The role of EMS in the rescue assignment

[rescue1]

Obviously the solution isn't to defund what you admit are overly funded fire departments, and increase funding to what you admit are underfunded EMS departments.

But if all you do is pull rescue money from fire departments and give them to EMS to perform rescue, won't you still have the same issue with an underfunded EMS side, just now they also have a well funded rescue company which has moved from fire to EMS?

I say we worry about the issues that EMS has right now, namely a lack of education and recognition, before we decide to start adding additional responsibilities.

 

[JPINFV]

But if all you do is pull rescue money from fire departments and give them to EMS to perform rescue, won't you still have the same issue with an underfunded EMS side, just now they also have a well funded rescue company which has moved from fire to EMS?

Isn't EMS already performing rescue operations, hence why they are looking at transferring rescue operations to the fire department? As such, why is the fire department receiving funding for rescue operations when the EMS department is the primary rescue service?

 

[Chief Complaint]

Obviously the solution isn't to defund what you admit are overly funded fire departments, and increase funding to what you admit are underfunded EMS departments.

I wish they had more funding, but it doesnt seem like that's going to change anytime soon.

Isn't EMS already performing rescue operations, hence why they are looking at transferring rescue operations to the fire department? As such, why is the fire department receiving funding for rescue operations when the EMS department is the primary rescue service?

Firefighters handle rescue, not EMS, in a fire based system. It's a joint effort, but the guys on the engine/truck/rescue handle tech rescue for the most part.

 

[rescue1]

Isn't EMS already performing rescue operations, hence why they are looking at transferring rescue operations to the fire department? As such, why is the fire department receiving funding for rescue operations when the EMS department is the primary rescue service?

Where is this taking place? If you're talking about the Pittsburgh article I don't know if the FD gets rescue funding or not.

As to the OP's issue, I think funding is broken up among the volunteer agencies. And volly funding tends to vary widely depending on where you are, so I wouldn't use that as a guide.

Also, if the fire department is already going to be there (per the OP), why not put rescue tools on their engine company (or a pump on their rescue). That way you can use the money spent staffing an EMS rescue to staff more ambulances, and use the FD crew to perform rescue.

 

[JPINFV]

Firefighters handle rescue, not EMS, in a fire based system. It's a joint effort, but the guys on the engine/truck/rescue handle tech rescue for the most part.

Except the recent conversation turned to discussing Pittsburgh, where EMS is apparently the primary team, not the fire department. See the following post:
http://www.emtlife.com/showpost.php?p=434540&postcount=32
Which you followed up with...
http://www.emtlife.com/showpost.php?p=434543&postcount=33

 

[Chief Complaint]

Was referring to the OP.

 

[Shishkabob]

Lastly, single role EMS agencies would not be able to fund the training and equipment costs that it takes to put together a top notch tech rescue program. From what i hear, many of them can barely keep their EMS equipment stocked due to lack of funding. Large career fire departments have the money to send their FFs/EMTs/Paramedics to lengthy courses in order for them to become proficient in tech rescues, as well as the money to buy quality tools for such jobs. Private companies will never be able to come up with that kind of funding.

The main FD my agency runs with has a budget nearly $70 million more than my agency, and runs 40,000 LESS calls than we do. Yeah, THAT'S efficient.


80% of most FDs runs are medical, so how about we split funding as such? Give the EMS agency 80% of the FDs funding. Imagine the awesomeness that could be done with that much more funding correctly placed where it can do the most good?


Infact, I'll settle for just 25%.

 

[Chief Complaint]

I agree with you, private companies should be getting more money.

I just don't think that they need to take over tech rescue ops.

 

[DrParasite]

Apparently Pittsburgh is thinking of transferring its rescue work over from EMS to the fire side of things.

http://www.firehouse.com/news/10812112/pittsburgh-officials-medic-contract-risking-rescues

did you read the article, and see the reasoning? EMS numbers are up, and run times are close to 17 minutes. Now, could this be due to the all ALS system that gets inundated with BS calls that can wait, while the FD is under 8 minutes to all calls? Or is it because PEMS don't have enough EMS units to handle the call volume (if they had twice as many EMS units, I would wager your entire yearly salary that response times would decrease substantially), while the FD has enough units to handle peak volumes and still maintain appropriate response times?

If you properly fund, train, and staff them, Public Works can handle rescue (no, I'm not suggesting it, just stating a fact). Having staff assigned to the rescue vehicles full time, as well as the equipment and training to do the job right is what you need.

and increase funding to what you admit are underfunded EMS departments.

increasing funding to EMS departments? nah, why on earth would we want to a crazy thing like that?

 

[rescue1]

I agree with you, but the fact remains that it could cost less money to transfer rescue to fire, use the ems staffing you saved to staff more ambulances, and call it a win, all without spending more money.
Maybe EMS is doing fine in Pittsburgh and it's just a power grab, I don't know the details. But why can't we worry about fixing the medical side of EMS before we try and take on more responsibilities?

