Fire Department EMS

minneola24

minneola24

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Lately on the forum I have seen alot that are very opposed to the Fire Department handling the EMS in the city/county.

Coming from a non ems citizen, I am wondering why many of you guys are opposed.
 
Part of it is that some firefighters view getting your medic cert as another required qualification for being a firefighter, and not actually be in to providing medicine / caring about the medicine aspect.
 
Because paramedics, aside from the service started out with some fire departments, like Miami, and Los Angeles County and are not third service and or private capital companies like some would like to see.
 
atropine said:
Because paramedics, aside from the service started out with some fire departments, like Miami, and Los Angeles County and are not third service and or private capital companies like some would like to see.
Click to expand...

Even though Miami was one of the earlier Paramedic birthplaces, Freedom House Amubance Service was already by far more advanced than some of the earlier FD models.
 
If you haven't noticed, atropine is more than a little... off...
 
Because we would rather see EMS run as a medical service, not just an addon to a fire dept. A lot of depts use medic as just another cert or rung on the promotion ladder
 
For the most part Fire EMS is an oxymoron.

The reason many are opposed for Fire Service EMS is due to many areas. One of my biggest reasons against Fire Service is their job and main focus is not medicine. It has never have been, never will be or should be. They can only wear so many hats and truly be proficient in so many. Their main focus is fire suppression, fire prevention and investigation and associated services such as rescue.

I never understood the reason why fire service was ever associated; except someone had to the job and they were there. It was either them or the funeral home at the time.

The other reason I mainly object is their methodology of teaching. Their system has been proven to be successful for their intent but again it is not medicine. They use the training method instead of using the education model. It is not the norm to find academically graduates within the ranks of a Fire Service. It is not necessary to have higher education for their role and to function well, not alike those in the healthcare profession. Their job is primarily blue collar and task orientated. That is not a bad thing, but this is not the way medicine or those that work in the medical field are educated the profession demands. Many of those do not realize there is a difference between training and education.

I realize there are great EMS services that are within Fire Services. I have to admit I have found that more of a rarity than the norm. It is not because of specific individuals but to the system. Again the administration of many FD emphasis is of course suppression and not EMS. It has been wide presented by associations that they do not endorse increased education levels or even accreditation of institutions that teach such programs. Also some of the same national level organizations and local FD's have admitted that EMS is simply a way to justify budgetary means to keep FTE and obtain funding otherwise that would never be achieved. This of course, does not set well among us that acclaim to be EMS professionals.

I am educated enough to know that not all of those within the Fire Service represents what I described. I also know that it is out of many of those providers hands to prevent or even change the system. Placing a burden on tax payers for lower quality or substitute services should not be allowed to justify funding for the fire service. There is very little defined management within the Fire Service itself and being able to justify their existence and the methods of their service.

R/r 911
 
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atropine said:
Because paramedics, aside from the service started out with some fire departments, like Miami, and Los Angeles County and are not third service and or private capital companies like some would like to see.
Click to expand...

You are WAY off as to why some think less of fire-based EMS. If even half of the firefighter/paramedics took paramedicine seriously instead of working their way up the chain to full time hose-jockey, then this discussion would be different. Unfortunately, you have medics out there who find the shortest mill to go through, get their card, and provide piss-poor care until someone retires so they can move up to the big-boy seat and slide down the big-boy pole.

Still don't believe me...answer me this: how many fire dept's would let their personnel go for two years for a proper education in paramedicine? How many firefighters would want to spend two+ years in classes they had no passion for or intention of using long-term?
 
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jtpaintball70 said:
Because we would rather see EMS run as a medical service, not just an addon to a fire dept. A lot of depts use medic as just another cert or rung on the promotion ladder
Click to expand...

But few want the additional education and requirements it takes to make it a real medical profession. Most would prefer the standards stay low which makes it almost ridiculously easy for any FF hopeful to obtain a cert just to improve their chance of hire. I do find it horrifying that so many FDs promote the "every FF a Paramedic" policy. But then I come from a time in the late 1970s when FDs looked at the 2 year EMS degree with value and those who had the degree were the ones chosen to work the Paramedic truck.

I also find the lack of incentive or motivation either by the EMTs themselves or the private companions to not move to the Paramedic level just as absurd. Again, in all but a couple of states it doesn't take that much to get the Paramedic cert. Some just whine and make excuses and when all else fails, they must blame someone or something even if it happens to be the FDs. There are opportunities out there for Paramedics in agencies that are nonfire but if one doesn't want to take the next step to be a Paramedic or to put some effort into finding an employer that may offer you a solid career, don't blame the FDs. Of course we also have those that just want to be an EMT with a few "advanced" skills and still want to make big bucks but not be held to the same accountability as the Paramedic.
 
el Murpharino said:
Still don't believe me...answer me this: how many fire dept's would let their personnel go for two years for a proper education in paramedicine? How many firefighters would want to spend two+ years in classes they had no passion for or intention of using long-term?
Click to expand...

Read my previous post.

