Orange County California

[Guest]

firephoto and JFong, thanks for the more detailed explanations.

 

Quite different from my neck of the woods.

 

Very few FDs run ALS fire units.  The ones that do only have to have one Paramedic on board and carry the same equipment that a squad/intercept type vehicle and ALS ambulance would carry.  The ALS ambulance has additional equipment requirements, but mainly related to being a transporting unit.  Most EMS is 3rd service, community non-profit, or FD based 911 wise.  Private EMS mostly does non-emergency transports and emergencies out of contracted care facilities.

 

The typical staffing for ALS ambulances is one paramedic and one EMT, but there are some places that staff with 2 medics.  Our paramedics also work off protocols that allow for most treatments without having to consult a physician first.  In fact, I rarely consult with a physician when I'm working my side job on the ambulance.  Unless you specifically need approval for an "advanced" procedure or medication (not many fall into that category), we just give a report to the receiving facility.  We also have the ability to do patient refusals and BLS downgrades under specific conditions without having to consult medical command.

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