 

[usalsfyre]

I agree with you, but the fact remains that it could cost less money to transfer rescue to fire, use the ems staffing you saved to staff more ambulances, and call it a win, all without spending more money.

Cause the union will go for THAT one....

Maybe EMS is doing fine in Pittsburgh and it's just a power grab, I don't know the details. But why can't we worry about fixing the medical side of EMS before we try and take on more responsibilities?

The fire service has a lot to fix in suppression as well.

 

[Ace 227]

I can only offer my personal experiences with it but generally myself and my partner just stand ready until the pt is extricated and then we assist with the backboarding, etc. However, I have been on-scene when a, less than capable, rescue crew is there and I have grabbed the cutters to get the pt out. I am a BVR Tech where as some of the first due companies(volunteer) do not have any. Whatever helps the patient.

 

[DrParasite]

I agree with you, but the fact remains that it could cost less money to transfer rescue to fire, use the ems staffing you saved to staff more ambulances, and call it a win, all without spending more money.
Maybe EMS is doing fine in Pittsburgh and it's just a power grab, I don't know the details. But why can't we worry about fixing the medical side of EMS before we try and take on more responsibilities?

the fact remains, you can close down 25% of the fire houses, stop doing EMS first response (which will decrease their run volumes by 80% and free up fire resources), put all the money saved into the EMS system putting more ambulances on the road, which would decrease response times to under 10 minutes, call mutual aid for any actual fire, let EMS handle all rescue (like they have been doing for 35 years, not really taking on more responsibilities is it?) so you don't need to tie up fire resources, and call it a win, without spending any money.

 

[Shishkabob]

I agree with you, but the fact remains that it could cost less money to transfer rescue to fire, use the ems staffing you saved to staff more ambulances, and call it a win, all without spending more money.

Or de-fund fire because they are needed on less calls, transfer some of the funding to EMS so they can staff more ambulances, and actually save money.


I like that one more.

 

[DrParasite]

in case anyone was curious about the numbers:

Pittsburgh Bureau of Fire
Personnel 630
Stations 29
Engines 28
Trucks 11

Total runs: approx 25,955, of which 12,164 were EMS & Rescue runs, and 225 were structure fires

(the above courtesy of wikipedia and PFD's website)

Pittsburgh EMS:
Personnel 156
Ambulances: 14
Rescue: 2
Stations: 13
Total runs: 56,500

(the above courtesy of the quoted article and PEMS website)

Anyone else want to use these actual numbers and facts to support their point of view?

 

[Shishkabob]

And I'm willing to bet PFDs budget is at least three the size of PEMS...

 

[DrParasite]

Three times????

PFD Budget: $53,004,325

PEMS Budget: $13,192,712

source: http://apps.pittsburghpa.gov/cbo/City_Council_Operating_Budget_2012_for_online.pdf

that means the FD's budget is 4x as big as the EMS budget.

btw, the public works budget is 2.5 times as large as the EMS budget, but still less than the FD's.

Can you imagine what EMS could do with a 53 MILLION dollar budget? Imagine how many lives we could save!!!!

 

[rescue1]

Yikes. That is not a stellar arrangement, and the city could probably lose some engines or trucks in exchange for some ambulances.

Though, would moving the rescue capability change anything? I feel like at some point we stopped talking about rescue and are now talking about bloated FD budgets. Which is an issue, just a different one.

 

[DesertMedic66]

Instead of cutting down fire departments budget and then transferring it to EMS agencies (most are private agencies) and then taking rescue work out from the fire department and giving it to EMS (no where to store tools on type 2 vans), why not fully combine EMS and fire.

Everyone seems to agree that the fire department has a pretty good union and good pay. If EMS gets combined with fire then single role medics pay should go up and you get a good union.

The budget for EMS and fire can be combined into one. If more of the budget needs to go to EMS then no big deal because its all one budget.

Also takes away who should do be doing extrication because its all one department now.

Now to wait and see who will tear this post apart because "fire and EMS are completely different things and should not be combined ever". :lol:

 

[Veneficus]

Instead of cutting down fire departments budget and then transferring it to EMS agencies (most are private agencies) and then taking rescue work out from the fire department and giving it to EMS (no where to store tools on type 2 vans), why not fully combine EMS and fire.

Everyone seems to agree that the fire department has a pretty good union and good pay. If EMS gets combined with fire then single role medics pay should go up and you get a good union.

The budget for EMS and fire can be combined into one. If more of the budget needs to go to EMS then no big deal because its all one budget.

Also takes away who should do be doing extrication because its all one department now.

That is the theory anyway. It seldom works out that way.

What actually happens is EMS gets even more of the shaft while the chief officers, who are mostly suppresion people, buy big shiney trucks that look nice in parades in case "the big one" hits.

They also spend a lot of money on trying to preserve outdated practices like an engine house every few blocks instead of a smaller number of regional stations.

Now to wait and see who will tear this post apart because "fire and EMS are completely different things and should not be combined ever". :lol:

It is not that they cannot effectively be combined, it is that it is so rarely effectively combined that it is more realistic to predict it will not work out as it should in theory.