Posts by renalmedic

    The 3:1 ratio for large hospital is going to be problematic; there are very few hospitals that don't accept children or have a delivery suite or have critical care (I'd suggest that the overwhelming majority actually have all three), if you're playing realistically almost every single hospital needs to be large. It might be better to limit MTC or Burns Centres (which are truly limited in the UK) to 1 in 10 or 15.

    Non-ED hospitals (e.g. Barts or Broadgreen for PPCI, Alder Hey for Children, East Grinstead for Burns) were always going to be complicated to do and I don't think that can be reasonably expected.

    The specialties also look good and I hope the team decide to replace not add. These new specialties would be realistic but would cause issues in combination with the current unrealistic specialties in my opinion.

    Totally agree.

    There is some variation in nomenclature and procedure around the country but the broadest definitions of why ambulances go to certain hospitals universally apply;

    DGH/TU, MTC, HASU, PPCI, Burns Unit, Burns Centre, Delivery Suite.

    There are lots of adult critical care transfer transfer teams that have sprung up in the last two years. ACCTS in Wales, RETRIEVE in South West, ACCS in EoE, ACCESS in London, and so on. They (mostly) have their own vehicles contracted from PAS or VAS or, in one(?) case, from the local NHS ambo trust.

    They do very little work, a small handful of jobs a day. Honestly don't see it adding a huge amount to the game.

    That said, I definitely *can* see a game play feature that requires players to transfer patients between their hospitals; e.g. from a hospital without Traumatology to one with. However, most hospitals I see in game are spammed with all the departments, the departments as they stand are grossly unrealistic, and a large chunk of players in any decent alliance won't have their own hospitals.

    The naming changes as you move between counties and, I don't think really means that much. Is a wholetime pump ladder in London less capable than a retained rescue Pump across the border in Essex? Is there a difference between an Extended Rescue Pump in Sussex and a Enhanced Rescue Tender in Suffolk?

    In terms of playing, I'd like to play realistic but I've settled for Rescue Pumps for whole time appliances and Water Tender for retained.

    renalmedic I'm not quite following your argument - are you implying that outside London there is nothing that happens that requires any form of ambulance command unit? Up here in Scotland, much more rural than most of England, ambulance command units are among some of the most regularly deployed special resources in the entire country (including other services). To say that they only go to pre-planned incidents when some ambulance command units in the busiest areas get mobilised 3, 4 or even 5 times per day is simply absurd.

    I'm saying that working alongside four ambulance services for the last decade, going to predominantly serious, major and otherwise interesting incidents and working academically in PHEM, I've never seen them deployed.

    I'm saying that I know that LAS that they use theirs a bit more frequently and that some days they even have the spare dispatchers to properly staff them!

    If you say that you have dispatchers on a mobile command unit running on jobs 5 times a day in Scotland I'll believe you, at least until I can catch up with one of their EPRR blokes.

    But, the final thing I'm saying is that none of this remotely convince me that ambulance service CUs should be operating as fire service CUs in game.

    YAS Manor Mill Resource Centre,

    Manor Mill Ln, Beeston, Leeds, LS11 8LZ

    EMAS Mansfield Operational Support Base, Hamilton Way, Mansfield, NG18 5FA

    I'm not sure whether ambulance services beyond London ever really use command units other than at preplanned events.

    In EEAST and London, IRO & LOM vehicles are set up with the ability to do a some of that function. In practice, we'll all just use Fire's command trucks.

    Ambo command vehicles are however, very different and distinct from the SIRU (or whatever it's replacement is going to be) and I wouldn't want to see a merger of them in game.

    I'd be happy to lose them from the game - I certainly never use them. But somce they're here, I think they should operate as an AO rather than as a fire command unit.

    An update about a year ago removed the need for HEMS from all missions.

    The only time they might be needed now is for alliance large scale missions.

    I presume its some sort of lowland SAR:?:

    Anyone done RNLI lifeguards so far?

    Where and how you built their stuff?

    I play realistic(ish).

    The RNLI website shows beaches where they have lifeguards. There are two problems; first there are a *lot* of them, there are also lots of places where lifeguards are provided by other organisations. Realistically, they don't all have 4x4s and jetskis but the missions in the game mean that you need to have quite a lot of them (expect you don't, cos the missions are relatively rare).

    I've built a Lifeboat Station for each RNLI lifeguard covered beach in my patch (~100 so far) and where I can find a local authority of volunteer lifeguard org. Each has one 4x4 and one rescue watercraft trailer. They generate overwhelmingly more major cruise liner evacuations than swimmers in difficulty.


    Severn Area Rescue Association. Another of the voluntary SAR orgs.

    Some of their 'stations' have hovercraft, lifeboats, boats on trailers, mud rescue, rope rescue and flood rescue. So hard to do realistically. They also have a lowland rescue & mountain rescue (at Beachley) capability so probably won't play well with SAR2 either.