# This abomination



## CFal (Oct 22, 2012)

"Ambulance, Rescue Truck & Fire Apparatus in One"

http://www.braunambulances.com/Models/Patriot.aspx












Seriously? What even is this?


----------



## Martyn (Oct 22, 2012)

I know...came across this on JEMS the other day, read the comments (you'll see what I think of it!!!)

http://www.jems.com/article/vehicle-ops/pumper-ambulance-model-improves-patient


----------



## DrParasite (Oct 22, 2012)

if the Fire Department can do ems, than EMS can do fire suppression.  All you need is someone thinking out of the box.

Why do you consider this an abomination?  because it has never been done before?  or because there is actually a problem with this concept?


----------



## CFal (Oct 22, 2012)

DrParasite said:


> if the Fire Department can do ems, than EMS can do fire suppression.  All you need is someone thinking out of the box.
> 
> Why do you consider this an abomination?  because it has never been done before?  or because there is actually a problem with this concept?



what happens when you need to transport and the fire isn't out yet?  what happens when the truck is transporting a patient and a fire breaks out?


----------



## JPINFV (Oct 22, 2012)

DrParasite said:


> if the Fire Department can do ems, than EMS can do fire suppression.  All you need is someone thinking out of the box.
> 
> Why do you consider this an abomination?  because it has never been done before?  or because there is actually a problem with this concept?




Hey, any fire fighters want to describe the issues with the quints as a combo truck/engine company?


----------



## Akulahawk (Oct 22, 2012)

Considering how some services have done some transport Engines... this version looks like some actual thought has been put into the end result. Sure, it looks odd, but it's far better than some transport engines I've seen.


----------



## Veneficus (Oct 22, 2012)

JPINFV said:


> Hey, any fire fighters want to describe the issues with the quints as a combo truck/engine company?



I'll bite.

The problem with the multipurpose units is that they are just large trucks full of stuff.

At a working structure fire, in order to effect a save (of people or property), you need multiple things happening simultaneously.

However, most departments simply do not have enough manpower in the initial response to be anything more than basement savers. Especially in more modern light weight construction. 

It is these "combo" units that make the case for regionalization of fire.

Simply put, most places don't need a 2000gpm pump, 1000 gallons of water, and a 120 foot basket.

Many small departments don't show up with enough people on scene initially to even do a search, interior attack, or well planned ventilation. 

I can say from experience if you are doing a search with a charged line either the fire isn't that bad or you are just looking for bodies. 

Anyway as for the piece of junk shown above. That is a cash cow for the manufacturer. 

Now instead of a one time cost for an engine that just sits around, a much less expensive rescue, and an ambulance, the city can now drive around wear and tear these beasts while paying extra for fuel. 

Also consider the redundancy for maintenence. 

Instead of 1 engine, 1 rescue, and 2 ambulances, you now have 2 of these things. (with all the associated costs) 

If small scale suppresion is what you want to do, a minipumper would be a much better investment. 

As well, if all your rescue gear is on this thing, you don't need a dual axel Heavy rescue truck either.

Not to be a kill joy, but I would advocate a regional fire authority actually capable of fighting fire ad heavy rescue instead of one of these on every block.

I hope somebody got a kickback.


----------



## JPINFV (Oct 22, 2012)

Haha... you're pretty much along the same line of thought I am of. In regards to quints, my understanding is that it seems most companies either get a barely suitable truck with a completely inappropriate engine (not enough hose, not a large enough booster tank, not a large enough pump) or a barely suitable engine with a completely inappropriate truck (not enough storage room for ladders and tools).

Similarly, from what I've seen it looks like the pump is barely suitable for a car fire, there's virtually no supply line, and the booster tank is an almost laughable 300 gallons. I don't even want to know what that thing rides like in the back.


----------



## usalsfyre (Oct 22, 2012)

That thing has "I was drunk at I Chiefs" written all over it...


----------



## Martyn (Oct 22, 2012)

DrParasite said:


> if the Fire Department can do ems, than EMS can do fire suppression. All you need is someone thinking out of the box.
> 
> Why do you consider this an abomination? because it has never been done before? or because there is actually a problem with this concept?


 
BECAUSE I AM AN EMT *NOT* A FIREFIGHTER!!!

I have NO desire to be a firefighter at all. If I am having a heart attack and call 911, I want an ambulance. If my house is on fire and call 911 I want a fire truck. Are EMT's/paramedics gonna be doing law enforcement soon as well? This just about sums up the USA for me, everyone meddling in everyone else's business and going round in circles achieving nothing.



