Thread: Ambo Details

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    Default Ambo Details

    Hey everybody, I am from Washington DC and I am looking for how other departments staff their ambulances, ie by splitting up details, seniority, etc.. we currently have no plan in effect so we get detailed to them on a daily basis never knowing from shift to shift whether your up or not, also we work a 24 hour shift but are currently only allowed to ride for 12 hours which causes more confusion and shifting of bodies. HELP.. are management has asked us to search for better solutions...bring them on..Thanks

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    We work the 24 hour shifts...Califonia schedule. We have two paramedics on the ambulance and at least 2 more bid to the station. We work (now) 3 round on the ambulance and you get a round off. We are trying to change that to get a 2 and 2. (2 rounds on 2 off). Granted we don't have the call volume as DC...but we can run the wheels off...so you do see quite a bit of burnout with the current system.

    I believe in Rockford, IL (someone correct me if I'm worng) they run 12 hours on the ambulance then switch in house with other medics. So you are only on the ambulance 12 hours a day. Good luck with that.

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    In Rockford (IL) we have to be on the ambo as FF/PM for at least 5-6 years. It is based off (non-officer or driver) seniority for becoming a medic and getting off the ambo.

    For example, I went to medic class at my 5-year mark on the job, spent 1 year in class assigned to an ALS Engine and ALS ambo while in class and then was reassigned to a non-precepting ambo and fire company. Some FF's choose to remain on the ambo for longer than the mandatory 5 years due to increased pay and then that allows a person with lower seniority to retire from the ambo and go back to a strictly fire company (which provides ALS first response).
    After your 5 years, you also have the option of downgrading your paramedic license to an EMT-I or EMT-B. Five of our 11 Stations house ambos. We work a 24 hour shift, and rotate AM's (0800-2000) and PM's (2000-0800) each shift. A few days out of the year, we are overstaffed (5 on the truck) and this creates a "Quint Boy" and you are off the ambo for the day.

    I hope this helps!

    rfd599
    www.IllinoisFireStore.com

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    We run 3 Ambulances / about 9000 runs per year. One ambulance is staffed full time with a Lt. and FF, one of which is a medic. The other two are cross-staffed with a fire company.

    They are permenant assignments, but the un-official rule is to move guys off of the ambulances to the fire companies and put OT on the ambulances. This works good for the ambulance guys in the summer and around holidays.

    The system is good and bad. For new medics you get allot of experience and the crew stays intact. You do your time and bid out when you can. It is worse for the officer, because they have more time on and have already worked there way up off the ambulance once as a FF, only to go back again.

    The drawback is the same as anywhere else that runs ambulances, missed fires and training due to call volume, and general burnout.

    One thing we do is use our ambulance crews for fires. The cross staffed ambulances respond on thier respective fire apparatus, and the Full time ambulance is the second half of the truck crew (unless there is a victim).

    One thing that it seems allot of places do is keep thier ambulance crews out of the fires. That to me would cause trouble, #1 because of the experience missed by the crews and #2 the general drop in morale by those crews knowing that they won't get to do fire duty.

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    We staff our ambulances with one FF/EMT-B and one FF/EMT-P. Shifts are up to the supervisors and their people; most of the crews work the ambulance the whole 24 hr. shift, and rotate to the engine company the next shift.

    In theory, all of the medics are supposed to rotate through the ambulances to keep everyone up on their skills. So, if you're a medic, there's no way to avoid at least some ambulance duty.

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    Quote Originally Posted by HuskerMedic View Post
    We staff our ambulances with one FF/EMT-B and one FF/EMT-P. Shifts are up to the supervisors and their people; most of the crews work the ambulance the whole 24 hr. shift, and rotate to the engine company the next shift.

    In theory, all of the medics are supposed to rotate through the ambulances to keep everyone up on their skills. So, if you're a medic, there's no way to avoid at least some ambulance duty.

    I know this can be a more cost effective measure and there are many great EMT-B's out there. Some better than some of medics. I personally don't like the idea of just one paramedic on the ambulance. With another paramedic you can shoot ideas off each other, someone else to verify medications, more ALS measures ongoing together, IV, intubation so on. Also on the tough sticks, there is another pair of eyes and hands to get an IV if one is having a "bad day".

    I'm not saying how this run is wrong....by no means here.....and as a medic, you really have to be up on all skills. I just think it is better working with another paramedic. A little less pucker factor. Just my opinion.

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    Quote Originally Posted by jccrabby3084 View Post
    I know this can be a more cost effective measure and there are many great EMT-B's out there. Some better than some of medics. I personally don't like the idea of just one paramedic on the ambulance. With another paramedic you can shoot ideas off each other, someone else to verify medications, more ALS measures ongoing together, IV, intubation so on. Also on the tough sticks, there is another pair of eyes and hands to get an IV if one is having a "bad day".

