Re: Call Delay in Pasadena

October 16, 2002

once again, what is response time??? how long did the system hold the call

in dispatch??? from time of dispatch to onscene is one measure of the

system, but the caller thinks it begins when he calls 9-1-1. is the time

measured from the time the system receives the call, or only from the time

it is dispatched?

john

Atwell Rasmussen, Ph.D., REMTP

Lieutenant, Education and Training

Greenville County EMS

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call delay in Pasadena

IF...repeat IF the time from the crew being dispatched to the time they

arrived was less than 8 minutes, don't bust ETMC's chops. Tragedies happen.

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October 17, 2002

,

When did 8 minute response times to anywhere become acceptable or common place.

I realize that in many instances responses do take 8 or more minutes. However,

What if the call were 2 blocks away and it still took 8 minutes. Would that be

an acceptable time frame. For sure we are now talking about response times. I am

in no way referring to the call in Pasadena. I can remember when EMS considered

anything greater than 4 minute response times as unacceptable. Remember that we

learned that the brain could only survive 4 minutes without O2. We would dash,

run, fly or tumble to the units at a rapid rate to do everything we could to

beat that 4 minute clock. Now days a medic will comb his hair, empty his

bladder, amble on to the truck, tune the radio to a good station and slowly

leave the station. Where is rush to the brain that says: someone is in a medical

emergency, I need to get my butt in gear and get there in a hurry. The better

prepared we are and the more rapid our response is from start to finish the less

strain outside influences place on our response times.

Henry

Kimbrow wrote:

> IF...repeat IF the time from the crew being dispatched to the time they

> arrived was less than 8 minutes, don't bust ETMC's chops. Tragedies happen.

>

> _________________________________________________________________

> Get faster connections -- switch to MSN Internet Access!

> http://resourcecenter.msn.com/access/plans/default.asp

>

October 17, 2002

Henry-

There is no way on this earth to guarantee an ambulance response to a person who

has stopped breathing in your 4 minute window, EVEN IF THE AMBULANCE IS TWO

BLOCKS AWAY.

Let's look at the time issues:

Assuming the collapse is witnessed and the witness dials the phone immediately:

*What will the time delay from dialing of the call to reception of the call by a

911 operator be?

*How long will it take for the 911 Operator to dispatch an available unit?

*Is the crew standing by in the day room or asleep?

*Does the unit have an automatic shore line disconnect or does it have to be

manually disconnected?

*Does the station have manual or power bay doors? Or are the doors left open

during shift?

*What are the weather conditions?

*How heavy is traffic?

*Does the unit have to cross any busy intersections?

*Is the house well lit and the number easily seen?

*Is this an apartment complex?

*Can the unit park close to the house or apartment?

*Are there any stairs?

Am I getting my point across?

As Safety Officer for my local EMS organization I find reliance on pure response

time as a measure of how effective a unit is to be a poor safety practice at

best, and verge on reckless disregard for employee and public safety at it's

worst.

The needs of the patient have to be balanced against the safety of the Emergency

Services responders and the public at large, and we cannot urge our Ambulance

crews to place speed above all other concerns.

My district is a small city, 20,000 nighttime residents, 40,000 daytime,

approximately 3 miles across, with a significant extraterritorial jurisdiction

to cover outside city limits. We are served by two " On-Duty " crews during the

day and one at night and bolstered by volunteer responders as well.

Under what can be described as a " Best Case " scenario, we manage to maintain a 6

minute response average under some reasonably strict driving restrictions.

Demanding as 4 minute response is a dangerous course........

This is why we teach CPR to all our High School students here in God's country

before they graduate. It Buy's time.

Regards-

Terry Dinerman EMTP

Re: call delay in Pasadena

,

When did 8 minute response times to anywhere become acceptable or common

place.