As an aside, look at these figures:

http://polkfire.polkfl.com/Information/StatisticalInformation/tabid/90/Default.aspx

as you can see fire have very few call outs to a real fire. EMS on the other hand...
All it proves to me is that fire needs all those extra call outs to justify their BIG expense. Someone please explain why a fire truck AND an ambulance both at the SAME station BOTH go to the same incident when there is NO fire? Sure, bariatric patient? Call for help when on scene. Who pays for all these wasted resources? The patient with inflated insurance costs to cover this stupidity. And in Polk county there are enough ambulance stations to cover everywhere, by the way.


----------



## TB 3541 (Oct 22, 2012)

Martyn said:


> BECAUSE I AM AN EMT *NOT* A FIREFIGHTER!!!
> 
> I have NO desire to be a firefighter at all. If I am having a heart attack and call 911, I want an ambulance. If my house is on fire and call 911 I want a fire truck. Are EMT's/paramedics gonna be doing law enforcement soon as well? This just about sums up the USA for me, everyone meddling in everyone else's business and going round in circles achieving nothing.
> 
> ...



While the fire department is very expensive to maintain, do you really want to cut back on their equipment? If you match the fire department's budget to their fire responses, you will end up with under-trained, under-equipped firefighters responding to fires. It would be like an ambulance service saying, "We only get 5 calls per year out of this particular post, so we're going to give the medics posted there a golf cart to respond with." That may be an exaggeration, but it paints the picture.

I think that this "abomination" is actually pretty cool, in concept (unsure how it would work in the real world). That thing looks massive in the patient compartment.


----------



## DrParasite (Oct 22, 2012)

Martyn said:


> BECAUSE I AM AN EMT *NOT* A FIREFIGHTER!!!
> 
> I have NO desire to be a firefighter at all. If I am having a heart attack and call 911, I want an ambulance. If my house is on fire and call 911 I want a fire truck. Are EMT's/paramedics gonna be doing law enforcement soon as well? This just about sums up the USA for me, everyone meddling in everyone else's business and going round in circles achieving nothing.


Dude, calm down, have an off duty beer (if you are of legal age), you are stressing this waaaaaaaaaay too much.

I do agree with you, when I'm having a heart attack, I want an ambulance, not a fire truck.  I have (pretty consistently) said that EMS should handle EMS, and the has no business being in EMS.

I do know of one small career department that has 2 FFs staff an ambulance.  If an EMS call goes in, they take the ambulance.  if a fire comes in, they get off the ambulance and take an engine.  If they are at the ER dropping off a patient, and a fire comes in, they take the ambulance to the fire.  Something like this might work for them.

You are not a FF, and don't want to be; that's cool.  I used to work for an EMS agency that had a pretty big rescue.  There was a volunteer FD, which may or may not get out on a daytime MVA.  Maybe this would allow them to have proper suppression while their rescue staff (the backup paid crew) extricated?

If they were fire certified (and many of us were), if the ambulance was first due at a house fire, they might even be able to stray some water, instead of standing around asking the FD to expedite.

oh, and on the topic of quints, look at what St. Louis Fire Dept did about 10 years ago; they went to an all quint department.  might have changed in recent years, but they did it and the city didn't burn down any more that it had been before.

btw, the argument against quints is a valid one; if you need 4 guys to do engine work, and 4 guys to do truck work, you can't replace both units with 6 guys on a quint.  But, and speaking from recent personal experience here, pulling up to a working structure fire on the truck with no engine in sight sucks.... even sucks more when the propane tank explodes from the inside 20 feet in front of you.  being able to pull the line and start putting out the fire before it spreads to the adjoining garage with hose off the truck is a much better option.

Again, just thinking outside the traditional box here, no need to blow a gasket..


----------



## Tigger (Oct 22, 2012)

CFal said:


> Seriously? What even is this?



A look at the future in some places. This will sound kind of funny given my posts in another thread, but given the right area this doesn't seem like all that bad of an idea. This sort of vehicle can adequatley handle 90% of a suburban district's calls.

The majority of calls are medical. Sometimes the vast majority. This has got it covered. Then you have car/dumpster/outside fires. One CAFS line (30 gallons foam+300 gallons water=crap ton of CAFS) is enough to deal with this. MVAs, odors, investigations, and alarms, no reason why this unit can't handle it. Even a room and contents fire could receive a good knock with the CAFS line. If it's a confirmed structure fire you're going to have more apparatus coming anyway.

Obviously you couldn't make every FD truck one of these, but in more outlying areas it's not the worst idea I've ever seen. Probably wouldn't go over real well in New England, but suburban Florida? Hopefully they're staffing it with more than two though, otherwise that could be an issue.


----------



## leoemt (Oct 22, 2012)

I like it. 

