# Which should EMS be merged with



## fortsmithman (Mar 15, 2009)

Should EMS be merged with a law enforcement agency or fire dept.   Personally I'd be more comfortable with being affiliated with a law enforcement agency because on a lot of of the calls i've been on we work with law enforcement.  I've only been on a call with fire once.  As well my agency is headed by my towns community constable.


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## TransportJockey (Mar 15, 2009)

This is one thing that I think should not happen in either direction. I truly believe that EMS needs to be a standalone agency, separate from PD or FD.


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## emtfarva (Mar 15, 2009)

neither, rather have it as a third service.


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## fortsmithman (Mar 15, 2009)

jtpaintball70 said:


> This is one thing that I think should not happen in either direction. I truly believe that EMS needs to be a standalone agency, separate from PD or FD.


I agree but which would your choice be if it were forced on you.  The only reason the community constable is in charge is that no one wanted the job it was forced on him.


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## emtfarva (Mar 15, 2009)

it would be fire.


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## Sasha (Mar 15, 2009)

Here, most of EMS is merged with fire service already.


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## PapaBear434 (Mar 15, 2009)

I would LOVE for EMS to be a third service, but unfortunately it isn't likely to happen with money situations being the way it is.  Twenty years ago, firefighters had a lot more to do than endlessly drill.  There were actual fires.  Now, thanks to new fire retardant building materials, fire codes, sprinkler systems and government mandated fire extinguishers every couple hundred feet, there aren't many big fires to deal with anymore.

From a purely financial standpoint, it makes sense to combine the Fire and EMS services.  Because while firefighters don't do their intended purposes all that much, you definitely want them around when a fire DOES happen.  You can't under-staff them.  In the mean time, they might as well be doing SOMETHING.  And with the baby boomers just getting older and older, EMS is going to be sucking up the budgets more and more.

Now, I think it would save more money in the long run to keep EMS a third service.  It HAS to cost less to send out a two man truck with one medic than sending out an entire engine with six or seven people for a lady with SOB.  But convincing the purse-keepers isn't going to be easy, as they pretty much deal in short term gains.  What can I do NOW to increase my numbers NOW to get reelected?


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## Bosco578 (Mar 15, 2009)

EMS should be merged with your local Taxi cab company(s). :birthday:


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## Sasha (Mar 15, 2009)

> It HAS to cost less to send out a two man truck with one medic than sending out an entire engine with six or seven people for a lady with SOB.



On a slightly unrelated note, while the six or seven people may be far too much for run of the mill calls, it's nice that when you get there and your SOB is critical you have six people to pull from into the back of the truck.

Perhaps I'm spoiled, doing all my rides with a fire service that tones out both the two to three man engine along with the 2 to 3 man rescue. I've never been short handed!


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## lightsandsirens5 (Mar 15, 2009)

Well, we already are part of the SO, so we're under LE.

Sasha, you guys staff engines with _six_ people?!? Or is that sarcasim? Most departments are lucky if their engine is staffed with 3!


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## Sasha (Mar 15, 2009)

Ah. I typed that wrong. It's nice to know there's an extra two people to pull into the back.

Sometimes, though, depending on what the call was dispatched as, you DO have six people!

We were dispatched for a "child seizing" once. We got two engines, two rescues, and a fire chief. Turned out to be a 19 year old who'se mom called for some muscle twitching in his sleep, but wow! It was a lot of people!


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## silver (Mar 16, 2009)

we should rejoin funeral homes, and then corner the market of death, as it is a recession proof business.


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## PapaBear434 (Mar 16, 2009)

Sasha said:


> Perhaps I'm spoiled, doing all my rides with a fire service that tones out both the two to three man engine along with the 2 to 3 man rescue. I've never been short handed!



Fire gets called out if they are closest.  It comes down to who will be there first.  If we beat them there, we'll usually call them off.


