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  1. #1
    B Shifter rjtoc2's Avatar
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    Default Info request for FD's that utilize Paramedic Engine Co.

    My FD is about to add Paramedic Engine Co.'s to augment our ALS ambulances. We are a large, urban fire department with four-person staffing. The paramedic responsibility will be added to several engines city-wide. Any info would be appreciated but I do have a few specific questions:

    1) Is the officer a paramedic?

    2) How many of the assigned people are paramedics?

    3) What are the roles of each member on the paramedic company?

    4) Do the paramedic engines answer "minor" runs alone and call an ambulance as needed for transport OR does an ambulance automatically answer with the paramedic engine?

    5) What is the run volume of your paramedic engines?

    Any info will be appreciated.
    rjtoc2

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  2. #2
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    We run paramedic engines.

    Some of the officer's are paramedics, but for the most part the paramedic assigned is a FF. If we have extra paramedics after each paramedic company (6) has one, the stations with paramedic officers get the first available.

    There is one paramedic assigned to each apparatus, unless the person is a new paramedic, then there are two for six months.

    The roles are the same as they would be in a non-paramedic company at fires. At medicals, the paramedic is in charge of patient care, and the officer is still responsible for the scene regardless of certification level.

    None of our engines paramedic or not respond without an ambulance to a medical, regardless of severity.

    All paramedic companies run between 1500 and 2500 calls per year.

  3. #3
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    Two of our three engines are ALS. Our EMS system requires one medic on the engine. I happen to be a medic but I don't have to because I'm the officer. For myself it is easy to keep and on occassion I'm the only medic on the rig. Plus I like the extra $2500. We function as a crew if the engine is on scene first I'll take charge of the call, otherwise the ambulance attendant is in charge of pt care.
    We always dispatch an ambulance to all calls, the ALS engine will go as a first responder when our ambulance isn't home. Otherwise we go to MVC's trouble breathing, unresponsive, unk medical, severe trauma, etc.
    We run an average of about 3 to 4 medic calls with the engine per day. Yesterday we chased only once with the ambulance running 3 additional calls, other days we run 12 or so, but I would say that 3 to 4 is about average.

  4. #4
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    Maybe not quite what you're looking for but......

    Quote Originally Posted by rjtoc2 View Post


    1) Is the officer a paramedic?
    No, it might be the firefighter, the A/O or the officer.

    2) How many of the assigned people are paramedics?
    All of our apparatus are ALS staffed all the time with a minimum of one paramedic. Probies have a FTO medic with them the first nine months. We run three and four person companies so you might end up with up to four paramedics at times.
    3) What are the roles of each member on the paramedic company?
    On EMS calls everyone functions to their EMT level. We expect a lot out of our basics though. They are trained to place electrodes, spike IV bags etc.

    4) Do the paramedic engines answer "minor" runs alone and call an ambulance as needed for transport OR does an ambulance automatically answer with the paramedic engine?
    In our system you get get the private ALS ambulance for transport and the closest fire unit on all 911 calls. The only exception is when there is a Dr on scene and they are calling for transport only.

    5) What is the run volume of your paramedic engines?
    It varies by station.

    Any info will be appreciated.
    H

  5. #5
    Forum Member GreenJT's Avatar
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    jtoc2;945269][FONT="Arial Narrow"]My FD is about to add Paramedic Engine Co.'s to augment our ALS ambulances. We are a large, urban fire department with four-person staffing. The paramedic responsibility will be added to several engines city-wide. Any info would be appreciated but I do have a few specific questions:

    1) Is the officer a paramedic?

    For my department anyone on the rig counts, just as long as there is a medic.

    2) How many of the assigned people are paramedics?

    minimum of 1.

    3) What are the roles of each member on the paramedic company?

    the paramedic makes the call on what happens as far as the patient care goes.

    4) Do the paramedic engines answer "minor" runs alone and call an ambulance as needed for transport OR does an ambulance automatically answer with the paramedic engine?

    the city I work for has a agreement( automatic aide) with the county and there dispatch. The city regiures a transport respond to any and all medicals minor to major. The county screens the calls and will send just a ALS engine to a fall. But if a medical falls in a zone and that rescue is out the BLS engine in that zone will go with the closest ALS unit will go, SO a BLS engine on a medical with the ALS engine 2nd due and on scene till a ALS transport is available.

