JPINFV
Gadfly
- 12,681
- 197
- 63
...because LA County contains so many well run models of fire based EMS. It's just too bad it's 2012 and not 1972.
The role of EMS in the rescue assignment
- Thread starter EMTswag
- Start date
...because LA County contains so many well run models of fire based EMS. It's just too bad it's 2012 and not 1972.
Chief Complaint
Forum Captain
- 429
- 1
- 0
Nailed it! Great post.
DrParasite
The fire extinguisher is not just for show
- 6,352
- 2,209
- 113
No; the statement was made that taking rescue away from EMS and giving it to FD would save money. The budget numbers were provided in response to linuss,s comment about budgets, as well as to point out that the problem isn't that EMS can't do Rescue, but rather, the funding isn't given to EMS to do ambulance work or rescue, it's given to the FD on a 4:1 ratio. Also, if you took some money and shifted it to EMS, many of the EMS problems would go away, and the reasons the FD should take over rescue would decrease substantially.
ok, first off, more EMS agencies aren't private agencies. they might be over all nationwide, but i think if you look at the total number of agencies, you will find more non-private ones than private agencies. And second, if you look at the EMS agencies that do rescue, you will find VERY VERY few private agencies. Rescue is expensive, especially in the begining (all the initial training, vehicles, PPE and equipment), and you need tax dollars to pay for it (and yes, EMS can and SHOULD be tax funded, but that's a discussion for another thread), most private agencies can't and won't pay for it. Thirdly, if you are looking to store tools on the type 2 vans, you are doing it cheap, half assed, and wrong. Look at the images I posted: all those agencies have dedicated rescue vehicles, dedicated rescue staff, and aren't running tools from the ambulance; they are using specialized vehicles designed for rescue operations. Just like you don't carry confined space rope rescue gear in an engine, you don't carry lots of wood for trench collapse on either a ladder or engine, and a hazmat truck is a specialized vehicle designed with all your hazmat crap, if you are going to do the job 100%, you need to have a vehicle and all the necessary equipment to do it 100%, so you can be ready for anything rescue related. Doing it halfassed and with a vehicle that is only designed to handle some types of incidents will mean you can't handle every assignment
yeah, and how often does that happen? how many mergers resulted in entry level paramedics making as much as entry level firefighters? Can you name any big departments like this? good in theory, almost never happens.
good in theory; in reality, EMS does 80% of the total run volume, FD get 80% of the budget. happens all over the country.
yeah, it's the single role EMS providers who are assigned to the Heavy Rescue, have all the gear and training they need to get the job done. Can you show me any department that would allow that?
Very few, because it makes sense to make them firefighters, allowing them to perform rescue from structure fires as well, or exist as a RIT.
My question is, when you look at the countries that we at EMTLife think do EMS correctly--Canada, New Zealand, Australia--none of them do rescue. They focus on medicine, and let the fire service focus on technical skills.
Hell, I had a partner who didn't know what a pulmonary embolism was. Why do we then want to make him also responsible for using hurst tools when he can barely do his primary job? Shouldn't we be more worried about educating our providers about medicine first?
I'm not saying that EMS can't do rescue. Like you said, Public Works can do rescue if they were trained. I'm just saying that with EMS in the infant (and occasionally crappy) stage here in America, it seems we're quick to throw new responsibilities on us just because. Also, no one has (at least over the last few pages) given a reason as to why EMS should run rescue as opposed to fire. All we've agreed on is that anyone can be trained to do it...which means it really doesn't matter who does it.
In the interest of full disclosure, I have never worked or volunteered in an area that had a paid fire department AND separate EMS. I only have experience in combined Fire/EMS departments, and paid EMS/volunteer fire areas (where I currently work). So I have no idea how that dynamic may work between different agencies.
DrParasite
The fire extinguisher is not just for show
- 6,352
- 2,209
- 113
which is odd, because FDNY (arguably one of the busiest FD's in the nation) uses truck companies for RIT, not rescues. and the truck companies typically do searches at structure fires, not rescues.
