# EMS Support Services van----What is it?



## BadEnoughDudeRescueRonny (9 Oct 2011)

Hi all, this is my first post back in a while, but I have a question for the Paramedics on this board.

The other day, I was crossing past one of the local Emerges and I noticed an EMS van parked in the ambulance bay. The van itself was just a regular full-sized van complete with the markings of the local EMS service in addition to it saying "Support Services" on the side of the vehicle. I've seen these vans around town a few times now, and I'm always curious as to what their purpose is and what exactly is meant by "Support Services". Do these vans basically just carry extra supplies, or are they from a special EMS sub-unit with very specific purposes? The vans themselves are not ambulances, but as I said, just a regular marked full-size van complete with lightbar and strobe lights on the rear. Any answers would be tremendously appreciated.

Thanks in advance guys!


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## mariomike (9 Oct 2011)

Not sure where you saw it.  

These are the ( most recent ) Emergency Support Units ESUs of the municipality I am familiar with ( They have come in various versions over the years, and date back to the late 1970's. Decommissioned ambulances were used prior to that. ):
"This vehicle is a supply and support vehicle. Based on a 2003 Freightliner LLC-FL80 chassis, this vehicle carries enough supplies to restock 10 ambulances. This vehicle provides light extrication equipment, electrical power, canteen facilities and a communications centre. This vehicle responds to all emergency incidents in conjunction with one of the emergency support buses. It is staffed 24-hours a day with one level I-ESU paramedic.":
http://www.flickr.com/photos/iduke/4211383555/sizes/z/in/photostream/
http://www.flickr.com/photos/gopherit2/4640435285/
http://www.flickr.com/photos/gopherit2/3969334903/
This type is becoming popular. The truck can drop off containers at various scenes:
http://www.flickr.com/photos/gopherit2/5235266404/

There is also Emergency Power Unit EPU,  Telecommunications Unit, various Special Operations ( Marine, Tactical, CBRNE, HU-SAR, PSU ) vehicles, and logistics support trucks and vans to distribute supplies among the 41 ambulance stations spread across the city. Equipment Retrieval vans pick stuff up from the hospitals, bring it in for cleaning, then put it back into the EMS system. There's station maintenance and cleaning vans etc.

It was not uncommon for people to confuse them with ambulances.


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## BadEnoughDudeRescueRonny (10 Oct 2011)

Thanks again MarioMike for answering any questions I have about various EMS Services! I'm always amazed at how diverse (and complex, for that matter) EMS services can be for a municipality. It's very interesting to see how many ancillary (would this be the right word?) services are necessary to keep those EMS buses running and able to deliver full services.


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## mariomike (10 Oct 2011)

BadEnoughDude said:
			
		

> It's very interesting to see how many ancillary (would this be the right word?) services are necessary to keep those EMS buses running and able to deliver full services.



Toronto has been operating a small fleet of EMS buses since 1977. The first was a re-built 1961 GMC "fishbowl".  Shown in top photo. All others since then have been custom built at the factory. The Orions came from Ontario Bus Industries OBI in Mississauga. 

Eldoardo:
http://www.youtube.com/watch?v=X2lSGnPl-ww&feature=related
Notice the big, blue "effin' A" on the back.  

Orion 1 ( old and new colours ):
http://www.youtube.com/watch?NR=1&v=gKEjyughXEE
http://www.youtube.com/watch?v=MYXkTunSOIc&feature=related

The Orion 1's had electro-hydralic ramps. 

Orion 2 - Multi-Patient Unit MPU4 - ( third photo ) 

MCI coach in fourth photo.

One of the old support units "exploded".:
http://s248.photobucket.com/albums/gg168/tems90/Toronto%20EMS%20Units/?action=view&current=ESU8exploded.jpg


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## BadEnoughDudeRescueRonny (11 Oct 2011)

Jeez, Toronto EMS gets so much cool kit! Our local EMS service has some great looking buses (and sounding, for that matter, thanks to the Whelen Cencom Q Gold Siren boxes simultaneously set to both the Mechanical and Yelp Tones with dual siren speakers) , Tac EMS Excusions and Supervisor Durangos, but I don't think that we have any of the multi-patient city bus ambulances. At least I've never seen one in action, however there may very well be one around somewhere. But then again, I'm not in the GTA, so we likely don't have the greatest need for all the cool kit around here just on account of the population size. 

Just one little thing I found a bit funny as I saw the pictures of the old paint scheme for the Toronto EMS support bus was that it reminded me of when Toronto Police used school bus yellow patrol cars. I mean they'd certainly stand out, but I think prowling would be difficult  ;D .

Bring back any memories  ?







Here's one that may elicit some nostalgia MarioMike  :

http://www.flickr.com/photos/18378305@N00/992071587/in/set-72157622561184781/lightbox/

Aside from the St. Patrick's day ornaments, I noticed that this 80's era van ambulance doesn't have a Star of Life on it, but just the standard medical symbol whose name eludes me (the snake on the pole symbol).


