With all the recent focus on the LAFD and Medical Response times, I have noticed a lot of wrong information out there in the news site comments and social media realms. Therefore, I feel there is a need to put out a little overview information about how the Emergency Medical Services work in Los Angeles County and the different methods various agencies use.
A few quick definitions:
ALS Ambulance- Advanced Life Support- Has at least one Paramedic (EMT-P) trained in advanced levels of life support.
BLS Ambulance- Basic Life Support- Staffed with EMTs at the basic (EMT-B) or intermediate (EMT-I) levels. EMTs are not able to use advanced protocols and drugs on their own and can only assist Paramedics with more advanced techniques.
EMT- Emergency Medical Technician. EMT-B is Basic level, EMT-I is Intermediate level, and EMT-P is Paramedic level. Not all states recognize the intermediate level as a separate certification level. Note: all firefighters are trained to EMT-B levels at a minimum as part of their firefighter certification.
Squad- A fire department designation for a specialty apparatus and its crew.
R/A- Rescue Ambulance- LAFD’s lingo for their ambulances.
LAFD- Los Angeles City Fire Department
LACoFD- Los Angeles County Fire Department
There are two major EMS system approaches in use in LA County:
LAFD and many of the smaller city departments use a FD operated Ambulance approach and the LACoFD uses a Squad and Private Ambulance approach in County unincorporated areas and in contract cities.
The FD operated Ambulance approach uses a FD Paramedic (ALS) Ambulance dispatched to each medical emergency call along with an Engine or a second ambulance (ALS or BLS) to insure sufficient man power is available on scene.
The LA County Fire approach uses a Paramedic Rescue Squad (Squad 51 from Emergency) and separate contractor BLS Ambulance approach to dispatch one of each to a medical emergency.
Both LAFD and LACoFD approaches will dispatch an Engine and Truck Company Task Force to calls for accidents, traffic collisions, and unknown information “man down” calls where a rescue or extraction of a patient may be required. The Engine and Truck Co. Task Force response mainly is to provide manpower and varied specialized equipment that may be necessary at a scene (Ladders, air-bags, saws, cribbing, etc.)
I have also noticed many people comment on “the waste of my tax payer dollars with all the fire trucks” for the one sick person. Unfortunately, all the fire trucks and equipment is dispatched because many times a two person crew of an ambulance cannot lift a patent safely do to size or weight (yes Americans are obese). Also, if the patient is in serious condition, two persons may be required to provide proper patient care while in route to the hospital. The large response also insures the proper equipment and manpower is available for the situation as many times the 911 operators get only limited details or conflicting details.
Of course, in many cases, the first on scene unit can call off excess responding resources if can be quickly determined they are not necessary. Other times, most will have arrived on scene before a definitive determination is made. While on scene, the additional Engine or other resources may be officially put back into service and available for the next call but will just hang out at the scene just in case additional aid or supplies are needed. It may look like a bunch of fire fighters just hanging around, but they are available for a call and would just be hanging around the station anyways if they had returned immediately to the station after being released from the scene.
Cost: I don’t know if there are any studies that show best practices, cost wise. From what I have found, both approaches claim to cost less for the tax payer.
Links to More Info: