bstone
Forum Deputy Chief
- 2,066
- 1
- 0
And anyone who disagrees with me is simply wrong. Always.
sent to me by a physician
- Thread starter Veneficus
- Start date
And anyone who disagrees with me is simply wrong. Always.
daedalus
Forum Deputy Chief
- 1,784
- 1
- 0
Around these parts, you would rather a private service take you non-911 than some of the fire based agencies.
LucidResq
Forum Deputy Chief
- 2,031
- 3
- 0
And around these parts, faced with a leg amputation, I would rather hobble myself to the hospital rather than have a certain few private companies take me.
I think it's a very broad generalization to say fire-based EMS is always bad. It definitely, definitely works well in some areas.
Funny how you don't hear an uproar among communities that are served by fire-based EMS, they seem to be satisfied with the service they are receiving.
reaper
Working Bum
- 2,817
- 75
- 48
Most communities have no clue, what service they have. Nor do they know if it is good or bad.
Now, with the budget crisis's going on, a lot more people are starting to question why a BRT is responding with an ambulance. The average Joe does not know what type of response they are getting. Throw their money away on things and they start to open their eyes and questioning the way things are done.
Does Fire/EMS work decent in some areas? Sure it does. But, I will never agree that it is the way it should be done. I think it does a disservice to EMS and holds it back. It is up to every community to step up and figure out what works for them and how they want their taxes spent!
Now, with the budget crisis's going on, a lot more people are starting to question why a BRT is responding with an ambulance. The average Joe does not know what type of response they are getting. Throw their money away on things and they start to open their eyes and questioning the way things are done.
Does Fire/EMS work decent in some areas? Sure it does. But, I will never agree that it is the way it should be done. I think it does a disservice to EMS and holds it back. It is up to every community to step up and figure out what works for them and how they want their taxes spent!
Try reading the entire post before you comment. The first sentence says "There will be crews dedicated to the ambulance for the shift." If anything, we actually have more resources than we need, IMO.
I don't know how things work out by you, but there isn't a pump panel, any pre-connects or ladders on our ambulances. The crew may help the Truck driver to throw ladders while on standby at the fireground, but are not getting dressed and actively participating in fireground operations otherwise. The medic crew is strictly EMS for the entire shift. Fire-based EMS works well here.
When I worked NYC EMS, we frequently ran out of available ALS units on busy tour 1's, leaving BLS units to handle cardiac conditions, arrests, diabetics, etc. alone. When I worked Charleston County EMS in SC, response times in the more rural areas would top 15-20 mins. We had BLS engine backup onscene within a few minutes, tops. The EMT's tubed a couple of pts(EMT's no longer intubate currently) for us well PTA, also.
You'll have to try harder to convince me that third service EMS can deliver the goods better than fire based EMS. If anything, third service EMS is understaffed, overworked, and can rely on FD help in certain areas anyway.
That's something that people say when they can't provide an effective argument.
When we show up onscene, the pt may be suprised on the large turnout. I inform them that the county cares about it's residents and would prefer to have adequate help should it be needed. Your tax dollars at work. If anything, the county's residents have come to expect our turnout as the status quo. As such, there would be complaints if service was reduced.
What are you, 12?
Having said everything above, I will admit that a fire-based EMS system needs to have well trained EMT/medics, and a well organized system with significant resourced dedicated to EMS. This includes a sufficient # of units, state of the art equipment, progressive protocols, and enough dedicated staff to cover vacancies.
I've heard stories of municipalities taking over EMS purely to boost call volume, allow billing, and to siphon $$$'s to the suppression side(FDNY does this with EMS, and they're seperate operations). I haven't seen that at Fairfax, or any of the surrounding jurisdictions, to my knowledge, with the exception of DC or PG county.
If it's run well, fire based EMS is a wise choice. If it's implemented for the wrong reasons, it can leave much to be desired.
