Ambulance service in Arlington Massachusetts 2021
Overview
When there is a medical emergency in Arlington, typically a call is made to 911. The 911 dispatcher at the Arlington police station will send 1 police car, 1 fire engine, and 1 ambulance to the emergency. If the call is thought to be serious, 2 paramedics will be dispatched also. The patient will be treated at the scene and while enroute to the hospital. At the hospital, advanced procedures and surgery will be used to save the patient's life. Statistics tell us that 95% of victims who suffer cardiac arrest outside of a hospital do not survive. Time is of the essence when responding to these medical emergencys.
From 1987 to Summer 2021, a team of Armstrong paramedics were based in Arlington. From Summer 2021 to Summer 2022 , the first due paramedic unit for Arlington was based a minimum of 12 minutes away in Woburn. Average response times for paramedics in Arlington shot up from approx 6 minutes to approx 14 minutes. One might assume that the consequences for Arlington residents have not been good. As of June 2022, there once again is a paramedic unit based in Arlington.
History / Background
prior to 1971 ... ambulance service provided by Arlington police prisoner wagon equipped with a stretcher and resuscitator. All patients transported to Symmes Hospital in Arlington ... Arlington police had some station wagons also .. they might have served as backup ambulances ... see 1971 town report for photo of officer joe steele with station wagon ... fire department probably also responded to medical calls with first aid kits and inhalators / resuscitators ... AFD had a 1959 Mack rescue truck at HQ ... but I dont think that it was ever used to transport sick people to the hospital ... probably because it did not have a door on the back
1971 fire department (FD] trained to Emergency Medical Technician (EMT] level and began to operate an ambulance (Rescue 1]. EMTs initially received 82 hours of medical training . Some police officers are also trained as EMTs. (The new Rescue 1 went into service on August 9, 1971 and handled 300 medical calls between then and Dec 31 1971 per 1971 Annual Town Report]
1982 ... Emerson Hospital in Concord started their paramedic program ... https://arlington.advantage-preservation.com/viewer/?i=f&d=01011871-12312005&e=advanced%20life&m=between&ord=e1&fn=arlington_advocate_usa_massachusetts_arlington_19981224_english_39&df=11&dt=20 ..... serves 14 communities ...... Greater Lowell EMS started their medic program in 1983
1983 ish Armstrong Ambulance begins to operate a SUV staffed by 2 paramedics who have 1,000 hours of medical training. This unit serves Arlington, Belmont, Watertown and Winchester mainly. (per 2016 ish burlington report] (no mention of medics in 1983 and 1984 Annual Town Reports] ... NOTE .... EMTs have 80 hours of training and provide Basic Life Support (BLS] ... paramedics have 1000 hours of training and they provide Advanced Life Support (ALS] ... ( more details from 2016 ish burlington report ... North Suburban Emergency Medical Consortium consisted of Lahey + Symmes Hospital + Choate Hospital in Woburn + ?Winchester Hospital ... initially there were 2 paramedic SUVs ... p1 was operated from lahey hospital by lahey hospital ... p2 was operated from brattle st in arlington by armstrong ambulance ... the suv were also known as nsp1 and nsp2 ... each suv was staffed 24/7 by a crew of 2 paramedics]
1984 .... arlington.advantage-preservation.com/viewer/?k=paramedic&i=f&d=01011871-12312005&m=between&ord=k1&fn=arlington_advocate_usa_massachusetts_arlington_19840301_english_1&df=1&dt=10 .... Chaulk Ambulance of Newton initially won contract to serve 10 towns for the North Suburban Emergency Medical Consortium ... concerns that just 1 unit was not sufficient .... AND ... HOLY CRAP ..... Arthur D Little was testing nerve gas over by Alewife T station for the Department of Defense
April 1985 ... legal notice in Arlington Advocate newspaper about start up of ALS with 1 unit in Burlington ... supported by Lahey + Symmes / Choate + Winchester Hospital ..... drive.google.com/file/d/1qPCXVrwghGLeoyf2i-WzWWLnTz0fo43W/view?usp=sharing ... medical control by Lahey ED and Choate ED ... serving Arlington, Bedford, Billerica, Burlington, Lexington, North Reading, Reading, Wilmington, Winchester, and Woburn
1985 ..... https://arlington.advantage-preservation.com/viewer/?i=f&d=01011871-12312005&e=advanced%20life&m=between&ord=e1&fn=arlington_advocate_usa_massachusetts_arlington_19851003_english_13&df=71&dt=80 .... Symmes ED had 16,000 visits ... 4 rooms + 1 cast room ..... seeking to develop ALS program
