# SC EMS/Fire Rivalry Makes News



## JCampbell (Sep 29, 2009)

http://www.wistv.com/Global/story.asp?S=11213468
COLUMBIA, SC (WIS) - A 3-year-old's death has the City of Columbia and Richland County making bold statements.

Richland County Coroner Gary Watts says Jaden Myers-Pugh died Sept. 17 of swine flu complicated by sickle cell anemia.

The chaplain for the fire department, Michael Bingham, says firefighters were not able to help drive the ambulance Myers-Pugh was in because of a Richland County Emergency Medical Services policy.

The fire department responded Monday afternoon.

"Public statements made by a few individuals who are associated with our department regarding this incident do not reflect the official views of the Columbia Fire Department or the City of Columbia," said Columbia Fire Department Chief Bradley Anderson. "We do not condone these statements."

Anderson says the fire department is conducting an investigation into the incident.

Myers-Pugh's death has re-ignited debate over a WIS News 10 investigation that started in 2007.

It's about an EMS policy that says when an ambulance responds and both medics are working on a patient, they have to wait for a back-up ambulance driver to take them to the hospital even if a firefighter is already on scene.

Bingham says he was watching when we questioned the policy back in 2007.

"I confess it dropped off my radar screen and I know it dropped off the public's," said Bingham.

When Myers-Pugh died, he said it all came back to him. He says firefighters were so traumatized by what happened, he was called in for counseling.

"I don't think guilt was the feeling at the scene, more anger," said Bingham.

Anger he says that even if paramedics are tied up, they can't help drive.

The county, who oversees EMS says its their policy, nut they are not the ones who have the power to change it.

Stephany Snowden with the county says they have not been approached by city officials to make that change.

"Richland County does not manage the fire department, therefore we do not dictate to city personnel," said Snowden.

The chaplain goes further, saying relationship between the fire department and EMS is like a sibling rivalry.

"Their relationship is maybe dysfunctional," said Bingham. "They don't talk to each other."

Snowden defends EMS and denies any sort of rivalry.

"The county has a tremendous respect for the fire department and I don't believe that would be accurate to say that there is a rival or that we're unwilling or uncooperative to work together," said Snowden.

Bingham says he knows he's risking it all by bringing up the subject.

"You can see people's lives are shattered," said Bingham. "It tears at your soul."

Eighteen months later, the county says its all just a matter of asking.

"I'm quite certain if the city administrator contacted the county administrator about this issue, I know are folks are on board," said Snowden.

Chief Anderson says he'll be reviewing the statements Bingham has released. 

As for Jaden Myers-Pugh's family, their lawyer did not answer the question if a lawsuit would be forthcoming, but said they are looking at their options.


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## JCampbell (Sep 29, 2009)

*Part two*

Columbia City Council to reexamine controversial EMS policy
Posted: Sep 28, 2009 5:40 PM Updated: Sep 29, 2009 10:48 AM


By Susan-Elizabeth Littlefield - bio | email

COLUMBIA, SC (WIS) - The Columbia City Council will discuss a controversial Richland County EMS policy that delayed emergency workers from taking a 3-year-old to the hospital.

Richland County Coroner Gary Watts says Jaden Myers-Pugh died Sept. 17 of swine flu complicated by sickle cell anemia.

The chaplain for the fire department, Michael Bingham, says firefighters were not able to help drive the ambulance Myers-Pugh was in because of a Richland County Emergency Medical Services policy.

"I know staff and myself have told [Richland County] the policy does not make sense, but we have not voted as a city council for them to change the policy," Mayor Bob Coble said.

The county oversees EMS and says its their policy, but says they don't have the power to change it. Richland County spokesperson Stephany Snowden said the county has not been approached by city officials to make that change.

"Richland County does not manage the fire department, therefore we do not dictate to city personnel," said Snowden.

"I did not know they wanted that -- it is their policy, of course," responded Coble.

Columbia Fire Department Chief Bradley Anderson says the fire department is conducting an investigation into the incident.

Myers-Pugh's death has re-ignited a debate over a WIS News 10 investigation that started in 2007.

It's about an EMS policy that says when an ambulance responds and both medics are working on a patient, they have to wait for a back-up ambulance driver to take them to the hospital, even if a firefighter is already on scene.

Bingham says he was watching when we questioned the policy back in 2007.

"I confess it dropped off my radar screen and I know it dropped off the public's," said Bingham.

When Myers-Pugh died, he said it all came back to him. He says firefighters were so traumatized by what happened, he was called in for counseling.

"I don't think guilt was the feeling at the scene, more anger," said Bingham.