Yes there are FDs that do encourage education. Some do have the 2 year degree in EMS when entering the FD because that gives them a head start to the Bachelors degree in whatever which is where the real promotions start.

It all depends on the FD you are with and how their hierarchy is structured. To bash all FDs is absurd since many private ambulance companies have done EMS wrong also with their own EMT and Paramedic mills in the backroom just for warm bodies providing cheap labor on the trucks. Of course, more than a few were only to eager to sign up just to get to play with the L/S and also had relatively no interest in medicine. The turnover often came not from the low pay but from realizing patient care was actually involved.
 
Intereting comments. From the look of it you guys are thinking that the firefighters don't want to be paramedics and only go through the training because of the requirement.

To be very well honest I think in a perfect world having the fire department run both EMS and Fire would be great. They respond to emergency's and their men can respond to a call with all the training they need, they can fight fires and treat the ill.

For example if someone is trapped in a vehicle and the firefighters come and get them out of the car what if the ambulance is 10 minutes away? Do the firefighters just wait?

I am not a firefighter or an EMT so what I say may make no sense.
 
No one is saying that the FD shouldn't be EMTs at minimum. Just that they should not be the sole / primary EMS provider in an area, IE control the ambulances.


In a perfect world, all LEOs and FFs would be EMTs minimum, and first respond to every call.




Many of us here also know that there are quite a few in the fire service out of necissity to be medics, rather then choice. My medic instructors are both fire medics, but would be private in a heartbeat if private could support their families, which sadly here in DFW, they cannot. If you want to be a career medic in DFW and retire, it's fire.
 
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Retracted.
 
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I have to say I do find this a little disturbing, but I'm glad to find out how many really people feel about the subject.

I'm in a Fire Sci program, just got my EMT-B. I want to be a Firefighter/Paramedic. Whenever I say that, people say something along the lines of "what, do you want to be a firefighter OR do you want to be a paramedic," or "nobody going into FD actually wants to be a paramedic" -- which I've found a little unsettling.

I really do have a passion for science and medicine, but the aspect of firemedic that really attracts me, as opposed to other areas of medicine, is that you get to be out in the field, in the community, interacting with people in *their* environment. I want to work in a poorer area and actually make a real noticeable difference in people's lives, while I'm working and when I'm not working, getting involved in community activities. Community involvement is not something that you can find in many jobs. Plus, you can actually afford to live on a FF's salary, whereas it's really hard to live on the salary you can receive from a private ambulance company.

I guess, I don't even really know what my point is here. It's just a little upsetting that people think and feel this way.
 
Maya said:
.

It's just a little upsetting that people think and feel this way.
Click to expand...

Truthfully, fire protection and EMS are two totally separate industries and professions. It would be like comparing the fire service and the city water works as the same. Both are city divisions and they deal with water.

Why would anyone consider medicine and fire suppression as one? What common denominator is there? Even if one discussed the role of rescue, that itself has nothing to do with EMS. It itself is a speciality. Yes, one could give first aid.. but; to describe performing medical procedures and ensure quality medical program? ..

EMS is more essential than even fire services. The responses are usually double to four times the number of fire related responses. So why not a third service? Why should EMS be linked to a company that has nothing to do or no focus within its scope?

In all reality, if one had to choose a city division we are similar to; it would be Police Services. Usually, they run off SOP and have to make critical decision making decisions routinely, self motivated and autonomous in their work performance. If there had to be a division to be linked to, there would be more common denominator in their method of management.

EMS can be a success as a third service. It has been proven, and in fact many are now even offering to manage fire services to reduce waste and be more productive. Why not place fire service under EMS? It makes as much sense as the later. The reason being, most true EMS professionals recognize that is not what is best, more than I can say vice versa.

R/r 911
 
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minneola24 said:
Intereting comments. From the look of it you guys are thinking that the firefighters don't want to be paramedics and only go through the training because of the requirement.

To be very well honest I think in a perfect world having the fire department run both EMS and Fire would be great. They respond to emergency's and their men can respond to a call with all the training they need, they can fight fires and treat the ill.

For example if someone is trapped in a vehicle and the firefighters come and get them out of the car what if the ambulance is 10 minutes away? Do the firefighters just wait?

I am not a firefighter or an EMT so what I say may make no sense.
Click to expand...

What you do not understand, being an EMT and being a medical professional is totally different. No one is doubting firefighters should not be medical first responder or even EMT trained, but is far from being medically educated as in being a health care provider. EMT is more of a first aid with little to no bio science and no in-depth medical education.

So yes, they could extricate and iniatially treat those involved in car crashes. Then allow those in the medical field to really treat and stabilize or simultaneously.

I ask this though, if fire services required at the minimal an associate degree in fire science, before applying; what would be the percentile of applicants?

R/r 911
 
Ridryder911 said:
For the most part Fire EMS is an oxymoron.

The reason many are opposed for Fire Service EMS is due to many areas. One of my biggest reasons against Fire Service is their job and main focus is not medicine. It has never have been, never will be or should be. They can only wear so many hats and truly be proficient in so many. Their main focus is fire suppression, fire prevention and investigation and associated services such as rescue.

