PUBLIC TESTIMONY
Testimony by Dr. Stu Weiss, Retired Emergency Room Doctor, on EMS Response Times and Practices
2:53:10
·
4 min
Dr. Stu Weiss, a retired emergency room doctor, provided testimony on various aspects of EMS operations and response times in New York City. He shared insights on staffing models, response time calculations, and potential areas for improvement in the EMS system based on his professional experience and knowledge of relevant studies.
- Discussed the effectiveness of different paramedic staffing models (1 vs. 2 paramedics per ambulance)
- Highlighted issues with current response time calculations, including the exclusion of vertical response time and gear preparation time
- Pointed out potential risks and benefits of the new Hospital Liaison Officer (HLO) system
- Commented on the outdated nature of the current Computer Aided Dispatch (CAD) system and suggested improvements
- Shared insights on the use of lights and sirens in urban environments and their impact on response times
Stu Weiss
2:53:10
Good afternoon now.
2:53:12
I'm sort of new at this.
2:53:13
So, excuse me, if I don't know what I'm what I'm
Evan Suchecki
2:53:16
the order I'm supposed to
Stu Weiss
2:53:17
do things.
2:53:17
And thank you for giving me a chance.
2:53:19
I wanted to comment on a couple of things I heard in in the testimony today.
2:53:24
First is that when they talk to you about 2 paramedics versus 1 paramedic, I'm an emergency room doc, retired now.
2:53:33
And there are studies showing that actually in other parts of the country, using 1 paramedic versus 2 does not statistically change the level of care.
2:53:42
So one of your comments was having more people in the ambulance is helpful, but just remember that the 1st paramedic, one of them is driving.
2:53:51
There's not 2 paramedics in the back and a third person driving.
2:53:54
There's one in the back and there's one driving.
2:53:57
And in other cities, they use the EMT to drive, and the paramedics stays in the back.
2:54:03
So there's a study in in prehospital care, looking at 2 paramedics versus 1 paramedics.
2:54:08
So that was one issue that you should take up as you're studying this.
2:54:14
2nd of all, in local law 119, statistics that you're looking at do not include vertical do not include vertical response time, and do not include the ambulance.
2:54:26
As you heard, the crew sort of gathering your gear.
2:54:30
When they clock when they push the button on their CAT system, it says on scene, the clock stops.
2:54:36
So there's a couple of minutes extra where they're going up.
2:54:39
In New York City, there's a lot of vertical transport time, but also there's a lot of getting your gear together, that kind of stuff.
2:54:46
So you you might wanna ask those questions about, well, what's the actual because you heard the the union person talking about 12 minute response times, and then maybe 3 or 4 minutes more of them gathering their gear.
2:54:59
The CAD system is really old.
2:55:02
I worked many events with the CAD system.
2:55:05
It's it's a text based system from, like, the 19 eighties.
2:55:09
If you could push them, the new CAD systems have visual, have a, you know, complex this plays, and you can see the ambulance is moving around.
2:55:19
There's GPS.
2:55:20
Oh, I'm sorry.
2:55:20
I'll I'll finish up.
2:55:22
GPS that you may want to look at as well.
2:55:25
The new HLO hospital liaison officer system that they talked about is wonderful except their their EMTs, so they can never take paramedic calls.
2:55:36
Like, you have to always sign off a patient to a higher level of care, not a lower level.
2:55:41
So that hospital says liaison will help with EMTs, but not with the higher levels of care.
2:55:47
And also in your question, the biggest risk is an emergency physician is the handoff time.
2:55:54
So now you're adding a level of handoff from the EMS crew that was on scene to a third a second HLO that's not on scene, and then they have to hand off to the ER dock.
2:56:06
So you're introducing a level of complexity that can increase patient risk.
2:56:12
You may want to think about that as well.
2:56:14
As far as sheets go, there are many times when I worked in the city hospital that we didn't have sheets in the ER, so there's no sheets to give to the ambulance.
2:56:22
So when you heard them say they didn't have an ambulance, a sheet to pick up her dad, That is, in fact, very fairly common.
2:56:30
And lastly, lights and sirens.
2:56:32
There's been many studies about lights and sirens in an urban environment do not significantly increase response time.
2:56:40
It makes a lot of noise.
2:56:42
Some ambulances, and I'm not gonna mention names, have 2, 3 I can't even tell sometimes how many sirens they have on the ambulance.
2:56:49
There's one of them that sounds like they has 15 as sirens on it.
2:56:53
It doesn't make people move over any better.
2:56:56
And in fact, the crew should be looking at every intersection and not depending on the noise to make them safe.
2:57:02
And lastly, Dako owns Ambulance, and Ambulance is the ambulance company that provides service.
2:57:09
So just a couple of points that I heard today.
2:57:11
I thought you might wanna thank you.
2:57:13
You're welcome.
