New York City EMS

[RedAirplane]

I did a search on the forum but I could not find anything on this topic.

Recently, I thought I was going to be moving to New York City, so naturally I looked into the EMS system. Although I never ended up moving, there were certain things about the NYC EMS system that are extremely perplexing to me.

It appears that in the 911 system, Fire Department and Hospitals provide ALS and BLS ambulances. It also seems that there are a lot of "volunteer" ambulances (Bravo, Park Slope, Central Park Medical Unit, etc.) that advertise non-911 numbers for emergency response.

Can somebody explain this to me? I wrote to the NYC Fire Commissioner and got a very long-winded response that said nothing of material importance.

The last thing I would want to have to do in an emergency is dial a bunch of numbers asking "Hey, do you have a unit near me? How soon can you send it?" I thought that the whole point of 911 was to do the most good for the most people, sending the nearest or most appropriate unit to each call. If there are EMS units not in this 911 system, it seems that one of the key benefits of the 911 system is somewhat crippled. But perhaps I am misunderstanding things.

Anybody who knows about this, please chime in. I am simply curious and confused, and hope I did not step on anybody's toes.

Best,
Ishan

 

[Handsome Robb]

The way I understand it is the 911 system will generally use FDNY units if they're available and close but also dispatch for the hospital services and volunteer services if they're the closest or there aren't any FDNY EMS units available. I'm not totally sure but I believe that most of the volunteer services end up responding with a paid ambulance as well.

This is how it was explained to me a while ago but I'm not 100% certain. Does that help at all?

 

[DrParasite]

The way I understand it is the 911 system will generally use FDNY units if they're available and close but also dispatch for the hospital services and volunteer services if they're the closest or there aren't any FDNY EMS units available. I'm not totally sure but I believe that most of the volunteer services end up responding with a paid ambulance as well. I know there's an ambulance that's

This is how it was explained to me a while ago but I'm not 100% certain. Does that help at all?

Close, but not quite. NYC's EMS system is one of the most screwed up systems in the nation. To start, the EMS system in NYC is composed of FDNY EMS units, and the Voluntary EMS units. The Voluntary units are typically hospital based, and supplement the understaffed EMS system, and typically cover the areas around the hospital. The hospital units typically have a first due/primary area, and if they are on an assignment, the closest other unit will be dispatched. They will also back up FDNY ambulances when their first due units are on an assignment.

Now, you asked about the volunteer ambulances..... they ARE NOT part of the 911 system, but are typically a historical agency that existed prior to the whole FDNY takeover. They have a first due area that was their area, but the are not dispatched by FDNY communications. They will overhear a call being dispatched and jump the call, and as long as they beat the 911 system ambulance there, they can take the patient and cancel the 911 ambulance. Since NYC EMS ambulances have historically had abysmal response times, it was sometimes quicker to call the volunteer ambulance on the 10 digit number instead of calling 911 and waiting for one to show up.

There are still a few volunteer fire companies that operate in NYC who do the same thing, and are not part of the 911 system.

 

[Handsome Robb]

Even worse than I thought.

When you say voluntary when referring to the hospital-based units do you mean the crews are volunteer or they're voluntarily part of the 911 system?

 

[firecoins]

Voluntary hospital units are paid crews. There are both bls and ALS.

 

[chaz90]

Every time I read about how convoluted this system is it frightens me. Absolutely unreal! I know I have no experience with NYC and its historical traditions and services, but I can't imagine calling 911 only to have some random undispatched ambulance or fire apparatus respond and cancel the city supported service I called! That this entire thing goes on with the tacit approval of the city is even more unbelievable to me.

 

[Bullets]

Post Sandy, FDNY has gotten better at allowing others to play in the sandbox. The volunteer Fire and EMS are actually dispatched by Central. FDNY has acknowledged that these places, the southern reaches of Staten Island, the Rockaways, are too far from any FDNY station and not busy enough to justify putting units out there.

And Hatzalah is direct called by the people, they are a whole other ball of wax

 

[RedAirplane]

In LA city, I know that Hatzolah is tied into the FD/911 system, where certain addresses are automatically assigned to Hatzolah. Seems like an easy enough solution everywhere?

 

[DrParasite]

Every time I read about how convoluted this system is it frightens me. Absolutely unreal! I know I have no experience with NYC and its historical traditions and services, but I can't imagine calling 911 only to have some random undispatched ambulance or fire apparatus respond and cancel the city supported service I called! That this entire thing goes on with the tacit approval of the city is even more unbelievable to me.

