Guest guest Report post Posted May 26, 2005 In a message dated 5/26/2005 2:52:30 P.M. Central Daylight Time, jpkimbrow@... writes: If ssm is a good thing, do any fire departments that you know of use it? Or cop shops? Louis N. Molino, Sr., CET FF/NREMT-B/FSI/EMSI LNMolino@... (IFW Office) (Cell Phone) (IFW Fax) " A Texan with a Jersey Attitude " The comments contained in this E-mail are the opinions of the author and the author alone. I in no way ever intend to speak for any person or organization that I am in any way whatsoever involved or associated with unless I specifically state that I am doing so. Further this E-mail is intended only for its stated recipient and may contain private and or confidential materials retransmission is strictly prohibited unless placed in the public domain by the original author. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 The Dallas Fire Department rotates ambulances to fill in at different stations as their system level drops. Is this not a form of SSM? They have also rotated engines to various stations not only within the city, but into neighboring cities as part of their mutual aid. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 The Dallas Fire Department rotates ambulances to fill in at different stations as their system level drops. Is this not a form of SSM? They have also rotated engines to various stations not only within the city, but into neighboring cities as part of their mutual aid. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 In a message dated 5/26/2005 4:45:39 PM Central Standard Time, bbledsoe@... writes: It is not a form of SSM--just prudent resource management. Doc, nice simile for ssm. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 In a message dated 5/26/2005 4:45:39 PM Central Standard Time, bbledsoe@... writes: It is not a form of SSM--just prudent resource management. Doc, nice simile for ssm. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 If ssm is a good thing, do any fire departments that you know of use it? __________________________________________________ Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 If ssm is a good thing, do any fire departments that you know of use it? __________________________________________________ Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 If ssm is a good thing, do any fire departments that you know of use it? __________________________________________________ Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 It is not a form of SSM--just prudent resource management. E. Bledsoe, DO, FACEP Midlothian, TX My Governor is a Jewish Cowboy! http://www.kinkyfriedman.com/ Re: re:SSM The Dallas Fire Department rotates ambulances to fill in at different stations as their system level drops. Is this not a form of SSM? They have also rotated engines to various stations not only within the city, but into neighboring cities as part of their mutual aid. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 It is not a form of SSM--just prudent resource management. E. Bledsoe, DO, FACEP Midlothian, TX My Governor is a Jewish Cowboy! http://www.kinkyfriedman.com/ Re: re:SSM The Dallas Fire Department rotates ambulances to fill in at different stations as their system level drops. Is this not a form of SSM? They have also rotated engines to various stations not only within the city, but into neighboring cities as part of their mutual aid. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 It is not a form of SSM--just prudent resource management. E. Bledsoe, DO, FACEP Midlothian, TX My Governor is a Jewish Cowboy! http://www.kinkyfriedman.com/ Re: re:SSM The Dallas Fire Department rotates ambulances to fill in at different stations as their system level drops. Is this not a form of SSM? They have also rotated engines to various stations not only within the city, but into neighboring cities as part of their mutual aid. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 Chad-- >. . . & SSM is a morale drainer for crews. The same goes for working a 24 >hour shift. That's all they >talked about in a recent management class we attended. How awful 24 hour >shifts are. Query: I can infer from this that most, or much, of ETMC EMS operates 24-hour shifts on an SSM basis? That is, posted or between postings, not in station. Crew has to be awake & alert for 24 hours, sitting in the box somewhere, regardless of call volume? OUCH! Conley Harmon As a student doing ambulance rotations at Dallas Fire & Rescue, I found it easy to be in the back of the box, ready to go, within 30 seconds of an EMS call being paged--from being asleep in a bunk. (I'm not saying the regular crew was there that quickly--but my risk of missing a call was getting dropped from the program.) -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.308 / Virus Database: 266.11.15 - Release Date: 5/22/2005 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 Chad-- >. . . & SSM is a morale drainer for crews. The same goes for working a 24 >hour shift. That's all they >talked about in a recent management class we attended. How awful 24 hour >shifts are. Query: I can infer from this that most, or much, of ETMC EMS operates 24-hour shifts on an SSM basis? That is, posted or between postings, not in station. Crew has to be awake & alert for 