Or lets think REALLY outside the box, and say since the FD doesn't have a RIT team, lets train and equip the EMS personnel as firefighters, and let them serve as the RIT team on working fires, while still being EMS personnel. I know, the concept blows your mind.
well, if your partner can barely do his primary job, than maybe he should be fired and replaced with a more competent person? I know what a PE is... I can also operate the hurst tools (although holmatro was waaaay lighter and easier to use). and I know I'm not the only one.
you know, your right. Then again, I haven't seen anyone give a reason why fire should run rescue instead of EMS, other than the fact that they have the funding, equipment, manpower and training to do so. So if you give EMS the funding, equipment, manpower, and training to do rescue, it takes away the reason for FD to do rescue.
The biggest reason for EMS to do rescue is because rescue is a "patient oriented" process, and who better to perform a "patient oriented" process, than the EMS providers who are the experts in patient care and what is best for the patient? I know many firefighters who can use the tools; but can that firefighter recognize that the patient is really sick, and needs to be extricated immediately? or if the FF being lowered on a rope rescue, can he or she perform an assessment on the patient to see what condition the patient is in? And before you says "yes, if they are an EMT", I will counter with "well, if you can teach the firefighter to be an EMT, I can teach the EMT to be a firefighter."
CentralCalEMT
Forum Captain
- 254
- 88
- 28
I do not see why everyone can not play well together in the sandbox. I just ran an over the side vehicle rescue where we had 2 (BLS) fire departments, 2 law enforcement agencies as well as my ambulance on scene. We all played nicely together and were able to get the patient up. I can not imagine our last patient waiting for the rescue to be completed before being evaluated by EMS. Every EMS system is different and what works in New York City will not work in the Sierra Nevada mountains. I do not necessarily think as a rule EMS should be doing rescue work (although some agencies do an excellent job) HOWEVER, it amazes me the number of times you see pictures of critical patients in rescue situations with EMS standing in the background waiting for the patient to be extricated. There are very few times, patient care and rescue work can not happen at the same time. With proper training and PPE, EMS should be working alongside whatever agency is doing the rescue work. If people put their egos aside (and yes it is possible, since I see it every day in my area) and works together, the job gets done well.
Last edited by a moderator:
FDNY still runs heavy rescues on working fires, though I don't know if they do RIT or just assist. I know they used to do RIT.
Bur are you advocating EMS based fire suppression as opposed to fire based EMS? Won't that have...you know...all the same problems that we have with combined service already? We can't argue against fire based EMS and then advocate EMS based fire.
Unrelated note, beer is delicious, but it does mean the rest of this debate is gonna have to wait till tomorrow. :beerchug:
Shishkabob
Forum Chief
- 8,264
- 32
- 48
Funny thing is, my agency's budget is also 1/4 the budget of our biggest FD partner. The local FD's budget is $118 million a year, while my agency is $30 million a year, and we run 40,000 more calls AND don't put a burden on the tax base. Looking at the proposed budget, the FD gets nearly 20% of the city's budget each year.
Yeah... "efficient".
It's generally not the field crews who don't get along (I say generally, because I have my own experiences as most do), but when it comes time to compete for the budget dollars that FDs and their unions tend to skew things in their way.
Correction: They tend to not do heavy rescue, but do tend to train their personnel in it, AND FD doesn't throw a hissy fit when a Paramedic gets in with the patient, like they do in some places. On top of that, in most of those places, FD doesn't try to move beyond fire and rescue saying they could do medicine just as well as EMS does.
No, in those places, it's rather an exception, instead of a rule, to see a firefighter with any medical training beyond that of a first responder.
Actually, it's split in 1/3s, with each third being private, public, and FD.
Weren't you the guy who said EMS shouldn't do rescue because EMS agencies have a hard enough time doing medicine and putting more on their plate means they'll suck?
Yes... yes you were.
Last edited by a moderator:
DrParasite
The fire extinguisher is not just for show
- 6,352
- 2,209
- 113
on a working fire dispatch, you get 2 engines, 2 trucks, and a BC. on a confirmed working fire, the assignment is upgraded to 4 engines, 2 ladders, 1 rescue, 1 squad, 2 bc, and additional ladder to act as the FAST/RIT truck. RESCUE and SQUADS often assist the RIT company, but they aren't assigned to RIT duties. But oddly enough, FDNY also has the truck companies do rescue, in addition to the rescue company
I am absolutely 100% against fire based EMS. I am also 100% against EMS based fire suppression.
