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Las Vegas and North Las Vegas Fire and EMS Cultivate Blended System

A few areas have resolved the duplications inherent in public/private "dual response" emergency medical services. The EMS role can be assigned entirely to private ambulance companies. Many jurisdictions, including the city of Henderson, have fire personnel provide emergency ambulance service as well as first response.

"Blended" systems also exhibit wrinkles specific to the locality, said John Wilson, general manager of American Medical Response, the ambulance company that provides emergency service in the Las Vegas Valley.

"When you've seen one EMS system," he quipped, "you've seen that one."

Las Vegas, North Las Vegas, and Clark County voluntarily belong to a regional franchise jurisdiction that establishes uniform practices for emergency medical services. Each of those jurisdictions negotiates its own emergency ambulance franchise contracts. MedicWest, the ambulance company that serves North Las Vegas, and Mercy, the one that serves Clark County and Las Vegas, are both owned by the same parent company, American Medical Response. Other ambulance companies are free to provide nonemergency transport.

By mutual agreement among participants, all responders to medical emergencies are dispatched by Las Vegas Fire Station No. 1. When someone calls the area-wide 911 system, operated by Las Vegas police at a different location, the person is asked whether the emergency is "police, fire or medical." If the answer is fire or medical, it is switched to the fire alarm office.

That dispatcher asks the location of the emergency and types it; locator software produces a map that will appear not only on her computer screen but also on the computers of emergency response units assigned to the call. The dispatcher then begins asking questions according to protocols which branch in different directions according to the last answer given. Anywhere in the United States, if the dispatcher asks, "Is the person conscious," and the answer is negative, the next question is, "Are they breathing?" If not, the dispatcher will always tell the caller how to do CPR. She doesn't ask whether the caller wishes to do CPR because it's better not to offer the option of saying, "I don't think I can!"

The protocols are the quickest way to determine the seriousness of the call .

Read More, 'Dual' doesn't always mean redundant

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