LA county EMS/Fire?

[EMTPi]

Hello all, I'm an EMT living in SE WI, working for a private 911/IFT and currently taking an AEMT course at the local Technical college.

I have always been a huge fan of the tv series Emergency! with Johnny Gage and Roy Desoto. I always thought it was a bit strange how the paramedic squad would respond initially and the ambulance would show up later. I saw a video on youtube of a modern LA paramedic squad operating in a similar manner and was wondering just how EMS works over there. Is there a tiered response? How do they coordinate responses?

Thanks

 

[Jim37F]

All 911 paramedic response in LA County is local fire department. Whether that's LA County FD, LA City, Torrance FD, etc. I'd wager a guess that half the local departments transport in their own FD ambulance. The others, and LA County Fire use private contracted ambulance companies for transport. And yes, they do use the Engine and seperate paramedic squad model. And yes, typically speaking fire will show up on scene first. And yes, you get an Engine, Paramedic Squad, and a BLS ambulance responding to all 911 calls for EMS.

For ALS transport, the medic will hop on the ambulance and both ambulance and squad will drive code 3 to the hospital (though I have had a couple calls where we drove code 2 w/ the medics) while the Engine goes back in service. For BLS transport the ambulance will transport code 2 while the Engine and Squad go back into service.

If you are a Paramedic for the private ambulance, on a 911 call you are only operating as an EMT, unless the fire medics allow you to do more.

There are 80 some odd ambulance companies in LA County. Only 6 have any 911 response: AMR, AmeriCare, Care, Gerber, McCormick, and Schaefer. (The rest are IFT only) And two of those (AmeriCare and Gerber) only have one city each (while Gerber pretty much lives and breathes the Torrance FD contract, with all 12-15 of their on duty rigs posted throughout the city, AmeriCare only has ~5-7 rigs in Santa Monica, it's a small side show from the rest of their county wide IFT operation)



So if you want 911 in LA County you either need to become a Firefighter Paramedic (remember you'll be competing at least a hundred applicants for every infrequent open slot). Or be an EMT making close to minimum wage, for a company that knows every EMT in th county wants to work 911 and will be applying so despite the lower wages than the IFT companies they can be pretty picky on who they hire (McCormick for example won't even consider your application if you don't have a recommendation from one of their employees)

 

[CALEMT]

Out here in Riverside County (couple hours from L.A pending where you live) its mostly a private ambulance company: AMR. With every 911 call depending what city you're in you will get a Fire engine with 3 personnel (there is at least 1 firefighter medic on a engine) and a ambulance with a EMT-B and a paramedic. The engine medic will turnover the pt to the ambulance medic and they will transport to the hospital. If its a critical call the engine medic and a firefighter if needed will "hop" on the ambulance.

Some stations out here have a medic squad (2 firefighter medics) at the fire station with those calls you will get the engine, squad, and private ambulance. Same thing for 911 calls squad medic will turnover pt care to the ambulance medic. If extra help is needed squad medic will hop on the ambulance.

Finally last but not least some battalions out here have Fire based ambulances at the stations. Meaning that the private ambulance company (AMR) does not run 911 contracts in those cities. Fire ambulances have 2 firefighter medics and the engine have at least 1 firefighter medic. Both will respond, usually the ambulance medic will initiate pt care and the engine medic will help out. If extra help is needed the engine medic will jump on the ambulance.

About 95% of the time the fire engine and/or medic squad will beat AMR to the call. For fire based ambulances it depends on what engine and ambulance gets the call. Sometimes the engine beats the box and vise versa. So if you want to run 911 in Riverside County you can be a EMT with AMR or become a firefighter medic with Riverside County Fire/CALFIRE. I know its not LA County but it is So CAL EMS.

 

[Bullets]

For ALS transport, the medic will hop on the ambulance and both ambulance and squad will drive code 3 to the hospital (though I have had a couple calls where we drove code 2 w/ the medics) while the Engine goes back in service. For BLS transport the ambulance will transport code 2 while the Engine and Squad go back into service.

They transport every patient using emergency warning devices?

 

[TRSpeed]

Out here in Riverside County (couple hours from L.A pending where you live) its mostly a private ambulance company: AMR. With every 911 call depending what city you're in you will get a Fire engine with 3 personnel (there is at least 1 firefighter medic on a engine) and a ambulance with a EMT-B and a paramedic. The engine medic will turnover the pt to the ambulance medic and they will transport to the hospital. If its a critical call the engine medic and a firefighter if needed will "hop" on the ambulance.

Some stations out here have a medic squad (2 firefighter medics) at the fire station with those calls you will get the engine, squad, and private ambulance. Same thing for 911 calls squad medic will turnover pt care to the ambulance medic. If extra help is needed squad medic will hop on the ambulance.

