there are only 7 medic rigs in seattle, each with 2 medics. that city has over a million people during weekday work hours. something's not right about the proportion of that. I talked to a friend of mine who used to work for AMR up there and said that AMR has at least 30 rigs roaming seattle streets during the same time. It says on the webpage that only 35% of 911 calls get a medic dispatched initially. a lot of the time he said that the Fire Dept. first responders would cancel them before they get an eval and just call AMR (BLS) to transport. Other times the medics would actually get there and do the eval but would still call AMR. He said they usually save their resources (yeah, their 7 rigs) for only the most critical people. he said that AMR usually ends up taking patients that they wouldn't even be allowed to touch anywhere else in the country. that seems like a big problem. I don't know what their standing orders are but I can't imagine that they're designed to be that liberal otherwise that's HUGE liability. It looks like benanzo layed out a pretty good case of how that system is slowly failing because of the medics having to cherry-pick their patients. it doesn't even sound like it's their fault, they just have to be mindful of the overall system load and available resources. I agree with benanzo that it sounds like something is about to change. We saw the same shift here in portland, it was slow but very necessary.