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Comment by tpeck | Hacker News Reader

We get an ambulance to the scene faster than 911, which is a great benefit of using Call9 - I completely agree that it would be a terrible disservice to cause a delay in emergency response. Because we have a direct line to an ambulance service dispatcher, we don't first need to go through a central call-center like other 911 emergencies. Therefore, we save time by a) not having to explain if its a medical vs. police/fire emergency, b) not explaining our location - they know it already, c) having the doctor tell them if advanced life support is needed vs basic life support.

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This doesn't necessarily seem like it's a guarantee - firstly, from my experiences working private ambulance, most are built and staffed to operate at or near capacity, as idle ambulances don't make money.

Depending on the location, when you dispatch ALS/BLS ambulances this way, whose medical license are the EMTs and paramedics working under? Does the county medical protocol director like/want this?

In cases of cardiac arrest, you're going to typically want more than an EMT and a medic on an ambulance. CPR is, as you know, a man-power intensive activity.

The three things you mention are not really problems in a 'modern' PSAP. "911, what are you reporting?" "Confirmed cardiac arrest". Even without that, in most areas around here criteria-based dispatch is used to determine ALS/BLS with an erring towards ALS if there's any question.

In my county (Washington state), the protocol states (and is met with 94% reliability that from call reception for EMS, dispatchers should have toned the appropriate unit(s) with 60 seconds of call reception, and those units should be en route within 2 minutes of that (even for in quarters response).

FWIW, Washington state is exceptionally good at treating cardiac arrest. See table 4 here: http://jama.jamanetwork.com/article.aspx?articleid=182614

SCA survival rate of 16% in Seattle, vs. 3% in Alabama or 5.5% in Toronto.

Still a long ways to go, even for the best regions.

Very true. As objectively as possible, I realize we're at the 'leading edge', and there are a lot of improvements, both here and elsewhere, to be made.

But then again, I'm sure Call9 would rather be compared to 'how we fare versus the best EMS systems in the country, not the worst'. :)

Toronto is more than 4x the population of Seattle and 2x the area though. And Alabama is a often rural state. It would be interesting to compare survival rates based on equal distances to a hospital.

How can you claim to get an ambulance to the scene faster than 911 (on a practical scale)? 911 / the ambulance are first responders.

We don't claim to - we do. Here's a great graphic on what happens when you Call 911: http://www.nyc.gov/html/911reporting/html/anatomy/call.shtml Our first step enters into this process later on in the schema, saving time.

It does, but it's a little disingenuous, too. You say things like "The ambulance dispatcher knows our location" - you mean, the location of all the facilities you service" (which isn't a stretch, most EMTs could probably recite the street address of every nursing home in their service area in their sleep).

A dedicated line gets you "Oh, this is Call9".

They still need to get pt demographics. ALS/BLS. The dispatcher still needs to find you an available ambulance. Dispatch it. Get the crews out and on the road.

Yes, the infographic breaks up a lot of that information, but the call receiving time is in many locations mandated to be within 60 seconds of reception to unit toned. And your service doesn't cut that to zero by virtue of "we have a dedicated line to an ambulance service".

And if they don't have that? Because that WILL happen. "Ambulance Co B, respond in place of Ambulance Co A, no units available".

"Call 911." And you've burned that time because you need to go back to the start.

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