September 1988 ... paperwork filed with state to operate an ALS unit from Arlington to serve Arlington, Winchester, Lexington, and Woburn ... administered and supported by Lahey, Winchester Hospital, and Choate..Symmes ... with medical control from Lahey ED and Choate ED ... drive.google.com/file/d/1xWTacvrTPFzlmxe-mcZPYjqJLSmtoYcr/view?usp=sharing
1988 ..... arlington.advantage-preservation.com/viewer/?i=f&d=01011871-12312005&e=advanced%20life&m=between&ord=e1&fn=arlington_advocate_usa_massachusetts_arlington_19880728_english_8&df=31&dt=40 .... Symmes Emergency Department has 3 fulltime doctors + nearly 20 nurses + 1 orthopedic technician + 4 nurses assistants ... doctors work 12 hour shifts
1990 ish Symmes Hospital closes
there was a time when the Arlington based ALS unit responded to many calls in Belmont ... maybe thru 2012 .. maybe they went to calls in Watertown also ... irc Lexington initially got ALS coverage from a unit at Emerson Hospital in Concord ... 5/9/2022
1995 circa 4 North Suburban paramedic units (all SUVs] are now operating in the area ... p1 Burlington + p2 ?woburn ? + p3 arlington + p4 sancta maria hospital ... patients are transported to trauma centers and local hospitals
2000 circa all police cars are equipped with defibrillators ... Armstrong Ambulance Service begins to provide ambulances as secondary responders in Arlington
2002 ... Winchester FD begins to operate their own medic ambulance ... with Action Amb as backup ALS provider ... Winchester FD ambulances have 4 minute average response time .... but Armstrong is providing 10 minute average ALS response times .... 12/24/2004 article or 12/24/2009 article .... arlington fd is looking into providing als in arlington
2003 ... woburn switched als provider from armstrong to action
2004 ... lexington FD begins full time operation of their own medic ambulance .... 5 firefighter / medics were added in 2002 ... 4 more experienced medics will be added in Spring 2004 ... info from 2002 and 2003 annual town reports for lexington ... used attrition to realign staffing ... here is the 2003 annual report .... records.lexingtonma.gov/weblink/0/doc/72732/Page1.aspx
2005 ... Cambridge FD upgraded from BLS to ALS .... ( presently CFD has 208 firefighter / EMTs plus 61 firefighter / paramedics .... per cfd website under ems or rescue 1 ... 12/13/2021 ] .......(5/9/2022 ... professional ambulance probably started to hire paramedics around 2005 also]
2009 ... lexington fd now operating 2 fulltime medic ambulances ... per 2009 lexington annual town report
2010 circa arlington 911 dispatchers are trained to give basic emergency medical advice to callers
2012 ... Belmont FD switched their ALS provider from Armstrong to professional
July 2013 ... Belmont FD began to operate their own medic ambulance
2000 to 2021 typical response times for medical calls in Arlington are ... 3 minutes for police ... 4 minutes for fire unit ... 5 minutes for fire ambulance ... 6 minutes for paramedics ... Virtually every year from 2000 to 2021 the Annual Town Report says that the fire department is studying the possibility of providing paramedic service
Summer 2021 the medic unit based at Armstrong Ambulance Service Headquarters at 88 Mystic St disappears into thin air. paramedics now respond to calls in Arlington from Woburn, Lexington, Cambridge, Winchester and Belmont . Arlington rarely reciprocates by sending Arlington Rescue 1 out of town
Dec 16, 2021 ... Arlington FD seems to be staffing both Rescue 1 and Rescue 2 on weekdays ... this somewhat helps improve care ... Rescue 2 is possibly being staffed by firefighters earning overtime pay
Currently ... The medic dispatch policy at this time seems to be .... Arlington 911 calls Armstrong Dispatch Center and requests a medic unit .... if the medic unit in Woburn is not available, then Arlington 911 has to start calling around to adjacent communities looking for an available medic unit .... Cambridge has FD Squad 4 (a non transporting van] based in porter Square, and medic ambulances from professional Ambulance Service ... Winchester FD has a medic ambulance based at their fire station in Winchester Center ... Lexington FD has a medic ambulance based at their East Lexington Fire Station .... Belmont FD has a medic ambulance based at their Trapelo Ave HQ .... Somerville and Medford are almost never called for assistance .... (5/9/2022 ... Medford is served by Armstrong Ambulance Service and Somerville is served by Cataldo Ambulance Service ]
OUTCOME
need to check studys to see what effect the loss of medics really has ,,,, this article from 2018 has huge amounts of info but no firm conclusions ... www.jems.com/operations/ambulance-crew-configuration-are-two-paramedics-better-than-one/ ... 12/12/2021