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## AJ Hidell (Mar 16, 2009)

Law enforcement, by far.  We actually have something other than sirens in common with law enforcement.  We have nothing in common with the fire service.  Success as a law enforcement officer takes strong critical thinking skills, an attention to details, powers of observation, a knowledge of the techniques and importance of good documentation skills, and an understanding of sociology and social order.  None of that is necessary to squirt water, and firemen are not hired for those qualities.  So, if you're talking about the qualities that those people bring to the table that would suit them to the practice of medicine, there is simply no comparison between the two.  All other factors being equal, I can turn an experienced cop into a much better medic than an experienced fireman, no doubt about it.

But yeah, EMS should not have anything to do with either service.  And for the reasons that PapaBear [incorrectly] laid out, if any merging is going to be done, the fire department should be merged with EMS, and not vice versa.  After all, we're the ones who are actually working for a living.


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## Sasha (Mar 16, 2009)

silver said:


> we should rejoin funeral homes, and then corner the market of death, as it is a recession proof business.



You may run into a conflict of interest there!


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## medic417 (Mar 16, 2009)

We should join the hospital.  We are medical.  We have nothing in common with fire or le.  Recall even the IAFF said something along the lines that multitasking leads to poor results.


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## lightsandsirens5 (Mar 16, 2009)

AJ Hidell said:


> Success as a law enforcement officer takes strong critical thinking skills, an attention to details, powers of observation, a knowledge of the techniques and importance of good documentation skills, and an understanding of sociology and social order.  None of that is necessary to squirt water.....



Really?!?!?!? Number one, the fire dept. does more that squirt water! :angry: Second, are you trying to say that it doesn’t take strong critical thinking skills to facilitate an urban SAR or work a multi-story building collapse? Or that you don't need attention to detail, powers of observation, and knowledge of the techniques involved to fight a structure fire?!? (Engine of big, fat, dumb clowns rolls up on scene, clowns jump out, run into burning house, roof collapses, kills all of them.) I'd venture to say that a structure fire (or any fire for that matter!) can be more volatile, dangerous, and unpredictable than an armed criminal! Documentation?!?! Don't even go there; maybe your starting firefighter doesn’t do as much paperwork as your starting cop, but anyone in fire with any rank does! And with computers that practically write reports for us now, it doesn’t take a nuclear engineer to write a PCR anymore.



AJ Hidell said:


> .......and firemen are not hired for those qualities.



Huh?!?!? They aren't. My answer is kind of implied above. Add to that that lots of departments are now requiring at least some kind of college education to get on. (At least if you don't want to be a probie your whole life.) That is more than EMS requires.



AJ Hidell said:


> All other factors being equal, I can turn an experienced cop into a much better medic than an experienced fireman, no doubt about it.



Care to explain how and why?




AJ Hidell said:


> And for the reasons that PapaBear [incorrectly] laid out, if any merging is going to be done, the fire department should be merged with EMS, and not vice versa.  After all, we're the ones who are actually working for a living.



So what exactly are all of the firefighters in the U.S. doing if they aren't working for a living? Are you saying it isn't a living, or are you saying that they aren't actually "working"?

All of what you have said is a jab in the eye of almost every single firefighter in this country.


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## Sasha (Mar 16, 2009)

> Second, are you trying to say that it doesn’t take strong critical thinking skills to facilitate an urban SAR or work a multi-story building collapse?



What he's trying to say is he doesn't like fire fighters, therefore he thinks they're dumb.


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## lightsandsirens5 (Mar 16, 2009)

Sasha said:


> What he's trying to say is he doesn't like fire fighters, therefore he thinks they're dumb.



Typical opinion of firefighters: Fat, dumb, and happy. (And tyrants trying to take over EMS.:wacko


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## medic417 (Mar 16, 2009)

lightsandsirens5 said:


> Typical opinion of firefighters: Fat, dumb, and happy. (And tyrants trying to take over EMS.:wacko



Honestly the water and sewer department should take over fire.  They are familiar with the calculations regarding water flow, pressure, etc.  Definitly more in line than having EMS take over fire.  EMS is medical and should be part of the medical system not fire or le.


