Driving to the hospital instead of an ambulance?

[s0me0nesmind1]

It still weirds me out that you can phone in a medical emergency in the US and a fucking fire truck turns up!

Why? When it comes to things like CPR from someone not breathing, it's a matter of getting there fast - if it's a fire-fighter or medical person - who gives a shit as long as they are certified? Both professions deal with CPR related stuff.

 

[Timorous]

Living in the UK the choice comes down to situation rather than cost. Since I live 2 minutes away from the local A&E I have often driven to the hospital rather than call an ambulance but it is situational. If something were to happen to my partner or myself then an ambulance is the only choice because we also have kids and we can't just leave them home alone yet, they are too young. Also we would call an ambulance if we were not sure if it was safe to move someone.

Everyone pays for an ambulance - it's just a matter of if you pay beforehand constantly (through taxation), or if you pay only as the services are needed.

Regardless, someone pays for that ambulance, the trained medical staff, and the medical equipment regardless of what country you're living in.

In the US system you pay constantly for your insurance and then pay out of pocket on top depending on the plan you have so how is that functionally different to taxation? Having the choice between which insurance provider you are going to get f'd by is not really much of a choice, it is an illusion of choice.

 

[Brainonska511]

Anyhow, it's nuts that many ambulance companies are not municipal or subsidised by taxpayer funding, are fully private, and will go after the rider for the big bucks if there is no insurance to bill.

Some areas have created this situation. It's pretty insane that there emergency ambulance services that are independently owned and operated, and then they just don't take any insurance so they can charge jacked up rates to captive audiences.

EMS services should be like other municipal services and covered by taxes.

 

[WelshBloke]

Why? When it comes to things like CPR from someone not breathing, it's a matter of getting there fast - if it's a fire-fighter or medical person - who gives a shit as long as they are certified? Both professions deal with CPR related stuff.

Well because an ambulance is a specialist vehicle with specialist staff that are there for that purpose. Fire trucks are massive vehicles for putting out fires.
I don't know what firetrucks are equipped with in the US but are you likely to get a cannula put in, IV fluids put up, morphine given and an ECG done while on the way to the hospital in one?

Sounds like it's just a tacit admission that services funded by the public are much better at this sort of thing than being left to private, for profit companies.

 

[nisryus]

Your kid also received the 1st aid from the ambulance.

Yeah, I thought I should be paying more, which I had no problem with because it was an emergency. Just surprised it was that low when I got the bill.

 

[Lost_in_the_HTTP]

EMS services should be like other municipal services and covered by taxes.

Some, like ours are run by the city or county. They bill insurance if you have it, but can waive charges on ability to pay if you don't have insurance or are under insured.

Other areas contract with private ambulance companies who have their own billing policies.

 

[MtnMan]

It still weirds me out that you can phone in a medical emergency in the US and a fucking fire truck turns up!

Most fire departments require that firefighters also have their EMT certification.

The population of my county is around 280K, much of it mountainous and rural. There are likely 160+ firefighter/EMTs on duty at any time in 35 - 40 stations across the area, vs. less than 20 ambulances staffed with paramedics. The county's goal is to get care to a patient within 5 minutes.

Additionally, many off duty or volunteer firefighter/EMTs are alerted through pagers or phone apps by the dispatch, and respond from home.

I'm aware of how this works as I was a volunteer firefighter/first responder for 30 years, and one grandson is a professional firefighter/EMT, the younger is a volunteer firefighter and in EMT classes currently.

 

[MtnMan]

And it used to be a small 'squad' truck with two members. Now due to consolidation and cost cutting measures, most of those smaller units are gone and you might get a full sized pumper or heavy rescue unit that might not even fit in your driveway

This has been studied in the fire service, and it is cheaper and more efficient to send the full sized pumper.

• First, they don't have to buy and equip a smaller truck, which can run around $100K.
• The fuel difference is pretty much not a factor. Most trips from station to patient are 3 - 4 miles. So 5MPG vs. 10MPG has little cost consequence.
• The little trucks are typically replaced every 5 - 6 years.
• The full size pumper will be in service 20 - 30+ years, simply because it is built for that level of service.

And if there is any other type of call before they get back to the station, they have the truck they need with them, and don't have to go to the station to swap trucks.

 

[MtnMan]

Well because an ambulance is a specialist vehicle with specialist staff that are there for that purpose. Fire trucks are massive vehicles for putting out fires.
I don't know what firetrucks are equipped with in the US but are you likely to get a cannula put in, IV fluids put up, morphine given and an ECG done while on the way to the hospital in one?

Sounds like it's just a tacit admission that services funded by the public are much better at this sort of thing than being left to private, for profit companies.

Time is of the essence! Especially when someone is not breathing, their heart has stopped, or uncontrolled bleeding. A minute or two is the difference between life and death, and a firefighter/EMT is prepared and equipped begin life-saving procedures.

Medical equipment is carried on every fire truck, including heart monitors, defibrillators, Oxygen, plus support equipment to move a patient, splinting, backboards, C-colars, etc. Typically, not drugs, because of level of training (EMT, vs Paramedic), but a patient assessment is often relayed to the paramedics before they arrive.

In addition, there are more people to safely move the patient. Getting a 200+ pound patient down or up a narrow flight of stairs is not a 2-person job. Even for routine transports where only EMS responds, it is not uncommon to hear the fire department dispatched for "loading assistance".