    5)What is the run volume of your paramedic engines?

    5 station department- 4ALS engines- 8000 calls roughly last year total.
    Any info will be appreciated.
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  6. #6
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    1) Is the officer a paramedic?

    So long as one person on the engine is a medic it's fine

    2) How many of the assigned people are paramedics?

    We're a jump company so it varies from 1-2 in addition to the ambulance

    3) What are the roles of each member on the paramedic company?

    The medic does the main patient care until the next ALS arrives, unless it's a basic call then anyone can do the work.

    4) Do the paramedic engines answer "minor" runs alone and call an ambulance as needed for transport OR does an ambulance automatically answer with the paramedic engine?

    The engine responds with the ambulance with nearly everything, although the response is under the discretion of the crews. Usually if the dispatch seems minor the engine will stay back unless asked or called. The other factor is where we respond, some of our locations require the engine crew to keep an eye on the medic crew.

    5) What is the run volume of your paramedic engines?

    Last years was about 450 on the engine only

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    .............................. .......
    Last edited by ehs7554; 01-27-2012 at 09:51 AM.

  8. #8
    Forum Member MemphisE34a's Avatar
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    Quote Originally Posted by Geinandputitout View Post
    We run paramedic engines.

    Some of the officer's are paramedics, but for the most part the paramedic assigned is a FF. If we have extra paramedics after each paramedic company (6) has one, the stations with paramedic officers get the first available.

    There is one paramedic assigned to each apparatus, unless the person is a new paramedic, then there are two for six months.

    The roles are the same as they would be in a non-paramedic company at fires. At medicals, the paramedic is in charge of patient care, and the officer is still responsible for the scene regardless of certification level.

    None of our engines paramedic or not respond without an ambulance to a medical, regardless of severity.

    All paramedic companies run between 1500 and 2500 calls per year.
    Just about word for word here. We have 33 units (ALS ambulances) and try to maintain 20 ALS pieces through out the city, but there are only 4 companies that are mandatory ALS - there are 56 fire stations.

    To be ALS companies are required to have at least (1) paramedic and (1) EMT.

    Total calls vary greatly with demographics. My engine is typically ALS and we maintain around 2500 runs per year. Whats funny is that our runs do not vary with your ALS status. ALS or BLS, we are dispatched on the same calls. There is no preference or variance from our FAO. An ALS company here is more of a help for the medic on the unit, and a break for the one on the apparatus.
    Last edited by MemphisE34a; 04-20-2008 at 11:59 PM.
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  9. #9
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    My department has 30 stations, and all the engines are als, sometimes they go BLS for a short amount of time, but for the most part they are fully ALS. In stations with two units (Quints, we don't transport) at least one of the units is ALS, and thats based purely on the personnel operating it. All apparatus, even type 3's that are cross staffed are stocked with als equipment. Anyways,
    1) The paramedic is usually a engineer or firefighter, but it can be the officer sometimes
    2) At least one person is a medic (we run 3 on every engine)
    3) The medic usually runs the show with the other two members helping out, every crew has their own routine
    4) Every call that is dispatched has a transporting unit respond as well.
    5) Our run volume varies, I believe the busiest is around 3800 calls a year, some are much slower, just depends on the area.

    Edit: In our area 99% of ambulances are ALS so it is usually just a transfer of care to the ambulance crew.
    Last edited by catscratch; 04-21-2008 at 12:42 AM.

  10. #10
    Forum Member aromania's Avatar
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    In our system ALS engine companies are the norm. In order to run with ALS capabilities in CAD a company is required to have two paramedics, any two members can be ALS. On my engine it happens to be the company officer (myself) and my engineer. For most calls, we rotate which one of us does the documentation and that person is "in charge" of the patient care. This system works well with the two senior members of the engine company being ALS. I have seen BLS captains "force" ALS firefighters to do and not do things against their better judgment and this can be an issue with company officers new to ALS companies (not always of course).

