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  1. #1
    Forum Member rschultzjr's Avatar
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    Default Medical First Responder Vehicles

    In the next couple of years my volunteer/part paid department is looking at starting a Medical First Responders program (being pushed hard by EMS). I've seen some departments that use a old police cruisers, Suburbans, Expeditions, pickups, and old ambulance style units. I am wondering what do you use to respond to Medical First Repsonder calls? Pros and Cons?


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    Quote Originally Posted by rschultzjr View Post
    In the next couple of years my volunteer/part paid department is looking at starting a Medical First Responders program (being pushed hard by EMS). I've seen some departments that use a old police cruisers, Suburbans, Expeditions, pickups, and old ambulance style units. I am wondering what do you use to respond to Medical First Repsonder calls? Pros and Cons?
    Our medical first responders are firefighters. They take the engine. Yes it's more more wear and tear, and lousy fuel economy, but when you can't fully staff a dedicated EMS vehicle separate from the firefighting roles, then there's no sense in leaving your best tool box at the station.
    All that fuel and wear and tear is still less than the added vehicle costs (initial purchase, maintenance, insurance, some duplicate gear, plus fuel).

    I take it you are looking at non-transport, and EMS only (not Firefighter/EMS)? Is it going to be BLS or ALS? Any estimate on the anticipated call volume? Any unique apparatus access requirements (vehicle size or weight restrictions, unpaved roads, etc)? Crew size?
    All of these will play a big factor in what you choose, and your best cost benefit calculations.

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    We're a vollie department where the majority of our firefighters are the same as our EMS responders. We have a couple that do only EMS, but they use the same vehicles for the most part.

    Right now we're using a quick-attack truck (GMC 5500 with a rescue-style body, tank, and skid). It doesn't get the greatest gas mileage (8 mpg or so), but we set it up to run all of our rescue and EMS runs.

    Before that, we put our EMS gear in a brush truck and responded with it. There was a time (and still have some guys that do it) when personnel licensed as EMT or above carried their own bag that had oxygen and related equipment, trauma supplies (bandages, dressings, c-collar, gauze rolls, etc), BP cuff and stethoscope, etc. Just a basic bag to handle 99% of our calls. The only issue is making sure someone brings the truck with the AED/cardiac monitor. The reason we went away from it was that the ambulance was spending a ton of money to supply members of 5 departments with oxygen bottles and regulators.

    I wouldn't recommend going to a purchasing a vehicle to do just medical response until you are doing it a while and get a feel for what you need. That is unless you just have the money to burn. If you're a career department, just put it on the engines. If you're volunteer, put it on a brush truck, or even see if they'll supply a certain number of responders with bags. You can even have a certain number of bags and let responders grab one from the station if they're going to be available and drop it off when they're not for someone else to use. There's a lot of options out there without having to buy a new vehicle.

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    Forum Member rschultzjr's Avatar
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    Thanks,

    We would be a non-transport unit, and according to our local EMS we could expect approximately 300 calls a year or more.

    We cover 77 square miles everything from highways to rural paved roads, from unpaved roads to two-tracks, from lakeshore area (tight on lane unpaved roads, well glorified two-tracks that go back to multi-million dollar homes) to farmland.

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    Quote Originally Posted by rschultzjr View Post
    Thanks,

    We would be a non-transport unit, and according to our local EMS we could expect approximately 300 calls a year or more.

    We cover 77 square miles everything from highways to rural paved roads, from unpaved roads to two-tracks, from lakeshore area (tight on lane unpaved roads, well glorified two-tracks that go back to multi-million dollar homes) to farmland.
    You sound a lot like us, but a bit busier.

    Like I say, I'd be reserved about buying a vehicle just for EMS runs unless you've just got the money. Give it some time to make sure what you need and put the EMS gear with your responders or put it on a brush truck or light rescue until you figure out what's going to work best for your operations.

    I assume you've got some kind of deal worked out where they're going to take care of your supplies and training?

    Our first responder program started probably 15 years ago, maybe a bit more. Since it's inception the ambulance district has been good about supplying us with a lot of our equipment. It's progressed from a handful of guys with first responder training to a non-transport ALS provider with several medics/ALS-certified RN's and even more EMT's. It's definitely good PR, especially with the older folks. When we went to pass a tax-base for our operations, the older folks were easy to convince when we talked about how much it was going to improve our ability to respond to medical calls.

    Good luck with it!

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    We use a '99 diesel chevy suburban with a custom cabinet set in the back. We dont like it and in the coming years we will be switching to a pickup with a rescue body. That being said, the truck is used for water/ice rescue and also tows the hazmat trailer.

