Los Angeles Fire Department Implements EMS Resource Plan

The Los Angeles Fire Department is a full-spectrum life safety agency protecting approximately 4 million people who live and work in America’s second-largest city. The LAFD’s 3,376 uniformed personnel and 333 civilian support staff address multiple...


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The Board of Fire Commissioners held public meetings to study paramedic staffing. City officials, fire department management, union leaders, firefighter/paramedics and members of the medical community offered solutions.

In January 2001, faced with mounting EMS problems, Fire Chief William R. Bamattre introduced a five-year Emergency Medical Services Resource Deployment Plan (EMS Plan). The plan addressed the chief’s goals of increasing paramedic coverage, improving EMS service delivery and providing a better working environment by reducing workloads.

The EMS Plan would manage the significant number of new paramedics, deployment of additional resources, and expansion of field supervision. The five-year plan would increase the number of paramedics and resources to meet the following objectives:

  • Paramedic resource at every fire station
  • Ambulance at every fire station
  • EMS captains in every battalion
  • Additional paramedic ambulances to provide workload relief for busy units
  • Additional paramedic assessment engines for paramedic personnel rotation

The mayor approved the EMS Plan in January 2001. It included hiring and training 500 paramedics over five years and increased EMS field supervision, resource deployment plans and workload relief plans. In the first year of the EMS Plan (2001/2002), the LAFD:

  • Upgraded three BLS fire companies into paramedic assessment units
  • Upgraded five BLS ambulances into paramedic ambulances
  • Added six paramedic

ambulances

  • Added nine BLS ambulances
  • Added nine EMS district captain offices
  • Hired 145 paramedics
  • Hired four nurse educators for paramedic continuing education
  • Revised EMS dispatch protocols
  • Trained LAFD uniformed dispatchers to National Academy EMD standards

By the end of the first year, the number of ambulances increased from 83 to 98, paramedic ambulances increased from 56 to 67, paramedic units increased from 84 to 98 and EMS captains on duty increased from six to 12. Paramedic response times decreased from an average of 7.2 minutes to 6.9 minutes citywide. The number of paramedic ambulances exceeding the workload limit was dramatically reduced, from 22 to just three. The number of fire stations where the firefighter/paramedics could rotate between the paramedic ambulance and the fire company was increased from four to eight. EMS incidents for the year increased 5%, from 261,619 in 2000/2001 to 274,341 in 2001/2002.

During the second year of the EMS Plan (2002/2003), the LAFD:

  • Upgraded 11 BLS fire companies into paramedic assessment units
  • Upgraded 1 BLS ambulance into a paramedic ambulance
  • Added four paramedic

ambulances

  • Added 13 BLS ambulances
  • Added four EMS district captain offices • Hired and/or trained 140 firefighter/paramedics

By the end of the second year, the number of ambulances increased from 98 to 115, paramedic ambulances increased from 67 to 72, paramedic units increased from 98 to 114 and EMS captains on duty increased from 12 to 16. Paramedic response times decreased from an average of 6.9 minutes to 6.8 minutes citywide. The number of fire stations where the firefighter-paramedics could rotate between the paramedic ambulance and the fire company was increased from eight to 15. EMS incidents increased by 2% from 274,341 to 280,395.

In April 2003, the LAFD achieved an EMS Plan objective by deploying at least one paramedic resource in every fire station district. In June, the department achieved another objective by deploying EMS captains in all of the 16 geographic battalions, thereby improving EMS supervision, training and management of field personnel.

During the third year of the EMS Plan (2003/2004), the LAFD:

  • Upgraded three BLS fire companies into paramedic assessment units
  • Upgraded three BLS ambulances into paramedic ambulances
  • Will be hiring and/or training 70 to 80 firefighter/paramedics

As of Jan. 11, 2004, the number of ambulances remains at 115, paramedic ambulances increased from 72 to 75, paramedic units increased from 114 to 120 and EMS captains on duty remained at 16. Paramedic response times are projected to decrease from an average of 6.8 minutes to 6.7 minutes citywide this year. The number of fire stations where the firefighter paramedics could rotate between the paramedic ambulance and the fire company was increased from 15 to 21. The number of EMS incidents is projected to increase by 4% this year.