Finally last but not least some battalions out here have Fire based ambulances at the stations. Meaning that the private ambulance company (AMR) does not run 911 contracts in those cities. Fire ambulances have 2 firefighter medics and the engine have at least 1 firefighter medic. Both will respond, usually the ambulance medic will initiate pt care and the engine medic will help out. If extra help is needed the engine medic will jump on the ambulance.

About 95% of the time the fire engine and/or medic squad will beat AMR to the call. For fire based ambulances it depends on what engine and ambulance gets the call. Sometimes the engine beats the box and vise versa. So if you want to run 911 in Riverside County you can be a EMT with AMR or become a firefighter medic with Riverside County Fire/CALFIRE. I know its not LA County but it is So CAL EMS.

Ok you can be at Kern County and fire is BLS and the Paramedic comes from the private ambulance. Even our BLS units run lower priority calls and they are in charge of a scene if fire responds. Completely different system only an hour or two away from La County.

They transport every patient using emergency warning devices?

Unfortunately LA county runs there system like this. Its ridiculous.

 

[DesertMedic66]

Out here in Riverside County (couple hours from L.A pending where you live) its mostly a private ambulance company: AMR. With every 911 call depending what city you're in you will get a Fire engine with 3 personnel (there is at least 1 firefighter medic on a engine) and a ambulance with a EMT-B and a paramedic. The engine medic will turnover the pt to the ambulance medic and they will transport to the hospital. If its a critical call the engine medic and a firefighter if needed will "hop" on the ambulance.

Some stations out here have a medic squad (2 firefighter medics) at the fire station with those calls you will get the engine, squad, and private ambulance. Same thing for 911 calls squad medic will turnover pt care to the ambulance medic. If extra help is needed squad medic will hop on the ambulance.

Finally last but not least some battalions out here have Fire based ambulances at the stations. Meaning that the private ambulance company (AMR) does not run 911 contracts in those cities. Fire ambulances have 2 firefighter medics and the engine have at least 1 firefighter medic. Both will respond, usually the ambulance medic will initiate pt care and the engine medic will help out. If extra help is needed the engine medic will jump on the ambulance.

About 95% of the time the fire engine and/or medic squad will beat AMR to the call. For fire based ambulances it depends on what engine and ambulance gets the call. Sometimes the engine beats the box and vise versa. So if you want to run 911 in Riverside County you can be a EMT with AMR or become a firefighter medic with Riverside County Fire/CALFIRE. I know its not LA County but it is So CAL EMS.

95% is not realistic for the area. It's more evenly spread throughout AMR and Fire.

 

[CALEMT]

They transport every patient using emergency warning devices?

Negative, most transports are code 2. The critical calls are transported code 3.

 

[Jim37F]

They transport every patient using emergency warning devices?

If its triaged to BLS no, then it's Code 2 normal driving, no lights or sirens etc.

If its an ALS transport then yes, those'll pretty much almost always be Code 3 lights and sirens.

 

[CALEMT]

95% is not realistic for the area. It's more evenly spread throughout AMR and Fire.

Not quite sure what you mean by realistic.

 

[DesertMedic66]

Not quite sure what you mean by realistic.

Fire does not arrive on scene before AMR 95% of the time. It is no where near that high.

 

[CALEMT]

Fire does not arrive on scene before AMR 95% of the time. It is no where near that high.

Ohhhh yeah that stat is to high, I guess is all depends on what city you are in and where the call is.

 

[Bullets]

Negative, most transports are code 2. The critical calls are transported code 3.

If its triaged to BLS no, then it's Code 2 normal driving, no lights or sirens etc.

If its an ALS transport then yes, those'll pretty much almost always be Code 3 lights and sirens.

Oh, to me Code 2 means lights, no sirens unless going through an intersection

No lights/no sirens is code 1

 

[Gordoemt]

If its triaged to BLS no, then it's Code 2 normal driving, no lights or sirens etc.

If its an ALS transport then yes, those'll pretty much almost always be Code 3 lights and sirens.

Who did u get hired by?

 

[Blueprint1970]

Santa Monica will have a new ambulance provider next year. No clue who but I hear SMFD is not happy with the current provider. Also heard they were interested at one point, in starting an A/O program.

You made a good point with the CAAS sticker. Is it hard to get ?

Also hear TFD is done with Gerber. Sounds like McCormick, will finally become the provider. But we will find out soon enough.

Redondo Beach is happy with McCormick.

 

[Jim37F]

Who did u get hired by?

Gerber

Santa Monica will have a new ambulance provider next year. No clue who but I hear SMFD is not happy with the current provider. Also heard they were interested at one point, in starting an A/O program.

You made a good point with the CAAS sticker. Is it hard to get ?