    Our engine answers 2500-2800 calls a year. For most EMS calls, we are dispatched alone and will advise on an ambulance if needed (in one city we automatically get a private ambulance on ALL EMS calls). If a FD ambulance is the closest unit to an EMS call, it would get dispatched along with the engine or ladder. In our area, the ambulances are about 90% BLS so we ride in with any ALS patients we encounter.
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  11. #11
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    My department runs 14 engine companies. Each engine company is equipped and stocked to be ALS, and there is one medic rostered at each engine company on each shift, but that doesn't guarantee that every engine is ALS every day (i.e. vacation, sick leave, training, etc.). On an average day, I would estimate that around 12 of the engines are ALS. We also staff five ALS ambulances, and four BLS truck (ladder/rescue) companies. I am a firefighter/paramedic.

    To answer your specific questions:

    1.) Any position on the rig (Captain, Fire Apparatus Operator, Firefighter) can be a medic. We have several Captain/Medics and no F.A.O./Medics at the moment (although they are allowed by contract); however, most of the medics are firefighters. Everyone on the rig is at least an EMT-basic. We do, also, have a few paramedics that, for whatever reason, choose only to function at the EMT-basic level. They do not count on the roster as a medic.

    2.) There is usually only one medic rostered on each rig each shift. There have been rare instances where two medics are rostered on a rig; however, this doesn't happen often, and when it does, you can almost bet that the "spare" medic is going to be floated out quite often to make another rig ALS.

    3.) In our department, the rule of thumb is that the captain is in charge of the overall scene, the medic is in charge of patient care. It is unheard of for a BLS captain to overrule a paramedic on a patient care decision. Usually, the captain acts as the scribe, documenting the call, while the medic directs the other crew member(s) in pt. care and performs the advanced level procedures. I have yet to have a captain that wouldn't jump in and perform hands on care, though, when the situation warranted it. In crews where the captain is a medic, usually they turn the scribe duties over to the FAO.

    I'm not quite sure what they would do at a mass casualty, where the first medic is supposed to start triaging; I would think being the officer who's supposed to also be in charge of the scene would cause a conflict of roles.

    4.) In our system, the nearest fire suppression rig is dispatched to every medical, as is the nearest ambulance. Usually, this is one of the engines, although it could be a BLS truck company if the engine is already out (every truck company is co-located with an engine). If the nearest rig is BLS and the officer, from the dispatch information, feels it is warranted, they can request the nearest ALS rig also be dispatched. Our ambulances are staffed with a medic and a basic; if additional help is needed on the way to the hospital, personnel are "borrowed" from the suppression rig to ride in.

    5.) Our run numbers are all over the board. I would like to point out, however, that just being a low run volume engine doesn't necessarily mean that engine will be the first to be without a medic. Things such as response time for the nearest ambulance are also taken into account.

  12. #12
    Forum Member Dave1983's Avatar
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    Quote Originally Posted by rjtoc2 View Post
    My FD is about to add Paramedic Engine Co.'s to augment our ALS ambulances. We are a large, urban fire department with four-person staffing. The paramedic responsibility will be added to several engines city-wide. Any info would be appreciated but I do have a few specific questions:

    1) Is the officer a paramedic?

    2) How many of the assigned people are paramedics?

    3) What are the roles of each member on the paramedic company?

    4) Do the paramedic engines answer "minor" runs alone and call an ambulance as needed for transport OR does an ambulance automatically answer with the paramedic engine?

    5) What is the run volume of your paramedic engines?

    Any info will be appreciated.
    ALS engines are the norm here, although some of the real busy stations run the ALS engine second out behind a two person medic rig. We also run ALS truck and squad (heavy rescue) companys.

    1) Sometimes

    2) State law requires a minimum of one EMT and one medic for ALS. Since all FFs here are at least EMT, there is always at least 1 medic on the rig.

    3) Medic is in charge of patient care, EMTs help the medic. If the Company Officer is a medic, then they are in charge of the other medics who may be on the rig. If they are an EMT, then its the senior FF/medic.

    4) ALS unit and ambulance (which are all ALS as well) on all 911 calls.

