Which SHOULD come first FIRE or EMS?

[flhtci01]

In our communtiy both EMS and fire are volunteer and separate organizations. EMS gets dispatched first. If it is highly likely fire is not needed they will not get paged out. If it is an accident that might involve extrication, additional manpower, etc., they get paged immediately after EMS.

 

[MJordan2121]

Firemen/EMT's

I believe that firemen are, indeed, essential. In South Mississippi, there seems to be a fire station every few miles and we only have around 9-11 ambulances at night covering two big counties. When we have to venture out the city into the county, it can sometimes take us 10-20 minutes to get there, depending on how far out it is. The firemen can get there fairly quickly and can at least give the pt oxygen, start getting pt information, use CPR, if needed, and can start c-spine immobilization, should it be necessary. I believe that we all work as a team and I am thankful they are there on every call with us. Plus, you never know if you will need lift assistance, backup, or whatever.

 

[Noctis Lucis Caelum]

I believe that firemen are, indeed, essential. In South Mississippi, there seems to be a fire station every few miles and we only have around 9-11 ambulances at night covering two big counties. When we have to venture out the city into the county, it can sometimes take us 10-20 minutes to get there, depending on how far out it is. The firemen can get there fairly quickly and can at least give the pt oxygen, start getting pt information, use CPR, if needed, and can start c-spine immobilization, should it be necessary. I believe that we all work as a team and I am thankful they are there on every call with us. Plus, you never know if you will need lift assistance, backup, or whatever.

Pretty much i agree with everything you said, especially the part on additional help. Also scene safety is a must.

 

[Jon]

I think your bigger issue is that your area is so fragmented and territorial that this is even a question.

Where I volunteer and where I work... we have county-wide dispatch. 911 calltakers enter the call in CAD, then a dispatcher selects the appropriate unit and pages Fire AND EMS over the pager frequency and dispatches the calls. PD is dispatched by their dispatcher... and because the fire dispatcher has to activate tones, etc, we often hear our calls go out to PD a few moments before we get the call.

If every fire house has their own dispatch... whoever the PSAP is has to pass the info to them, then the fire house needs to dispatch... that takes time. if the PSAP has to make 2 phone calls... I'd call the ambulance first, probably because it is doing the most good the most times. BUT THIS ISN'T THE PROBLEM! THE PROBLEM IS THAT YOU SEEM TO HAVE LOTS OF "LITTLE KINGDOMS" THAT WANT TO BE THIER OWN BIG-CITY FIRE DEPARTMENT.

 

[EMTWintz]

In our communtiy both EMS and fire are volunteer and separate organizations. EMS gets dispatched first. If it is highly likely fire is not needed they will not get paged out. If it is an accident that might involve extrication, additional manpower, etc., they get paged immediately after EMS.

That is exactly how it is here. Only one step further. If there is a medical ER on the interstate, then at least one Fire truck rolls so they can route traffic. We only have 2 part time police officers and its the luck of the draw if they show up.

 

[Flight-LP]

I keep hearing responses citing "traffic control" or "barrier". Do you really honestly believe that your fire truck was designed to be a traffic barrier. Is that what your community spent over $100,000 on? Doubtful.................

Also, how many of you are trained in traffic control? I don't mean standing out in the street with a flashlight. I am referring to true knowledge in directing the flow of traffic, appropriate hand signals, flow patterns, etc.

The answer will probably be very few. It is not your job to handle traffic, thats why God invented law enforcement! Let them do their job, you do yours if it is even needed on that scene. God help any agency that gets an unknowledgable FF run over, or worse yet, cause another wreck because they don't know what they are doing. Stick with what you know.....

 

[EMTWintz]

I keep hearing responses citing "traffic control" or "barrier". Do you really honestly believe that your fire truck was designed to be a traffic barrier. Is that what your community spent over $100,000 on? Doubtful.................

Also, how many of you are trained in traffic control? I don't mean standing out in the street with a flashlight. I am referring to true knowledge in directing the flow of traffic, appropriate hand signals, flow patterns, etc.

The answer will probably be very few. It is not your job to handle traffic, thats why God invented law enforcement! Let them do their job, you do yours if it is even needed on that scene. God help any agency that gets an unknowledgable FF run over, or worse yet, cause another wreck because they don't know what they are doing. Stick with what you know.....

