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• Dec. 15, 2007 - Paramedics, Experience, Location, Guns, Genesee County Ambulance Issue

Angie,

I took a peek at your blog by clicking on the link in your email. Good Stuff.

I just wanted to add a bit of information for you to consider for your next blog entry.

My niece is an EMT/Paramedic with XXX Ambulance. She will soon be joining the Genesee County Sheriff's Department as an ALS/Paramedic (Advanced Life Support). The ALS designation is a national certification which allows my niece, xxxx, to do more advanced work with patients in the field. When she joins the Sheriff's department her job will become even more dangerous than it is now. She will be a paramedic with a gun. Just picture my niece, all of 5 ft 2 inches and maybe 105 lbs with long blonde hair and big blue eyes. Picture her with a gun and no bullet proof vest. Picture her back with a great big target on it. Picture my cute little niece lifting a 300 lbs man out of a burning building or under a hail of bullets and you will feel my anxiety over her job.

XXXX is just over 21 years old and has been in the field for several years. When she was first starting out as a "probie" she worked out of the northern Genesee County area, from Clio to Flint. She is now based out of a suburb and works mostly in the downtown Flint and greater Flint areas. I say all this to give you the background for my following comments.

My first thoughts about combining all the ambulance services under one shield were completely negative. No regulation for pricing, who decides which emergency gets the first ambulance, will the dispatcher send help to richer neighborhoods before poorer, ostensibly more dangerous neighborhoods? Who will be there to guarantee a competitive market boosting the need for better service?

My niece has explained it this way. Currently, the ambulance companies are on a roster which goes in a certain order. The next company up gets the call. Even if another one is closer, any 911 dispatcher who receives a call requesting an ambulance takes a look at the next company available and they get the call.

The Ambulance company receives the call from 911. That ambulance dispatcher looks to see if they have any vehicles available. If they don't, they tell the dispatcher to contact the next available company and ask them. The dispatcher goes down the roll until an ambulance company accepts the call.

Then the communication between the rigs, their dispatcher, the 911 operator and any emergency response teams (fire, police) gets really hairy. By this time, it could be a few minutes to many, many minutes before the responding units arrive at the location and have an understanding of the situation. Too often, my niece has arrived at a location to be held back by police because there was someone shooting. Sometimes she gets there and she has to run out because no one reported a dangerous situation ... and she found it and had to call the police.

If one ambulance company doesn't fit the bill, I understand. I am all about fair play in the market place. But there needs to be a central dispatch who knows the exact location of every rig, the experience or licensing level of the personnel (are they just an EMT or do they have Paramedic or ALS Certification?

The dispatcher must know every bit of know information about the situation, and have the ability to update all responders in real time. The dispatcher must know every location of every responding unit, and can contact all at once. The responders must be able to speak to each other without dispatch relaying and delaying effective response times and outcomes.

I don't know about you, but if my mom is having a heart attack from her chemo treatments, I want to know that the fastest vehicle with the highest trained personnel is on its way. I want them to know as much information before they walk in my door as possible so that unnecessary delays won't cause her more pain, or risk death.

I know, too much information. But I am passionate about the safety of the responders (one of my brothers is a trooper with the State Police) and the people they are risking their lives to help.

Thanks for your blog and for keeping your clients informed.

Dawn Ferguson

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• Jan. 8, 2008 - RE: Paramedics, Experience, Location, Guns, Genesee County Ambulance Issue

Posted by Jeff

Dear Dawn

I have been a sheriff paramedic in this county for the past 14 years and Im sure I know your neice.  Rest assured the do provide us with bullet proof vests.  The problem in this county with EMS is not the fault of the ambulance companies  the problem is the people in charge (ex: Med Control, 911 , County Politicians) have been asleep at the wheel for the past 10 years.  The ambulance companies tried unsuccessfully in 2003 to be able to buy automatic Vehicle Locators but Loyd Fayling from 911 didnt want any part of it.  Also in 2004 Genesee county Med Control recieved a federal grant and purchased 65 radios just like the police carry but 911 and med control refuse to give them out..

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• Jan. 8, 2008 - RE: Paramedics, Experience, Location, Guns, Genesee County Ambulance Issue

Posted by Jeff

Dawn

Sorry I ran out of room in the last comment.  That problem has always been with the people in charge and not the companies or the providers.  Check the Flint Journal in May 2003 to see where they fought not to allow the ambulances to get AVL's  The system we have right now is a good system that needs a little fixing(radios&AVL) would fix any problems this county is having.  the problem is that there a political forces working behind the scenes that are all about the money and nothing about the patient, are you aware that under the new proposed system you will no longer be able to choose your hospital.  you will automatically go to the closest hospital Due to faster turnaround times.  There are 65 ambulances licensed in this county right now and the new plan will lower that to 20. Any time the government gets involves is a bad thing Competition is a good thing. 

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• Jan. 15, 2008 - RE: Paramedics, Experience, Location, Guns, Genesee County Ambulance Issue

Posted by Ryan Cohee

I spent nearly 6 years working for various companys in Genesee Co and the over all prob is, no matter who or how many services run the county, there is no way anyone can make any money to pay their bills anymore.  The Fire departments need to get it together and start running EMS in their own citys and twps. What we pay in our taxes for the deputy/medics could supply a good start to our fire departments.  Why do we need deputy /medics when 85% of our EMS Co are ALS? Put those deputys out on the road patroling for the PD only. There are and have been many fixes to the system but the so called gods at Genesee central have tried to hard to play god.