    5) Were in a rather slow area, so ours run between 2500-3000 calls a year. I think the busiest company in the county runs about 8000 a year with the average probably around 4000.

    BTW, we have been running ALS engines since '86.
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  13. #13
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    Quote Originally Posted by rjtoc2 View Post
    My FD is about to add Paramedic Engine Co.'s to augment our ALS ambulances. We are a large, urban fire department with four-person staffing. The paramedic responsibility will be added to several engines city-wide. Any info would be appreciated but I do have a few specific questions:

    1) Is the officer a paramedic?

    SOME OF OUR CAPTAINS ARE PARAMEDICS BUT TYPICALLY NOT THE PRIMARY MEDIC ON THE RIG.

    2) How many of the assigned people are paramedics?

    WE HAVE A DAILY MINIMUM OF AT LEAST ONE PARAMEDIC ON EVERY ENGINE OR TRUCK COMPANY. WE RUN THREE MAN ENGINES AND FOUR MAN TRUCK... SO DEPENDING ON THE PERSONNEL ON DUTY OR ASSIGNED TO A CERTAIN HOUSE WE MAY HAVE UP TO THREE OR FOUR MEDICS ON A COMPANY.

    3) What are the roles of each member on the paramedic company?

    PRIMARY PT CARE FALLS TO THE PARAMEDIC. IF MULTIPLE MEDICS ON DUTY WE SWITCH OFF CALLS AND WORK AS PARTNERS (I.E. RADIOMAN, PATIENT MAN) EMTS ARE USED TO ASSIST THE PM W/ NON-ALS STUFF.

    4) Do the paramedic engines answer "minor" runs alone and call an ambulance as needed for transport OR does an ambulance automatically answer with the paramedic engine?

    WE RUN ON EVERYTHING IN THE CITY. WE HAVE PRIVATES THAT PROVIDE THE TRANSPORT BUT IF IT'S AN ALS CALL SINCE WE ARE USUALLY THERE FIRST WE CONTINUE PATIENT CARE AND RIDE IN TO THE E.D. THE PRIVATES GIVE US A RIDE AND OUR ENGINE OR TRUCK COMPANY FOLLOWS UP TO THE HOSPITAL TO PICK US UP. IF NO PRIVATE AMBULANCE IS AVAILABLE WE TRANSPORT IN OUR SQUAD (FD AMBULANCE) THE ONLY MEDICALS WE RUN W/O THE BOX ARE PUBLIC ASSISTS (SUCH AS "NEEDS HELP INTO BED" "FALLEN W/O INJURY" ETC) BUT HOSE OFTEN TURN INTO MEDICALS AND WE END UP REQUESTING A BOX TO TRANSPORT.

    5) What is the run volume of your paramedic engines?

    DEPENDS ON WHICH HOUSE YOUR WORKING OUT OF BUT I'D SAY IT AVERAGES AT LEAST 5 -6 MEDICALS PER DAY AT MY HOUSE.

    Any info will be appreciated.
    FEEL FREE TO CONTACT ME IF I CAN GIVE ANY FURTHER INFO

  14. #14
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    Quote Originally Posted by rjtoc2 View Post
    My FD is about to add Paramedic Engine Co.'s to augment our ALS ambulances. We are a large, urban fire department with four-person staffing. The paramedic responsibility will be added to several engines city-wide. Any info would be appreciated but I do have a few specific questions:

    1) Is the officer a paramedic?

    2) How many of the assigned people are paramedics?

    3) What are the roles of each member on the paramedic company?

    4) Do the paramedic engines answer "minor" runs alone and call an ambulance as needed for transport OR does an ambulance automatically answer with the paramedic engine?

    5) What is the run volume of your paramedic engines?

    Any info will be appreciated.
    Tale of two different cities....

    1) City of Norfolk- All personnel are ALS providers. Everyone but the ECC/LCC (permanent position) and the Officer rotate onto an ambulance tour. However the OIC and the ECC/LCC are still ALS providers.

    City of Va Beach- Sometimes. We do run ALS engines and as long as one person is an ALS provider, that unit will log on as Eng 'x'-P or Lad 'x'-P.

