Fire-based EMS vs EMTs?

[Veneficus]

"Add-on" training means, by definition, that after everyone is done the fire training, some people go on to a special class for the EMS component.

I don't think that is a true or factual statement.

As was stated, unless you are spending equal and adequete time. It is an add on. Think about it.

200 hours for professional firefighter training.
120 hours for EMT.
40 hours hazmat ops.

now if it was:
200 hours fire training.
200 hours of EMT.
200 hours of hazmat.

then it is equal.

 

[mc400]

well I am a FF/PM for a dept that runs Engine and rescue ambulances. My goal for myself cannnot speak for everyone is to be as highly trained as possible. My future goal is either RN or PA that will move me into a future beyond my prpobable 20 year fire career. We love ems around here. It is our bread and butter. we run 40-50 working fires a year with probably 100+ rubbish and vehicle fires to go along with our 6000 other calls. A lot of Fire medics piss me off as well as the private ambo guys we work with when we run into other jurisdictions. There is a problem as a whole not just Fire or EMS. I think a good system is an ALS first response Fire Dept along with an EMS division of non-firefighters on ambos. Yet I love the fact that when on a fire and I am on the rescue it is 2 extra hands to stretch line, S/R or any other fire ground activity where as ems only parks and watches.

 

[JJR512]

If you are learning those disciplines at the depth to make independant decisions, you certainly don't have time for anything else.

Why not?

The only reason why you wouldn't have time for anything else is if the one thing takes up all of your time. Nothing takes up all of anyone's time. There is time to study fire fighting before they get to the EMS part. Or they can do the EMS part first, but sooner or later, that part is going to be done with, and then there's going to be plenty of time to study fire. Unless the person dies immediately after studying the EMS part.

You can argue that nobody can be an expert in more than one thing and that's fine, but that doesn't mean the person doesn't have the time to study more than one thing. And it is THAT comment that you made, that a person doesn't have time to study more than one thing in-depth, that is WRONG and is what I am directly addressing with this and the preceding paragraph.

As an example suitable for EMS, if you have a patient in septic shock, you might have to chose which therapy, the order, as well as the possibility of withholding treatment based on presentation or comorbidity. Take my word, that is an art, and it cannot performed well by people who are responsible for 10 other things.

When a FF/EMT or a FF/Paramedic shows up on scene and is functioning as an EMT or Paramedic, he isn't responsible for 10 other things. He is only responsible for providing EMS, patient care. At least this is true in my experience. I'd hate to see a person be responsible for both fighting the fire and providing EMS care at the same time. If that's the way it is in other areas, no wonder you guys are all so upset about it. That's not the way it is here, though.

 

[JJR512]

I don't think that is a true or factual statement.

As was stated, unless you are spending equal and adequete time. It is an add on. Think about it.

200 hours for professional firefighter training.
120 hours for EMT.
40 hours hazmat ops.

now if it was:
200 hours fire training.
200 hours of EMT.
200 hours of hazmat.

then it is equal.

You are talking about two very different concepts, equality and whether or not something is an add-on.

If an academy class goes through 200 hours of fire training and 200 hours of hazmat training, then the entire class is graduated and sent out into the field, and six months later one-third of the students are called back to receive 200 hours of EMS training, well that's EQUAL but it's also ADD-ON.

If an academy class goes through X hours of fire training and Y hours of EMS training and Z hours of hazmat training, then all three components are CORE components, even if none of the hours are the same.

Look at it this way. If I go to McDonald's and order a #1 Combo, I get a Big Mac, french fries, and a drink. Those are the CORE components of that value meal. It doesn't matter if the weight of the french fries equals the weight of the Big Mac. It doesn't matter if it takes me the same amount of time to drink the soda as it does to eat the fries. All three of those things are the core components of the value meal. Now, if I also order an apple pie, that pie is an add-on. It isn't part of the meal. Again, it doesn't matter if the apple pie weighs the same as the Big Mac or if it takes me the same amount of time to eat it. It isn't part of the meal, so it's an add-on.

 

[Veneficus]

Nothing takes up all of anyone's time.

I respectfully invite you to a week of my schedule.

And it is THAT comment that you made, that a person doesn't have time to study more than one thing in-depth, that is WRONG and is what I am directly addressing with this and the preceding paragraph.

A week of my schedule + fire school simultaneously?

How about in sequence?