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• Feb. 12, 2008 - RE: Paramedics, Experience, Location, Guns, Genesee County Ambulance Issue

Posted by Jim
   Dawn medics have vests on. its not as dangerous as you may think hail of bullets events are rare. 911 calls the CLOSEST company first. but does not know if they have a rig available or not. All of the companies in this county offered to buy avl's which would tell 911 rig location availibilty and licensure. Lyod failing did not like this plan.As for one ambulance company controled by the government is not that great either. I live in Saginaw,But work as a paramedic in Genessee county. The reason I work here is the care is better in this county . in Saginaw MMR is the lone company. They are overworked, they have fewer ambulances per person which equals greater profit. I know your niece.shes nice.
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• Mar. 18, 2008 - RE: Paramedics, Experience, Location, Guns, Genesee County Ambulance Issue

Posted by Barker
Dawn, I am a retired dispatcher who worked at Genesee County 911 for 10 years. Please be assured that every dispatcher there is very well trained. It is hard for citizens to understand that there are questions that need to be asked, most times when people are calling for an emergent situation, they are nearing hysteria. A dispatcher may ask all the right questions and not get the right answers. I know of many calls where people have called in for stomach pain...and when people arrived to the scene, the stomach pain was a gunshot wound to the stomach. This was an actual call! Sometimes people are hiding things. There is no Genesee County dispatcher that would ever send emergency personal into a dangerous situation on purpose. As for the way  calls are dispatched, the policy is that the closest available ambulance will be sent, and the computer system recommends the ambulance to the 10th of a mile, it is not just a list, and they are always called, even if they were just sent on a call. Since my retirement I do work part time at an ambulance company. I feel that since I have seen things from both sides, I see where everyone is coming from with a single ambulance service, but, I feel that this will create longer waits for service since there will be less ambulances to cover the county. I think that med control could make some changes that could correct many of the problems. starting with many that the other responders have noted. Good luck to you, and your niece. I hope it helps you rest easier knowing that there are an amazing group of people supporting and backing her up every day. The quality of service from our Police, Fire and EMS providers is outstanding.
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• Aug. 14, 2008 - RE: Paramedics, Experience, Location, Guns, Genesee County Ambulance Issue

Posted by Mike

Dawn,

I've been working in Genesee County for a long time and I can assure you that the problems in this system rest soley with Genesee County 911's leadership and the Genesee County Medical Control Authority. I have to disagree with Mr. Cohee on the suggestion that the government run EMS through their fire departments. The taxbase in this county is shrinking every day to the point that some governmental units aren't sure that they will be able to make it yearly without cutting critical services such as fire departments. Even with a millage, there's not a bunch of money falling out of the sky. That EMS millage will dry up soon too...if it even passes again. On top of that, the unions would make damn sure they get the lions share of your money. It is always more cost effecient to have private companies do the work. Look at everything that's contracted out by governments now.

This county has some great ambulance companies and if you asked other states/counties if they would like more ambulance companies, they would scream "yes". Which is why Genesee County bureaucrats trying to push companies out of business is so disturbing... Makes you wonder what the real reason is?

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• Oct. 3, 2008 - RE: Paramedics, Experience, Location, Guns, Genesee County Ambulance Issue

Posted by Aaron

To anyone that reads this little ditty.  I live in Lapeer county, grew up in Macomb, lived in Oakland, and now work in Genesee county.  I am an EMT-B and a veteran military medevac sgt so I've been around the block once or twice.

What we have here in Genesee county is a good system in as far as the individual companies, EMT-B's, EMT-P's and Sherrifs.  We all commit to our careers and care deeply for our patients and our companies.  Most of us jump from comapany to company for a little change but we all know each other and know many of our patients quite well.  Several people come from outside of Genesee county because we have a unique area here, even if it means we lose on our hourly wages as compared to what EMT's make in other counties.

However the system we work in is severly outdated mostly due to expenditures that the politicians do not want to approach.  Not to mention a lack of direct action by medical control to push the politicians and money movers to keep regulations on the EMS world.  They have a decent grasp of medical authority, but making moves for a direction in EMS isn't really controlled by our Med Control.

Having competition between companies can be a boon, or it can be a bad thing and we all see it.  We wish we could do like other parts of the country and have high speed central dispatching with GPS control and stuff.  It would be better for our patients, but without a major lobbying effort or a push from the public it's not going to happen.  Not to mention changing the system will mean changes to a major component of buisiness in this area.  A good group of people work EMS in this county and jobs are hard to find as it is.  We try to do what we love, but how can we when there would only be certain openings in the future. 

Has anyone thought of pushing for Critical Care transport?  Aeromedical evac?  How about central privatized dispatching with all 13 or 15 services that we have?  Lapeer county centralized but the demographics there are different.  Macomb county has several companies, but they barely overlap.  This causes problems in providing equal care to everyone.  We can go on and on about changes to the systems and everyone has a good idea. 

We need to bring in someone that understands EMS, not statisitcs and money making...but EMS and Prehospital business and really put this system together so we can get some definite direction for the people that bust their humps out there every day.  Lets tweak the system so we make the rest of the country take notice of what we are doing here.  We have the education in place, the companies, and the practices...lets make them shine!

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• Oct. 4, 2008 - RE: Paramedics, Experience, Location, Guns, Genesee County Ambulance Issue

Posted by Angie Ridley
When I started this post, my son was a college student.  Since then, he went through basic training and combat medic training.  He is in the Reserves.  Now he is an EMT working out of ambulances.  WOW!!!
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