Another Florida EMS goes Fire

[VentMedic]

http://www.theledger.com/article/20...tle=Polk-Fire-May-Inherit-Some-EMS-Ambulances

Thursday, June 25, 2009

Polk County Fire May Inherit Some EMS Ambulances

BARTOW | Polk County Fire Services could inherit up to five of Emergency Medical Services' 32 paramedic ambulances.

If approved by Polk County commissioners, the plan would combine fire and medical services in some areas. This would allow the county to meet the needs of some of the more rural areas that have a shortage of either medical or fire service coverage.

It would improve efficiency, according to fire and emergency medical officials.

One ambulance had already been taken over by fire services at the Golfview station in Lake Wales, and six paramedics and emergency medical technicians have been cross trained to respond to both medical and fire calls.
Up to 24 more EMS paramedics and emergency medical technicians could be cross trained.

 

[berkeman]

Wow, that was quick. How in the world do you quickly cross-train medics and EMTs to fight fires? Put them through the fire academy on a fast track?

 

[VentMedic]

Wow, that was quick. How in the world do you quickly cross-train medics and EMTs to fight fires? Put them through the fire academy on a fast track?

We've done this some many times throughout Florida that we're getting kinda good at it.

Usually they will give the EMT(P)s 1 - 3 years to get their fire certs. Unfortunately there will be those that really not up to taking the fire academy physically. They may be SOL for a job especially since the state is largely Fire based EMS.

 

[46Young]

Are they putting them through suppression so they'll be subject to FLSA, or are they really going to be riding fire apparatus? I'm a huge fan of fire based EMS from the employee's side, for $$$'s, benefits, pension, DROP, working conditions and such. It's typically a much better deal than third service, private, or hospital based(save the Carolinas). I do think it's wrong to take over an EMS agency and force them to do suppression. There should be a single role option for those who don't particularly care to run into a burning building.

 

[TransportJockey]

So whenever I go to visit my home county it's all fire based... great.

 

[EMTinNEPA]

46Young, are those $$$'s, benefits, pension, DROP, working conditions and such also aren't worth having to join the bucket brigade and going running into burning buildings? Or sitting back and watching firefighters who run a tenth of your call volume make twice as much as you? Or having to bear witness to sub-par paramedics who are paramedics just because they want to ride in a shiny wed fire twuck?

The $$$'s, benefits, pension, DROP, working conditions and such could be there on the third service, private, and hospital based as well if people realized the grave injustices fire-based EMS does to them and demanded a third service.

 

[EMTinNEPA]

Oh, and VentMedic...

I'm so sorry to hear that.

 

[Sasha]

I'm so sorry to hear that.

We do fire based EMS well. It's not a tragedy.

 

[EMTinNEPA]

We do fire based EMS well. It's not a tragedy.

What facts do you have to support the claim that you do it well?

 

[Melclin]

I don't get this thing about fire based EMS. EMS is a completely separate field, with different skill sets, requiring different people, different equipment and go to predominantly different jobs.

Here we have Police, Fire, and Ambulance. All are completely separate (in fact ambulance is not even technically an emergency service here). I don't get why people think its perfectly okay to have major state run (correct me if im wrong, Im assuming here) FDs and EMS is an after thought to be left to the whims of FD or private companies. I hate the idea that EMS seems to become ancillary to firefighting.

Where I come from the ambulance service gets way more calls, has an equivalent or bigger budget and has been professionalized more widely and for longer than FD. I'm not belittling the water fairies but the FD is a completely different service with a completely different role. FD fights fires and do all that awesome hero stuff and Ambos are medical practitioners. You wouldn't take a nurse and say, oh well, there's not much to your field so we'll teach you how to fight fires as well.

 

[Sasha]

What facts do you have to support the claim that you do it well?

What proof do you have that we don't?

Fire Based EMS is great, if done right. We are obviously doing something right as the entire state can provide ALS to all it's residents and visitors, no matter how rural and poverty stricken the area it. I had some fantastic preceptors at the FD who were wonderful medics. One thing is here, at least, the FDs make an effort to appear professional and neat, have training every single week. While you have the private services that respond with half tucked in shirts, messy hair, unrestrained long hair and get training maybe once every couple months.

I live in an FD response area and I am confident that when they respond, I'll have competent medics, not so sure when I run around in R/m's response area.

 

[EMTinNEPA]

What proof do you have that we don't?

Fire Based EMS is great, if done right. We are obviously doing something right as the entire state can provide ALS to all it's residents and visitors, no matter how rural and poverty stricken the area it. I had some fantastic preceptors at the FD who were wonderful medics. One thing is here, at least, the FDs make an effort to appear professional and neat, have training every single week. While you have the private services that respond with half tucked in shirts, messy hair, unrestrained long hair and get training maybe once every couple months.

I live in an FD response area and I am confident that when they respond, I'll have competent medics, not so sure when I run around in R/m's response area.

ALS response in my area is 100% third service, while the Fire Departments can only provide BLS services. There are some great EMTs running with the FD-based BLS service, but only because they work, or at one time worked, for one of the paid ALS third services. The ones that haven't are disgustingly apparent. Here you have FF/EMTs who will hold onto a patient's wrist for two seconds and declare that their pulse is thirty. You have FF/EMTs who bring cardiac arrest patients down the stairs in a stairchair, and block their airway with an OPA in the process because they can't grasp the concept of gravity. You have FF/EMTs who will wait on scene for the medics to get there.

As for looking neat, I would hardly call responding in ripped jeans and a stained FD T-shirt neat. The paid services in my area have uniform requirements that, if not met, result in the offender being sent home.

The only two places in my county that I feel safe are the two bigger towns, because they have paid ALS third services. If I'm in some of the more rural areas in the Northern or Southern parts of my county, I will still get the same paid ALS third services, but I do not feel safe knowing who will get there first, if they even manage to crew.

