Boston EMS

[TacSupport1]

New A-2
2016 Ford F-450/Braun Liberty

Boston EMS A-2 by Seth Granville, on Flickr

[edburke]

I knew I forgot to put a pic up somewhere....I just completed a Powerpoint for the recruits that goes over maintenance points and cab electronics operation....the photo of the Ford/Liberty I used was a cropped shot that looked almost identical to this, only about a month earlier without truck numbers

 

   

[TacSupport1]

Ed,

This ambulance is different in some ways, including the chassis and new lettering/striping, and no cab mounted lightbar. Are there new people on the spec committee? Any particular reasons for going away from the Terrastar and the larger module?

Also, I guess the era of the push bumpers are over. Out of curiosity, did it have to do with cost, or compatibility with airbag sensors, etc?

[BFD190]

Are these four wheel drive. Thought I read that some would be 4x4. Missing something without the bar. I might just be a fan of the lightbar. Sharp looking.

[edburke]

Are these four wheel drive. Thought I read that some would be 4x4. Missing something without the bar. I might just be a fan of the lightbar. Sharp looking.

A2 and A18 are 4X4, the idea was to test them in different environments.  A2 is Roxbury, inner city, where it will come in handy in the snow and A18 is Hyde Park, almost suburban, with large amounts of parkland as it is adjacent to the Blue Hills reservation.

[edburke]

Ed,


This ambulance is different in some ways, including the chassis and new lettering/striping, and no cab mounted lightbar. Are there new people on the spec committee? Any particular reasons for going away from the Terrastar and the larger module?


Also, I guess the era of the push bumpers are over. Out of curiosity, did it have to do with cost, or compatibility with airbag sensors, etc?

 

The lettering/striping is a modernized version of the old paint scheme.  Flip back through the pages of this thread and you'll see what I mean.  The lightbar was an unnecessary expense, as these things throw as much, if not more light than the GMC/Internationals-they saved about $40,000 by removing the lightbars from the order.  It is 50/50 as far as the rank and file goes on this move, so you may see them back.  The Terrastar was the worst chassis we ever had, uncomfortable for the crew, constantly in for service, etc.  There are GMCs that are still in the fleet as spares that are outlasting the Internationals.  The truck committee that spec'ed these trucks was a combination of new and old, and with the uncomfortable seats in the Internationals, they claim that they "found the most comfortable seats possible and built an ambulance around them."  They looked at other medium duty trucks, but the ride in all of them was similar to the Internationals, so they started looking at smaller chassis.  They put a lot of work and thought into the trucks, and I think we're going to be happy with the result.  I don't know what happened with the bully bumpers-there was a delay in the development of the model for the Terrastar and it just seemed to be one of those things that passed quietly into the night.

[TacSupport1]

Thanks for the info Ed! Much appreciated. Just one more question, standard suspension or did they do anything special like liquid springs?

[TacSupport1]

Boston Public Health Commision is using this former Boston EMS ambulance chassis as a plow/sander truck



 

Former BEMS Ambulance Chassis by Seth Granville, on Flickr

[edburke]

Thanks for the info Ed! Much appreciated. Just one more question, standard suspension or did they do anything special like liquid springs?

Adjustable air bags

[edburke]

My current ride, a 2001 GMC Yukon, formerly Chief of Department Serino's (retired) vehicle.  The vehicle is officially assigned to Research, Training and Quality Improvement and generally shared by the Captains responsible for the Academy and the ALS Coordinator.

 

   

[edburke]

One of the other RTQI vehicles, a 2004 Yukon, formerly the on-duty shift commander's vehicle

 

   

[ff168577]

My current ride, a 2001 GMC Yukon, formerly Chief of Department Serino's (retired) vehicle.  The vehicle is officially assigned to Research, Training and Quality Improvement and generally shared by the Captains responsible for the Academy and the ALS Coordinator.

 
<a class="bbc_url" href="http://www.firepics.net/groupboards/index.php?app=core&module=attach&section=attach&attach_rel_module=post&attach_id=333775">2168.jpg</a>

You need some more lights on there boss

[edburke]

You need some more lights on there boss

 

 

DashMaster, 2 dual head strobes inside the rear window and a total of 12 hideaway strobes in the headlights, tail lights, directionals and reverse lights...you can't miss it.