I can't speak for everyone else's FD but I know ours has had training in traffic control. Our FD has the flares, the air traffic cone thingys and the hand signals down pat.

 

[slawson]

Let me just make clear though folks, I didn't ask the question because it's "my kingdom" or any other territorial issues - it was a pt issue really.

The way I saw it in relative to an accident with injuries - anything you do to delay the first agency arriving on scene was, in my opinion, a wrong decision.

If a car is in the middle of an heavy intersection - to me it makes since to get the FD there asap to be able to secure the scene.

Having PD do traffic control is great - and probably should happen, however, here it's just not set up that way and I don't have ample opportunity to change that. Traffic is another duty tasked to the fire department.

I asked the question just to see everyone's opinion on them. And I thank you - keep them coming. It seems the solution to this is to attempt to get them dispatched using a simulcast broadcast via the radio.

Currently dispatcher calls private ambulance service who then calls the closes ambu station. The FD is dispatched via radio & alphanumeric pager as backup.

 

[41 Duck]

BUT THIS ISN'T THE PROBLEM! THE PROBLEM IS THAT YOU SEEM TO HAVE LOTS OF "LITTLE KINGDOMS" THAT WANT TO BE THIER OWN BIG-CITY FIRE DEPARTMENT.

Yes you CAN get an amen!



Later!

--Coop

 

[Ridryder911]

Personally, I like firefighters to get there first.

First to see if the scene is safe/hazardous materials (dead firefighter bodies on the ground is a good clue) or hear the shots fired.

Second: See if there is loose wild animals, or various decomposition

Third: Carry my equipment and the patient.

Hey, they have to do something!...

R/r 911

 

[FFMedic1911]

By reading some of the post it is clear we have some fire haters on the board.IMO and this is coming from a firemedic who takes both jobs serious,fire and ems should be dispatched at the same time.If you have an eta of 15 min for any ambulance and 5 for a fire truck why would you make someone wait to receive care.This stupid hose monkey(me) saved a 16 y/o male involved in an mvc once by keeping the airway open while waiting on ems.I think sometimes we let are little kingdoms get in the way of what we are here for in the first place.

 

[BossyCow]

Its all situational. ......

Ideally the decision to dispatch fire should be made on a case by case basis. EMS should be notified first on EMS calls.

Best post on the topic! It has to depend on the systems involved. In our system the FD has not just people trained in traffic control but actual card carrying State DOT Flaggers. All heavy extrication equipment are carried on the fire trucks. Also, after the pt is loaded into the ambulance and on their way to the hospital in the ambulance, fire stays on the scene until the glass is up, road is clear and everything is done.

To say that fire is worthless on a scene is a gross generalization based on anecdotal information.

 

[Ridryder911]

I don't hate firefighters. Just they are not EMS. Truthfully, most fire services are more strategically placed with multiple stations more than EMS services and can respond faster. Even though I was joking, in reality it is true in comparison EMS is much busier than fire.

I don't see a problem with having Fire Service on the scene as long as it is in the role as first responder only. Having only two EMS personnel on most medical calls is ridiculous. Yes, even though I was joking it only makes sense to assist in carrying and assisting on the call.

When dispatching, why not dispatch simultaneously? We do. The tones go out on both frequencies at the same time; therefore one is not over another.

 

[Code 3]

I don't hate firefighters. Just they are not EMS. Truthfully, most fire services are more strategically placed with multiple stations more than EMS services and can respond faster. Even though I was joking, in reality it is true in comparison EMS is much busier than fire.

I don't see a problem with having Fire Service on the scene as long as it is in the role as first responder only. Having only two EMS personnel on most medical calls is ridiculous. Yes, even though I was joking it only makes sense to assist in carrying and assisting on the call.

When dispatching, why not dispatch simultaneously? We do. The tones go out on both frequencies at the same time; therefore one is not over another.

Is the FD you run with a BLS provider? If not, would your views change if every fire department in your county was ALS? I'm just curious because in my county every FD is ALS with the exception of two cities that still use FF/EMT's.

 

[Ridryder911]

No, my FD is not ALS. Personally, I don't believe FD should be the ALS providers. I have worked in systems that has such, and believe if one is going to provide ALS care, one should have to ride in with them.

R/r 911

 

[Hastings]

I enjoy having the FD or PD on scene before I arrive for the reasons you listed in the original post.