Paid services in my area can provide a paramedic on every call. Paramedics who, I know from experience, have gone through paramedic school, then have undergone a several-month long preceptorship under direct supervision of the service's medical director, and undergo 36 credits of continuing education (education, NOT training) every year, not including the specific courses required by the service.

I see nothing that your FD can provide that my third-service and private companies cannot, except maybe paramedics who focus on being paramedics instead of being jacks of all trades.

 

[VentMedic]

I'm so sorry to hear that.

Why? Much of Florida is Fire Based EMS. We do have several excellent FDs providing excellent medical care to the public. Granted we do have a couple of areas like Collier County but much of that is largely due to bad, bad management and does not represent the rest of Florida.

ALS response in my area is 100% third service, while the Fire Departments can only provide BLS services.

You have FF/EMTs who will wait on scene for the medics to get there.

Our first responders are Paramedics. We don't wait for another service to show up with a Paramedic nor do we have to drive real fast to intercept with a Paramedic ambulance.

I see nothing that your FD can provide that my third-service and private companies cannot,

See above statement. It sounds like your FD needs to upgrade to ALS to improve on the service provided to the patients since your private Paramedics can not get there as quickly.

For busy FDs who do fight a lot of Fires, I am opposed to this. I also see a problem with the EMTs from the county and private services who have no desire to fight fires putting the other fire fighters in danger at a fire scene. It goes both ways on the jack of all trades skills. Most of our FFs are Paramedics when they join the FD. If they don't like the EMS part, they can usually rotate off to an engine or ladder later. Those that like EMS will usually stay and perfect their medical skills/knowledge. Many of the senior Paramedics with FDs had degrees in EMS because that was what it took to get hired many years ago. I do hate to see the medic mill mentality that has taken over but again that problem also exists in private companies which have their own mills to get warm bodies working on the trucks.

 

[EMTinNEPA]

It sounds like your FD needs to upgrade to ALS to improve on the service provided to the patients since your private Paramedics can not get there as quickly.

Did you not read the horror stories of their EMTs? If they let morons like that volunteer, I don't even want to imagine what kind of medics they'd hire. What they need to do (and probably will do eventually) is pay one of the two private services to staff a paid medic at their station 24/7. My service already does that for one volunteer service, and it's one of the primary ALS trucks for the entire county.

 

[VentMedic]

Did you not read the horror stories of their EMTs? If they let morons like that volunteer, I don't even want to imagine what kind of medics they'd hire. What they need to do (and probably will do eventually) is pay one of the two private services to staff a paid medic at their station 24/7. My service already does that for one volunteer service, and it's one of the primary ALS trucks for the entire county.

Volunteer? What's that? We provide only paid services.

 

[EMTinNEPA]

And if I may ask for clarification, Vent, do your Fire-Based Services allow paramedics to be just that: paramedics? Or do they want all of them to be ACLS, PALS, PHTLS, AMLS, PEPP and GEMS certified paramedic fire suppression hazmat high-angle confined space swift-water vehicle rescue technicians? If they are separate, how does paramedic salary compare to firefighter salary?

 

[EMTinNEPA]

Volunteer? What's that? We provide only paid services.

I know, I oppose it as well. However, considering the number of calls the volunteer BLS services fail to crew for, half the time it's like they don't even exist at all.

 

[VentMedic]

And if I may ask for clarification, Vent, do your Fire-Based Services allow paramedics to be just that: paramedics? Or do they want all of them to be ACLS, PALS, PHTLS, AMLS, PEPP and GEMS certified paramedic fire suppression hazmat high-angle confined space swift-water vehicle rescue technicians? If they are separate, how does paramedic salary compare to firefighter salary?

In my area, if they are working on the Paramedic Rescue unit or they are the lead on an ALS engine, they meet the full rerquirements as a Paramedic.

Our FDs also have many well trained specialists for the hazmat and water rescues. Even there you can not expect one to alway be a jack of all trades. If the emergency requires a dive team, a team who is very well trained for that will be dispatched. We do not believe in "yeah they took a course once and did a couple of dives" mentality. Some FFs can be trained to provide all the services in a day or two course. However, if they don't retrain and review often, what good is it? Paramedics of all services can brag about being able to intubate a child or do a cric but if they don't at least train, retrain and review often, how good will they actually be at that skill if they haven't practiced since medic school?

In some departments, it is about an average of $5 - 8k more with a Paramedic cert. Howevr, there are other ways a FF can advance their salary. As it stands now, the Paramedic cert is the easiest.

 

[EMTinNEPA]

In my area, if they are working on the Paramedic Rescue unit or they are the lead on an ALS engine, they meet the full rerquirements as a Paramedic.

Our FDs also have many well trained specialists for the hazmat and water rescues. Even there you can not expect one to alway be a jack of all trades. If the emergency requires a dive team, a team who is very well trained for that will be dispatched. We do not believe in "yeah they took a course once and did a couple of dives" mentality. Some FFs can be trained to provide all the services in a day or two course. However, if they don't retrain and review often, what good is it? Paramedics of all services can brag about being able to intubate a child or do a cric but if they don't at least train, retrain and review often, how good will they actually be at that skill if they haven't practiced since medic school?

In some departments, it is about an average of $6 - 8k more.

No, I meant can you be JUST a paramedic, not a firefighter? And is it the $6k - 8k more for the firefighters or for the paramedics?

 

[VentMedic]

No, I meant can you be JUST a paramedic, not a firefighter? And is it the $6k - 8k more for the firefighters or for the paramedics?

If you come in with the Paramedic cert, they get a higher pay.

No, we do not have our EMS/FD set up like NY or SF.