Dallas Fire Department EMS Care - Quality

sir.shocksalot

sir.shocksalot

Forum Captain
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TomP said:
People who c-spine just to CYA is one of my biggest pet pives, we are supposed to be pt advocates and do whats best for our pt's and strapping someone on an uncomfortable board when they don't need it is horrible practice.
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The entire procedure of c-spining is an exercise in CYA. There is no, nor was there ever, scientific evidence the procedure actually does anything. Remember when everyone got their tonsils out? Or how about when we used to do blood letting? It's the story of medicine.

I think culture is a huge part of EMS care in some places. The protocols might look pretty good but what is actually being practiced on the ground is a whole different reality. There is a FD in the Denver area who has it in their protocols to intubate but the reality is that all airways are "controlled" with a King-tube. Same FD has protocols for up to 200mcg of Fentanyl, reality is that rarely is 100mcg pushed, usually it's 50mcg or so. Department culture is at least partially responsible for how care is provided, and I think any department really pushes people to drink the kool-aid is really prone to having huge patient care problems.

Indoctrination really isn't good for any industry, but is especially deleterious to medicine.
 
Shishkabob

Shishkabob

Forum Chief
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medicsb said:
So there seems to be a lot of hear-say... "They don't intubate... I don't think they have X drug..." blah blah blah

Their protocols are online for everyone to see for themselves: http://www.biotel.ws/
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Except the issue: Biotel is more of a mix and match type of medical control, allowing each department they oversee to choose what protocols they have and to what extent they go.

Example: Back in 2010 they came out with RSI. Some FDs adopted full RSI, some adopted only PAI, and some, such as Dallas, were like "Nope, we don't trust our people, don't give us more drugs to play with"
 
F

Fish

Forum Deputy Chief
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All of this aside, I do hear that Dallas has great benefits and pay :)
 
T

Trashtruck

Forum Captain
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Hmmm, let me see...
Don't treat anybody, talk them out of needing an ambulance, 'BLS' every call, and enjoy great pay and benefits.
Yep! Sounds like a Fire Dept. to me.
 
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Tigger

Tigger

Dodges Pucks
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Trashtruck said:
Hmmm, let me see...
Don't treat anybody, talk them out of needing an ambulance, 'BLS' every call, and enjoy great pay and benefits.
Yep! Sounds like a Fire Dept. to me.
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Sounds like a substandard EMS provider to me, and pretty much nothing else.
 
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Medic2409

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Word, rumor, is that DFD is trying to get out of EMS, and has approached a certain green ambulance company about doing so.
 
RocketMedic

RocketMedic

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That would be epic. I'd move for it.
 
F

Fish

Forum Deputy Chief
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Medic2409 said:
Word, rumor, is that DFD is trying to get out of EMS, and has approached a certain green ambulance company about doing so.
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Would have to go out to competitive bid, can't just chat and bring in a service without a bid
 
RocketMedic

RocketMedic

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Fish said:
Would have to go out to competitive bid, can't just chat and bring in a service without a bid
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AMR and Acadian, perhaps Rural/Metro or Paramedics Plus. It's home turf for all of them. Perhaps a Medstar expansion?
 
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Trashtruck

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Medic2409 said:
Word, rumor, is that DFD is trying to get out of EMS, and has approached a certain green ambulance company about doing so.
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I'm not familiar with how the DFD runs EMS. Could somebody give me a run down on it?

What is the proposal to remove EMS from the Dept.? Isn't EMS a financial crutch(or shoring!) for most FD's? This seems counter-intuitive to me.
 
U

usalsfyre

You have my stapler
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They were talking to a couple of companies about back-up at high volume times only (first to second hand knowledge of this). DFD getting completely out of EMS isn't going to happen.
 
F

Fish

Forum Deputy Chief
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Trashtruck said:
I'm not familiar with how the DFD runs EMS. Could somebody give me a run down on it?

What is the proposal to remove EMS from the Dept.? Isn't EMS a financial crutch(or shoring!) for most FD's? This seems counter-intuitive to me.
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911 is not a financial gain for anyone
 
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Trashtruck

Forum Captain
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I never said it was profitable. EMS within a Fire Dept. brings in more funding and a larger budget for the Dept.
I'm just wondering why DFD wants OUT? The rest of the country FD's seem to want to take over EMS.
 
F

Fish

Forum Deputy Chief
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Trashtruck said:
I never said it was profitable. EMS within a Fire Dept. brings in more funding and a larger budget for the Dept.
I'm just wondering why DFD wants OUT? The rest of the country FD's seem to want to take over EMS.
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Gotcha,

What is funny is....... We have Chiefs from Larger Fire Depts that ran EMS getting jobs around here as Chiefs at smaller Depts (4-5-7 station depts) that when asked if they want to takeover EMS reply with "It is a headache, a not profitable headache....."

It brings in a bigger budget, but the guys on the Floor want nothing to do with it....... In my experience
 
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Veneficus

Forum Chief
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Fish said:
Gotcha,

What is funny is....... We have Chiefs from Larger Fire Depts that ran EMS getting jobs around here as Chiefs at smaller Depts (4-5-7 station depts) that when asked if they want to takeover EMS reply with "It is a headache, a not profitable headache....."

It brings in a bigger budget, but the guys on the Floor want nothing to do with it....... In my experience
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Nothing has changed...

One of the reasons the guys want nothing to do with it is because fire and EMS attract entirely different and distinct personalities.
 
F

Fish

Forum Deputy Chief
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Veneficus said:
Nothing has changed...

One of the reasons the guys want nothing to do with it is because fire and EMS attract entirely different and distinct personalities.
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Yes,

Where we work the County is run by a third service EMS agency and all Fire Departmetns are non-transporting BLS, the FDs at the floor level love it this way. And so do we on the Ambulance, we both went into our different careers for different reasons and do not want to mix it
 
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