2021 annual report for the MEDIC ONE program in the Seattle area .. 2 or 3 X higher save rate than other places ...kingcounty.gov/depts/health/emergency-medical-services/~/media/depts/health/emergency-medical-services/documents/reports/2021-Annual-Report.ashx ... note ... MEDIC ONE is the office in the County public Health Dept who work to save as many people as possible .. they do that by training tons of people in CpR, and funding 26 medic ambulances, and partially funding maybe 80 basic ambulances, etc .... median BLS travel time is 5.2 minutes ... median ALS travel time is 7.7 minutes .... BLS dispatch time is 1 minute ... ALS dispatch time is 2 minutes
Arlington has never done any study of the effectiveness of the EMS system afaik
The state EMS law in Mass was written around 1972 .. it says ... IF a community provides ems ... it must have 2 EMTs in each ambulance .... if they use medics, there must be at least 1 medic on each ambulance ... they have lots of rules about the number of bandaids on each ambulance but they never do any analysis of save rates or response times ... there is also a statewide SOp for the medical procedures that a medic can perform ... its like 200 pages long .... many states have these Standard Operating procedures and they are all probably very similar .... (update ... the Mass state ems law was updated in approx 2000 ... possibly by recognizing / designating trauma centers and heart attack hospitals and stroke hospitals etc]
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Bottom line .... it sure seems that King County has good results ... and they use many paramedics with response times of 7 minutes ... which would make one think that Arlington will have very bad results with average medic response times of 12 or more minutes ... and no effort to train the public in cpr and no PulsePoint system ... Dec 14 2021
archive.md/p5SLO ... Disney World FD is short staffed ... woman possibly died for lack of epinephrine ... 12/16/2021 .... this is a prime example of a bad EMS response having a bad outcome
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NOTE
The National Fire Protection Association is a private company in Quincy Mass that publishes "standards" .....NFPA 1710 ... alarm processing shall occur in 60 seconds for 90% of incidents and 90 seconds for 99% of incidents ... 60 second turnout time (put on pants and coat etc and get in vehicle] ... maximum travel time of 4 minutes for AED / first responders .... maximum travel time of 8 minutes for ALS ... this is the closest thing that the USA has to a 'national response time requirement'
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docs.google.com/spreadsheets/d/1jPLjawdJj9T_nBKZMAcv5ECJh_By2jFq_C5fuj8jRLA/edit?usp=sharing ... spreadsheet of AFD incidents Oct 12 2021 thru Oct 19 2021
we also have some radio tapes of ems action on Arlington fd radio channel ... email ,,, afd oct 18 19 13 etc
just found a great report from burlington fd about their need for medics from 2016 ish ... many of same issues arlington is now facing ... basically armstong abandoned them so they started to operate their own medic ambulances ... www.hsdl.org/?view&did=804454
MY DEFINITIONS
medic ambulance = ambulance staffed by 2 medics or staffed by 1 medic and 1 EMT
basic ambulance = ambulance staffed by 2 EMTs .. such as Arlington FD Rescue 1 ... such as most Armstrong ambulances
INFO FROM NOV 17 2014
Looking at old Town Reports - Arlington Mass - Part 1 - The Paramedic Saga
1997 Annual Town Report - Arlington has been a member of the North Suburban Paramedic Consortium for 10 years - (translation - the Armstrong Ambulance Service (a private company) has been providing paramedics to cover Arlington for 10 years now ie 1987 to 1997)
2000 Annual Town Report (ATR) - in light of declining Medicare reimbursements to private ambulance companies, Arlington FD is
considering becoming the paramedic provider for Arlington
2001 ATR - a ALS study report will be available before the 2002 Town Meeting
2002 ATR - no mention of ALS
2003 ATR - no mention of ALS - Armstrong donates 7 AEDs to PD
2004 ATR - no mention of ALS
2005 ATR - ALS study will be done in 2006
2006 ATR - ? no mention of ALS
2007 ATR - will study ALS
2008 ATR - still exploring ALS
2009 ATR - still exploring ALS
2010 ATR - still exploring ALS
2011 ATR - still exploring ALS
2012 ATR - still exploring ALS
2013 ATR - ? still exploring ALS
I kid you not - approx 8 years in a row they have included the same exact sentence in the Annual Town Report
I wonder if any of the ALS reports were ever really written?