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## fortsmithman (Mar 16, 2009)

lightsandsirens5 said:


> And tyrants trying to take over EMS.:wacko:


My towns FD was offered the ambulance service because it had no coordinator.  The fire chief said no we don't want ambulance.  So the town dumped the ambulnce service on the community constable's lap.   Now the constable is resonsile for ambulance,  animal control, parking enforcement, traffic enforcement, And enforcement of various municial bylaws.  This took place before i joined the service a year ago.


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## VentMedic (Mar 16, 2009)

lightsandsirens5,

You've attempted express your opinions in defense of Fire Fighters. Now, let's have the reasons why you have not advanced to the Paramedic level. It really isn't that much extra education but it does bring improved patient care with advanced assessment and treatments. Is fire fighting your first priority? Do you not have any interest in medicine beyond a first-aid level? The arguments presented in defense of fire fighters are exactly why fire fighting and medicine are two very different fields. 



lightsandsirens5 said:


> (*Engine of big, fat, dumb clowns rolls up on scene, clowns jump out, run into burning house, roof collapses, kills all of them.*)


 


lightsandsirens5 said:


> Typical opinion of firefighters:* Fat, dumb, and happy. (And tyrants trying to take over EMS.*:wacko


 


lightsandsirens5 said:


> All of what you have said is a jab in the eye of almost every single firefighter in this country.


 
Talk about a jab in the eye of FFs! Your words give a harsh description and truly offend. You have used this description of firefighters in two posts. Reading back I did not see anyone else use this description. I must question your opinions here since you use very negative words about fire fighters. Is this how you truly see fire fighters even though you are trying to defend them? 

Your arguments are contradictory and further illustrate why fire and EMS are very different. If you do not like EMS, stick to fire fighting and please don't advance to the Paramedic level. Try to do at least one job well and if you decide it is fire fighting, find a better way to present a pro FD argument rather than using more negativity.


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## AJ Hidell (Mar 16, 2009)

*lightsandsirens*, I was a professional firefighter for nearly seven years.  That's PROFESSIONAL, not a volunteer or a wannabe who paid his way through some academy hoping to be one some day.  I have a second bachelors degree with a minor in fire science.  You're not going tell me anything about the fire service that I don't know, so save your breath.

I have also actually worked in police based EMS.  I have taught students from both professions.  Have you?  Do you have any professional experience in either system, or in educating them, to qualify you to authoritatively comment on them?  Or are you just getting overly defensive over what was intended to be an intelligent conversation, based upon factual information, and not a emotional outburst based upon our delicate "feelings"?  

Fortsmithman intended an intelligent thread here.  You obviously have some opinions to offer on the subject, and are certainly as welcome as anyone to do so.  But when you go off half-cocked with this insulting and argumentative emotional rant like this, your points are completely lost in the rhetoric.


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## reaper (Mar 17, 2009)

Sanitaion Dept.!


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## lightsandsirens5 (Mar 17, 2009)

VentMedic said:


> lightsandsirens5,
> 
> You've attempted express your opinions in defense of Fire Fighters. *Now, let's have the reasons why you have not advanced to the Paramedic level.* It really isn't that much extra education but it does bring improved patient care with advanced assessment and treatments. Is fire fighting your first priority? Do you not have any interest in medicine beyond a first-aid level? The arguments presented in defense of fire fighters are exactly why fire fighting and medicine are two very different fields.



Well, my county dosent have paramedic protocols and will not support medics. I am going to advance as soon as I can afford it.





VentMedic said:


> Talk about a jab in the eye of FFs! Your words give a harsh description and truly offend. You have used this description of firefighters in two posts. Reading back I did not see anyone else use this description. I must question your opinions here since you use very negative words about fire fighters. Is this how you truly see fire fighters even though you are trying to defend them?
> 
> Your arguments are contradictory and further illustrate why fire and EMS are very different. If you do not like EMS, stick to fire fighting and please don't advance to the Paramedic level. Try to do at least one job well and if you decide it is fire fighting, find a better way to present a pro FD argument rather than using more negativity.



True, I'm sorry that I lost my mind and went balistic.:blush: I should not have used those descriptions, it was my opinion that that is the way many view firefighters, I may be wrong.