I realize that in many instances responses do take 8 or more minutes. However,

What if the call were 2 blocks away and it still took 8 minutes. Would that be

an acceptable time frame. For sure we are now talking about response times. I

am

in no way referring to the call in Pasadena. I can remember when EMS

considered

anything greater than 4 minute response times as unacceptable. Remember that

we

learned that the brain could only survive 4 minutes without O2. We would dash,

run, fly or tumble to the units at a rapid rate to do everything we could to

beat that 4 minute clock. Now days a medic will comb his hair, empty his

bladder, amble on to the truck, tune the radio to a good station and slowly

leave the station. Where is rush to the brain that says: someone is in a

medical

emergency, I need to get my butt in gear and get there in a hurry. The better

prepared we are and the more rapid our response is from start to finish the

less

strain outside influences place on our response times.

Henry

Kimbrow wrote:

> IF...repeat IF the time from the crew being dispatched to the time they

> arrived was less than 8 minutes, don't bust ETMC's chops. Tragedies happen.

>

> _________________________________________________________________

> Get faster connections -- switch to MSN Internet Access!

> http://resourcecenter.msn.com/access/plans/default.asp

>

October 17, 2002

Terry,

Of course I got your point and do not disagree with anything you said. My post

was not a condemnation that demanded a 4 minute response time. It merely pointed

out that in days gone by 4 minutes was the time frame that we attempted to get

close to because anything greater in the time of a full arrest

was downhill. No where did I say or expect crews to go balls to the wall

disregarding the safety of the public or themselves. I did however state that

the medics of today don't seem to have or feel the sense of urgency that I did

when I was younger. If you will re-read my post a little slower without

a gut reaction you might see that my post was not meant to be threatening.

Certainly, if you knew a little about me you would know that I after almost 33

years in the business, I know what is going on in the EMS world and need very

little education in the concept of EMS.

Henry

Terry Dinerman wrote:

> Henry-

>

> There is no way on this earth to guarantee an ambulance response to a person

who has stopped breathing in your 4 minute window, EVEN IF THE AMBULANCE IS TWO

BLOCKS AWAY.

>

> Let's look at the time issues:

>

> Assuming the collapse is witnessed and the witness dials the phone

immediately:

> *What will the time delay from dialing of the call to reception of the call by

a 911 operator be?

> *How long will it take for the 911 Operator to dispatch an available unit?

> *Is the crew standing by in the day room or asleep?

> *Does the unit have an automatic shore line disconnect or does it have to be

manually disconnected?

> *Does the station have manual or power bay doors? Or are the doors left open

during shift?

> *What are the weather conditions?

> *How heavy is traffic?

> *Does the unit have to cross any busy intersections?

> *Is the house well lit and the number easily seen?

> *Is this an apartment complex?

> *Can the unit park close to the house or apartment?

> *Are there any stairs?

>

> Am I getting my point across?

>

> As Safety Officer for my local EMS organization I find reliance on pure

response time as a measure of how effective a unit is to be a poor safety

practice at best, and verge on reckless disregard for employee and public safety

at it's worst.

>

> The needs of the patient have to be balanced against the safety of the

Emergency Services responders and the public at large, and we cannot urge our

Ambulance crews to place speed above all other concerns.

>

> My district is a small city, 20,000 nighttime residents, 40,000 daytime,

approximately 3 miles across, with a significant extraterritorial jurisdiction

to cover outside city limits. We are served by two " On-Duty " crews during the

day and one at night and bolstered by volunteer responders as well.

>

> Under what can be described as a " Best Case " scenario, we manage to maintain a

6 minute response average under some reasonably strict driving restrictions.

>

> Demanding as 4 minute response is a dangerous course........

>

> This is why we teach CPR to all our High School students here in God's country

before they graduate. It Buy's time.

>

> Regards-

>

> Terry Dinerman EMTP

> Re: call delay in Pasadena

>

> ,

>

> When did 8 minute response times to anywhere become acceptable or common

place.

> I realize that in many instances responses do take 8 or more minutes.

However,

> What if the call were 2 blocks away and it still took 8 minutes. Would that

be

> an acceptable time frame. For sure we are now talking about response times.

