How to learn the hard way, 30 minutes or it's free, does not apply to emergency services.

lack of warmth: How to learn the hard way, 30 minutes or it's free, does not apply to emergency services.

I had to read the article.

FTFA: According to records, the 911 call was made at 1:25 a.m. A DC fire truck arrived only nine minutes later, but an ambulance was unavailable. According to Prince George's County Fire & EMS records, DC Fire did not call Prince George's County for assistance until 1:47 a.m. One minute later, the county dispatched an ambulance from Oxon Hill to go to Ford's home in Southeast Washington. It arrived at 1:58 a.m.

It appears the delay was on DC's side, not with the ambulance that responded from Prince George's County. And I'm also curious why DC is sending them the bill for the ambulance, and NOT Prince George's County. It was a mutual aid response, and at that point all of the billing should have been handled by them.

But this isn't the first time that DC Fire Department has had "total failures". They can't get enough people to staff their units, and don't have enough units to cover their area - the same problem Detroit is having right now - and they have to rely on outside EMS agencies to cover the slack through mutual aid. This is the same department that cut all their Paramedic ALS units at night because they didn't have enough coverage to maintain them.

doyner: Should have called a taxi.  They're much quicker in the DC metro area and cost 1/10 that of an aberlance.

The cost is irrelevant. An ambulance with trained staff and proper equipment can mean the difference between life and death for people with critical injuries or illnesses. It's actually better to wait 5 or 10 minutes for them, than it is to drive yourself or load someone in a car and go if they're in life-threatening distress.

ALS ambulances basically bring a resuscitation suite to the patient's side.

What SHOULD have happened was the moment the dispatcher realized they had no ambulances available on their Computer Aided Dispatch software, they should have called the neighboring county and requested a mutual aid response. This was DC's foul-up, and they're going to own it if the media has anything to say about it. There's no excuse for a Bravo or Delta level call being held for 22 minutes before calling for mutual aid.

Does DC not have any private services that can be contracted to provide coverage when they run out of units?

doyner: My issue, really, is how much of that $780 is from cost transference as opposed to the actual cost of the service...however shiatty.

If it was a call that had a Paramedic ambulance respond, and was billed as an ALS1 Emergency transport, then 780 dollars once you factor in transport milage rates sound about right.

doyner: And while an amerlance does have equipment and personnel, it doesn't matter if they're not available. Taxi drivers in DC are much more efficient in getting someone from point A to point B.

There was an ALS pumper on scene in 9 minutes. They can provide most of the same treatment an ALS ambulance will provide other than transport. Since the article doesn't go into detail about what was going on, and DC refused to comment about it, we'll never know what the whole story is until more details are released by either the family or the media. Many of the larger cities in the United States have roll-over contracts with the private ambulance services in their area that provide interfacility and non-911 ALS transport, so that if their ambulance reserves are depleted by call volume, they can roll them over to the private service and have coverage for that patient.

On the other hand, this is frowned upon by certain "groups" of people, but it's a great solution to a problem that doesn't really have an easy one otherwise. I find it hard to believe that Washington DC doesn't have an AMR or Rural Metro operation, or some other local private service as big as it is.

namatad: but, strangely enough, the hospital, which was probably 5-10 minutes away, has better equipment and DOCTORS!!!

unless you can guarantee that an ambulance will come before you die and unless you can guarantee that taking he cab will kill you, you literally have

Are you really sure about that? You're actually more likely to wait in the waiting room longer by self-presenting in a STEMI than calling 911.

It's the copper penny's time.
if you do not have exact change in 30 mins or less,  we are going to round up to the nickel.
that's my two cents


/redhot

It's DC, what do you expect?

So wait a minute...

We supposedly pay taxes for government services... but instead the government services create a monopoly and then send people who use them bills for services rendered?

Guess that's why the social contract isn't a written one.

namatad: BronyMedic: doyner: Should have called a taxi.  They're much quicker in the DC metro area and cost 1/10 that of an aberlance.

The cost is irrelevant. An ambulance with trained staff and proper equipment can mean the difference between life and death for people with critical injuries or illnesses. It's actually better to wait 5 or 10 minutes for them, than it is to drive yourself or load someone in a car and go if they're in life-threatening distress.

ALS ambulances basically bring a resuscitation suite to the patient's side.