I do think that fire and EMS (at least advanced and transporting EMS) need to be seperate. Maybe something like EMS is a seperate agency and fire still provides basic first response would work. As for the FD transporting.....that is probably not a good idea. Yes EMS needs to be on it's own, but don't pull all EMS from the FD.


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## lightsandsirens5 (Mar 17, 2009)

AJ Hidell said:


> *lightsandsirens*, I was a professional firefighter for nearly seven years.  That's PROFESSIONAL, not a volunteer or a wannabe who paid his way through some academy hoping to be one some day.  I have a second bachelors degree with a minor in fire science.  You're not going tell me anything about the fire service that I don't know, so save your breath.
> 
> I have also actually worked in police based EMS.  I have taught students from both professions.  Have you?  Do you have any professional experience in either system, or in educating them, to qualify you to authoritatively comment on them?  Or are you just getting overly defensive over what was intended to be an intelligent conversation, based upon factual information, and not a emotional outburst based upon our delicate "feelings"?
> 
> Fortsmithman intended an intelligent thread here.  You obviously have some opinions to offer on the subject, and are certainly as welcome as anyone to do so.  But when you go off half-cocked with this insulting and argumentative emotional rant like this, your points are completely lost in the rhetoric.



Again, I'm sorry. See my previous post.


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## fortsmithman (Mar 17, 2009)

Here in Fort Smith we have a fire chief who knows that fire and EMS needs to be be separate.  Because he was offered the towns ambulance service and he refused to take it over.


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## CHITOWNMEDIC (Mar 17, 2009)

EMS should be a separate agency. Too many conflicts in the firehouse, not enough understanding of the job from the P.D. side.


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## zacdav89 (Mar 17, 2009)

I would have to say that if we had to merge with another public safety agency it would be in our best interest and our patients to join with the fire service. It could come down to a trust issue, if faced with a patient that was involved in some not so legal activities before requesting our help they might not be willing to call for an ambulance or disclose pertinent information for fear of going to jail or other legal consequences.


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## Ridryder911 (Mar 17, 2009)

Here's a unique thing. WE *ARE NOT *PUBLIC SAFETY NOR HAVE WE EVER BEEN! 

We are medical, just like the name says. Never had a safety course in EMS, never taught one either, never discussed in the curriculum. 

We have as much business in either one of those than attaching to a furniture store. 

R/r 911


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## zacdav89 (Mar 17, 2009)

That could be another debate topic, the agency I work for and those around in our area do safety talks with school children about bike safety, I think that we not just an expensive over sized taxi cab. I also feel that are lack of openness with the public has made us the red headed step child of the emergency service, were young, if we don’t want to end up fire or law enforcement based ems we need to get out there and let the public see us, let do some preventative care.


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## tydek07 (Mar 17, 2009)

EMS should not be merged with anything.

EMS is EMS
Fire is Fire
Law enforcement is Law enforcement


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## downunderwunda (Mar 18, 2009)

Why does EMS have to be merged with anyone?

There is this belief that EMS is the poor cousin, when infact, it is Fire that should be the poor cousin.Fire spend more time (Paid Services) doing everyone elses work than their own. 

Usually when organisations merge, there is some commonality, where is the commonality between ems, fire & law enforcment? There is none. The core business of fire, is fightin fires, where is thecorellation between that & EMS?

Law enforcment have their own issues, none of which are medical.

I fail to see why this is a relevant topic. The topic should be what stratergies can be put in place to ensure EMS is 
Funded properly
Educated properly
Run economically responsibly
Free from the threat of takeover from Fire as they try to justify their existance though their lack of work 
Paid staffin at professional levels with genuine career progression, not based of Fire

Lets push EMS as a proper career, not an add on to fire.


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## JPINFV (Mar 19, 2009)

Well, the fire departments should be merged with EMS. After all, there's a much greater need for paramedics, so we should insure that everyone is a medic first, and then use fire fighter as some minor rung on the advancement ladder.  

Paramedics: Because fire fighters need heroes too.


