'll throw a wrench into this discussion... How do you feel about individual facilities or entities entering into their own contracts for ambulance coverage-- separate from the city or county EMS system. The perfect example of this is nursing homes... who call private contracted ambulance services for everything... How do you feel about these contracted ambulances responding from several towns or dozens of miles away, while competent ambulances sit in the town?

Love it!!!! volunteer EMS systems in general love it when a facility has a contracted provider for routine stuff, so their volunteers don't get tied up on interfacilities. some paid EMS agencies love it too, since it make sure their 911 units are available for 911 calls.

Do you think these nursing home runs are "below" the city EMS? Are the extended response times justified because the patients are in a "healthcare setting"? We all hope this isn't happening for cardiac arrests and the like, but we all know it does. Thoughts?

yes and no. for EMERGENCIES, please call 911. chest pain, diff breathing, cardiac arrest, seizures, new onset altered mental status, recent fall, unconscious, etc, call 911. For non-emergency stuff, abnormal labs, fall 3 days ago no complaint of pain, fever with no other complications, feeding tube came out, or trips to the doctor's office, please call the contracted provider.

but if it's an actual EMERGENCY, a new onset of something potentially life threatening that hasn't been going on for 3 days, than 911 is absolutely appropriate. but otherwise, call your contracted inter facility non emergency company.

 

[Christopher]

directed to you and any other county based, so if you have an area on the county line, will you only pull from your county, or will your dispatch center call the next county over and say "I have a call in town on the county line, do you have a closer unit?"

We routinely standby for neighboring counties (and sometimes even for South Carolina). We have everybody in our radio banks and just flip and talk with their dispatch for where they'd like us to standby or if they have traffic for us.

 

[JPINFV]

I'll throw a wrench into this discussion... How do you feel about individual facilities or entities entering into their own contracts for ambulance coverage-- separate from the city or county EMS system. The perfect example of this is nursing homes... who call private contracted ambulance services for everything... How do you feel about these contracted ambulances responding from several towns or dozens of miles away, while competent ambulances sit in the town?

If they could properly decide who needed to go via 911 vs the slow boat, I wouldn't care. In my experience they lack that ability, thus I believe that any time a patient is transported to the emergency room (CCTs exempted), that it should be done via the 911 system.

 

[Tigger]

Love it!!!! volunteer EMS systems in general love it when a facility has a contracted provider for routine stuff, so their volunteers don't get tied up on interfacilities. some paid EMS agencies love it too, since it make sure their 911 units are available for 911 calls.yes and no. for EMERGENCIES, please call 911. chest pain, diff breathing, cardiac arrest, seizures, new onset altered mental status, recent fall, unconscious, etc, call 911. For non-emergency stuff, abnormal labs, fall 3 days ago no complaint of pain, fever with no other complications, feeding tube came out, or trips to the doctor's office, please call the contracted provider.

but if it's an actual EMERGENCY, a new onset of something potentially life threatening that hasn't been going on for 3 days, than 911 is absolutely appropriate. but otherwise, call your contracted inter facility non emergency company.

What if the contracted provider can provide a higher level of service (ALS) with a better response time than the municipal service?

 

[usalsfyre]

What if the contracted provider can provide a higher level of service (ALS) with a better response time than the municipal service?

Or equipment (mechanical ventilation) the municipal provider refuses to? Or transport to appropriate facilities when the municipal provider refuses to go anywhere but the closest?