    I'm not saying how this run is wrong....by no means here.....and as a medic, you really have to be up on all skills. I just think it is better working with another paramedic. A little less pucker factor. Just my opinion.
    We run a tiered response with the nearest engine company. In theory, all of our engines are supposed to by staffed by a medic; in practice, usually about 10 of the 14 are ALS. If the call is a priority call, two ALS rigs are supposed to be dispatched no matter what (this means having three rigs show up at a call isn't uncommon).

    If the call is bad enough, the engine medic will ride in as a third member of the crew; we can take other staff off the engine, too, in cases of things like full codes.

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    Got ya...It is just nice to have another medic looking out for you.

    We run somewhat similar...we still have 2 medics on the ambu, but do have medics riding the pumps too. A pump gets sent along with ambu for diff breathing, chest pain, trauma, and PNB.

    I have heard horror stories in CME's. One was a new paramedic in rural setting could not establish an IV for a diabetic....so decided to give an amp of D50 IM...not good, she's no longer a medic.

    Another was a medic working with an EMT-B during a code...just put a NRB on instead of getting an airway or worry about ventilations.

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    With another paramedic you can shoot ideas off each other, someone else to verify medications, more ALS measures ongoing together, IV, intubation so on. Also on the tough sticks, there is another pair of eyes and hands to get an IV if one is having a "bad day".
    So who's driving? Oh, that's right- the other medic that's on the truck to "help"the first medic.

    One was a new paramedic in rural setting could not establish an IV for a diabetic....so decided to give an amp of D50 IM...not good, she's no longer a medic.
    Good! She shouldn't be.

    Another was a medic working with an EMT-B during a code...just put a NRB on instead of getting an airway or worry about ventilations.
    The problem here isn't that another medic wasn't there to recognize the incorrect treatment. The problem is a moron medic and a moron EMT. How the system is run has nothing to do with it.

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    Quote Originally Posted by emt161 View Post
    So who's driving? Oh, that's right- the other medic that's on the truck to "help"the first medic.



    Good! She shouldn't be.



    The problem here isn't that another medic wasn't there to recognize the incorrect treatment. The problem is a moron medic and a moron EMT. How the system is run has nothing to do with it.


    That is true about the last one there, it probablly was a moron medic and EMT. Although many medics fresh out of school go to a service that run a medic and EMT. You could be great in school, but doesn't mean you'll be great in the field. The only way to improve is to have more time out there. That is why it is nice to shoot ideas off one another.

    As for the driving part...if it is a critical call there are two medics in the back and an EMT of FF driving...just like Huskermedic said too. If we had to do a paramedic intercept with an outlying agency...both medics are in the back and someone else is driving.

    This is not something to get worked up about...I never said a one medic one EMT system is wrong. I just feel as a medic, it is nice to have another pair of trained eyes and skills there along with you.

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    We use a rotation. All our personnel are Firefighter/Paramedic trained.

    We only run 2 man squads(Ambulance).
    If it's a call of a serious nature we roll the engine and some of the Jumpseaters will ride the squad to the hospital.
    If we get a call for a vehicle crash, the jumpseaters will roll the rescue.
    Take the officer out of the equation because they are always riding the BRT.

    The rotation is as follows:
    Engine Operator;
    Engine Jumpseat;
    Engine Jumpseat;
    Drive squad;
    Doc squad;
    Repeat.
    Marc S.
    Firefighter/Paramedic
    Solon Local 2079

    (Previously posted as Hobbitt. Registered December '02,)

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    Default Squad Scheduling

    The way we do it on my department is that the schedule is made out 1 month in advance with the majority of the squad assignments going to the junior guys (such as myself). We ride for the entire 24 hours. Our work schedule is 24/48 with a kelly every 3 weeks. Typically we have 8 actual working days in a month so I ride the squad 6 out of 8 days and then get to ride the engine or ladder 2 days out of the month. It really doesn't bother me because I am third from the bottom on the seniority. Only seems right that the senior guys should ride less. We do have a rule that the top 3 guys in seniority do not ride the squad period. Sometimes the squad may have a 10 year guy and a 1 year guy, sometimes two 1 year guys. It all really depends on how the shift scheduler makes out the schedule.

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    Quote Originally Posted by twalk1010 View Post
    We do have a rule that the top 3 guys in seniority do not ride the squad period.
    We get paid a paramedic "bonus". We are also required to keep medic card for 12 years.(that's a whole 'nuther situation) If the three top dogs never ride the squad they will be pretty rusty when they have to for whatever reason. If you maintain your card then you ride the squad as per the rotation guidelines...That's what you get paid to do!
    Marc S.
    Firefighter/Paramedic
    Solon Local 2079

    (Previously posted as Hobbitt. Registered December '02,)

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