 

[WelshBloke]

Time is of the essence! Especially when someone is not breathing, their heart has stopped, or uncontrolled bleeding. A minute or two is the difference between life and death, and a firefighter/EMT is prepared and equipped begin life-saving procedures.

Medical equipment is carried on every fire truck, including heart monitors, defibrillators, Oxygen, plus support equipment to move a patient, splinting, backboards, C-colars, etc. Typically, not drugs, because of level of training (EMT, vs Paramedic), but a patient assessment is often relayed to the paramedics before they arrive.

In addition, there are more people to safely move the patient. Getting a 200+ pound patient down or up a narrow flight of stairs is not a 2-person job. Even for routine transports where only EMS responds, it is not uncommon to hear the fire department dispatched for "loading assistance".

I'm not suggesting that firefighters can't be well trained and equipped, it's just a weird situation where you can get a huge fire truck to a medical incident quicker than an ambulance.
That suggests that there are more firetrucks than ambulances and that they have better coverage. Which is weird given the size and staffing needs of both vehicles.

 

[Lost_in_the_HTTP]

That suggests that there are more firetrucks than ambulances and that they have better coverage. Which is weird given the size and staffing needs of both vehicles.

There are. By far. Our county EMS has two rigs full time with two or three more that can be staffed with call-in people.

We have five volunteer FDs, each with at least two pumpers and one rescue unit.

The nearby 'big' city (of about 20,000) has four full time fire stations with at least two rigs each and a private ambulance service that serves the entire county. I'm not sure how many units they have. The rest of the county has several more FDs, some paid, some volunteer, some hybrid of both. the number of FD unit to EMS units is easily 4:1, maybe higher.

In that county, FD can be on scene in 5 minutes or so while EMS may be 20 minutes away.

 

[WelshBloke]

There are. By far. Our county EMS has two rigs full time with two or three more that can be staffed with call-in people.

We have five volunteer FDs, each with at least two pumpers and one rescue unit.

The nearby 'big' city (of about 20,000) has four full time fire stations with at least two rigs each and a private ambulance service that serves the entire county. I'm not sure how many units they have. The rest of the county has several more FDs, some paid, some volunteer, some hybrid of both. the number of FD unit to EMS units is easily 4:1, maybe higher.

In that county, FD can be on scene in 5 minutes or so while EMS may be 20 minutes away.

My point is that that is weird. There will be a higher number of calls needing a response by an ambulance than there will by a firetruck.

The reason you do it this way is that you guys don't want to have publicly funded health care but have publicly funded firetrucks so you do it this way and pretend it's a logical way to do things.

 

[MtnMan]

I'm not suggesting that firefighters can't be well trained and equipped, it's just a weird situation where you can get a huge fire truck to a medical incident quicker than an ambulance.
That suggests that there are more firetrucks than ambulances and that they have better coverage. Which is weird given the size and staffing needs of both vehicles.

There are more fire trucks than ambulances, and since fire ratings are also based on road distance, fire departments have stations in less densely populated areas. EMS units are typically stationed in the more populated areas.

A department's fire rating (determined by the state department of insurance) effect homeowner and business fire insurance rates are based on multiple factors, including road miles from the closest station. Locally, the goal is to have a fire department within 5 road miles of every home/business.

 

[Lost_in_the_HTTP]

A department's fire rating (determined by the state department of insurance) affect ....

ISO is a private company that provides all sorts of ratings data to insurance companies:

Insurance Services Office - Wikipedia

en.wikipedia.org

Among their services are the Fire Suppression Ratings given to fire departments.

 

[Lost_in_the_HTTP]

My point is that that is weird. There will be a higher number of calls needing a response by an ambulance than there will by a firetruck.

In the US, FDs respond to pretty much anything where life or property may be at risk, traffic accidents, power lines down, flooded roads and other natural disasters, falls down stairs and other household or workplace incidents, shootings and other crime scenes, and so on.

The term 'first responder' applies to fire, police and ems personnel.

 

[MtnMan]

ISO is a private company that provides all sorts of ratings data to insurance companies:

Insurance Services Office - Wikipedia

en.wikipedia.org

Among their services are the Fire Suppression Ratings given to fire departments.

In my state, it is the state DOI that determines a departments rating.

 

[UnklSnappy]

I drove myself to the hospital when I had my heart attack. But it is only 2 minutes away and was quicker than calling for EMS.

 

[Noid]

On the evening of June 10th I had a terrible pain from my back / stomach just under my left ribcage. Ten hours of extreme pain, with four of them on the floor doubled up. Dry heaves and colored spots in my vision at times --- I had 3 or 4 more days of "attacks". This stone passed on morning of the 18th.

I still need this crystal analyzed ...

yea .. I thought about calling an ambulance ...

 

[william jones2324]

I think it all depends all the severity of the patient. If it's a severe condition which needs a 1st aid necessarily then calling the ambulance is the best way.

yes you are right ambulance is right choice for this

 

[skyking]

I drove myself to the hospital when I had my heart attack. But it is only 2 minutes away and was quicker than calling for EMS.

My wife drove me in at 2 AM. I got up, wtf is this pain and fuck fuck fuck. Woke her up, ran through the shower and off we go. It was not that bad but, it was not going away either. Turned out to be myopericarditis, but the pain is similar. They ran me though the cath lab later that night and I was out the following morning, after never being admitted.