As a primary unit it wouldn't be practical. However, it would be useful for use on crowded freeways or maybe for a private industrial safety team.


----------



## emscrazy1 (Oct 23, 2012)

Martin, why the hate towards Fire? You live in a fire based ems community and worked in one as well. You see that the majority of calls are handled by medics who care about ems just as much as fire. It works around here. Works fairly well too.


----------



## Bullets (Oct 23, 2012)

Chill, and look up Public Safety Officer. There are a few places where extreme is cross trained and you do rotations. One month your in a cop car, next your in an ambulance, next your in an engine 

I like that thing, btw


----------



## lightsandsirens5 (Oct 23, 2012)

I notice an extreme hatred towards fire in the EMS community. Why? Of course we all know of those departments that get in the way more than anything, but seriously people, is the fire service of no benefit to EMS? 

Why is a paramedic off of a fire engine any different than a paramedic off of an ambulance? Same education, same (often better) equipment. And quite frankly, more hands are amazing! 

Look what happens in systems where there isn't fire EMS. We roll up top the ER, one medic on the back with our GSW patient. And inside we are met by a team of 15 people. What on earth is wrong with having a two man ambulance crew and a three man engine crew on scene? I sure as heck don't want to handle a good portion of the calls I get alone! 

I see nothing to loose and everything to gain by having an engine with two our three medics accompany my ambulance on most calls. 

When I have a heart attack, I don't want an ambulance! I want whatever vehicle had the closest paramedic and his or her equipment. I don't care if it's an ambulance, a fire engine, a cop car, or a freaking geo metro.

I may be branded as a heretic, but I think it is high time EMS stopped hating fire and fire stopped hating EMS and started working together for the good of the community.

Now, this vehicle is cool in concept. Personally, I think it is a waste of money, it probably cost half a million plus. But maybe the situation dictates it. I've seen heavy rescues that can transport in case the ambulance is delayed, and it's kind of a neat concept. I don't know if it's totally called for, but they laughed at the Wright brothers too.


----------



## Veneficus (Oct 23, 2012)

lightsandsirens5 said:


> I notice an extreme hatred towards fire in the EMS community. Why? Of course we all know of those departments that get in the way more than anything, but seriously people, is the fire service of no benefit to EMS?.



As I have said, fire can be beneficial to EMS. However, most of the time it isn't. I think largely the reason is generational. 

Even in mixed service departments most of the guys with 3 or more bugles are old school suppresion minded people. They are doing what they know to the best of their ability. The trouble is, what they know doesn't really matter anymore. The world has changed.

Undoubtably there are progressive departments that are more EMS minded. So far though they are the minority, and I suspect will be for the forseeable future. After all, you impress your boss by being what he wants, not by showing him how little he knows. 

Because of the paramilitary nature and seniority systems in how fire is run, it is a very difficult prospect to change direction. 

However, we must concede that fire has probably led the campaign to hold back EMS providers, not for the benefit of the patient or public, but for their own greed and inability.

It is what it is.



lightsandsirens5 said:


> Why is a paramedic off of a fire engine any different than a paramedic off of an ambulance? Same education, same (often better) equipment. And quite frankly, more hands are amazing!



Ideally it shouldn't be. But both attitude and skill come into play. Most engine or truck based medics I know spend very little time with a patient. As they do not transport usually, they do not see what happens next at the hospital. Consequently they do what best benefits their role and not set the patient up for success at the next step, it basically creates not only another detrimental handoff (all handoffs are detrimental, even in hospital) but it can even inhibit this continuum of care. There is also the issue of overtreatment. 



lightsandsirens5 said:


> Look what happens in systems where there isn't fire EMS. We roll up top the ER, one medic on the back with our GSW patient. And inside we are met by a team of 15 people. What on earth is wrong with having a two man ambulance crew and a three man engine crew on scene? I sure as heck don't want to handle a good portion of the calls I get alone!



No offense, but what does a medic really do for a GSW victim? 

I don't buy the more hands theory is better really.

A single highly skilled, knowledgable, and experienced provider can be worth 10 or more who are not.



lightsandsirens5 said:


> I see nothing to loose and everything to gain by having an engine with two our three medics accompany my ambulance on most calls.



I see skill dilution, overtreatment, and lack of continuity of care. 



lightsandsirens5 said:


> When I have a heart attack, I don't want an ambulance! I want whatever vehicle had the closest paramedic and his or her equipment. I don't care if it's an ambulance, a fire engine, a cop car, or a freaking geo metro.



Again no offense, but I want the guy who will drive me to the PCI lab. I don't care if it is a neighbor. I can do the ASA myself, the diagnostic NO and 12 lead in the field are really just gravy.



lightsandsirens5 said:


> I may be branded as a heretic, but I think it is high time EMS stopped hating fire and fire stopped hating EMS and started working together for the good of the community.