I am

> in no way referring to the call in Pasadena. I can remember when EMS

considered

> anything greater than 4 minute response times as unacceptable. Remember that

we

> learned that the brain could only survive 4 minutes without O2. We would

dash,

> run, fly or tumble to the units at a rapid rate to do everything we could to

> beat that 4 minute clock. Now days a medic will comb his hair, empty his

> bladder, amble on to the truck, tune the radio to a good station and slowly

> leave the station. Where is rush to the brain that says: someone is in a

medical

> emergency, I need to get my butt in gear and get there in a hurry. The

better

> prepared we are and the more rapid our response is from start to finish the

less

> strain outside influences place on our response times.

>

> Henry

>

> Kimbrow wrote:

>

> > IF...repeat IF the time from the crew being dispatched to the time they

> > arrived was less than 8 minutes, don't bust ETMC's chops. Tragedies

happen.

> >

> > _________________________________________________________________

> > Get faster connections -- switch to MSN Internet Access!

> > http://resourcecenter.msn.com/access/plans/default.asp

> >

October 17, 2002

Mercy! There's more being said about an 8-minute response to a 911 call than I

could've imagined possible. One person stated it " makes me sick " . Wonder if the

limited description of the call makes them sick or the response by the listserve

does. It doesn't matter, though. How can anyone really involved in EMS show any

real concern just hearing about an 8-minute response?

I work for ETMC-EMS, am not in the position to know every detail about the call,

but here' s my thoughts: I wouldn't be concerned yet if this was your service

(there's just not enough information to be) and 8 minutes is very common

everywhere. Some places are always gonna be 8 minutes away or 18 minutes away no

matter where your truck(s) is (are). How can anyone be concerned about units

staying in a motel temporarily (if that is the optimal place to put it).

Apartments, houses, motels, etc. have been used for many years as stations by

many companies if they serve the need. Sitting on the side of the road has to be

done sometimes too.

Has ETMC done something to a few of the more vocal listserve members and this is

their way of trying to " get back " at us? We're an fairly experience company that

seeks to be of high quality. We don't attack others. As we are a somewhat larger

provider - maybe that's why some " smaller " folks want to take a shot at us? Mmm.

A Tyler firefighter who's on this listserve posted the article long after it was

on this site but for what reason? Is he trying to stir up more stuff? I don't

know and he may respond and I'll find out. That alone sounds like he wants to

report " bad news " about the service that he is has affiliation with. What'd we

do to him? Maybe he's just reporting the news. I'll give the benefit of the

doubt. When I hear potentially-scathing news about any EMS group - my first

reaction should NOT be to see negative stuff and go along with it. Much less

relish seeing another provider getting criticism. Criticism of YOUR service does

not set well with me either. My first reaction should be to leave it alone and

then as I learn more make an opinion. It's believed that fire departments have

the brotherhood they do because (actually many reasons) one reason is they stick

together. We will never have that brotherhood with this eagerness to bash.

The priority thought on this whole thing is sadness for the family in losing

their child. Please put your thoughts there too. Not one person on this

listserve knows if anything done (or not done) by any responder contributed to

the child's demise. Kids die too. We also had 2 crewmembers do everything they

could to save this child. The same as you would do. They're going through

somewhat of a tough time and (guaranteed) they wish they could've gotten there

in 1-2 minutes. There is no big deal here except a family losing their kid. And

that, of course, IS a very big deal. Please say a prayer for them. I love my

children, don't want to lose them, and absolutely hate this for them. Right now

the rest of this is just an 8-minute response time.

Don.

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October 18, 2002

I said it makes me sick, and not because of the response time, but because there

was no mention of anyone on scene trying to resuscitate this child, which might

have saved the child. ANYONE can give rescue breathing, and I'm guessing, grant

you, but I think had someone attempted this in that house, that the child MIGHT

still be alive. Does anyone know if this was done ? EMS/FD units are going to

arrive when they can, but initial efforts are of the utmost importance in an

emergency situation. People die, but was every effort possible made to avoid it,

is the question. Were all resources available exhausted? If all was done and the

outcome was still mortality, then everyone did the best that they could do.

There are no win win situations in life. Years ago I worked for a Volunteer EMS

service that responded from homes, so I'm not knocking services that do what

they can afford to do, as long as the service provides decent service.