    If it were only for EMS I think an SUV with a pullout tray would work fine. I would recommend a cage between the passenger compartment and equipment storage so things dont hit you in a crash

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    We are a volunteer department that runs EMS as well as fire, so first out the door is the ambulance. In the event that additional manpower is needed, both ambulances are committed, or the engine company is dispatched on a priority 1 call, we run the engine. The idea is that we then have the engine staffed for a second call if needed.

    Depending on staffing we also have the option to run one of the utility vehicles. We have Ford Expeditions and Explorers. ALL of these units have a first responder bag with O2, BP cuff, airways, Bag-Valve Masks and assorted bandages and other supplies. The biggest reason to take the utility vehicles is if for some reason an engine driver is not available.

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    Quote Originally Posted by rschultzjr View Post
    Thanks,

    We would be a non-transport unit, and according to our local EMS we could expect approximately 300 calls a year or more.

    We cover 77 square miles everything from highways to rural paved roads, from unpaved roads to two-tracks, from lake shore area (tight on lane unpaved roads, well glorified two-tracks that go back to multi-million dollar homes) to farmland.
    I will help you break this down based on what you told me.

    If you were thinking of using a large full sized fire apparatus, don't. Here is why

    Rural unpaved roads, tight = No place to park your huge fire apparatus out of the way of the transporting unit, more difficult to pass oncoming vehicles that are in the way.

    77 square miles = You could be a long way's away from an incident that your apparatus may be needed at. That, and if your are on an EMS call you can not leave until you have handed your patient off to the transporting agency and they don't need your help anymore. That's a long delay before your unit arrives on the scene where your apparatus was needed.

    If you were thinking of using a small type VI style pumper consider this. I don't know where you live, but do you have cold winter temps? If so, you'll need to have tank and pump heaters. Picture being on a call for an hour while your unit is outside in freezing temps. Crack! Might be an OK option though as long as you mitigate these dangers.

    I wouldn't worry about wear and tear on existing vehicles, 300 calls a year isn't too crazy. But fuel, you will use up a lot of fuel with a large pumper or the like. Potentially several thousand dollars more a year in fuel compared to an efficient 25 mpg vehicle.

    Don't buy brand new, wait until you have some experience and better idea of what you like and don't like. Get a decent used one and beat the crap out of it for like 5 years. By then you will have a good idea of what you need.

    My suggestion, try one of these options.

    1) AWD car. (Subaru would be a reliable choice)
    2) 4x4 Small Pickup with topper. (Extended cab or 4dr Chevy Colorado maybe)

    Good luck with EMS. It is very rewarding and much appreciated by the community!

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    Forum Member FIREMECH1's Avatar
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    My 5 cents.

    Since you posted up that you're not transporting, you have a couple issues that you need to answer.

    1. Will the rig needed have to be able to flow water at a fire as support or not.

    2. If this is to be an EMS vehicle only, and not support for a fire run, how many people will be responding when you get an EMS call???

    If it was me (going off of #2), I'd spec a 4 door 1 ton with 4 wheel drive, in a pick-up configuration. This will give you manpower space, as well as the ability to go wherever you need to go. Gas is OK, but diesel is better.

    Now comes the tricky part of the build/spec. The box on the frame rails that will carry your equipment and supplies. You need to find what your identity/ability is going to be. If your set on ALS then you're good with a box with roll up doors, or standard metal doors. If your thinking you might get into water/ice rescue, then a utility type box may work with side compartments, and your water/ice rescue equipment in between the sides, with a rear entry door for those tools.

    You need to find out what you are really planning on doing in the long run. Because in 2 years, you may have wished you bought something else.

    FM1
    I'm the one Fire and Rescue calls, when they need to be Rescued.

    Quote Originally Posted by EastKyFF
    "Firemens gets antsies. Theys wants to goes to fires. Sometimeses they haves to waits."

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    +2 even though we do VERY limited Ems. T.C.

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    Forum Member islandfire03's Avatar
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    A good used type 3 ambulance can be a very useful truck for Combination duty.
    There is plenty of compartment space, plenty of legal seating room , AC & heated rear compartment for rehab at fire scenes and a warm dry place for you cold water rescue members to change up in. Then in the future if you decide to become a transporting service you will have had experience in working out of a type 3.
    We recently sold a low mile [44k] 1995 ambulance for 5k ,and there are plenty of good condition used units out there at reasonable prices.

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    Quote Originally Posted by islandfire03 View Post
    A good used type 3 ambulance can be a very useful truck for Combination duty.
    There is plenty of compartment space, plenty of legal seating room , AC & heated rear compartment for rehab at fire scenes and a warm dry place for you cold water rescue members to change up in. Then in the future if you decide to become a transporting service you will have had experience in working out of a type 3.
    We recently sold a low mile [44k] 1995 ambulance for 5k ,and there are plenty of good condition used units out there at reasonable prices.
    If you're going to buy something for running EMS calls, this is a good, multi-functional option. A department nearby us got a rig on an "indefinite loan" from the ambulance district and uses it much like this. They run medicals, use it for rehab, put patients inside during inclement weather (hypo/hyperthermia, wrecks in the rain, etc), and are now putting their RIT equipment onboard to respond it as a RIT team on mutual aid runs.

