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We have the same thing here. They changed the local divert protocols for our service to where the hospitals can request divert and they get one hour. After that, they have to call for any additional hours, at which point a supervisor goes to the hospital and evaluates the situation to see if they will get another hour or not. The other option is they have to wait an hour before they call again to go on divert for another hour. We have a total of six local EDs we use. Two are major trauma centers, two are good all around EDs, two are just about glorified clinics (this one is my opinion of course). The reason the EDs are only allowed an hour (as opposed to up to six hours in the past) is because it was discovered that the divert status was being abused by some of the hospitals. They were using divert just to not have to deal with ambulance traffic. It was also found that the hospitals weren't moving patients as fast as they should be, which during flu season and summer time when it's busy is a must. They were taking their time on things like labs and moving patients upstairs. So this was a large factor. The new protocols solved a lot of the issues that were causing all of the EDs to go on divert, since when one went on divert, the next closest hospital would get overran with ambulance traffic, and within an hour, all hospitals were forced open. Now with the city and suburbs growing and more people abusing EMS and EDs, they hospitals are all about at capacity we we've had to wait in the ER for 30-40 minutes for a bed.

They came to Oklahoma about two years ago and have been expanding rapidly every since. They started as a transfer service and have grown to taking over some of the 911 services in the smaller communities and providing mutual aid to some of the fire-based services that only run a few ambulances in a busy area (from what I've been told, mutual aid consists of late night BS calls and all nursing home calls). I've been told they have filed against some of the services they want to take over with the state health department, but if they have a legit complaint, meh. Will be interesting to see how it all pans out. They seems to have taken over a lot of small town and mom-and-pop operations that really weren't making it, so it brings the question, how will they make it? So far they have been going strong.

Yeah, the problem is the trucks are paid for out of a different pocket than our paychecks, which is where a lot of the issues seem to be derived from.

Sorry it took so long, here's some info and pictures. 2008 Ford Super Duty Type I For EMSA personnel, differences from the other trucks we've found. Pros: Twin Turbo [*]VERY quite, sounds like an unleaded engine [*]Smooth ride [*]Air-ride goes up when truck is put into drive, even if rear doors open [*]New truck smell [*]Slightly different flash pattern on emergency lights [*]Monitor on the front console - Can check O2 level in tank, adjust temp/fan in box from front, check outside and box temp, time/date, time since power on [*]New radios - can change background color [*]Radio speaker in box is always on and the volume knob on rear radio will control volume, even when on remote [*]Front seats confortable [*]Trucks factory equipped - Miles to empty fuel, miles per gallon display (average 6.5mpg!) [*]Two 12VDC outlets on console in addition to factory one Cons: No armrest on front seats [*]Rear jump seats have to be removed to put larger patients on spine board on bench [*]MedUSA dock is mounted backwards (for now). Can't reach it from box [*]No partitioned cup holder area, just all open [*]No cubby hole to put gloves in [*]Very little leg room compared to older trucks [*]Can't fit large books in doors [*]No LED dome lights in box, still those crappy halogens [*]Still no air horns

So far we've had great results with the EZ-IO. That in conjunction with the Res-Q-Pod makes the outcomes from short down time arrests far about what it used to be.

Our local police department is using them now on their traffic units (most don't have a roof-mounted light bar) and said it seems to get more attention. I doubt we'll get them for our ambulances since we don't even have air horns yet. Would be nice to get something to grab more attention of drivers on their cell phone.

We use it and I love it. It has its problems, but for the most part it is very handy. Like was said already, cuts down on radio traffic (with 36 trucks, that really helps). Mapping is decent. We train new employees not to use it, but it can be a nice aid in some cases.

I work for a private service. There's two divisions, one for Oklahoma City and one for Tulsa. I work for the Tulsa side. Our coverage area is around 650,000 people in Tulsa, 3 surrounding larger suburbs (about 20k population), and a few small towns. We work with 5-6 fire departments as first responders on a regular basis and a few others on occasion. We also utilize the surrounding ALS services (both fire-based and private) as mutual aid. We do 911 and transfers. Average call volume (including non-emergent transfers) is about 6-10 per 12 hour shift. We have a good working relation with all other services we encounter on a normal basis (fire, pd, other EMS). We get along pretty well with anyone. We do call on mutual aid and they call on us on a regular basis and we've gotten used to working with their personnel and local fire departments. One of the advantages of a private service is we are open to bid for the city every 5 years, so we have to prove that we provide the highest quality service at an affordable price to stick around. It also makes it so the level of training is above the state required and most of our equipment is tested and proven. One of the draw backs is currently most of the surrounding private services are starting at a better pay and we have to go through a lot of hoops to get a raise.

I am the beginning of eternity, the end of space and time. I am the beginning of every and the end of every place. What am I? Answer: The letter "E"

Maybe put them on the best-access barn door?

I saw'em for the first in at the Hale Koa in Honolulu. I figured they were to mark an elevator that either was larger or had an override. Guess I was right (for a change, hehe). Yeah, I wish they had more of those around where I work. Of course after a while you learn which elevators to take in certain buildings.

In a disaster or large-scale event, those personnel from groups like CERT or other local ERTs can be assigned to someone like a paramedic for a medical team. Imagine you have a large tornado hit a populated area (say a smaller town with only a few ambulances on duty). Responding ERT personnel can be assigned to teams with a local EMT/FF/Paramedic and be utilized for more medical manpower. Most people forget that in an event where multiple agencies come together, you can mix personnel (remember ICS?). We had a plane crash drill not too long ago and one of the things we realized was it would be very effective to take some of the responding EMTs/Paras and give them a small team of American Airlines ERT personnel (since they are already at the airport for a given event and trained in first aid and CPR) to maximize the ability to treat and move patients to the transport area.

Something simple and fairly cheap would be some Whelen TIR3s or LIN3s. They are around $50/ea. new, but all you have to do is wire them up to power, as they have a self-contained flasher and sync wire so you can wire multiple ones together. That and they are small. I've always been a fan of hide-away strobes. You should be able to find some decent priced used ones online.

Result: 17 of 20 85%

best... tag... ever...