    2) Norfolk- again everyone.
    Va Beach- only a few fire department personnel are EMT-I or EMT-P. You receive 10% bonus a month for achieving ALS cert. Therefore you can have an engine or ladder with 3 ALS providers, or one. There is at least one ALS provider on duty at every station everyday.

    3) Norfolk- not sure.
    Va Beach- as an EMT-B..I do what the ALS provider feels needs to be done. There are no preassigned roles on EMS calls short of..the ALS provider does the stick.

    4)Norfolk and Va beach it both depends on the nature of the call. In Norfolk, 9 times outta 10 you are getting an engine or ladder and the ambulance. However you frequently hear the engine get cleared up based on dispatcher comments. In Va Beach all Priority 1 calls get a Fire and EMS response. However on minor EMS calls, the EMS dispatcher can dispatch an Engine or Ladder based on the ambulance being delayed due to time or distance, or staffing.

    5)No idea for Norfolk. All I know is they are busy.

    Va Beach- varies by station. Slow units like Engs 5,6,13, and 17 are SLOW. But when they get an EMS call it is usually an ALS call with frequent trips to the hospital via Nightingale helo. Uptown everyone stays busy. I know we rotate EMS duties at Co 11 between Eng 11 and Eng 14. We don't really break it down by EMS/Fire in house too much. I know the busiest day I had was 14 EMS calls in July last year.
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  15. #15
    Forum Member engine13A's Avatar
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    1) Is the officer a paramedic?
    can be, although it has become a bit of a problem with trades and overtimes and having the regular medic detailed out if they are short handed.

    2) How many of the assigned people are paramedics?
    1 unless the medic is FTOing a new medic

    3) What are the roles of each member on the paramedic company?
    we have 3 ff and an officer..medic can be any one of them...ff's are all emt b's and all are qualified to drive and pump so they usually rotate...seems like all we do is take vitals for the medics and set up iv stuff.


    4) Do the paramedic engines answer "minor" runs alone and call an ambulance as needed for transport OR does an ambulance automatically answer with the paramedic engine?
    we have private ambulance service which runs with the engine or truck automatically. occasionally they will run alone on check a wrecks or other police asst. calls and then have to call an ambulance.
    5) What is the run volume of your paramedic engines?
    we have 30 engine companies and it runs the gammut from slow to busy, my engine company runs a little under 3000 trucks about half that.

    pm me if u need more info!

  16. #16
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    We run medics on engine, towers, trucks, squads, hell probably even brush trucks! They are only typically counted as an AFRA (ALS First Responding Apparatus) if they have their medic gear on the rig. About 85% of our medic units in the county are one medic and one BLS provider. So if the call is a Charlie call (for those who LOOOOOVE EMD!) you may get one BLS unit and the AFRA to upgrade if needed. On a Delta or Echo call, you have to have a minimum of two medics for the patient. So you could have the closest BLS ambo and engine responding, the medic transport unit and an AFRA for one patient.

    1) The officer can count as the AFRA (my Captain and two Master Fire Fighters are) However, we ensure that they is another unit driver on the rig so if the officer upgrades, the Master can ride the seat and some one else drive.

    2) On all AFRA units we staff 4, one or more being a medic. BLS units- 3 career unless the station is up staffed

    3) The medic handles/starts patient care and we all jump in and set stuff up or assist the medic in any way.

    4) Our county dispatches and EMS unit on all calls and depending on the call type, you may just get the ambo or the fun filled EMS box. But units can cancel each other without justifcation over the radio, or the AFRA can cancel the medic unit and elect to upgrade the ambulance in order to keep a medic unit in service. In addition, the supression piece also goes back in service but with 3 and is no longer an AFRA.

    5) Engine- about 3500 a year ( around 12- 14 calls a 24 shift)
    Tower- about 2800 a year (around 8 to 10 a 24 hour shift)
    Each Medic unit (2 in house) same as truck maybe a little bit mroe
    Each BLS unit (2 in house) about 3000 a year
    Last edited by Nozzleman141; 04-23-2008 at 09:41 AM.
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    To give you a quick breakdown of my department. We are a mid-size department located in East Texas We have 8 stations with 4 front line medic units.