    Here and there you can find 4x4 units or ones that still have the automatic chain systems if you live somewhere that it's needed.

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    Quote Originally Posted by Catch22 View Post
    Here and there you can find 4x4 units or ones that still have the automatic chain systems if you live somewhere that it's needed.
    We trade in a 4x4 Type 1 ambulance every three years (9 years old) and get about $7.5K for them. This is a little long to keep them frontline for us, but there's plenty of these out these for the type of thing you're looking into.

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    Based on the use you described, I'd suggest a full size SUV with a gasoline engine.

    Some Expedition/Tahoe/Suburbans are offered on state bids for very reasonable pricing.

    C6

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    We are a volunteer dept, non-transport and the majority of our FFs are med responders. We use an ambulance but are trying to replace with a crew cab with a rescue body. The ambulance is dangerous to our personnel that rides in the back, so we quit allowing that. It has seatbelts, but we prefer not to let members ride back there. The ambulance doesnt have a lot of storage, and it is packed to the gills, barely under GVW. I would not recommend an ambulance. BTW, we are about 28 miles from the ems base and when we roll up on the scene folks are like "wow the ambulance is here". Only to learn two minutes later that we cant take them to the hospital. Locals know, but summer home people just cant understand why it takes the paramedics 22 minutes to get there. We are hoping to get a helicopter from FEPP surplus property. Could you imagine what they would say then. lol

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    Forum Member islandfire03's Avatar
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    Quote Originally Posted by farmerfire1156 View Post
    We are a volunteer dept, non-transport and the majority of our FFs are med responders. We use an ambulance but are trying to replace with a crew cab with a rescue body. The ambulance is dangerous to our personnel that rides in the back, so we quit allowing that. It has seatbelts, but we prefer not to let members ride back there. The ambulance doesnt have a lot of storage, and it is packed to the gills, barely under GVW.
    I'm not sure why you feel that it's dangerous to ride in the back of an ambulance that is designed to carry personnel in the rear belted seating positions? Is it the optimum position ? no ,but certainly not any more dangerous than other vehicles when operated safely.

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    Quote Originally Posted by islandfire03 View Post
    I'm not sure why you feel that it's dangerous to ride in the back of an ambulance that is designed to carry personnel in the rear belted seating positions? Is it the optimum position ? no ,but certainly not any more dangerous than other vehicles when operated safely.
    Personally, even as a medic, I'd rather keep people out of the back of an ambulance box whenever possible. Have you ever seen one after a roll-over? They don't hold up well at all. At least not the ones I've seen.

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    Forum Member islandfire03's Avatar
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    Catch : Read the last three words of my quoted statement.
    " when operated safely"

    If you don't drive out of control and show due care while driving, you can minimize the chances of having any accident. In 37 years in EMS I've been in one accident and it was while we were stopped at a toll booth on the interstate and got rear ended by a moron tourist that was searching in the glove box for change.
    I don't count the raccoons, foxes, skunks and turkeys we hit over the years, or the deer that ran into the side of the box early one morning.

    Yes you are correct that ambulances don't hold up well in rollovers. They're not supposed to be used that way. Not many vehicles do well in rollovers.

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    Maybe he means due to the "packed to the gills" also. Most of the ambulances I have seen that are now first responder/Rescue vehicles have so much stuff on the floor it would be projectile paradise in back in any accident.

    Brings to mind a 360 I did on the ice once in a type II ambulance, downtown Albany NY. Old lady in back said quite loudly to the ashen faced EMT - "is everything ok?"

    He told me later EMT's are supposed to drive... LOL

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    Quote Originally Posted by rschultzjr View Post
    In the next couple of years my volunteer/part paid department is looking at starting a Medical First Responders program (being pushed hard by EMS). I've seen some departments that use a old police cruisers, Suburbans, Expeditions, pickups, and old ambulance style units. I am wondering what do you use to respond to Medical First Repsonder calls? Pros and Cons?
    Presently, with 200 square miles of primary response area, the volunteers use their POV's. Quite often they don't go anywhere near a fire station enroute to an EMS call.

    The issues I have with this is too many vehicles on the scene sometimes, but more equipment. I only have so many AED's, so many 02 setups, etc. How do I distribute them?

    I am presently trying to find a suburban or such that we can equip and stock. It will be housed at a station, but anyone who is going to be in the district can take it home, and respond with it directly from their house. (Standard instructions about availability, alcohol, etc) If while it is at their house they decide to run down to the store in district, they can use that vehicle. If they go out of the district they return it to the station.

    If they have it, they MUST remain in district, MUST be alcohol free, and the MUST respond.

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