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## firecoins (Mar 20, 2009)

I believe we need to merge EMS with the Correctional department or Sanitational Department.  It just makes sense.


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## fortsmithman (Mar 20, 2009)

firecoins said:


> I believe we need to merge EMS with the Correctional department.



3 out of 15 of my services members are also corrections officers.
4 out of 15 members are coroners.


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## AZFF/EMT (Mar 20, 2009)

I believe the fire based ems system I work in works really well. 6 firefighter/emt/paramedics on every call at a minimum. MVA's get more depending on the severity. In my neck of the woods there is no debate over it. It is what we do and everyone I know loves it. Our engines have 2 basics and 2 medics and our rescues are 1 and 1. We do not fight a whole lot of fire but we run a lot of medical calls and MVA's. We are a total hazard system providing Fire, EMS, extrication and technical rescue. We train every shift on fire related topics and have to complete 60 hours of CE's not including our Refresher class.

It is not too much to do both. 

I do think the a fire department with ALS engine company's along with an EMS division may be a great way to go, but seperate private services seem to cause a lot of headache's. No oversight, no pride, no employee retention just a revolving door. With the EMS division set-up there is a place for the men and women who do not want to fight fire to also provide emergency services and work in public safety. Any problems at the station our due to weak leadership who allow it and bad apples who chose to be :censored::censored::censored::censored::censored::censored::censored:'s. 

I think Fire and EMS go hand in hand and EMS should be public safety. If you dial 911 the people who show up should be a public safety agency. 

I know in the phoenix metro area we have been doing the fire based ems thing for years and the hard times of adjusting are in the past and many places the change is new or is still going on and there are oldtimers on each side who do not want to accept the change and will do anything to cause problems.


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## JPINFV (Mar 20, 2009)

Then why not combine fire with police? That way we can have it be a three way with members trained as EMTs, fire suppression technicians, and officers.


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## TransportJockey (Mar 20, 2009)

AZFF/EMT said:


> I believe the fire based ems system I work in works really well. 6 firefighter/emt/paramedics on every call at a minimum. MVA's get more depending on the severity. In my neck of the woods there is no debate over it. It is what we do and everyone I know loves it. Our engines have 2 basics and 2 medics and our rescues are 1 and 1. We do not fight a whole lot of fire but we run a lot of medical calls and MVA's. We are a total hazard system providing Fire, EMS, extrication and technical rescue. We train every shift on fire related topics and have to complete 60 hours of CE's not including our Refresher class.
> 
> It is not too much to do both.
> 
> ...



Do you require every single person who just wants to run EMS to also be a FF? If so, that is my main problem. I'm sorry, but I want to be a medical proffesional, not a crosstrained JOAT. If EMS is to be stuck staying with fire, at least let the medics who want to try and be hired to not have to go through fire training if they are just going to work a rescue.


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## AJ Hidell (Mar 21, 2009)

AZFF/EMT said:


> In my neck of the woods there is no debate over it.


Lack of debate = lack of progress

That's why Arizona is one of the most backwards, unprogressive states in the US for EMS.  Not a single accredited paramedic school in the entire state.  Medic mills galore.  Restrictive, bare bones, cookbook protocols that constrain even the flight medics.  Nurses call your shots.  Yeah, a lack of debate has served you well.  Not.  But I guess if it's all you've ever known, it's no surprise that you don't know any better.


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## medic417 (Mar 21, 2009)

AZFF/EMT said:


> I believe the fire based ems system I work in works really well. 6 firefighter/emt/paramedics on every call at a minimum. MVA's get more depending on the severity. In my neck of the woods there is no debate over it. It is what we do and everyone I know loves it. Our engines have 2 basics and 2 medics and our rescues are 1 and 1. We do not fight a whole lot of fire but we run a lot of medical calls and MVA's. We are a total hazard system providing Fire, EMS, extrication and technical rescue. We train every shift on fire related topics and have to complete 60 hours of CE's not including our Refresher class.
> 
> It is not too much to do both.
> 
> ...