It's anger, he says, that even if paramedics are tied up, they can't help drive.

The chaplain goes further, saying relationship between the fire department and EMS is like a sibling rivalry.

"Their relationship is maybe dysfunctional," said Bingham. "They don't talk to each other."

"Public statements made by a few individuals who are associated with our department regarding this incident do not reflect the official views of the Columbia Fire Department or the City of Columbia," said Chief Anderson. "We do not condone these statements."

Snowden defends EMS and denies any sort of rivalry.

"The county has a tremendous respect for the fire department and I don't believe that would be accurate to say that there is a rival or that we're unwilling or uncooperative to work together," said Snowden.

Bingham says he knows he's risking it all by bringing up the subject.

"You can see people's lives are shattered," said Bingham. "It tears at your soul."

Eighteen months later, the county says its all just a matter of asking.

"I'm quite certain if the city administrator contacted the county administrator about this issue, I know their folks are on board," said Snowden.

Chief Anderson says he'll be reviewing the statements Bingham has released. 

As for Jaden Myers-Pugh's family, their lawyer did not answer the question if a lawsuit would be forthcoming, but said they are looking at their options.


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## Lifeguards For Life (Sep 29, 2009)

seems to be one benefit of integrated fire/ems. in my area the majority of the ambulances are operated by fire. i like the setup


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## Hal9000 (Sep 30, 2009)

That's interesting.  I have now added a third area to my belt.  The first area has fire and EMS, with EMS completely separate, and three-man crews paid for, which makes a world of difference.  Fire provides suppression and technical skills but is not paged out at all for EMS.  They regularly train with us but want to focus on fire and only want to remain assisting with patient care when called.  The system is the best of those I work(ed) for. EMS +1 and fire +1!

Another system did dual pages.  Unfortunately, it was a very poor example of fire/EMS with separate systems providing multiple responders, and with fire being first on scene only about 50% of the time, meaning that the fire medics could not even remain physically proficient in such skills as IVs (And it was never good to see the multiple botched IVs on patients such as diabetics w/associated difficulties.), as they were generally only there to...do whatever it was they were doing while we loaded the patient and transported.  The EMS was stingy and only provided two man crews, meaning that aid was often needed. This often made fire necessary, as the EMS was always being stretched thin.  EMS -1! 

I am not in a place with integrated fire/EMS.  It shames me to say that they have very few medics and need many more, but get by with telling the public that the EMT-Is are "Paramedics 24/7 to serve and protect."  While all the fire trucks are brand new, many of the ambulances are old, which is not bad in itself, but does show where the priorities lie.  Fire -1!    

So many systems can have faults.  I enjoy a system where fire works hard on technical rescue, is able to assist EMS, and where EMS is knowledgeable and proficient in all areas medical, as well as cross-training with fire on such items as extrication and technical rescue.  I do not enjoy wasted resources, and I do not enjoy when I see "Fire/Rescue" ambulances (I suppose I'd like it to say something about medicine somewhere.), and I really dislike it when Intermediates are referred to as Paramedics.

In relation to the article, I would say that the best interests of the patients should be kept in mind, and it seems such is not happening.  The favorite system, which I mentioned before, would make use of a fire driver if it were needed, although the need was minimal due to having three EMS paid per ambulance.


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## TheMowingMonk (Sep 30, 2009)

Even though I work Private EMS, I do personally think that EMS should be Fire Intergrated, All the systems I have seen were Transport EMS is intergrated with the Fire Department or at least with the county make so much more sense, I mean there still is a rivalry between the EMS and Firefighters (some big cities to the north of me in particular) but it doesnt seem nearly as bad as some of the conflicts ive seen between Private Transport EMS and Fire. So far the best ive seen if intergrated Fire and EMS where the transport units are run by firefighters. No Rivarly and Easier transport decisions


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## reaper (Sep 30, 2009)

This is nothing more then Fire using nothing, for their gain.

If you seen the original article on this incident, you would see the truth. When EMS arrived on scene, the medics took the child from the house to the unit. FD stated that they did not leave the scene for another 4 minutes! Where is the problem here?

In that time they were getting the pt on the monitor, iv access,and airway. I highly doubt that 4 minutes made the difference in whether this child survived. This was just Fire freaking out on scene!

In our dept., we do allow FD to drive us in, if needed. This rarely happens. One because we will have a second unit or supervisor close, or two, because FD will not drive for us. We have 27 different FD's in one county and it is up to there Chiefs, if they can drive. Some will help when needed. Some will not down an engine, for a lowly EMS call!

If this was a major delay on scene, then I could see a problem. This is nothing more then Fire using a tragic event, to try and make EMS look bad in public eye.