I never understood the reason why fire service was ever associated; except someone had to the job and they were there. It was either them or the funeral home at the time.

The other reason I mainly object is their methodology of teaching. Their system has been proven to be successful for their intent but again it is not medicine. They use the training method instead of using the education model. It is not the norm to find academically graduates within the ranks of a Fire Service. It is not necessary to have higher education for their role and to function well, not alike those in the healthcare profession. Their job is primarily blue collar and task orientated. That is not a bad thing, but this is not the way medicine or those that work in the medical field are educated the profession demands. Many of those do not realize there is a difference between training and education.

I realize there are great EMS services that are within Fire Services. I have to admit I have found that more of a rarity than the norm. It is not because of specific individuals but to the system. Again the administration of many FD emphasis is of course suppression and not EMS. It has been wide presented by associations that they do not endorse increased education levels or even accreditation of institutions that teach such programs. Also some of the same national level organizations and local FD's have admitted that EMS is simply a way to justify budgetary means to keep FTE and obtain funding otherwise that would never be achieved. This of course, does not set well among us that acclaim to be EMS professionals.

I am educated enough to know that not all of those within the Fire Service represents what I described. I also know that it is out of many of those providers hands to prevent or even change the system. Placing a burden on tax payers for lower quality or substitute services should not be allowed to justify funding for the fire service. There is very little defined management within the Fire Service itself and being able to justify their existence and the methods of their service.

R/r 911
Click to expand...

Rid's right. For every FD that takes EMS seriously and does it well, there are 10(I'm being generous) that do it poorly, and for the wrong reasons.

Until recently in Fairfax medics used a loophole to drop their cert. You would get hired, complete the academy, then drop it and still keep the job. We're now required to keep it until we promote out of it.

You only need make apparatus tech to drop your cert anyway. Drivers are being detailed to medic units frequently and some have threatened to go inactive with their medic cert as a result. Foolish, as we receive about 11,000 to 13,000/yr in incentives plus 2 steps(another 5 grand+) over the basic FF. I guess even here some don't take the medic profession seriously as they should.

There's even a "status B" provision for medic officers who don't want to be detailed off of their suppression piece. They don't receive ALS incentive pay, or the $2/hr ride pay as a medic, but can do medic OT. The fire chief advised that the dept was dropping that program, though. Either you're a medic or you're not.

There are many of us who enjoy the medic profession, however. My dept has it's faults, but EMS delivery and resources dedicated to this division is more than adequate.

As I've wrote earlier, the only advantages fire based EMS has over third service is better staffing and better employee working conditions/benefits.

A fire based single role EMS division with properly dedicated resources would be the best of both worlds. I say fire based for the employee's benefit mainly. EMS organizations have little political influence to improve their position as a stand alone entity.

Other than Acadian, I don't know of any privates that run things as well as a good TSEMS or FBEMS agency.
 
Maya said:
I have to say I do find this a little disturbing, but I'm glad to find out how many really people feel about the subject.

I'm in a Fire Sci program, just got my EMT-B. I want to be a Firefighter/Paramedic. Whenever I say that, people say something along the lines of "what, do you want to be a firefighter OR do you want to be a paramedic," or "nobody going into FD actually wants to be a paramedic" -- which I've found a little unsettling.

I really do have a passion for science and medicine, but the aspect of firemedic that really attracts me, as opposed to other areas of medicine, is that you get to be out in the field, in the community, interacting with people in *their* environment. I want to work in a poorer area and actually make a real noticeable difference in people's lives, while I'm working and when I'm not working, getting involved in community activities. Community involvement is not something that you can find in many jobs. Plus, you can actually afford to live on a FF's salary, whereas it's really hard to live on the salary you can receive from a private ambulance company.

I guess, I don't even really know what my point is here. It's just a little upsetting that people think and feel this way.
Click to expand...

People feel this way for several reasons. FF's using the P-card to circumvent the hiring process with no real desire to be a medic. FD's have taken over EMS in their jurisdiction and have not provided a single role EMS position, basically shutting out anyone not willing to go fire. This adds to the first reason as above. Poor quality providers result.There are numerous cases of FF's treating EMS poorly.

Some are also resentful towards the superior $$$'s benefits and retirement afforded to fire based personnel. Many in EMS need to work several jobs to stay afloat, and have a dismal retirement to look forward to financially. I know, I was there myself for a while.

FD's have been known to siphon off EMS revenue to support the suppression division.

I personally don't find it difficult to maintain proficiency in both EMS and suppression. We get CME's on duty and that helps. We also drill EMS as well as suppression topics. Maintaining both is certainly easier than going through medical school, I would think. Maintaining both disciplines is not as difficult as some would make it out to be.

In the academy I noticed that the medics, including myself, had an easier time with suppression material/testing. We were also used to running algorithms for skills having done so in EMT and medic school. Basic FF 1/2 is certainly not rocket science. Real life application will be cultivated in the field through drills and experience. Maintaining medic proficiency is no different than if you were working single role. It's all depends whether the individual is lazy or not.
 
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