How skillful of a firefighter do you think you would be?
(I think that firefighting requires considerably more dedication than the minimum to be good at it from having done it.)

When a FF/EMT or a FF/Paramedic shows up on scene and is functioning as an EMT or Paramedic, he isn't responsible for 10 other things. He is only responsible for providing EMS, patient care. At least this is true in my experience. I'd hate to see a person be responsible for both fighting the fire and providing EMS care at the same time. If that's the way it is in other areas, no wonder you guys are all so upset about it. That's not the way it is here, though.

"I think a good system is an ALS first response Fire Dept along with an EMS division of non-firefighters on ambos. Yet I love the fact that when on a fire and I am on the rescue it is 2 extra hands to stretch line, S/R or any other fire ground activity where as ems only parks and watches."

I rest my case.

 

[JJR512]

I respectfully invite you to a week of my schedule.

OK, and at the end of a week of your schedule, what comes after that? Another week! My isn't time lovely? It's like it goes on and on...

A week of my schedule + fire school simultaneously?

Who said anything about "simultaneously"?

How about in sequence?

Exactly, now you're on the right track. One might not be able to study two things at the same time, but one can certainly study one thing first, followed by another.

This is the model used by Howard County. The EMS core component has a certain amount of time dedicated to it.

How skillful of a firefighter do you think you would be?
(I think that firefighting requires considerably more dedication than the minimum to be good at it from having done it.)

As with anything I might try, how successful I am at something depends not so much on what I may have studied before it or after it, but how much attention and dedication I give to what I'm trying now.

There are certainly many other variables. If I dedicated two days to becoming an EMT, naturally I would fail. If I dedicated two weeks to becoming an EMT, I might pass but I doubt I would be as good as I would if I had dedicated two months. But I spend two months in a class with an incompetent instructor vs. two weeks with an extremely competent instructor, I might be better off with the two-week class rather than the two-month class. But if I take that two-month class with the incompetent instructor and really dedicate myself to learning around the instructor's shortcomings, I'll have a lot more time to do my own research and figure things out for myself. And there are many other variables as well. It's very difficult to make blanket statements and I think too many people here are trying to make blanket statements that might be true much of the time, but certainly aren't true all of the time.

"I think a good system is an ALS first response Fire Dept along with an EMS division of non-firefighters on ambos. Yet I love the fact that when on a fire and I am on the rescue it is 2 extra hands to stretch line, S/R or any other fire ground activity where as ems only parks and watches."

I rest my case.

What you quoted in italics, and you're resting of your case on it, has nothing to do with what you quoted from me immediately prior, so I'm not sure why my quote was left in there.

 

[Chimpie]

I have to agree with JJR512 on several points. I'd quote them individually but I'm on my phone.

I believe we are talking about fire/ems combined vs. EMS being either private, hospital based, a completely separate but gov't dept, or something else.

I've never experienced hospital based EMS but it seems strange to me, the same way private emergency ems does. I'm all for capitalism, but public emergency response should not be conducted by private businesses.

Why make govt EMS a separate entity when fire assists with a majority of EMS calls anyway?

And I hate the argument that firefighters didn't apply to do EMS. Boo hoo. Times have changed and you have to adapt. Thanks to better codes and increased safety the number of fires have dropped dramatically. As mentioned above, EMS calls are now the bread and butter of some if not most fire departments. If a firefighter can't get on board with that then maybe it's time to retire or find a different job.

 

[JPINFV]

Why would fire need to assist ont he majority of EMS calls anyways if the EMS service is properly funded?

The police department often assists the fire department on calls (traffic control, etc). Should the police department and fire department merge?

 

[Chimpie]

Why would fire need to assist ont he majority of EMS calls anyways if the EMS service is properly funded?

The police department often assists the fire department on calls (traffic control, etc). Should the police department and fire department merge?

Interesting point. When you say properly funded what do you mean? What would you like to see added?

 

[usalsfyre]

I've never experienced hospital based EMS but it seems strange to me, the same way private emergency ems does. I'm all for capitalism, but public emergency response should not be conducted by private businesses.

It did to me too, when I was on the east coast. Now fire-based EMS seem strange.

Why make govt EMS a separate entity when fire assists with a majority of EMS calls anyway?

Became in most places they don't. The only place this happens daily is large cities.