Also hear TFD is done with Gerber. Sounds like McCormick, will finally become the provider. But we will find out soon enough.

Redondo Beach is happy with McCormick.

I def heard SMFD wants to dump AmeriCare. Something about a 25min response time to a full arrest? At least that's the rumor I've heard.

We still do occasionally send a unit up to Santa Monica to post, and a few weeks back I coulda swore I overheard on the radio that unit get an SMFD call, but that could easily have been a first in call (I distinctly remember the call was in SM and they had to confirm it was code 2 instead of 3)

I have seen a lot of Redondo Beach Fire coming in w/ McCormick to Little Company of Mary. It strikes me as a little odd that the RBFD medic unit is an ambulance, not a squad, so is McCormick their BLS backup or what?

I haven't heard anything about TFD wanting to drop us. It wouldn't necessarily surprise me either way. Torrance wants a 6 min ambulance response time, but they also want the ambulances responding code 2 to all calls. (Fire can upgrade us to code 3 after they get on scene). To meet that 6 minute code 2 response, we have 12-15 units in Torrance at any one time. Whereas by comparison, McCormick only has about 2 units covering Hawthorne (straight from the mouth of a McCormick EMT I was chatting up at the hospital earlier).

So unless McCormick (or Care/AmeriCare/AmbuServe/GCTI/whoever else wants the TFD contract) is willing to commit at least 6-8 units to Torrance, and/or is able to lobby Torrance to drop the code 2 only and/or increase response time allowances, Gerber will be able to keep the TFD contract.

 

[billydunwood]

Culver City Fire Department has a very interesting department. Every apparatus has a paramedic and ALS equipment. They have 3 engines, 1 ladder truck and 2 ambulances ALL which have at least 1 paramedic(2 in the ambulances and usually more than 1 on the engines because many of the FF are already medics). They generally use McCormick as a backup(sometimes 3x per day) and requests ALS from McCormick most of the time. But it's always good to know here in CC if you need a paramedic, no matter what engine or apparatus responds, there will be at least 1 medic if not more

 

[chaz90]

Culver City Fire Department has a very interesting department. Every apparatus has a paramedic and ALS equipment. They have 3 engines, 1 ladder truck and 2 ambulances ALL which have at least 1 paramedic(2 in the ambulances and usually more than 1 on the engines because many of the FF are already medics). They generally use McCormick as a backup(sometimes 3x per day) and requests ALS from McCormick most of the time. But it's always good to know here in CC if you need a paramedic, no matter what engine or apparatus responds, there will be at least 1 medic if not more

Joy of joys! You too can get a truckie who went to paramedic school in the late 80's and last intubated a live patient when Clinton was President! Just so you know there is an opposing viewpoint to your thoughts on ALS oversaturation, many on this website find the system you describe here to be one of the very worst imaginable.

 

[TRSpeed]

Lol exactly what I was thinking.

 

[billydunwood]

Joy of joys! You too can get a truckie who went to paramedic school in the late 80's and last intubated a live patient when Clinton was President! Just so you know there is an opposing viewpoint to your thoughts on ALS oversaturation, many on this website find the system you describe here to be one of the very worst imaginable.

Wow, that was funny. Actually, not really. Many of the Fire Fighters were hired as paramedics when they applied and actually a lot of them are relatively young(not paramedic school in the 80's). Plus, I would rather have a paramedic on the engine than an EMT-B just in case anything happens. I would rather have ALS and not need it than not have ALS and have it be tied up or 10 minutes away. By the way, this system has been working fine for years and CCFD has an excellent reputation for both firefighting and medical service

 

[chaz90]

Wow, that was funny. Actually, not really. Many of the Fire Fighters were hired as paramedics when they applied and actually a lot of them are relatively young(not paramedic school in the 80's). Plus, I would rather have a paramedic on the engine than an EMT-B just in case anything happens. I would rather have ALS and not need it than not have ALS and have it be tied up or 10 minutes away. By the way, this system has been working fine for years and CCFD has an excellent reputation for both firefighting and medical service

I'm not criticizing Culver City Fire in particular, nor am I trying to be funny. Honestly, I'm not even questioning the fire fighters who did what they had to do to become career FFs in your area. What I've seen in systems just like what you describe is having fire-medics (Fire first, medic a distant second) serve as apathetic providers who attended paramedic school only because their department mandated it. Age or time of experience wasn't really the point of my initial post. When people want to do one job and are forced to do another as they wait for what they've really wanted all along their "temporary" job performance suffers.

Having a paramedic on every call "just in case" only ensures this medic goes on too many "IV Monitor" BLS transfers and sees too few acute calls. You also take away the ability of the EMT to recognize the need for ALS and provide basic transport services on their own.