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Orange County California
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Quote:to further complicate things, ocfa is now in a test program with engines 13 , 35 an 47 which are pau's  to  acess , treat  and transport a patient with the pau unit thus returning the als unit to service, if it is deemed by the pau unit that  a full als unit is not needed. most cities in orange county have been doing this for years, the calls are prioritized into alpha, bravo, Charlie, delta and echo responses. alpha and bravo are bls calls with a bls engine and ambo sent. Charlie, delta and echo are als calls with a bls or pau  engine and als engine sent along with an ambo
The first part seemed a little confusing?    Are you saying the test program is having the medic from an assessment engine transport with the private BLS ambulance?  Which ALS unit is returning to service, the paramedic engine or an ALS ambulance from the FD?

 

The systems I've been working in for the past 20 years here have all had some sort of call prioritization.  Where I'm at now has a 5-tier similar to what you describe.  Two are BLS responses and the other three are escalating severity ALS responses.  On the ambulance side of things, there isn't much of a response difference as most EMS in the county is paid or primarily paid and operating ALS ambulances.  There are a few BLS units in play here and there, sometimes due to staffing issues that end up downgrading the unit rather than cutting it.

 

Depending on the community, only some categories get a VFD first response unit (BLS) automatically or all responses get it.  In some places, the highest priority calls will get an additional ALS unit dispatched - either an ALS ambulance from another service or one of the few paramedic response units in operation.

 

The prioritization concept is a great idea, however for us at least, the majority of calls seem to get over-prioritized - in many cases by more than 1 tier.
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