I do disagree with a municipal FD taking over EMS and not allowing for single role EMS under the FD banner. This unfairly shuts out career EMS personnel from continuing their career there. However, that isn't a factor in how effective the EMS system is.
Also, to help stem the tide of medics who get their cert solely to circumvent the FD hiring process and increase their odds, an experience pre-requisite should be enforced to be considered for a firemedic position. Possibly 1-3 years ALS experience prior. Give preference to those who worked EMS only as well, for a higher probability of landing one that's serious about EMS.
Perhaps some of you can help by posting fire based single role EMS agencies for those that want FD quality benefits without having to do suppression. I started a thread requesting info on quality EMS agencies to help others. Please post there.
I've heard stories of municipalities taking over EMS purely to boost call volume, allow billing, and to siphon $$$'s to the suppression side(FDNY does this with EMS, and they're seperate operations). I haven't seen that at Fairfax, or any of the surrounding jurisdictions, to my knowledge, with the exception of DC or PG county.
If it's run well, fire based EMS is a wise choice. If it's implemented for the wrong reasons, it can leave much to be desired.
I do disagree with a municipal FD taking over EMS and not allowing for single role EMS under the FD banner. This unfairly shuts out career EMS personnel from continuing their career there. However, that isn't a factor in how effective the EMS system is.
Also, to help stem the tide of medics who get their cert solely to circumvent the FD hiring process and increase their odds, an experience pre-requisite should be enforced to be considered for a firemedic position. Possibly 1-3 years ALS experience prior. Give preference to those who worked EMS only as well, for a higher probability of landing one that's serious about EMS.
Perhaps some of you can help by posting fire based single role EMS agencies for those that want FD quality benefits without having to do suppression. I started a thread requesting info on quality EMS agencies to help others. Please post there.
JPINFV
Gadfly
- 12,681
- 197
- 63
So, remind me. If fire based EMS is so good, why aren't the fire departments trying to take over the police department? After all, fire suppression has just as much in common with medical care that it does with law enforcement.
see this thread: http://www.emtcity.com/index.php?showtopic=14392
firecoins
IFT Puppet
- 3,880
- 18
- 38
Nor do I hear that about people receiving terrible service from volunteer corps. I don't think public communities are aware of what they should be or could be getting.
Btw, our ALS personnel go on duty quarterly to EMSCEP, for 8 hours of con-ed taught by PA's, RN's, and RT's. We also incorporate EMS drills with our in station suppression drills. These are part of the monthly training matrix, and is required. This makes my NREMT-P and state recerts painless. CCEMS would mandate us to attend 6 hours monthly on our day off(for straight time, not OT!) At NSLIJ, and I'm surewith many hospital based/privates, you're on your own with CME's.
In my jurisdiction the current system works well. Our personnel are assigned to either EMS or suppression apparatus for the shift. In that capacity the EMS division functions the same as a third service agency. We are resource rich, so tying up an ALS engine for a few moments or so is no big deal.
The intent of a PSO would be to wear all three hats at the same time. The only way for a PSO program to work would be for those crosstrained to be dedicated to either LE, fire, or EMS only depending on the shift. Logistical nightmare if one could be subject to performing all three functions on the same shift.
The FF EMT/medics here have proven that one can be proficient in both of these disciplines. To complete medic school, a fire academy, AND a police academy would be spreading the individual too thin.
Nassau County PD runs EMS for the county along with vollies. LEO's are crosstrained to EMT-B. ALS are single role. On a call, the LEO will meet up with the county ALS unit, which typically has one crew member only, to assist pt care and drive the ambo to the hosp. The LEO is now out of service for police matters until they're driven back to their cruiser. Now add suppression duties to the list. Doesn't work. That's one example of what the union was arguing.
Last edited by a moderator:
JPINFV
Gadfly
- 12,681
- 197
- 63
So it only works well when fire can divert resources from EMS to fight fires, but not if it goes the opposite way? Cool beans. At least we know where fire stands when they continue to basterdize EMS.