    1) Is the officer a paramedic?

    In many cases yes, In 1994 the department began requiring that all personal hired after this date be a paramedic. Since then many have promoted through the ranks and are now Station Officers. We do have some that were hired prior to 94 (like myself) that went and got their Medic even though we were not "required"

    2) How many of the assigned people are paramedics?

    The department requires at least 1 be a medic at all times. With the large number of medics it is beginning to be unusual to not have at least 2 or more medics on the Engine/Ladder

    3) What are the roles of each member on the paramedic company?

    We serve a primary care giver until the Ambulance crew arrives, at this time we give our report and they take over patient care. We remain on the scene until transport to assist in any way we are needed.

    4) Do the paramedic engines answer "minor" runs alone and call an ambulance as needed for transport OR does an ambulance automatically answer with the paramedic engine?

    Our engine response to "Minor calls" depends on the availability of an medic unit. If the run is in a Medics first due district and they are in there district they are often dispatched alone. If the call is in a "non-medic" district or in a Medic district, but they are on another run then the Engine will be dispatched as a first responder to have a unit arrive and begin patient care while a medic responds from another district across town.

    5) What is the run volume of your paramedic engines?

    This is dependent of the district of course. My Engine and Medic consistently have the highest call volume in the city. On a normal month we will respond to 450-500 out of my station. Of that If I had to guess (I do not have the hard numbers in front of me) 85% are medical runs. Being the Medic at my station is gone a lot my leaving no medic in my district we run a lot of medic responses off my Engine.


    I hope this information helps, if you or anyone would like more information please feel free to PM me.
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  18. #18
    Forum Member footrat's Avatar
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    Quote Originally Posted by rjtoc2 View Post
    My FD is about to add Paramedic Engine Co.'s to augment our ALS ambulances. We are a large, urban fire department with four-person staffing. The paramedic responsibility will be added to several engines city-wide. Any info would be appreciated but I do have a few specific questions:

    1) Is the officer a paramedic?

    2) How many of the assigned people are paramedics?

    3) What are the roles of each member on the paramedic company?

    4) Do the paramedic engines answer "minor" runs alone and call an ambulance as needed for transport OR does an ambulance automatically answer with the paramedic engine?

    5) What is the run volume of your paramedic engines?

    Any info will be appreciated.

    1) Sometimes. Our department is an integrated fire/EMS department, running a high percentage of ALS fire apparatus, as well as ALS squads, which are a manpower unit comprised of firefighter/EMT driver and a paramedic captain. The captains are rescue captains, not fire captains, and they are battalion medical officers. They perform medical oversight and training for the battalion, respond to major incidents (fire or EMS), and generally run EMS calls. That said, we have single-companies, and even double-companies without a rescue (ambulance) in the house. Those companies get a paramedic captain on the engine. If the captain is off, they may move a medic over to keep it ALS, but not always. On other ALS apparatus, usually the medic is not an officer, but if he is AOIC that day, he may still ride seat, or he could be driving.

    2) We have rotations, not permanent assignments to apparatus. Typically, there is no set number of medics at a station, so long as the unit status battalion and county wide maintains a good ALS coverage. Some days, a station with a quint, hazmat, rescue, and a crew (a unit used to keep wear and tear down on the hazmat) might have two medics at the station. The crew and the rescue will be ALS, with the hazmat and quint BLS. The crew responds like a squad. With only one medic at the station though, the quint will be ALS, with all other units BLS.

    3) Typically, if the driver is the medic, he leads pt care. Others help according to need and ability. One person will be designated to gather pt information and document pt care and vitals. If the cpt is the medic, the driver is the info man.

    4) Unfortunately, our dispatching is kind of random. It's really weird. An ALS engine might run a minor medical call all by themselves, and have to call for a rescue, or a BLS rescue might run the call by themselves without anyone else.

    5) Depends upon the area. They could run 3,000 calls a year, or around 8000.

  19. #19
    Forum Member
    Join Date
    Dec 2006
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    Default

    So you could have the closest BLS ambo and engine responding, the medic transport unit and an AFRA for one patient.
    I don't even have the words.....

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