24 hours, sitting in the box somewhere, regardless of call volume? OUCH! Conley Harmon As a student doing ambulance rotations at Dallas Fire & Rescue, I found it easy to be in the back of the box, ready to go, within 30 seconds of an EMS call being paged--from being asleep in a bunk. (I'm not saying the regular crew was there that quickly--but my risk of missing a call was getting dropped from the program.) -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.308 / Virus Database: 266.11.15 - Release Date: 5/22/2005 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 Bill, Hunt county is similar in the drive from Greenville to Commerce. Often it does not make sense from a field point of view why a crew needs to drive 30 minutes to post. However, if the move was not made, what would the ETA to the next call be? Rural Texas is is the victim/benefactor of SSM. Do not get me wrong, I am not a big supporter of it, I am just trying to point out a few key items that lead to SSM. From my observations, rural EMS is confronted with several problems: 1) Larger areas to cover that lead to longer response and transport times. 2) Less dense population base per square mile. 3) Average lower mean household income which translates into less tax revenue for the local government and ultimatley less revenue for public safety. 4) Higher percentage of uninsured households than the rest of the Texas (which currently has one of the highest rates of uninsured households per capita in the nation). 5) Dwindling reimbursement and stricter reimbursment criteria from the state and federal programs (Medicare and Medicaid). 6) Fewer trained personnel to actually ride the ambulances. Not to mention that since Texas went to the Natinal Registry Curriculum, the pass rate for the folks new to EMS is down by nearly 40% and the actual enrollment is down as well. The bottom line is that the bottom line dictates what can and cannot be accomplished with limited means. The truth of the matter is that the rural systems--volunteer departments in particular) are becoming more and more dependent on grants, private donations and local fund raisers. The larger rural services such as ETMC EMS and Champion have some subsidy money and subscription programs in place to help offset the cost of operating. There is no easy fix to the argument of SSM. In a perfect world, we would have a fire station with apparatus and gold plated MICUs every square mile and free trauma center in every community. The only option for now is for EMS providers and personnel to pull together, quit bickering and join groups like the Texas Ambulance Association and the American Ambulance Association to lobby for reform. As a united voice we can and will make changes. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 26, 2005 If Tylers' system works, why does Whiteoak drive 40 miles to cover Carthage? Or the 'Primary truck' that sits 'centrally located' cover most of Tyler? I can remember some other post moves that took almost 30 minutes to get to. How does that reduce response times? Just curious................. Bill EMT-P Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 27, 2005 (Responding to a previous post) Well I may be misreading the question but wouldn't response times be reduced if a truck was moved closer to an area that was 40 miles away than if they were to makeup the 40 mile drive during an emergency? Central Tyler is Level 1 post but our 7 other Tyler posts are positioned to respond outside-in. If you've ever driven down South Broadway or around the southern sections of the Loop in Tyler from about 8am-8pm, then you would know that a unit could not make the contractual response time from the hospital to a call at S. Broadway & Cumberland. I'm not arguing SSM, I'm just stating FACTS that keeping a truck in that area when call volume allows, would significantly and does reduce response times. No computer, no person can ever predict where an emergency is going to happen. No system is perfect, no matter what method they use. People have an emergency, they want an ambulance parked across the street. My only concern & my priority is to get an ambulance to that patient as quickly as possible, even if that means calling another service. Priority 1 is my crew though & if they're called to do a transfer or make a post move & they feel they cannot do it, then we do everything possible to accomodate. But again, administration looks at the bottom dollar & the statistics that are brought to them when trying to allocate additional resources. I have never been privy to a meeting relating to additional resource allocation but I don't think the first question is, " well are the crews getting enough sleep at night or could I add another truck for them to make sure they get the needed 8 hours of rest that is reccomended? " I seriously doubt it. They go by the numbers in black & white placed in front of them. My job is to follow the policies & procedures set forth by the company for which I'm employed & to ensure others do so as well. Gene my only question to you though comes from this statement you made earlier: " Sometimes simplicity and common sense can do more than the most elaborate computer program. Stick pins in a map for every call, look where the pins are, and concentrate your power