Keeping the Fire in EMS Response

[mrhunt]

Soooooooo our department will either show up all antsy....then ask to be immediately cleared because they have a fire to go to....

or else they'll just straight up say they arent available.
Or they'll respond to call and the second were on scene just bounce.

Fire's trump all for our area. Must be nice to have it the opposite.

 

[Achilles]

Looks like @DrParasite is pretty busy so I’ll ask later...

 

[DrParasite]

Looks like @DrParasite is pretty busy so I’ll ask later...

yeah i've been travelling a lot, and still trying to catch up. BTW, Virginia's EMS symposium was awesome, highly recommended.

source?

to which part? that ALS fire departments don't save lives? well, you can look at https://www.jems.com/2019/04/16/too-many-medics-debating-a-tiered-response-vs-all-als-ems-system/ saying all ALS units aren't always good. for the fire specific stuff, you can check out https://epmonthly.com/article/back-to-basics/. Are you able to provide any statistics that support the claim that ALS first responders have a statistical impact on patient mortality?

As for the giving up EMS calls, just go into any firehouse, especially a busy fire house, and ask them if they were to stop going on EMS calls what their thoughts would be.

ok....

don't believe me? you can check out the data for yourself https://www.nfpa.org/News-and-Resea...ls/Emergency-Responders/Fire-department-calls

under staffed or overused?

understaffed. We (EMS providers) can't stop people form calling 911, and it's generally not a good practice to deny sending an ambulance, without at least assessing the patient (public education can only work so well, especially with the push for socialized medicine, 911 and the ER will remain the catchall). Not only that, but we have spent decades educating the public that in case of an emergency, they should call 911; maybe we should have clarified what an emergency is, but you can't put that genie back in the lamp now. We should be sending EMS to EMS calls, and only requesting the FD when we need additional manpower (lifting assistance, cardiac arrest, rescue situations/MVAs, etc), but too many EMS systems are underfunded and understaffed.

My unscientific opinion is you should have as many BLS units as engines in a given area, and ALS units as ladders and specialty pieces. In an all ALS system, has as many ambulances as staffed engines for a given areas.

 

[DrParasite]

Isn't every west coast fire department an EMS department that sometimes goes to fires?

to be honest, the furthest west I've ever been is vegas second most west I've been is maybe ohio?.... many departments on the east coast, where I have spent most of my life, are fire departments that go to fires as well as EMS calls (although outside of the north east and midatlantic I am seeing more EMS departments that go to fires).

I wouldn't say dying left and right but I work in a county that runs about 150,000 calls a year. Naturally 80% of those calls are medical in nature so thats 120,000 medical aids a year spread out of about 90 something stations. So yeah, not only are we (the FD) taxed, but AMR as well who not only runs with us being the county FD but all the municipal cities that don't contract. So AMR's call volume is even more than ours.

Translation: your fire department handles about 30,000 calls year spread out over 90 stations. The other 120k calls, your bandaiding AMR not having enough EMS units to handle the call volume.

Statically how many fires have you gone to with an active rescue? Cause for me they're few and far in-between. I can't say for certainty but I would imagine if there was reports of victims trapped then thats a life-safety issue and I couldn't imagine being diverted as a first or second due apparatus. Third or fourth due then yeah maybe.

First off, the word is statistically, not statically. However, you do make a fair point. I guess I could ask you how many minutes does it take a fire to double in size? https://www.statter911.com/2011/05/...ry-fill-in-the-blank-and-tell-me-your-source/ had a couple different answers. and how many firefighters does it take to put out a "bread and butter" structure fire..... now if you start removing firefighter apparatus from a fire response, do you really need so many engines and ladders?

Oh and a nomenclature thing for me being a west coaster but fire trucks typically don't get diverted... fire engines on the other hand will.

We call our trucks ladders, or towers, and engines are either engine, wagon, pumpers, etc. When i was referring to trucks, I was referring to any big heavy fire vehicle used for fire suppression.

Some places won't even send a ladder to an EMS assignment; while others will. It all depends.

 

[CALEMT]

Translation: your fire department handles about 30,000 calls year spread out over 90 stations. The other 120k calls, your bandaiding AMR not having enough EMS units to handle the call volume.

What does this even mean? I'm curious how you came up with 30k calls spread out over 90 stations. What happened to the other 90k calls? You do understand that AMR is the sole private 911 ambulance in one of the largest counties in the nation. Not only do they handle the ~120,000 medical aids that we get per year but other non-contract city FD's as well in the county. Those statistics I cannot provide for you because I don't know them.

 

[DrParasite]

150,000 calls for the FD - 120,000 medical aids = 30,000 non-medical calls (IE, fire and rescue calls) over 90 something stations. The medical aids (more likely than not) could have been handled solely by AMR, if they had enough ambulances to respond in a timely manner, but as I said before, it's easier to bandaid an under funded and staffed EMS system with a FD first responder. You are taxed because AMR doesn't have or isn't given the funding or resources to handle EMS on their own.

Also, 120k calls a year might sound like a lot for a county, but last I checked, the former city I used to work in handled about 75k calls just for that city. And NYC does about 300k calls a year just for one city. Jersey City EMS handles 90k incident a year, just for that city. So yeah, AMR is busy, but the reality is if they had more units, they wouldn't be as busy. And if they had more units, they wouldn't need to tax the FD to be a first responder to stop the clock.

Hope that clears it up for you

 

[CALEMT]

It did. Thank you.