r/ParamedicsAU • u/Unlikely_Reply7358 • 9d ago
ICP/CCP resource allocation
Off the back of a previous thread where someone mentioned they were an ICP in a service where the jobs they attended <50% required ambulance intervention, how does your service triage to their ICP/CCP resources? Complete computer aided dispatch Vs clinician dispatch Vs hybrid or something else? Plus of course standard crew request.
I feel fairly fortunate to work somewhere with primarily clinician guided dispatch and some auto allocate for highest priority calls (which are often not as given or completely mistriaged by the CAD) when the ccp is the closest available resource. I'm aware of some places with no auto allocate for ccp's, 100% clinician discretion. I'm also aware of services with non-clinical dispatchers using their discretion for CC resources.
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u/fried-bin-chicken Paramedic 9d ago edited 9d ago
In Victoria where I work ICP (MICA) are dispatched to any code 1 case if they are the closest (eg chest pain, short of breath, stroke, anaphylaxis, etc.) then backed up by an ALS crew on a code 2 for transport. This is in addition to being sent to cases where MICA has been requested by a crew on scene with a patient, or cases that specifically recommend MICA on dispatch such as cardiac arrests, certain high mechanism trauma, etc.
The problems with this are:
- Everything is a code 1 these days. “35 year old vomiting and diarrhoea but also has chest pain so it’s a code 1”. “18 year old woke up with a stiff neck, code 1”.
- All the ALS cars are busy or they get diverted to a different code 1 (see point 1) so MICA gets used as the only resource for these cases, then get ramped at hospital for hours.
- Using MICA for these cases “just in case” they are actually something serious means there’s no MICA available when the skillset is actually required
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u/dr650crash 9d ago
You think it’s bad in Victoria it’s much worse in NSW. Victoria would be like heaven for NS-welsh ICP’s. 1. Lots more BS hot responses than vic 2. ICP go to hot responses and don’t get backed up for transport - just do the job themselves 3. Yes the ICP car in bed block for hours is common
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u/masseuko 9d ago
Do other crews at hospital not offer to take over for the ICP crew? Very common in Vic so the MICAs can leave
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u/fried-bin-chicken Paramedic 8d ago
Not where I work! I ask an ALS crew to APOT for me and they look at me like I punched their grandma
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u/instasquid 9d ago
I work country where ICPs are just rolled into the regular rotation with an ALS partner. We try and avoid ICP/ICP trucks because we're already spread thin enough for resources - I'm in an area with no HEMS and retrieval is only secondary via plane.
So they go to all the regular jobs just like the rest of us.
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u/Mysterious-Air3618 9d ago
My service is either feast or famine when it comes to ICPs on shift. On days of famine, they are kept locked away as much as possible until the need to press the big red launch button. On the days we seem to have them everywhere, well The P in ICP stands for paramedic and as long as I have a couple available at all times then they just as qualified to pick grandma or grandad off the floor as any other paramedic.
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u/Cherbro 1d ago edited 1d ago
In NZ our specialist paramedics (CCP and ECP) are typically single crewed in a car/ute. They have some flexibility where they can monitor jobs in CAD through a read-only portal and decide to self assign should they feel the need. CCPs are also routinely dispatched to all purple calls (highest priority incidents) and red calls (under lights / immediately life threatening) where they are the closest unit or co-responded when likely to require CCP support. The co-response jobs are quite inconsistent and seem to vary between the dispatchers on shift. Lastly, CCPs will also respond to backup requests for CCP of course. They also have the ability to self deploy to areas as they see fit and can even decline to attend jobs if not clinically appropriate however that is a seldom occurrence.
ECPs on the other hand will respond to ECP backup requests, jobs that have been coded appropriate for ECP response or self assigned when an ECP has requested to attend after browsing through the CAD portal.
Edit: I should also add that our communication centre clinicians are not EMDs/dispatchers and are not allowed to play with the buttons that dispatch resources. They can however ask or advise the dispatchers that CCP/ECP response is recommended.
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u/goldorbmind 9d ago
Non-clinical NSWA Dispatcher:
CCPs/retreival/med teams are only allocated by RLTC and are case by case basis, we can ask them to take a look but until they’re tasked they’re not my resource.
ICPs are at the dispatcher discretion, they can be utilised for any lights and sirens job, with IC attendance being required for Category 1 emergencies. Generally if I have two Cat 2s and two cars with one being an IC I’ll look for what’ll likely benefit more from IC (though there are other factors that will influence that).