What SHOULD have happened was the moment the dispatcher realized they had no ambulances available on their Computer Aided Dispatch software, they should have called the neighboring county and requested a mutual aid response. This was DC's foul-up, and they're going to own it if the media has anything to say about it. There's no excuse for a Bravo or Delta level call being held for 22 minutes before calling for mutual aid.

Does DC not have any private services that can be contracted to provide coverage when they run out of units?

you know what also works?
call both
call 911 tell them your dad isnt breathing, HURRY!
and then call a cab

take whichever one comes first

yes of course, the ambulance has fancy medical equipment
but, strangely enough, the hospital, which was probably 5-10 minutes away, has better equipment and DOCTORS!!!

unless you can guarantee that an ambulance will come before you die and unless you can guarantee that taking he cab will kill you, you literally have nothing to lose.
but go ahead and wait, but I am not willing to bet my life ....
your mileage may vary

Are you drunk?
Nttawwt

BronyMedic: Are you really sure about that? You're actually more likely to wait in the waiting room longer by self-presenting in a STEMI than calling 911.

Interesting.  I keep hearing the mantra in news articles that you get no different treatment from having an ambulance called versus getting yourself to a hospital.  That seems to refute that pretty effectively.

I would let them take it up with the estate, after probate etc...

namatad: but, strangely enough, the hospital, which was probably 5-10 minutes away, has better equipment and DOCTORS!!!

There's really nothing a hospital can do to fix a non-perfusing heart rhythm that an ALS ambulance can't. The ED uses the same types of drugs and equipment that are carried on an ambulance. Our system's hospital actually uses the exact same heart monitor/defibrillator we carry on our ALS rigs on their crash carts.

Our nearest hospital is half an hour away. Regardless, the chance of a successful resuscitation drops sharply by the *minute*. The brain and heart don't like being deprived of oxygen, and quality CPR/ventilation/drugs in a taxi isn't going to happen.

mllawso: Our nearest hospital is half an hour away. Regardless, the chance of a successful resuscitation drops sharply by the *minute*. The brain and heart don't like being deprived of oxygen, and quality CPR/ventilation/drugs in a taxi isn't going to happen.

so even in a cab we'd be better off if we had solid chest compressions on the way to the hospital?

Fista-Phobia: [images.sodahead.com image 269x350]

If you look closely, you can see the flood of tears on the inside.

So? Stiff 'em.

ultraholland: so even in a cab we'd be better off if we had solid chest compressions on the way to the hospital?

It's impossible to do effective chest compressions in a cab, especially while moving. It's pretty difficult to do them in the back of an ambulance even. It's why most Cardiac Arrests will be worked at a scene unless there's a legitimate reason to scoop and run - like a myocarditis that could be crashed to ECMO, a PE or surgically correctable cause/traumatic arrest. Everything a Paramedic team does will be the same thing an ER doctor will do in the initial resuscitation - intubation, drugs, defibrillation, etc.

There's a major push right now to make Paramedics able to pronounce in the field in cardiac arrest with a primarily cardiac cause versus transporting a body lights and sirens after 20-30 minutes of effort due to the fact that continued efforts will not make any difference.

DanZero: Not asinine. They still require payment.

If you order a pizza and the guy doesn't show up until next morning, would you still pay him?

BronyMedic: Fista-Phobia: [images.sodahead.com image 269x350]

If you look closely, you can see the flood of tears on the inside.

[lynnrockets.files.wordpress.com image 611x404]

Nah. He's broken. He'll wait as long as it takes!

Keep spending your money on bombing Lbgs  in Iraq, Afghanistan...and soon to be other places....lol
Fauking stuupid Americans with their priorities in mayhem..........

Quality of life in the US....sure there is....bwhahahahahahahaa!

ACLS only work in the movies....chances are very poor even in CCu's with all the toys....but meh...what da fuq do I know......

you gonna dx prinz, vs, emboli, vs thrombus, vs conduction defect, reperfusions, tamp., dissection, dilation, etc.   gawd I can go on and on and on.......

Just learn to compress at least 100 compressions per minute...allow adequate recoil and get to a hospital in under twenty minutes.....from onset.......seriously..... take them yourselves to the hospital.... fark the transports.

SweetDickens:

Cool story bro.

Smeggy Smurf: DanZero: Not asinine. They still require payment.