LOL @ 6 people responding to every call what a waste of tax payer funds.  

http://forums.firehouse.com/showthread.php?p=1037880

A letter from the IAFF in part says the following:

"The IAFF opposes the consolidation of fire and emergency services departments with local law enforcement agencies, including the move to so-called "public safety officers" who are cross-trained to perform both fire/EMS and law enforcement functions at the same time at an incident.

Implementing PSOs undermines effective fire suppression and emergency medical response by relying on personnel on scene to act in multiple roles -- roles that are often at odds with each other and which cannot be done simultaneously, such as securing a crime scene and treating a gunshot victim or attacking a fire. 

The roles, training and equipment for fire fighters/paramedics and police are vastly different and distinct and should remain separate. In addition, the consolidation concept breaks up the company unit of a fire department, whereas police respond as individuals or in teams of no more than two. It also frequently means a reduction in fire fighter staffing and crew size.

Attempts to consolidate fire and police departments are traditionally associated with efforts to cut the cost of public safety, but the anticipated benefits are rarely realized and instead result in poor service, increased risk for the community and require additional resources -- thus increasing costs. "



Wow how could they say that? They have claimed for years that there is no problem multitasking. They force EMS into fire. But now some are trying to force fire into police they don't like that do they. Police and fire are more closely related than Fire and EMS. Also EMS is a two man team. I don't know but seems like they just made my point of opposing EMS being forced to join fire for me.


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## Veneficus (Mar 21, 2009)

AZFF/EMT said:


> I believe the fire based ems system I work in works really well. 6 firefighter/emt/paramedics on every call at a minimum. MVA's get more depending on the severity. In my neck of the woods there is no debate over it. It is what we do and everyone I know loves it. Our engines have 2 basics and 2 medics and our rescues are 1 and 1. We do not fight a whole lot of fire but we run a lot of medical calls and MVA's. We are a total hazard system providing Fire, EMS, extrication and technical rescue. We train every shift on fire related topics and have to complete 60 hours of CE's not including our Refresher class.
> 
> It is not too much to do both.
> 
> ...



I wonder, if EMS duties require a more public health role and less simply transporting to a healthcare provider as is the current trend worldwide would the fire agencies there accept such a role?


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## firecoins (Mar 21, 2009)

fortsmithman said:


> 3 out of 15 of my services members are also corrections officers.
> 4 out of 15 members are coroners.



Coronors are MDs here.  No MDs inour service except the medical director.  He's an ER doctor, not a medical examiner.


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## VentMedic (Mar 21, 2009)

firecoins said:


> I believe we need to merge EMS with the Correctional department or Sanitational Department. It just makes sense.


 
Some very successful EMS services have been out of prisons. EMT-B is taught in many prisons especially in that states the don't do a background check for certification.

We also know how useful prisoners have been in firefighting.


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## firecoins (Mar 21, 2009)

VentMedic said:


> Some very successful EMS services have been out of prisons. EMT-B is taught in many prisons especially in that states the don't do a background check for certification.
> 
> We also know how useful prisoners have been in firefighting.



I was kidding since EMS should be a stand alone agency.  

I know prisoners are used a FF somewhere but not where I live.


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## AZFF/EMT (Mar 21, 2009)

Well at my department before we put up more engines we used to roll rescue's only on almost every call and have to wait for a volunteer or two to show up. Noq that is fine on the medical calls that are not very complex, but working a code 2 man isn't very productive, extricating a patient from a vehicle with 2 men isn't very productive eitherLifting 400 pound patients through a trailer and out to your gurney isn't very easy either and I am a pretty freaking strong guy. We run mutual aid to a town about 30 miles south of us and the only unit they have is an ALS rescue augmented by about 7 volunteers which never show up. This town runs about 1000 calls a year and they have the SR85, I8 and maricopa highway running right through the town. I know the people down there trapped in there vehicles for 30+ minutes sure wish an engine with 4 extra guys were on scene. There fires are even better, havent lost a foundation in years. Now when that rescue is gone, those medical pateients wait 30+ minutes for treatment from one of our rescues on mutual aid. Or they may get a first responder volly 1 man engine to show up and hold there hand while the circle the drain. I would think having an ALS engine in town would sure help a lot.