2003 Annual report has photo of Brian Connors donating AEDs to APD
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Historical Note
I can remember International Harvester Suburban ambulances operated by Belmont police, Winchester police and Stoneham police. This would have been early 1970s. Lexington FD had a cadillac ambulance ... maybe Reading FD also. Somerville always had private ambulances iirc. Medford FD never had an ambulance iirc. Cambridge FD had their huge 1969 Mack rescue truck running as their primary ambulance for many years. Larry Ferrazani wrote a book about it called "Rescue Squad". Here is a photo of their 1969 Mack firenews.org/mass/c/cambridge/ant307.jpg ... before that cfd had a big 1960 heavy rescue truck that served as an ambulance also firenews.org/mass/c/cambridge/CambridgeCDResJD.jpg
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Updates
12/16/2021 ... added Disney item ... added info about AFD staffing 2 ambulances weekdays
5/9/2022 ..... recently p3 and FS1 have been responding to some als calls in arlington .... 'fs1' is 'field supervisor 1' ... maybe 1 medic in a suv from medford .... p3 ran some calls last week but disappeared over the weekend
5/9/2022 ... added info about 1985 and 1988 and 1982 and 1984
5/9/2022 ..... here is a list of emergency departments at local hospitals that have closed over the last 40 ish years ... symmes in arlington + sancta maria in cambridge + lawrence memorial in medford + somerville + choate in woburn + waltham
June 7 2022 ... something new seems to be happening .... Armstrong Ambulance Service is now operating their "p15" unit and "FS1" unit in Arlington ...... and p15 is maybe being dispatched on the Arlington FD radio channel at times ... p15 is a transport unit (an ambulance] staffed by 1 or 2 Armstrong medics and maybe 1 Armstrong EMTs ... FS1 is a SUV with 1 medic ... it is aka Field Supervisor 1 ... maybe it is intended to serve Waltham or Medford actually ... and p3 seems to be running more calls in Arlington ... but the mutual aid ALS units and mutual aid transport units are still making frequent appearances in Arlington ... (June 9 2022 ... yes p15 is being dispatched on the Arlington FD radio channel 460.60R]
June 7 2022 ... last night at virtual Town Meeting, Assistant Town Manager Sandy pooler reported that town unions had agreed to new work / labor contracts ... FD was at 72nd percentile vs nearby Town Managers ... EMTs certifications went from 3.75% to 5% of base pay ... FD budget will remain level funded .... or something along those lines
June 7 2022 .... recently learned that Armstrong Ambulance CEO Raymond is / was on the NEMLEC Foundation Board ... as is / was Bedford police chief ? Borgano ? (who may be married to the Director of public Health in Arlington ... and maybe who grew up on Mt Vernon St] ..... and Quinn is / was the treasurer of the NEMLEC Foundation ... Quinn is ex Marine with "ptsd" who ran an insurance company in Arlington for ?20? years until the feds recently convicted him for illegally collecting social security disability payments for 20 years ..... (was Michael Quinn a Town Meeting member in 2012 or 2015? is that the same Quinn? the name Michael.Quinn at gmail is on my list of TMM Emails ] .... we have no idea what the 'NEMLEC Foundation' does .... NEMLEC is the NE Mass Law Enforcement Council ... afaik they basically have / had a swat team and 2 regional radio channels
June 7 2022 ... info from 1993 BAPERN case .... " At all times relevant to this case, the Town of Newton, whose police chief William Quinn served as the chair of the GBPC, fulfilled that role. Quinn, in turn, relied heavily on Timothy Coogan, a civilian employee of the police department, to conduct the daily operations of the GBPC. Coogan became a full-time employee after graduating from law school and ended his affiliation with Newton in mid-1985, when the offenses underlying .... " ... any relation?
August 18 2022 - for the last 2 or 3 months - ALS calls in Arlington have been receiving a response from P15 based at Armstrong HQ Mystic St - and Arlington FD has reverted to just 1 Rescue on duty - so essentially things have gone back to status quo with a slight enhancement - 1987 to 2021 the Armstong paramedics based on Mystic St responded to calls in a SUV - June 2022 to present the Armstrong medics are responding in an Armstrong ambulance
August 18 2022 - updated the Overview section of this webpage.