Ehhh, it's not that bad. It's not much different than calling 911, requesting a FDNY ambulance and having a hospital-based voluntary ambulance (which is'nt supported by the City) show up. As long as an ambulance shows up, with a properly trained and equipped crew, do you really care what names is on the outside?

Furthermore, the "undispatched" ambulances often have a better response time than the 911 system ambulance, and are often preferred because they have always service the area. Think of it this way: if you live in Rockaways Queens, and Rockaway ambulance has historically answered the calls when you called 911, would you want a Rockaways ambulance (which you donate funds to and has always been there for you) or FDNY ambulance to show up when you called 911?

In LA city, I know that Hatzolah is tied into the FD/911 system, where certain addresses are automatically assigned to Hatzolah. Seems like an easy enough solution everywhere?

I'm not going to go into Hatzolah, except to say that probably wouldn't work for NYC..... With between 100 and 200 apartments in every high rise building, the time it would take to create and maintain the list in the 911 center (and update every time someone moved out) would be cost prohibitive. Plus you are bypassing a closer ambulance for the service of your preference, and if Hatzolah can do it, why shouldn't every ambulance service in the city be able to do the same, to drive business towards their company?

 

[ZombieEMT]

Even if the hospital based and other local volunteers squads are not dispatched via the 911 system, there are several things to consider. #1 - If they are licenses and meet the same standards, there should be a similar level of care, no? #2 - If you call 911 and they direct the call to the appropriate area volunteer after, it might take longer than just calling the 10 digit number. Does it seriously take you that much more time to dial an extra 7 digits? #3 - When calling most of these other organizations with an emergency call, they will send a unit or contact someone else. The same way as if you had called 911 and there is no FDNY unit available. #4 - FDNY has their own budget and income. Do you think they want to toss away income from transport if not needed? They might want help, but not on all calls.

 

[adamNYC]

Lets not forget the private paid ambulance companies (not hospital or volunteer based) who have IFT/transport units AND dedicated 911 units such as Transcare & Seniorcare. A freshly-certified EMT can do transport for them for x amount of time and can be promoted to their 911 unit.

 

[medicdan]

Sorry to hijack, but knowledgeable people seem to be involved. What's the (best) procedure to get NYC REMAC? Is it best to pursue a job, and get service sponsorship first, under their umbrella or are there other ways to get approval for the test?

What is the exam like? Is time best spent reviewing protocols and medications or is it oral cases, etc.?

Thanks!

 

[adamNYC]

REMAC certification required for EMT-Bs in NYC to be employed or just the NY State Cert?

 

[medicdan]

REMAC certification required for EMT-Bs in NYC to be employed or just the NY State Cert?

I was asking about the ALS/Paramedic REMAC exam, I don't know if EMTs need it.

 

[Crackcicle]

Sorry to hijack, but knowledgeable people seem to be involved. What's the (best) procedure to get NYC REMAC? Is it best to pursue a job, and get service sponsorship first, under their umbrella or are there other ways to get approval for the test?

What is the exam like? Is time best spent reviewing protocols and medications or is it oral cases, etc.?

Thanks!

There is no need for any sponsorship. The only requirement is a NYS medic card. Assuming you have that, a visit to the NYS REMAC website to register for the test is the next step.
The test itself is two parts. One part is questions based on nyc protocols and the other is scenario based. I'm not familiar with the new scenario part - they've changed it since I last had to take it - it used to be oral scenarios with a REMAC physician. I believe it's now writing out an assessment and treatment for a patient based on a scenario.

 

[RedAirplane]

Sorry to (re) hijack the thread, but out of curiosity, does anyone know anything about Central Park Medical Unit in particular? I see a lot of videos on YouTube with Central Park Medical Unit rolling up on a scene with police department already on scene-- are they part of the official dispatch?

 

[adamNYC]

Look at their ambulance photos on their site look for the FDNY EMS 911 participating member logo.

Any NYC ambulance that has that logo is part of the NYC 911 system

 

[Crackcicle]

They are not dispatched by the 911 system. They either respond to calls that were placed directly to them, or, more likely they listen to scanners and show up on calls lime all of the volunteers in NYC.

 

[CodeBru1984]

Sorry to (re) hijack the thread, but out of curiosity, does anyone know anything about Central Park Medical Unit in particular? I see a lot of videos on YouTube with Central Park Medical Unit rolling up on a scene with police department already on scene-- are they part of the official dispatch?

Perhaps this website could help you out. http://www.cpmu.com

 

[adamNYC]

Crack circle then why do they have the fdny 911 participating member logo on their truck?