You can't charge for a service not rendered.  I'd hang the one who sent the bill after a conviction of fraud.

The city still sends a bill printed from an ink jet. biatches.

911 is a joke

ElwoodCuse: 911 is a joke

[1.bp.blogspot.com image 375x400]

Just ask my man right here with a broken neck.

Smeggy Smurf: They wouldn't if we started hanging them for fraud.  They'll either run out of morons or get the idea that fraud isn't viable any more.

I'm curious to hear your justification that this was not just bad taste, but fraud.

ElwoodCuse: 911 is a joke

in your town, maybe.

Dickens, your ignorance is impressive. Might I try to enlighten you?

In cardiac arrest your chance of resuscitation is about 90 percent if immediately defibrillated. The chances decrease by about 10% for every minute between cardiac arrest and first defibrillation, even with CPR.

FNG: Emergency services and their costs depend on where you live.

If you have good insurance or on Medicare, you get the full gambit.

If you take a taxi or drive to the ER you spend countless hours trying to find parking and then waiting. If you arrive in an ambulance you get prelim treatment immediately.

Where I live, just outside of DC, ambulance service costs anywhere from $200 to $750 depending on what they have to do on the way to the hospital.

Emergency service personnel are very fast, and very thorough.

I feel bad for this family, but from my unfortunate experiences with situations like this, emergency personnel are top rate.

Yay for non-socialized medicine!

Sideshow....may I illuminate you.......take the blue pill dude.....you are gonna need it.
...but your 90% is the kool-aid Jim Jones fed his group.

oh if you do drive....just park at the er door and drag their ass in the door...they do not want to come outside and get you....something something about liability......

SweetDickens: Keep spending your money on bombing Lbgs  in Iraq, Afghanistan...and soon to be other places....lol
Fauking stuupid Americans with their priorities in mayhem..........

Quality of life in the US....sure there is....bwhahahahahahahaa!

ACLS only work in the movies....chances are very poor even in CCu's with all the toys....but meh...what da fuq do I know......

you gonna dx prinz, vs, emboli, vs thrombus, vs conduction defect, reperfusions, tamp., dissection, dilation, etc.   gawd I can go on and on and on.......

Just learn to compress at least 100 compressions per minute...allow adequate recoil and get to a hospital in under twenty minutes.....from onset.......seriously..... take them yourselves to the hospital.... fark the transports.

You know what? You don't get to criticize until you learn how to spell, punctuation correctly, and apply proper grammar. It's the least you can do before maligning an entire medical system.

/end grammar nazi

Addendum: because otherwise, you look/sound like an idiot.

Gah.

/punctuate, or 'apply punctuation'

I changed the sentence and tense went to hell.

I wonder how many calls the district got that night for illnesses/injuries that didn't actually require emergency services (head aches, coughs, scratchy throat, hangnails, etc.).

Smeggy Smurf: BronyMedic: Smeggy Smurf: They wouldn't if we started hanging them for fraud.  They'll either run out of morons or get the idea that fraud isn't viable any more.

I'm curious to hear your justification that this was not just bad taste, but fraud.

Billing for a service not rendered is fraud.  You wouldn't pay for a beer you were never served would you?

Again, I'm curious to hear how you feel services weren't rendered? There was an ALS Pumper on scene within 9 minutes (The national standard is 10 minutes) and delivering care, and a neighboring county sent a mutual aid ambulance which transported the patient to the hosptial after a substantially incompetent delay on the part of DC, but they did render care. I'm willing to bet that what happened was the mutual aid agency billed DC for the response, and DC in turn passed the bill to the patient like they normally do through their contracted billing agency without knowing the details of the call.

While it's rather a dick move, and poor PR to send the family a bill after their substantial delay in obtaining transport, there's too little information in the article to ascertain whether the delay was the cause of his death, or if it was something that was not preventable in the first place.

However, it's not fraud.

Summoner101: I wonder how many calls the district got that night for illnesses/injuries that didn't actually require emergency services (head aches, coughs, scratchy throat, hangnails, etc.).

Plus druggies or poor people that just wanted a warm bed and a chance to steal some supplies from an ER.

ladyfortuna: Gah.

/punctuate, or 'apply punctuation'

I changed the sentence and tense went to hell.

.......seriously......that was messed.....