1. Scene safety.
2. Extrication.
3. Triage.
4. Initial vitals.
5. Availability for lift assist.



And those are all well within a first responder role. They're invaluable in that manner. It just speeds things up, and makes things more efficient. They're there to make initial contact prior to my arrival and they're willing to step aside once I get there. I have no complaints. Again, I really value the first responders.



Edit: That being said, EMS contact should never purposely be delayed.

 

[slawson]

By reading some of the post it is clear we have some fire haters on the board.IMO and this is coming from a firemedic who takes both jobs serious,fire and ems should be dispatched at the same time.If you have an eta of 15 min for any ambulance and 5 for a fire truck why would you make someone wait to receive care.This stupid hose monkey(me) saved a 16 y/o male involved in an mvc once by keeping the airway open while waiting on ems.I think sometimes we let are little kingdoms get in the way of what we are here for in the first place.

I was kind of thinking the same thing FFMedic... my primary concern is for the pt. The earlier someone can initially make pt contact the earlier someone can provide even the slightest benefit to that pt.

FD's here do much more than extricate / fire supression on scene. As the below posts state, clean up glass, make sure rdway is ready to reopen etc. At least here, FD offers much benefit to the overall scene and to the pt than in other cases.

It seems the solution is for simulcast dispatch. Both tones, both frequencies.

The other obstacle is getting the central dispatch to do that one small change.

 

[FireResuce48]

I keep hearing responses citing "traffic control" or "barrier". Do you really honestly believe that your fire truck was designed to be a traffic barrier. Is that what your community spent over $100,000 on? Doubtful.................

Also, how many of you are trained in traffic control? I don't mean standing out in the street with a flashlight. I am referring to true knowledge in directing the flow of traffic, appropriate hand signals, flow patterns, etc.

The answer will probably be very few. It is not your job to handle traffic, thats why God invented law enforcement! Let them do their job, you do yours if it is even needed on that scene. God help any agency that gets an unknowledgable FF run over, or worse yet, cause another wreck because they don't know what they are doing. Stick with what you know.....

Do you not position your apparatus for maximum barrier protection?
And police aren't always available. Especially if you are running out of a place that tends to see allot of crime. There just might be other stuff going on. Also the extra set of lights at night really helps light up the scene.

I also don't see why allot of people are so against fire medics or even firefighters in the basic rolls. I personally know so excellent fire medics that are running in Maryland that you could rely on for excellent patient care and could count on while on the fire ground.

 

[marineman]

I have no problem with firefighters being on scene as long as they move aside when we get there so we can get to work. As for which should be paged first, my thought is because the ambulance has a longer travel time and will in the end to the patient the most good dispatch the ambulance first. All of ours are dual page anyway so we don't have that issue.

I'm not a medic yet but I don't really like the thought of ALS fire services if they're not transporting. If the ALS fire service gets on scene prior to the medics as we've seen in Florida especially if they're not working on an ambulance with major patient contacts their skills probably aren't that sharp. The potential negatives of ALS fire treatment by far outweigh the minor benefit.

Also at least locally we are supposed to get 2 sets of vitals before interventions to ensure an accurate baseline and prove trending. One can be a set taken by the first responders but the second must be our own. If a fire fighter comes in and starts a bunch of ALS procedures it makes that impossible to get and could inhibit quality patient care down the road.

 

[FFMedic1911]

I have no problem with firefighters being on scene as long as they move aside when we get there so we can get to work. As for which should be paged first, my thought is because the ambulance has a longer travel time and will in the end to the patient the most good dispatch the ambulance first. All of ours are dual page anyway so we don't have that issue.

I'm not a medic yet but I don't really like the thought of ALS fire services if they're not transporting. If the ALS fire service gets on scene prior to the medics as we've seen in Florida especially if they're not working on an ambulance with major patient contacts their skills probably aren't that sharp. The potential negatives of ALS fire treatment by far outweigh the minor benefit.

Also at least locally we are supposed to get 2 sets of vitals before interventions to ensure an accurate baseline and prove trending. One can be a set taken by the first responders but the second must be our own. If a fire fighter comes in and starts a bunch of ALS procedures it makes that impossible to get and could inhibit quality patient care down the road.[/QUOTE]
This is news to me.If this is true i make a vote we stop this silly practice and go back to the days of being ambulance drivers.Wow i knew this als stuff was the devil.