Lets hear some opinions on this

[Fish]

It has been said multiple times that Fire Departments have "suppressed" themsevles out of business, with Code enforcements, Fire Inspections, Fire Prevention, etc....... Now, we know that typically 80% of a Fire Departments call volume is EMS, but in your opinion would you say that we are starting to see EMS phaze out the need for FD first response with the Addition of Vents, Lucas Devices, etc...? We know that one big role of FD first response is to stop the clock, but is the need for them on scene with Vents and Machines that do compressions for us deminishing? Also, we have started to see a lot of power stretchers, improved stair chairs, and priority dispatch limiting the need for First Response Assistance.

Wondered the opinions of people on here, I am not sure how I feel about it either way yet.

 

[Epi-do]

Since we do not carry a vent, thumper device (or something similar), or have power stretchers, I can still find plenty of uses for the fire guys. I think if you have a service where you have access to those types of toys, it may decrease the need to take extra people in with you during transport, but in areas with long response times for the ambulance, you will still see a need for someone who can get there quicker to begin patient care. I don't know if that will always be firefighters, but some sort of first aid provider will still be needed as a first response.

 

[Handsome Robb]

We have vents but no compression device. Fire is definitely helpful to have around on some calls, other times it just makes unnecessary crowding of the scene. Also fire doesn't stop the clock here, it only stops when we mark on scene.

 

[Shishkabob]

I would say they're "fazing out" due to new devices, but for the fact that they really aren't needed on most calls.

Infact, a study just released from Canada says that fire first response, for BLS fire and ALS EMS, is helpful on only 2% of the calls.

http://www.torontosun.com/2011/10/12/firefighters-not-much-help-on-medical-calls



I'd rebute that and say that they're helpful on every call they decide to carry my patient / stretcher / monitor / bag, but that's besides the point. ^_^

 

[fast65]

Eh, I guess we may be kind of phasing them out, however, I still find them helpful sometimes. It's nice to have an initial response there to kind of get the ball rolling on what you might need to get the person out (i.e. stair chair, soft cot, etc.), plus the extra man power is always nice to have as far as lifting goes. But I guess around here I'm kind of lucky to have a lot of the firefighters be EMT's or paramedic's for our company as well, so I can trust most of them to be helpful on scene.

We carry vents on our ambulances, but we don't carry compression devices. Honestly, the occasion where I need either of those on a 911 call isn't very common, and I have never set up a vent on a pt. that I or someone else intubated in the field, they always end up getting bagged all the way to the hospital. The only time I use the vent is on IFT's.

 

[Chief Complaint]

Some of the agencies around here are moving towards, or already have a medic on every apparatus in the county. Im completely ok with fire showing up to a medical emergency first since they can provide close to the same level of care as an ambulance.

 

[Fish]

I would say they're "fazing out" due to new devices, but for the fact that they really aren't needed on most calls.

Infact, a study just released from Canada says that fire first response, for BLS fire and ALS EMS, is helpful on only 2% of the calls.

http://www.torontosun.com/2011/10/12/firefighters-not-much-help-on-medical-calls



I'd rebute that and say that they're helpful on every call they decide to carry my patient / stretcher / monitor / bag, but that's besides the point. ^_^

Interesting

 

[46Young]

A few thoughts...

That 80% number may be true when you look at the number of EMS runs vs the number of suppression calls, but that doesn't tell the whole story. There are several different types of incidents that dispatch multiple suppression units, such as a box alarm, an inside gas leak, a Hazmat incident, an alarm bell, or a brush fire. A box will have a supp/EMS ratio of 9/2 in this county. Gas leak, 4/0. Alarm bell, 3/0. Hazmat, 2-5/1. Brush fire, anything from 1-infinity/one or two. A more accurate measure would be to take all the different units, count each call, and then tally the results for a proper fire/EMS ratio.

The more you move from urban to rural, the more relevant fire becomes with providing EMS.

