Hacker News Reader

Comment by derefr | Hacker News Reader

I feel like most communities could really use a city-government-backed non-emergency medical dispatch. Not the ambulance/EMS (which is for emergencies and/or for bringing people to the hospital); not the police (who are armed and trained to respond with violence); just medical-ish people who could be called out to those in need of some important-but-not-urgent medical attention.

It could even just be a volunteer service of community members with good upper-arm strength, first-aid training, and an extended form of Good Samaritan-law protections. Semi-professional first responders, with no other qualification than being a first responder.

So basically, lifeguards. For places other than pools.

Some communities that don't have many fires dispatch their firefighters for this, and that works pretty well. But most fire units don't have enough downtime for that to be workable.

View on HN

I'm a recently minted volunteer firefighter in northern Solano county (about 1hr north of SF). What you're describing is pretty much how it works here, and as I understand it, most other rural areas.

90% of our staff are volunteers. Some of the guys have EMT training (and some are EMTs in their day job) but most of us have just enough training to take vitals and do CPR until the pros arrive. Outside of fire season, maybe half the calls are medical? We're pretty remote so we get on scene faster than the ambulance. If you call 911, we show up.

Fun fact, this is largely a consequence of the reduction in house fires since building codes were improved in the mid to late 20th century. As house fires got rarer, cities had a conundrum; you obviously still need firefighters when fires cropped up, but the reduced rate of them made them sit idle a lot. The shift of medical duties into firefighters was a solution to that problem; give them something productive to do between increasingly rare house fires.

To add a data point, that's basically one of the roles of firefighters in France. You can learn a bit more in here [1]. The highlights: " In addition to providing fire protection and rescue, the French fire service is also one of the providers of emergency medical services.", and "As of December 2015, there were 246,900 firefighters in France [with] 78% voluntary/call firefighters."

[1]: https://en.wikipedia.org/wiki/Fire_services_in_France

It’s the same in much of the US- the majority of services rendered by fire stations are medical in nature. Most fire stations I’m aware of require all professionals firefighters to be EMTs (emergency medical technicians) and include at least one paramedic per shift/station.

I think this can vary though, as I’ve heard places like New Haven Connecticut rely heavily on private ambulance services.

I live in a small town that has the same dispatch for all those services (police/fire/EMS). Covers a couple counties if I understand correctly. I guess we are weird in that police and fire are "public safety" instead of separate.

As far as 911 dispatch goes, this is fairly common. In my experience, it's not uncommon to get an ambulance and a police officer for the same call, even if only one is needed. This seems to be the norm for calls where a neighbor has fallen ill (or, in the case of the elderly, literally fallen over and can't get up).

A person sleeping in -13C is a serious medical emergency. There is a high probability he could die from hypothermia.

In technical terms, "serious medical emergency" means "a person is heavily injured and at risk of loss of life or permanent disability without expert medical intervention".

A homeless person generally does not need a doctor's / EMT's attention to survive, a cab to the nearest shelter is sufficient.

If he's been out in that weather long enough to fall asleep, he needs medical intervention.

In Germany, we have both of this. The phone number 116117 connects you to the non-emergency (defined as: you don't need an ambulance crew to pick you up) medical hotline, and semi-professional first responders called "Helfer vor Ort" in some of our states (https://de.wikipedia.org/wiki/Helfer_vor_Ort).

And just to clarify for the non-Germans: this is a nationwide number which connects you to your local service, much like 112/911 does.

In big cities it generally goes to a call centre staffed by nurses or EMTs, who will do basic triage over the phone and can dispatch an ambulance or on-call family doctor to your home if necessary. Or they may just tell you to take some paracetamol and go to your regular doctor during their opening hours.

In smaller towns it may go to a local doctor/nurse/pharmacist who is rostered to take the calls.

Except that since corona the regional hotline is overloaded and you can wait >1 hour only to be disconnected.

Reply on news.ycombinator.com