And I hate the argument that firefighters didn't apply to do EMS. Boo hoo. Times have changed and you have to adapt. Thanks to better codes and increased safety the number of fires have dropped dramatically. As mentioned above, EMS calls are now the bread and butter of some if not most fire departments. If a firefighter can't get on board with that then maybe it's time to retire or find a different job.

I would argue that your in the minority in that sentiment. Ask your coworkers, how many of them TRULY want to do EMS and are not looking forward to the day when they can come into work and only worry about putting their stuff on the BRT?

 

[Putrid Existence]

For the record, I didn't know what else to title the thread, as I'm not entirely familiar with the proper terms for each kind of person and their role within EMS. Still learning folks.

 

[usalsfyre]

When someone can give me an argument for fire-based EMS that doesn't involve jobs, the evils of capitalism (ignoring that most FDs are reimbursed for transport), or "we're here already" then you can start to convince me. All of the above are singularly poor reasons for an entity doing EMS.

 

[Veneficus]

I'm all for capitalism, but public emergency response should not be conducted by private businesses.

I agree, but then who is willing to pay for it?

Why make govt EMS a separate entity when fire assists with a majority of EMS calls anyway?

I am not saying it shold be a seperate entity. I am saying that dedicated providers under any "department" are more skillful at what they do than the "jack of all trades" many firefighters are forced to be. As a firefighter I was expected to know a vast amount of largely unrelated topics. Some of them I never performed outside of a once a year drill. I don't think or pretend I was good at them. I also had the opportunity to be a part of a dedicated company, and what skills were performed and depth of knowledge was definately 1st rate, because it is all we did.

If a fire department wants a dedicated and propely funded and run EMS division, I can get behind that. But I don't see a whole lot of it.

I take issue with providers that really believe they are great at everything they were once trained on but rarely do because it is that kind of hubris that gets people hurt or killed.

As mentioned above, EMS calls are now the bread and butter of some if not most fire departments. If a firefighter can't get on board with that then maybe it's time to retire or find a different job.

Exactly. But the problem is the old guys who are usually senior officers reliving the glory days and the young guys really look up to them and try to emulate it.

I don't doubt it is changing, but the pace is not exactly quick.

 

[Chimpie]

I would argue that your in the minority in that sentiment. Ask your coworkers, how many of them TRULY want to do EMS and are not looking forward to the day when they can come into work and only worry about putting their stuff on the BRT?

And think that right there is a big point in all this. Here locally, where EMS is part of Fire, those working on the ambulance work on the ambulance. Those that work on the BRT work on the BRT. Unless you're picking up a shift that's there's no surprises. There's no switching vehicles.

 

[22cent]

Thank you for that insight. I am in the trenches of an agency that is quite hostile to the EMS division, namely the ones who actually care about the job. When there is more interest in fire, the cause of ALS takes the backseat, many of them think we should only provide BLS care and go back to the good old days of straight volunteer. Its like moving backwards but I guess some people like that idea.

 

[usalsfyre]

And think that right there is a big point in all this. Here locally, where EMS is part of Fire, those working on the ambulance work on the ambulance. Those that work on the BRT work on the BRT. Unless you're picking up a shift that's there's no surprises. There's no switching vehicles.

The question is, do they WANT to be on the ambulance, or are they marking time till they can "promote" to something else?

 

[Chimpie]

When someone can give me an argument for fire-based EMS that doesn't involve jobs, the evils of capitalism (ignoring that most FDs are reimbursed for transport), or "we're here already" then you can start to convince me. All of the above are singularly poor reasons for an entity doing EMS.

They may be poor reasons to you but they are very valid starting points to me, the tax payer/possible patient.

 

[Chimpie]

For the record, I didn't know what else to title the thread, as I'm not entirely familiar with the proper terms for each kind of person and their role within EMS. Still learning folks.

No worries.

 

[Chimpie]

The question is, do they WANT to be on the ambulance, or are they marking time till they can "promote" to something else?

They want to be there. Again, why would you apply to a department that you know does both if you didn't wanted to work EMS?

And for those already on a department that's making the merge, adapt and enjoy or find a department that meets your needs and makes you happy.

 

[Veneficus]

And think that right there is a big point in all this. Here locally, where EMS is part of Fire, those working on the ambulance work on the ambulance. Those that work on the BRT work on the BRT. Unless you're picking up a shift that's there's no surprises. There's no switching vehicles.

That is exactly how it should be.