Today, I worked IFT with an EMT that vollies for the Woodstock Rescue Squad in Shenandoah, VA. Originally, he told me that Shenandoah County was mostly a farming community. Then, retirees and professionals with money from DC and Northern VA began to migrate there, drive up property values, and demanded urban level services RIGHT NOW. The county's volunteers couldn't keep up with the EMS demand, so the county had to hire career FF/EMT's and FF/medics. Why dual? Because they can't possibly fund the hiring of seperate fire and EMS, so they have to combine roles.

I work in a fire based system, on a bus that provides frequent mutual aid into Loudon County, Sterling in particular, which is all volunteer fire and EMS from what I've been told. About 25% or more of my call volume is into Sterling's first due. They have BLS, Trauma (EMT-Enhanced), and ALS units. When they get out is hit or miss, but they rarely have ALS on the overnights. Loudon County built and provided 24/7 career staffing in Ashburn. That crew told me that they run into Sterling often themselves. The volunteer system can't keep up, and having seperate career EMS and career fire apparently cost effective for them, or they would be doing that already.

As a contrast, NYC has seperate fire and EMS. Yes, FDNY EMS is technically fire based, but they are seperate from the Jakes. In addition, there are many hospital based EMS providers in the city (my background), maybe 30% of all units, by my guess. If you care to count, here's where you can do that:

http://www.fdnyems.com/EMS Unit Location Charts.pdf

In urban systems, seperate services work better. Units are stacked close together, the hospitals are close, and the tax base can support seperate services.

My point of all this is, every location has it's own unique situation and needs. It's difficult to paint the entire EMS realm with the broad brush of generalization. For every Florida, DC, and CA, there are many places that would be SOL without fire to help out.

Edit: Also, no matter how well modern technology and fire prevention reduces fire's call volume, it will still take the same amount of time to respond to the incident. Keep in mind that modern homes have a fire load that consists of synthetic materials inclusing plastics, that burn much hotter and quicker than legacy homes, which are mostly class A materials, which is wood and cloths. Modern type 5 homes also have huge void spaces. My point? Homes can be charged with smoke filled with dangerous gases such as CO, Hydrogen Sulfide, ans Cyanide much quicker than in the past, and rooms can flash in a matter of a few minutes. In fact, when you compare a legacy room to a modern one, the former takes over 1/2 hour to flash, and the latter takes less than five minutes. Cut staffing and deployment, and help will be too late.

 

[mycrofft]

"being phased out", please.

A gradual, graduated process.

Heck, cutting back on smoking helped reduce fires quite a bit, but seasonal wild land fires have gotten more serious over time.

Some airports use their firefighters/rescuemen as refuelers most of the time. I cannot think of an analog of that for big cities' urban areas...landscapers?EMT's? If taxpayers saw what the routine can be in most fire stations they would get really itchy.

 

[Fish]

The article Linuss posted is interesting, but I think the number is smaller there than here because the scope of those Fire Fighters is a lot less than what they can do here.

Here they can do the following standing order for Basics:

ASA
Albuterol
Nitro
Epi SQ
Oral Glucose
o2
Check Blood Sugars


What I got from that Canadian article is those Toronto FF can only do CPR, AED, o2 and first aid?

 

[thegreypilgrim]

In urban systems, seperate services work better. Units are stacked close together, the hospitals are close, and the tax base can support seperate services.

My point of all this is, every location has it's own unique situation and needs. It's difficult to paint the entire EMS realm with the broad brush of generalization. For every Florida, DC, and CA, there are many places that would be SOL without fire to help out.

Just make EMS a state-level agency and keep FD local. This spreads the risk levels out in a more even fashion and takes advantage of a wider revenue pool to help equalize costs and disparities in access to services.

 

[SteveTP]

What I got from that Canadian article is those Toronto FF can only do CPR, AED, o2 and first aid?

That would be correct. In order to do all the things you mentioned, they would have to take the two year course and write the exam; something I imagine alot of them are unwilling/unable to do.

It does seem that fire services are reducing the number of medical calls they attend, especially around here (even for the full time services). The statistics do seem to be in place to support this.