there. Keep your trucks on the periphery of the area so that they can run both in and out. " Is this not what SSM is? This is how we choose where our trucks are positioned, based on the previous 20 week data & SSC Supervisors looking at this data & deciding where these units should be positioned, which is on the periphery so they can respond from the outside-in (Tyler). Since we do not use a full SSM, only in select areas, this is what I have come to know as SSM & your statement pretty much nails it on the head. So please correct me if I'm wrong. I've truly enjoyed the discussions from everyone though. I've gained new knowledge about things I didn't know about before & if I posted anything over my realm of knowledge & expertise, I apologize but glad to see everyones two cents. I've had some interesting phone calls from those reading some of the statements. :-) Chad > > > > Chad Richey > > > > SSC Supervisor > > > > ETMC EMS > > > > Tyler, Tx > > > > > > What, exactly, does an SSC supervisor do? And have you measured > > the > > > effect of SSM on crew health and morale? > > > > > > Mike > > > > > > > > > > > > > > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 27, 2005 Wes, As I am using this group as a learning tool, I am a certified EMD, Advanced with MPDS. Do you feel that giving people with absolutely no medical knowledge pre-arrival instructions degrades patient care or just the methods that MPDS uses to do so? The family that I gave these instructions to to deliver their daughter about 6 months ago very much appreciated the instructions given to them to successfully birth a baby in the living room floor of their home. What is your concern with MPDS as opposed to APCO's PAI's? Or do you just prefer no PAI's be given at all & we just take the call information & hang up? Chad > a, I've got the utmost respect for the exceedingly difficult job that dispatchers do. What I do question is the proof/efficacy of MPDS dispatching and the proprietary methodology. > > -Wes Ogilvie, MPA, JD, EMT-B > Austin, Texas > > Re: Re: SSM > > > > I probably felt the same way you seem to feel, but i have been a paramedic > for the last 24 years, the last 5 of those as an educator. I have been > involved with the communication center during that time, and actually have > become certified by NAEMD - yes the " front " for MPDS, but I have tremendous > respect for dispatchers since i have left actual field work. Dispatchers do > a job that no one else would do, certainly not most Paramedics. > Dispatchers are constantly making immediate decisions, and are constantly > criticized, and ridiculed by " professionals " . I have truly become a better > paramedic since that time. > > Lynn MBA NREMT-P > Educator, PEMSS Program > Northwest Texas Hospital > Amarillo, TX > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 27, 2005 Wes, As I am using this group as a learning tool, I am a certified EMD, Advanced with MPDS. Do you feel that giving people with absolutely no medical knowledge pre-arrival instructions degrades patient care or just the methods that MPDS uses to do so? The family that I gave these instructions to to deliver their daughter about 6 months ago very much appreciated the instructions given to them to successfully birth a baby in the living room floor of their home. What is your concern with MPDS as opposed to APCO's PAI's? Or do you just prefer no PAI's be given at all & we just take the call information & hang up? Chad > a, I've got the utmost respect for the exceedingly difficult job that dispatchers do. What I do question is the proof/efficacy of MPDS dispatching and the proprietary methodology. > > -Wes Ogilvie, MPA, JD, EMT-B > Austin, Texas > > Re: Re: SSM > > > > I probably felt the same way you seem to feel, but i have been a paramedic > for the last 24 years, the last 5 of those as an educator. I have been > involved with the communication center during that time, and actually have > become certified by NAEMD - yes the " front " for MPDS, but I have tremendous > respect for dispatchers since i have left actual field work. Dispatchers do > a job that no one else would do, certainly not most Paramedics. > Dispatchers are constantly making immediate decisions, and are constantly > criticized, and ridiculed by " professionals " . I have truly become a better > paramedic since that time. > > Lynn MBA NREMT-P > Educator, PEMSS Program > Northwest Texas Hospital > Amarillo, TX > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 27, 2005 There's something that concerns me about MPDS and their insistence that you can only follow their protocols. (Also, I have concerns about the MPDS people producing biased research and claiming that they are a " standard of care.) A medically trained provider should be able to use their discretion and judgment. From what I understand, APCO allows the medical director to modify the pre-arrival instructions. In my opinion, the cards are a great tool for EMS systems where the dispatchers are not medically trained. In an ideal world, someone would develop a good program to train EMS providers to give prearrival instructions. -Wes Ogilvie, MPA, JD, EMT-B Austin, Texas In a message dated 5/27/2005 1:22:48 AM Central Daylight Time, carichey@... writes: Wes, As I am using this group as a learning