FD responding to medical aids

[terrible one]

as im sure this topic has been beat to death, im curious and bored and wonder what the opionions on an ems site are.

how does your county work?
are your 911 calls screened? can you get a BLS car only? code 2 responses? triad response? pvt ambulance first in? etc...

having worked/interned/done ride alongs in LA, VC, Kern, SB counties ive seen varied ways of doing this.

with the budget crisis in Cali i would love to see some changes in ems. especially in LAcounty, which currently (in certain catchment areas) has a Truck, Engine, Squad, and ambulance respond to a stubbed toe. very very ineffecient if you ask me. and a waste of resources/money

pros/cons and opinions are welcomed.

 

[EMTinNEPA]

Just like QRS, just like Fire Suppression-based EMS systems, it's nothing more than a way for the Fire Department to pad their call volume, make themselves look busier than they really are, and get more tax monies as a result. Only time Fire should be anywhere near an EMS call is if there's a rescue to be done, if the Fire Service provides HazMat services, or if EMS has Fire dispatched for manpower (lift assist, CPR in progress, etc.).

 

[Mountain Res-Q]

In my area I would agree with BLS Fire Response of 2-3 FFs in a rescue or squad unit. We run 4.5 ALS ambos up here and response times for them can vary from 3 minutes to a hour depending on location. Fire can be on scene in 2-10 minutes (at most). However, a standard medical call in my area gets the ambo and (at most) 1 vollie station, 1 state engine, and 1 district engine. Wosrt case this means 3 Engines (5-10 FFs) and a Chief in addition to the ambo for "stbbed toe calls". Fire First Response (with compatent FF/EMTs on board) is vital IMHO for certain more remote areas. But, yes sometimes it is overkill in response to some calls. Even in the event of a code, all you need is the ALS crew and 2-3 FFs (or CPR). If it is rescue involved then you can call more (appropraite) resources. And I know the response by some is that you never knwo what teh call may turn out to be and teh additional hands are needed... but everyone would say that as far a patient care (no rescue) is involved, 10 FF/EMTs in addition to the Ambo crew is a waste. All to often they send all of that to a "stubed toe" and then a second call for a pin in is fielded 10 miles away and nothing is in a position to respond quickley. We actually had an incident 2 years ago where 2 people burned to death in a house fire because all the closest fire units were on BS medical calls and out of position to respond. But a few FFs are valuable in medical calls in the right situation, IMHO.

 

[DrankTheKoolaid]

re

FD FR are always welcome on my calls. Better their back going out then mine.

 

[NomadicMedic]

Where I work it's an engine as first response and maybe a fire paramedic unit. We (private BLS) respond cold, to transport if the patient is BLS.

 

[Proud2bffemt]

In our area most of the calls are handled by just ambulance whether it be 1 or 2 as some are in major vol areas which are BLS and a Paid ALS company comes to assist for the call. However in one particular town the FD rescue is toned out as well on all calls. The FD truck is a certified QRS with EMTs onboard. Its nice to have that back up I/M/O for lifting and the occasional OOPS calls where extra hands are needed and the like.

There have been times where the EMS gets o/s and stands down the rescue as situations dictate and they will stand down its not a we were called we are comming issue.

So take it how u may

 

[terrible one]

FD FR are always welcome on my calls. Better their back going out then mine.

Its nice to have that back up I/M/O for lifting

interesting you point that out. in certain places ive worked FD has REFUSED to help lifting pointing out that they have a 30 year career to worry about.

i have no problem with fire showing up when needed. but we dont really need an entire light force company showing up for someone with a cough.

 

[CAOX3]

Rather have them come with us and cancel them if their not needed then have to wait for them when they are needed.

 

[BLSBoy]

I love my Brothers showing up to give a hand, when needed. ALS level calls, lift assist, or as needed for certain circumstances.

Otherwise, sit back and wait for the big one!

 

[Seaglass]

In my county, fire goes to all emergency medical calls. If it's really bad and nobody else has gotten there, they transport. (All of our FFs are BLS, and most are ALS.) Otherwise, a BLS/ALS private team shows up. Usually everyone's called at the same time, meaning that you get tons of people at a single call.

 

[Sasha]

how does your county work?
are your 911 calls screened? can you get a BLS car only? code 2 responses? triad response? pvt ambulance first in? etc...

Here, the only BLS ambulances are strictly IFT. At least in central Florida, but I'm pretty sure this is a state wide thing.

Here, Fire is the major EMS provider (And I think they do a fanstic job, especially in smaller departments.) The major exception in my area being Orlando Fire, which shows up on scene to stand around and look pretty while Rural Metro does their transporting. There are a few private and third 911 services in Florida, but it is widely fire based.

 

[djmedic913]

In my area, during the day, the FD is dispatched for more calls. At night it seems they are dispatched to less, even ALS level dispatches.

If we take a trip back in time to the 70's, the FD did a lot of fire prevention. and they were very effective with it, coz they almost put themselves out of business. So many FD's took on EMS to show the taxes payers that they were still needed.

Since where I am now, the ambulance station is centrally located with all ambulances stationed there, so to dispatch an engine that will get there before us and begin BLS Pt care is a good thing. Most of the members of our FD actually don't mind doing EMS or helping or even getting vitals for us.

Where I used to work tho, many members of the FD hated EMS.

What the Fire Service and the Fire Department needs to realize is that after all of there successful fire prevention in the 70's that the Fire Department is EMS that occasionally puts out fires.

 

[46Young]

Fairfax County FRD has 37 stations, with 37 ALS engines, with an engine medic riding the left bucket. All other suppression pieces have firefighters trained to EMT-B. Our ambulances are staffed by either two medics( Primary Training Unit Medic), medic/EMT("one and one Medic"), or two EMT's(ambulance). Msot ALS calls are dispatched with both a medic and an engine, to provide at least two medics for the pt. The engine medic can ride with the other medic to the hosp. If the engine and medic are from the same house, and the medic is a PTU, the truck/tower/rescue will take the call, keeping the engine in service in case another ALS call comes in their first due. This won't happen with the one and one, as there will only be one medic onscene. Multiple crews can crowd the scene, but we have a good system worked out. When on the engine, the driver and firefighter will get the cot, and the ALS bags. I'll bring the monitor and O2. I'll begin assessmant and pt interview. The bucket firefighter will obtain BP, pulse, resp count, BGL, temp, O2 admin per my request. I'll hook up the monitor. My officer will write down all pt info, and give report to the medic based on what info I've provided. If the medic arrives prior to, or at the same time as us, we'll ask the crew what they need, and I'll help with assessment, ALS interventions, and I'll also make sure that they're treating the pt appropriately. I ride the medic about 50-60% of the time, by my estimate. I'm equally as happy on either piece. For MVA's, an engine will always be dispatched, for ALS backup, to pull a bumper line in case of a car fire, and to block lanes. Suppression pieces will position to protect the scene from traffic, and will stay until the medic/ambo leaves the scene. They'll position so, if the apparatus is struck by another vehicle, it'll roll away from the scene. When I worked in NY, it was typically our ambulance only, unless it was a pin job, or multiple pts. I've been nearly run over more times than I care to remember. You fire dept haters should think about that. ALs engines, or ever BLS/CFR rigs may be the only help nearby. Chances are, most EMS agencies will tend to be slightly or grossly understaffed, rather than a surplus of units. Even in NYC, jobs can be stacked up from time to time. When I worked BLS, there were numerous occasions that no medics or help otherwise were available, and we had to handle the situation ourselves, when we really could have used the extre manpower.