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## 46Young (Oct 1, 2009)

You're freakin kidding me, right? The onus in 100% on the third service single role EMS agency here. It's their policy, not fire's. Maybe the four minutes (so you say) of delay may or may not have made any difference in this pt's case, but then again it very well may have. 

Check the other links to the story under the main article. What's more important is that their (Richland EMS') policy doesn't even allow FF's to assist in pt care inside the ambulance, either. So, there's a double whammy of delaying txp to the hospital and not allowing FF's to help with pt care (BLS, so the medics can more rapidly initiate ALS, or maybe do CPR enroute to the hosp). The FF's definitely have a plausible argument. Try again, slappy.


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## reaper (Oct 1, 2009)

46Young said:


> You're freakin kidding me, right? The onus in 100% on the third service single role EMS agency here. It's their policy, not fire's. Maybe the four minutes (so you say) of delay may or may not have made any difference in this pt's case, but then again it very well may have.
> 
> Check the other links to the story under the main article. What's more important is that their (Richland EMS') policy doesn't even allow FF's to assist in pt care inside the ambulance, either. So, there's a double whammy of delaying txp to the hospital and not allowing FF's to help with pt care (BLS, so the medics can more rapidly initiate ALS, or maybe do CPR enroute to the hosp). The FF's definitely have a plausible argument. Try again, slappy.



That's a good policy. If the FD wants to help more, why are they not getting medical training? First Responder does not cut it. We do not allow any FF in the back of our units, unless they have atleast EMT. We have several FD's that are FR only and they do not help in the unit.

What gives the FD any right to think they have the right to drive an ambulance? Most FF's are not trained in driving. I only let FF's drive, that also work pt for us. I know they can handle it. There have been numerous times over the years, where I have been trashed in the back of an ambulance, from a FF driving crazy. No Thanks!

It may also be a policy, due to insurance regulations. Just like some cannot hire below 25 years of age. They may only allow employees to drive their units. That is our policy, due to insurance. The only FF's that can drive us, are ones that are also employed by EMS.

So maybe the FD can stop whining and go back to school for an education. Then they would have an argument for their side. Our larger FD's are all FR's only. They do not want to have any more training. Funny thing is all the vollie services are minimum of EMT, with a lot of medics. They care and they ask for the help in getting their people educated.

So, before you jump to defending all FF's no matter what, you may want to look at why policies are in effect, in the first place.

You can take your "Slappy" comment and stick it back in your pocket. When you get around to learning from experience, come on back.


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## exodus (Oct 1, 2009)

Do I live in the only city where upgrades are based on needs? If our engine is constantly screwing up, or 'needs' to be upgrade it is. If the box is the one that needs to be, it is upgraded then!


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## 46Young (Oct 1, 2009)

Silly me, I thought that first responders could do CPR, take vitals, perform spinal motion restriction, splint, bandage, admin O2 via NRB, NC or BVM. Call me crazy, but some of that may come in handy with a critical pt, so the medics are free to do ALS in a more rapid fashion.

If you feel that it's not doing the pt a disservice by delaying onscene times by slowing down interventions and waiting for another bus (who knows for how long?), then I don't know what to tell you.

I've never said that the fire service is perfect, and that I defend them at all costs. What I have said is that whenever a dept has an issue, typically in CA or FL BTW, the fire based EMS lynch mob comes out and puts a spin on the story as if the entire service is like that. It certainly isn't. 

What do you mean by learning from experience? Where are you going with that?


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## cruzJD (Oct 1, 2009)

There are a few FF that we run with that are able to drive for us and there are a few FF that are able to help in the back of the rig.  We have a mixed fire / EMS with paid and volunteer.

Our protocol calls for 2 EMT or higher for a bus to run.  Both of the drivers I get during my week are the second EMT.  Friday and Saturday I normally end up one a volunteer (ride along with) EMT to make it a 3 man unit.

They dispatch a “fire support vehicle” or a second EMS unit with most ALS calls unless it’s a 3 man unit.  I have problems from time to time with our ride along not being a lot of help when I need to depend on them because they don’t see it often.


I volunteer one day a week on my day off with the fire department.  Most of the drivers fight to get me on there truck.


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## dragonjbynight (Oct 2, 2009)

Lifeguards For Life said:


> seems to be one benefit of integrated fire/ems. in my area the majority of the ambulances are operated by fire. i like the setup




I agree, our service is integrated, Its a very small town with only one rig, however, we also have a county ambulance service who oversteps there bounds on occasion, which leads to some of that rivalry. Otherwise, we are paged out just like a fire for all ambulance runs.


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