Once again, we have crews dedicated to EMS units. No one's cannabalizing ambulance crews for suppression duties. We upstaffed for this purpose.
JPINFV
Gadfly
- 12,681
- 197
- 63
The fact that you consider it "upstaffed" to be properly staffed gives it away.
Yes, we hired enough personnel to adequately fill positions for both sides. We routinely have one or two extra FF's above minimum staffing in each house for each shift who are up for detail, if a vacancy should need to be filled. They will be sent to fill either an EMS unit or suppression unit, whichever is lacking in staffing.
This ensures that no units are run down due to staffing. You give upstaffing a negative connotation. What, exactly, is wrong with the way my dept handles vacancies? As far as my dept is concerned, being upstaffed IS being properly staffed. No units will be run down.
A prime third service example: CCEMS handles vacancies by forcing employees to stay for up to an additional 24 hours past the normal shift, which is a 24/48. This can happen as frequently as is necessary, and does, irrespective of how much OT the employee has signed up for. The forced OT isn't only on a one for one basis, it can be for any unit in the county. Personnel are also subject to being on call for a 12 hour block twice monthly on their days off, no stipend given, only OT $$'s if they're called. Forced OT has also prevented some from completing their monthly CME's.
Is that your idea of "properly staffed" as opposed to upstaffed?
The CCEMS scenario is common to many areas, I'm sure. This only serves to significantly lower morale, promote attrition, and provide fatigued techs coming to your aid. No wonder why EMS only is frequently seen as a stepping stone job. Third service EMS is awesome. Been there, done that. Wasted six months of my life that I'll never get back.
I challenge those viewing this forum to advise how third service EMS, properly run, is superior to fire based EMS, also properly run. I repeatedly hear claims of FBEMS as being substandard providers, apathetic toward the medical field, not staffing EMS units properly, siphoning $$$'s from EMS to fire, firemedics dropping their medic cert after getting on, having engines stay onscene routinely for 20 mins+ waiting for a bus to stop the clock.
These are examples of NOT being properly run. These complaints vary from dept to dept, and ought not be indicative of FBEMS as a whole.
Tell me how TSEMS is superior, both from the public's vantage point, and that of the employee. Serving the public is why many of us chose this path, I've vollied in the past as well, but this is how I provide for my family.
I came to the realization after only four years in EMS that it's highly unlikely that you'll see this career to the end after 25 years or so(even more if your service doesn't have a pension). Many burn out at or around the 10 year mark. I had lots of fun in NY working T1's, but I owed myself and my family a better deal. Sadly, those in EMS typically use it as a stepping stone to a better career, go fire based for a better deal, or are stuck with no realistic way to better themselves. If this doesn't describe you personally, that's a good thing. Career advancement for EMS only agencies is sorely lacking when compared to fire and LE.
These are examples of NOT being properly run. These complaints vary from dept to dept, and ought not be indicative of FBEMS as a whole.
Tell me how TSEMS is superior, both from the public's vantage point, and that of the employee. Serving the public is why many of us chose this path, I've vollied in the past as well, but this is how I provide for my family.
I came to the realization after only four years in EMS that it's highly unlikely that you'll see this career to the end after 25 years or so(even more if your service doesn't have a pension). Many burn out at or around the 10 year mark. I had lots of fun in NY working T1's, but I owed myself and my family a better deal. Sadly, those in EMS typically use it as a stepping stone to a better career, go fire based for a better deal, or are stuck with no realistic way to better themselves. If this doesn't describe you personally, that's a good thing. Career advancement for EMS only agencies is sorely lacking when compared to fire and LE.
Also, in the interest of fairness in comparing the ideal TSEMS vs the ideal FBEMS, the TSEMS would be on it's own, with no EMS aid from local FD's, other than lift assists or help on an MVA. This is in reference to response times, timely delivery of ALS care, and more medically trained personnel onscene.