tool, I am a certified EMD, Advanced with MPDS. Do you feel that giving people with absolutely no medical knowledge pre-arrival instructions degrades patient care or just the methods that MPDS uses to do so? The family that I gave these instructions to to deliver their daughter about 6 months ago very much appreciated the instructions given to them to successfully birth a baby in the living room floor of their home. What is your concern with MPDS as opposed to APCO's PAI's? Or do you just prefer no PAI's be given at all & we just take the call information & hang up? Chad > a, I've got the utmost respect for the exceedingly difficult job that dispatchers do. What I do question is the proof/efficacy of MPDS dispatching and the proprietary methodology. > > -Wes Ogilvie, MPA, JD, EMT-B > Austin, Texas > > -----Original Message----- > From: Lynn <eric.lynn@n...> > To: > Sent: Thu, 26 May 2005 16:06:29 -0500 > Subject: Re: Re: SSM > > > > I probably felt the same way you seem to feel, but i have been a paramedic > for the last 24 years, the last 5 of those as an educator. I have been > involved with the communication center during that time, and actually have > become certified by NAEMD - yes the " front " for MPDS, but I have tremendous > respect for dispatchers since i have left actual field work. Dispatchers do > a job that no one else would do, certainly not most Paramedics. > Dispatchers are constantly making immediate decisions, and are constantly > criticized, and ridiculed by " professionals " . I have truly become a better > paramedic since that time. > > Lynn MBA NREMT-P > Educator, PEMSS Program > Northwest Texas Hospital > Amarillo, TX > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 27, 2005 There's something that concerns me about MPDS and their insistence that you can only follow their protocols. (Also, I have concerns about the MPDS people producing biased research and claiming that they are a " standard of care.) A medically trained provider should be able to use their discretion and judgment. From what I understand, APCO allows the medical director to modify the pre-arrival instructions. In my opinion, the cards are a great tool for EMS systems where the dispatchers are not medically trained. In an ideal world, someone would develop a good program to train EMS providers to give prearrival instructions. -Wes Ogilvie, MPA, JD, EMT-B Austin, Texas In a message dated 5/27/2005 1:22:48 AM Central Daylight Time, carichey@... writes: Wes, As I am using this group as a learning tool, I am a certified EMD, Advanced with MPDS. Do you feel that giving people with absolutely no medical knowledge pre-arrival instructions degrades patient care or just the methods that MPDS uses to do so? The family that I gave these instructions to to deliver their daughter about 6 months ago very much appreciated the instructions given to them to successfully birth a baby in the living room floor of their home. What is your concern with MPDS as opposed to APCO's PAI's? Or do you just prefer no PAI's be given at all & we just take the call information & hang up? Chad > a, I've got the utmost respect for the exceedingly difficult job that dispatchers do. What I do question is the proof/efficacy of MPDS dispatching and the proprietary methodology. > > -Wes Ogilvie, MPA, JD, EMT-B > Austin, Texas > > -----Original Message----- > From: Lynn <eric.lynn@n...> > To: > Sent: Thu, 26 May 2005 16:06:29 -0500 > Subject: Re: Re: SSM > > > > I probably felt the same way you seem to feel, but i have been a paramedic > for the last 24 years, the last 5 of those as an educator. I have been > involved with the communication center during that time, and actually have > become certified by NAEMD - yes the " front " for MPDS, but I have tremendous > respect for dispatchers since i have left actual field work. Dispatchers do > a job that no one else would do, certainly not most Paramedics. > Dispatchers are constantly making immediate decisions, and are constantly > criticized, and ridiculed by " professionals " . I have truly become a better > paramedic since that time. > > Lynn MBA NREMT-P > Educator, PEMSS Program > Northwest Texas Hospital > Amarillo, TX > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 27, 2005 There's something that concerns me about MPDS and their insistence that you can only follow their protocols. (Also, I have concerns about the MPDS people producing biased research and claiming that they are a " standard of care.) A medically trained provider should be able to use their discretion and judgment. From what I understand, APCO allows the medical director to modify the pre-arrival instructions. In my opinion, the cards are a great tool for EMS systems where the dispatchers are not medically trained. In an ideal world, someone would develop a good program to train EMS providers to give prearrival instructions. -Wes Ogilvie, MPA, JD, EMT-B Austin, Texas In a message dated 5/27/2005 1:22:48 AM Central Daylight Time, carichey@... writes: Wes, As I am using this group as a learning tool, I am a certified EMD, Advanced with MPDS. Do you feel that giving people with absolutely no medical knowledge pre-arrival instructions degrades patient care or just the methods that MPDS uses to do so? The family that I gave these instructions to to deliver their daughter about 6 months ago very much appreciated the instructions given to them to successfully birth a baby in the living room floor of their home. What is your concern with MPDS as opposed to APCO's PAI's? Or do you just prefer no PAI's be given at all & we just take the call information & hang up? Chad > a, I've got the utmost respect for the exceedingly difficult job that dispatchers do. What I do question is the proof/efficacy of MPDS dispatching and the proprietary methodology. > > -Wes Ogilvie, MPA, JD, EMT-B > Austin, Texas > > -----Original Message----- > From: Lynn <eric.lynn@n...