Sounds great. Except they are both fighting for the same piece of pie.



lightsandsirens5 said:


> Now, this vehicle is cool in concept. Personally, I think it is a waste of money, it probably cost half a million plus. But maybe the situation dictates it. I've seen heavy rescues that can transport in case the ambulance is delayed, and it's kind of a neat concept. I don't know if it's totally called for, but they laughed at the Wright brothers too.



If your heavy rescue can transport, what is the point of waiting for an ambulance? That is like BLS waiting onscene with a gunshot victim for ALS.


----------



## DrParasite (Oct 23, 2012)

lightsandsirens5 said:


> Why is a paramedic off of a fire engine any different than a paramedic off of an ambulance? Same education, same (often better) equipment.


oh hell no.  you can't say that, and honestly believe it.  

I don't deal with fire paramedics, but I do deal with fire EMTs.... and any fire EMT who says they do EMS gets laughed at by me.  You pull up on the engine, do a couple interventions (ie, throwing a patient on a NRB and telling the ambulance to hurry up), maybe write down some info, and then turf the patient to the transporting EMT or paramedic isn't doing EMS; that's a first responder.  Don't get me wrong, it's fun to do, but it's not EMS.

Now if that firefighter paramedic is treating the patient all the way to the ER, on a routine basis, dealing with both sick and not sick patients, than I will be more inclined to say they do EMS.  Remember, education is important, but experience (and having lots of patient contacts, both sick and not sick) is even more so. 


lightsandsirens5 said:


> Look what happens in systems where there isn't fire EMS. We roll up top the ER, one medic on the back with our GSW patient. And inside we are met by a team of 15 people. What on earth is wrong with having a two man ambulance crew and a three man engine crew on scene? I sure as heck don't want to handle a good portion of the calls I get alone!


so assign a 3rd EMT to the ambulance, so you can have a 2nd person in the back for those sick patients.  not a firefighter who doesn't do EMS, an EMT or paramedic who is experienced and has treated lots of patients from contact to drop off in the ER. 

most places consider the FD to be lifting power, or CPR compressions, or a bureaucratic stop the clock.  But if it's a choice between an experienced ambulance working trained in EMS, or a firefighter on an engine who does EMS once in a while, I will take the ambulance jockey any day.  Nothing against those who do actually spend time regular time on an ambulance, those guys are different than the FFs with an EMT patch.


lightsandsirens5 said:


> I see nothing to loose and everything to gain by having an engine with two our three medics accompany my ambulance on most calls.


well, except it puts the engine either OOS or short until they get the rest of their crew back.  and then you are OOS until you drop them off.  and what happens if that engine's first due get a working for w/ entrapment?  now the water is delayed until they get back in their area.


lightsandsirens5 said:


> When I have a heart attack, I don't want an ambulance! I want whatever vehicle had the closest paramedic and his or her equipment. I don't care if it's an ambulance, a fire engine, a cop car, or a freaking geo metro.


odd.... just like in a trauma, you need definitive care, which can be a CATH lab or a cardiologist to determine if you need a CABG or some other surgical intervention, or if the doc wants to treat it medically (which you can probably do as well in the field).  remember, time is muscle, and you need proper transport to the ER to definitively mitigate the problem.


----------



## DrParasite (Oct 24, 2012)

Is this one better?http://www.firefighternation.com/slideshow/fit-job





Talk about an all hazards vehicle... if you put a tower on it, it can top a quint for most versatile fire apparatus!


----------



## bigbaldguy (Oct 24, 2012)

KILL IT KILL IT WITH FIRE! 

No wait those hose monkeys will just put it out :/

Well played firefighters well played indeed.


----------



## bigbaldguy (Oct 24, 2012)

Sorry it was either thumbnail or enormous pic. I can't edit on iPad.


----------



## Tigger (Oct 24, 2012)

DrParasite said:


> Talk about an all hazards vehicle... if you put a tower on it, it can top a quint for most versatile fire apparatus!



And it's ran by deputies!

Actually I don't think the sheriff's office in Broward actually staffs fire apparatus with deputies but the FD does fall under them.


----------



## Trashtruck (Oct 25, 2012)

usalsfyre said:


> That thing has "I was drunk at I Chiefs" written all over it...



This made me laugh out loud! 
Oh man...revolutionizing Fire/EMS, overnight, on a bar napkin. Brilliant!


----------



## Ruamkatanyu (Oct 25, 2012)

Wonder if The NYPD ESU is thinking about getting one of these.


----------