[ff168577]

DashMaster, 2 dual head strobes inside the rear window and a total of 12 hideaway strobes in the headlights, tail lights, directionals and reverse lights...you can't miss it.

Lol. I'll retract my statement.

[LED138]

How bad is the whine and flicking with all of the strobes going?  Who does the installs on vehicles like that? Shops or do they get purchased? 

 

-Steve

[FireMedic049]

Ed,

 

After watching some of the Boston EMS episodes, I have a few questions if you don't mind.

 

1. I noticed in a couple of instances the BLS units administered nebulizer treatments, which in my state is reserved for the Paramedic level.  Do the EMTs have an expanded scope of practice to allow for that stuff or are they actually EMT-I?

 

2. Given the heavy reliance on BLS transport units vs ALS transport units, does Boston utilize any sort of paramedic response vehicles (other than field supervisor units) to meet up with the BLS units?

 

3. When an ALS & BLS unit go to the same call, it seemed like both paramedics rode in with the patient (regardless of the actual need for multiple providers).  In some cases, it appeared that they did so in the BLS unit rather than their unit and I assume one EMT drove and the other brought the 2nd unit to the hospital.  Is this the normal practice?  Are the BLS units stocked with ALS equipment to some extent for that or do the paramedics need to bring whatever ALS gear they need with them from their truck?

 

4. How often do you encounter situations where a patient needs ALS, but it's not available due to having such a small number of ALS units on duty?

 

 

Just curious since your system is a lot different than what's in my area, including a city a little smaller that Boston.

 

Thanks.

[fenwayfrankee]

1) Nebulized Albuterol was started in Boston as a "Special Project Waiver" with the state several years ago. It was successful enough that the state adopted it as a BLS intervention. Intranasal Narcan started the same way.

 

2) For the most part, Boston operates as a non-transporting ALS service, just in ambulances. There has been talk over the years about putting the medics in SUVs, etc, but there has been concern that they may end up on a scene and a BLS truck would either be delayed or unavailable and the medics would be stuck there. There is only one medic supervisor per shift. With rare exception they do not actually "work" as medics and transport in BLS trucks.

 

3) Except when extremely busy, a BLS truck is always sent with and ALS truck. Typically, if the ALS crew is going to work the patient, they will go in the ALS truck. Sometimes, for a variety of reasons they may end up in the BLS truck. In this case everything in the ALS truck is duplicated in a portable form. For critical patients, both medics will ride in back and the BLS will drive. In less acute cases, if in the ALS truck, the medics will transport by themselves, leaving one medic in back and the other driving.

 

4) I guess this depends on your definition of "needs". Without getting into a philosophical discussion about what ALS can and should do, I would say that its fairly rare for someone who "needs" ALS intervention not to get it. That being said, Boston is unique in the fact that 90% of the transports go BLS. There are other systems, one just on the other side of the river that ALS' 90% of their transports. Plus, there a numerous private ambulance companies around town that are used for mutual aid when needed and available.

 

 

 

 

Ed,

 

After watching some of the Boston EMS episodes, I have a few questions if you don't mind.

 

1. I noticed in a couple of instances the BLS units administered nebulizer treatments, which in my state is reserved for the Paramedic level.  Do the EMTs have an expanded scope of practice to allow for that stuff or are they actually EMT-I?

 

2. Given the heavy reliance on BLS transport units vs ALS transport units, does Boston utilize any sort of paramedic response vehicles (other than field supervisor units) to meet up with the BLS units?

 

3. When an ALS & BLS unit go to the same call, it seemed like both paramedics rode in with the patient (regardless of the actual need for multiple providers).  In some cases, it appeared that they did so in the BLS unit rather than their unit and I assume one EMT drove and the other brought the 2nd unit to the hospital.  Is this the normal practice?  Are the BLS units stocked with ALS equipment to some extent for that or do the paramedics need to bring whatever ALS gear they need with them from their truck?

 

4. How often do you encounter situations where a patient needs ALS, but it's not available due to having such a small number of ALS units on duty?

 

 

Just curious since your system is a lot different than what's in my area, including a city a little smaller that Boston.

 

Thanks.

[recoveringspark]

There are 5 als days and eves, and 3 at night.  They are spread thin all the time but no ALS at night happens a lot.  

[firephoto]

In the entire city?

[recoveringspark]

what i mean to say is no ALS available, Ed can explain better than I