> > To: > Sent: Thu, 26 May 2005 16:06:29 -0500 > Subject: Re: Re: SSM > > > > I probably felt the same way you seem to feel, but i have been a paramedic > for the last 24 years, the last 5 of those as an educator. I have been > involved with the communication center during that time, and actually have > become certified by NAEMD - yes the " front " for MPDS, but I have tremendous > respect for dispatchers since i have left actual field work. Dispatchers do > a job that no one else would do, certainly not most Paramedics. > Dispatchers are constantly making immediate decisions, and are constantly > criticized, and ridiculed by " professionals " . I have truly become a better > paramedic since that time. > > Lynn MBA NREMT-P > Educator, PEMSS Program > Northwest Texas Hospital > Amarillo, TX > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 27, 2005 Where I work, we post units when other stations in the county are running calls, in order to prevent excessive response times in the empty districts, but not after 0100 unless the county drops to status 1. The worst part of posting is WHERE it occurs, rather than the actual posting itself, imho. If we had a better location to park our carcasses at, it wouldn't be so unbearable. I personally hate posting, but it is (unfortunately) part of the job. Barry McClung, EMT-P Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 27, 2005 Where I work, we post units when other stations in the county are running calls, in order to prevent excessive response times in the empty districts, but not after 0100 unless the county drops to status 1. The worst part of posting is WHERE it occurs, rather than the actual posting itself, imho. If we had a better location to park our carcasses at, it wouldn't be so unbearable. I personally hate posting, but it is (unfortunately) part of the job. Barry McClung, EMT-P Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 27, 2005 Where I work, we post units when other stations in the county are running calls, in order to prevent excessive response times in the empty districts, but not after 0100 unless the county drops to status 1. The worst part of posting is WHERE it occurs, rather than the actual posting itself, imho. If we had a better location to park our carcasses at, it wouldn't be so unbearable. I personally hate posting, but it is (unfortunately) part of the job. Barry McClung, EMT-P Quote Share this post Link to post Share on other sites
Guest guest Report post Posted May 27, 2005 Actually, that's pretty much a misstatement. Dallas Fire-Rescue does use a " fill-in " system. BUT, Dallas Fire-Rescue uses satellite-location based dispatching to dispatch the closest unit, and has a formula built in to automatically kick out an engine/truck to accompany an ambulance exceeding the programmed, planned response threshhold. They've been doing that for 10+ years now... and can show the data for each call as to why each unit was assigned as closest, etc... and show that for extended response times for ambulances they're adding BLS responses to put providers on scene as fast as possible. Additionally, Dallas F/R has three paramedic engines that ALWAYS have a paramedic on them and carry ALS gear, supplementing ALS/MICU response in areas of town that are farther out and don't warrant MICU placement based on call volume, but do need ALS response within certain timelines. How many private companies place " sprint trucks " with ALS gear in heavy demand areas, supplementing their MICU coverage? While if a sector of the city does get low on ambulances, they will send a unit to " fill-in " , they're sending them TO A STATION, for a determined reason (all the response units in the area are out for an extended time, such as a hospital transport, etc.) - generally I've only seen this when 4 or more contiguous ambulances are out. They " fill-in " at place they can back in, rest, eat, sleep, whatever they need to do until relieved. Of course, they also rotate their personnel off the ambulance every third shift (or something like that), giving them a break. " Pure " paramedics don't have that luxury - there's nothing to rotate them off to... DFR does use peak-demand units (non 24-hour units), but the medics earn OVERTIME for working them, and they're at STATIONS. They have a " home " that's not a gas station parking lot. Mike > The Dallas Fire Department rotates ambulances to fill in at different > stations as their system level drops. Is this not a form of SSM? They have also > rotated engines to various stations not only within the city, but into > neighboring cities as part of their mutual aid. > > > > > Quote Share this post Link to post Share on other sites