Are 6 guys needed on every call? No, of course not, but it sure is great to have when you need them. The old way of send an ambulance and call for help if you need it cost patients very critical time. How many diabetic problem calls have you run on to get on scene and find a code? or ill person/DB ect. 

Engine's stabalize and assist treatment, movemnet, and ride in on the rescue when manpower is needed. I've seen a dramatic change in the outcome of our patients in the past two years since going to the current system. And when the rescues are all out on calls, the patient still gets an ALS engine company on scene in 5 minutes to treat and stabalize until a transport unit can get on scene.


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## AZFF/EMT (Mar 21, 2009)

The way I see it we do provide a public health service.


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## daedalus (Mar 21, 2009)

AZFF/EMT said:


> Well at my department before we put up more engines we used to roll rescue's only on almost every call and have to wait for a volunteer or two to show up. Noq that is fine on the medical calls that are not very complex, but working a code 2 man isn't very productive, extricating a patient from a vehicle with 2 men isn't very productive eitherLifting 400 pound patients through a trailer and out to your gurney isn't very easy either and I am a pretty freaking strong guy. We run mutual aid to a town about 30 miles south of us and the only unit they have is an ALS rescue augmented by about 7 volunteers which never show up. This town runs about 1000 calls a year and they have the SR85, I8 and maricopa highway running right through the town. I know the people down there trapped in there vehicles for 30+ minutes sure wish an engine with 4 extra guys were on scene. There fires are even better, havent lost a foundation in years. Now when that rescue is gone, those medical pateients wait 30+ minutes for treatment from one of our rescues on mutual aid. Or they may get a first responder volly 1 man engine to show up and hold there hand while the circle the drain. I would think having an ALS engine in town would sure help a lot.
> 
> Are 6 guys needed on every call? No, of course not, but it sure is great to have when you need them. The old way of send an ambulance and call for help if you need it cost patients very critical time. How many diabetic problem calls have you run on to get on scene and find a code? or ill person/DB ect.
> 
> Engine's stabalize and assist treatment, movemnet, and ride in on the rescue when manpower is needed. I've seen a dramatic change in the outcome of our patients in the past two years since going to the current system. And when the rescues are all out on calls, the patient still gets an ALS engine company on scene in 5 minutes to treat and stabalize until a transport unit can get on scene.


When RNs are in charge of the treatment decisions of supposed physician extenders, than the system is broken. That is not to say that RNs are not very highly educated individuals, who also are more educated than most paramedics, but that it is indeed a strange relationship to allow RNs to control your treatment decisions. 

Also, EMS is not public safety. It is supposed to be medicine.


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## Veneficus (Mar 21, 2009)

AZFF/EMT said:


> The way I see it we do provide a public health service.



I would be interested to hear what public health initiatives your department is involved with.


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## boingo (Mar 22, 2009)

JPINFV said:


> Then why not combine fire with police? That way we can have it be a three way with members trained as EMTs, fire suppression technicians, and officers.



Oh no, can't do that, 2 completely different jobs according to the IAFC.  Fire fighting and medical care are exactly the same, just like plumbing and carpentry....see?


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## firecoins (Mar 22, 2009)

Veneficus said:


> I would be interested to hear what public health initiatives your department is involved with.



AEDs in school with community CPR.


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## EMTinNEPA (Mar 22, 2009)

EMS is medicine.  EMS is not firefighting.  EMS is not law enforcement.  EMS is not public safety.  EMS is medicine.  It should not be merged with anything.  It should stand alone.  EMS is medicine.  I have repeated the flaws of fire-based EMS over and over again until I was blue in the face, and my points do not change.  I don't even want to imagine PD-based EMS.  EMS is medicine.  Period.


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## firecoins (Mar 22, 2009)

Only cops can be blue in the face.  We use red and white.


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## JPINFV (Mar 22, 2009)

firecoins said:


> Only cops can be blue in the face.  We use red and white.



Of course that depends on where you are. Some states allow blue lights on all emergency vehicles.


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