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## mariomike (11 Oct 2011)

BadEnoughDude said:
			
		

> Aside from the St. Patrick's day ornaments, I noticed that this 80's era van ambulance doesn't have a Star of Life on it, but just the standard medical symbol whose name eludes me (the snake on the pole symbol).



We used to joke about the "stare of death", but the only place I saw the Star of Life is on our colours:
http://www.torontoems.ca/main-site/about/history-files/heraldic-grant.html

The snake on the pole would be the caduceus. We wore them on our left sleeve. Each one represented five years of completed service.

The other pic is a one man reponse unit.


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## BadEnoughDudeRescueRonny (12 Oct 2011)

Mariomike, I have yet another question about response units, specifically the one-man units. Here, we seem to have a bunch of them, only we use Dodge Durangos or _sometimes_ just Chrysler Minivans. What are the one-man units generally used for? Are they basically to provide an extra Paramedic to a scene in the event of a larger-scale case or can they be dispatched solo for more minor cases?


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## mariomike (12 Oct 2011)

BadEnoughDude said:
			
		

> Mariomike, I have yet another question about response units, specifically the one-man units. Here, we seem to have a bunch of them, only we use Dodge Durangos or _sometimes_ just Chrysler Minivans. What are the one-man units generally used for? Are they basically to provide an extra Paramedic to a scene in the event of a larger-scale case or can they be dispatched solo for more minor cases?



T-EMS has had an Emergency Response Unit (ERU) program since the early 1980's.  But, the program received a big boost in 2003. 
Last I heard, they were operating 18 ERUs at peak weekday, and 16 at peak weekend. They were on the road from 0600 to 0200, seven days a week. 
They are on "mobile deployment" for their entire 12 hour shift. ie: "Chute" time from station is eliminated. Being smaller than ambulances, they are much more agile in city traffic. 
ERU paramedics are not typically required to wait in emergency departments to off-load patients, and are therefore quickly available for new assignments.
ERU "clock-stoppers" do improve response time statistics. 
On the negative side: They can't transport. They can't get you off the frozen sidewalk, onto a stretcher, and into a heated ambulance with privacy. The ERU paramedic is forced to work without a partner. 

This is a T-EMS ERU. I bet he put the siren on because of the firehouse.  
http://www.youtube.com/watch?v=KRMpNRf3LLs&feature=related
Most of us tried to keep siren use to a minimum in residential neighbourhoods. Especially at night.


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## Neill McKay (12 Oct 2011)

mariomike said:
			
		

> They were on the road from 0600 to 0200, seven days a week.
> They are on "mobile deployment" for their entire 12 hour shift. ie: "Chute" time from station is eliminated.



I wonder if you could explain this in a bit more detail.  Do they just drive around the way a police car would?

Somewhere I got the impression that ambulances do this in my area, and I've always wondered what the advantage is.  Even when it's on the road, it's still in only one place at a time -- that may or may not be close to the next call.


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## mariomike (12 Oct 2011)

N. McKay said:
			
		

> I wonder if you could explain this in a bit more detail.  Do they just drive around the way a police car would?



ERUs spend their time either mobile - for a running start - or in stations where the amulance is on a call.



			
				N. McKay said:
			
		

> Somewhere I got the impression that ambulances do this in my area, and I've always wondered what the advantage is.  Even when it's on the road, it's still in only one place at a time -- that may or may not be close to the next call.



I believe Toronto is the first city to use SIREN.  
They say it reduces the dispatch process from two or three minutes, to less than three seconds.

It also increases the Unit hour Utilization UhU ( calculated by dividing the number of transports - not calls - initiated during a given period of time, by the number of unit hours - hours of service - produced during the same period of time ).

"The Optima Corporation is currently developing an ambulance real-time management system called Siren Live for the Toronto Ambulance Service. Siren Live will be used by the Toronto Ambulance Service to relocate ambulances in real time in order to provide the best ambulance response times possible.":
https://secure.orsnz.org.nz/conf41/content/cd/Papers%20and%20Abstracts/T4%20Richards.pdf

Optima live:
http://www.theoptimacorporation.com/optima-live

"The right place. The right time. Every time."
( That's what it says on the brochure.   )


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## Sheerin (13 Oct 2011)

Niagara I presume is using SIREN as well as a pilot project for the MOHLTC.  I believe it's almost done, but I don't really know.  Plus who knows if even if it's a success if the MOH will switch over to the new system for all their CACCs or if they'll continue to use the current one (which really doesn't work that well).  

Plus the lease for fleetnet is coming up in a few years so no one knows what they'll do when that expires.  Granted fleetnet is something that has to be decided by all the stakeholders (MOH, MTO, OPP, Ministry of Corrections, etc).  Personally I really wish we'd go over to Toronto's radio system.  I really like the fact that their portables don't rely upon vehicle repeaters like the fleetnet system does.  Particularly with respect to the 10-2000 system, where if I hit the panic button the system looks for whatever vehicle repeater is can find, not necessarily the one you're on so when it pops up on the screen at CACC the vehicle number won't match.  This can be a big problem if you have a gun to your head or are seriously injured as they won't know which crew is need of desperate help.


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