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Timmy

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My volunteer corps has Captain, 1st and 2nd Lts. as far as command of crews and procedures on the road. Then we have president, vp, treasurer, & secretary for the building and administrative side.

On scene, its our corps officers that take command unless we are involved with other orginzations like FD where we each keep to our respected areas and check in with one another. With ALS, they pretty much command pt care but our officers are still there because lately we been on the outs with a few als units.

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I think there does need to be a formalized command structure, particularly on a large incident, but people need to not go overboard and just get silly.

Well you'd think that... Apartly arguing with other officers and digging thought the Hi-Vis bag and getting out the commander vest is more important than saving someone’s life. Everyone NEEDS to know who’s running the scene! lol!.... You wouldn’t believe all the bitching and back slashing they all do!

I worked as a comms person at a major event. The 'command bus' is in a different location from the first aid posts. Someone collapsed literally 6 meters from the bus and they made me call a response team to attend because it wasn’t our job to treat and everyone on the bus was non-operational (admin)! So this poor patient had to wait 2 minutes while we stared out the window at them. But hey the command team though it was a job well done because they got to see there ambulance with the lights on pushing its way though the crowd, ohh and they also thanked the response team for such a quick on scene time! What a joke!

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Sure you need a command structure, volunteer or not, I would dare to say ESPECIALLY as a volunteer. With that being said, most "ranking" people I"ve dealt with always have a complex and really don't have a clue what they're doing, but they can push a pen and paper better than anyone this side of the Mississippi!

In all reality I've seen it both ways. I've seen people who don't need a command structure at all other than a Director or Chief. And they do just fine. Then I've seen groups of people that without leadership at ALL levels, things would fall to poop if they had to rescue a cat from a tree.

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Especially with a private service, i would think this could get confusing, at is recently has for one of our local private services who felt the need after 25 years to adopt the paramilitary model, down to chevrons on the sleeves and collar brass. They have the following structure, some of which seems based on training and level and some of which seems to be completely arbitrary.

Basics with less than 3 years are "private first class" and wear the corresponding military collar brass and stripes.

Basics between 3 and 5 years are corporals

Basics over 5 years wear seargents insignia and carry the title "command EMT-B"

Intermediates, of which they have very few, have been given the title and tidbits of MasterSeargent (chevrons with rockers)

Paramedics of any experience level are lieutenants.

Ops Manager (paramedic) is Captain

The non-certified ambulance owner who collects all the fees is called "The Major" god help us all.

I have crossed this service off my list as a potential employer. Any service that has this probably developed it out of "BOssman tell me who has to do what I say" arguments. Its idiotic, if confuses people, and gets them laughed at by LEOs and Municipal services with ranks that make sense. If it clarified the chain at an MCI i might be a little more for it, but it doesnt even have that much real world value.

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Do you really need a command structure on scene if all it is is you and your partner if you're both the same cert level? I've never had a "I'm in charge because I'm (the attendant, FTO, been here longer, different cert that's not recognized locally, in medic school, passed the didactic part of medic school but failed clinicals, etc) argument." Personally, I refuse to get into an argument on scene unless it is really FUBAR (ex: cancer patient looking like taking a turn for the worse, husband and daughter insist that they want nothing done for the patient and to take the patient to their PMD's hospital 40 min. away instead the hospital 2 minutes away. I'm 99% sure we can accept verbal requests to "withdraw or withhold resuscitation" [as it's worded in local protocol], she has no clue, especially if the husband is willing to ride with us to the hospital). You really can't get that FUBARed treatment wise as BLS though (BLS argument: 15 LPM O2, no 10, no 15, etc?)

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I feel the need to add my 2 cents here....

I am currently serving on a Vollie Service with NO EMS command structure... and I have to tell you.. it's frustrating... there needs to be that "go to" person on every department. I agree that having someone in charge on every call is not necessary; however; having someone back at the station who gives structure and direction is imperative.

Just my 2 cents.

Jo

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Bah!

The problem with rank structures in volunteerism is that volunteerism generates thes egomaniac "i have no life" overbearing power hungry tossers who use the rank for a sense of self worth. In volunteerism this is disastrous.....

I dont know about you guys, but generally i dont volunteer to be told what to do and ordered around. There are times when this is necessary and i can dig that, but other times its just maniacal.

When vollies dont have ANY input into their own group they pack up and leave, and rightly so - why volunteer for something that is overbearing 100% of the time when it does not have to be?

Volunteers generally dont need "managing" they need "mediating"

And they wonder why St John has recruitment and retention issues :?

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I am a member of a volunteer department. Our department Chief and the deputy and assistant chiefs for fire and EMS are voted on. Our bylaws set up minimum training requirements. All the requirements are classes taught through the Maryland Fire and rescue institute. Right now 3 of our chiefs are also paid to do what they are volunteering for. Chief and one fireside chief are paid firefighters. Our head EMS chief is a paramedic on for Maryland State Police, who handle most medevac in MD. Below the Chiefs are Capt, LT and SGT. Once again there are requirements for these positions. Those interested submit letters of interest and the chiefs chose the officers.

Mostly the rank structure is used within the building. Most ranks correspond to different duties which must be accomplished and provide a chain of command to work problems through. I only ride EMS, so once we get on the scene, who ever is the OIC of the ambulance is in charge. If there are several crews, usually a command will be set up using ICS, so each OIC has someone to report to. Seems to work good for us.

If I did not make any of this clear enough let me know and I will attempt to clarify.

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