But those who do advocate for combined services always say FD can do ems, so using the same logic, I just said let EMS fight fires. If you are in favor of one because it can work, than you can't be against the other (and both are equally absurd or equally a great idea, depending on which side you fall on).
have one for me, the boss frowns when I start drinking while at work
Chief Complaint
Forum Captain
- 429
- 1
- 0
Only skimmed the last couple pages of responses, but let's be serious for a minute. Private EMS agencies have no physical requirements for employment. Career fire departments require that a certain standard be met. That's why private EMS agencies don't take over rescue ops. Fat people aren't much good at a trench rescue scene.
CentralCalEMT
Forum Captain
- 254
- 88
- 28
I am sorry you have had bad experiences with private EMS personnel who do not do the job well. However......not all private EMS is full of fat and lazy slobs. Within an hour of I work, yes there are several companies that have people that are an embarrassment to EMS. However, where I work, we routinely have to hike in miles to our patients at high elevations in horrible conditions, assist with over the side rescues, and are in generally good shape. Nobody that works for us is overweight We are allowed to do PT on duty and most of us do. Like I said before, there are EMS providers who make the rest of us look bad, but I am tired of career firefighters dismissing private EMS entirely because of the actions of a few.
I believe EMS should totally be trained in rescue, and be allowed (and trained, and expected) to provide patient care during the rescue operation.
Sorta like tactical medics, we cross train with LE to provide medical care on scene of a SWAT incident, but we don't take over law enforcement nor does LE take over EMS.
My philosophy remains that firefighters already have big trucks and tools, and plenty of time on their hands. This is even more true if they are not ALS fire departments (which I'm not the biggest fan of).
I'll also admit my idea is based mainly on cost/benefit analysis, and on the somewhat crazy idea that the money saved from fire doing rescue could be used to fund more ambulances.
That being said, it sounds like some of the firefighters near Linuss are pee pee heads if they refuse to allow EMS to access a patient during rescue. EMS should be an integral part of rescue assignment.
How does ATCEMS run rescue? I almost applied for Austin Fire Department a year ago, and their website implied that they also did rescue stuff. Does ATCEMS assist the FD, or is it the other way around?
Also, "because they're fat" is probably not a good reason to exclude EMS from rescue. This is public safety. It's like a fat person party.
Last edited by a moderator:
Bullets
Forum Knucklehead
- 1,600
- 222
- 63
See Flemington-Raritan First Aid Squad...
they are the primary RIT team for their area and assists the local FDs with fire suppression
the old truck carries all their tech rescue stuff
For those who claim that EMS cant fund a rescue division, i can point to many here in NJ, both volunteer like Wayne Memorial First Aid, Hybrid like Flemington, and paid, like UMDNJ who operate heavy rescue trucks and do so very well. My home town operates EMS rescue, but the local FDs are trying to get in on it, buying used tools and pumps because they just dont do fire work any more. I have not had positive experiences with these volunteer fire companies. I have been in a car that another town was cutting and they shook that thing like San Fran in 1989
Last edited by a moderator:
DesertMedic66
Forum Troll
- 11,340
- 3,513
- 113
I guess I view rescues differently due to the fact that all fire engines here have at least one medic on board with all the other firefighters being EMTs. Rescue work is still based on medical (with the fire medic being in charge). The ambulance (EMS) waits for the patient to get removed (to an extent. We will help backboard in the vehicle etc) and then transport.
Fire has the man power, has the tools, has the training, has the gear, and has the medical aspect covered. We are pretty much just a taxi.
Fire has the man power, has the tools, has the training, has the gear, and has the medical aspect covered. We are pretty much just a taxi.
- 7,904
- 2,878
- 113
Doesn't UMDNJ staff their heavy rescue with only two people?
It is important to understand in structural firefighting, a rescue company functions more like a force multiplier.
Not only for rescue but for anything else that is needed on the fire ground.
All of the dedicated fire service rescue companies I am familiar with require time on an engine + time on a truck + time in rate to even remotely qualify for the assignment.
Just because a department has a rescue truck doesn't make them a rescue company similar to larger cities like NY, Chicago, etc.
Actually, many european countries train their medics in tech rescue.
Advancing into specialized rescue, like mine, mountain, collapse, etc is an upward mobility promotion.
I'm not advocating not training EMS in rescue techniques. I'm just advocating making the fire department the AHJ for rescues. If fire and EMS are separate (which they have to be for this topic to make sense), then EMS should absolutely be included in the rescuing process.
And yes, Tigger, according to their website, UMDNJ's rescue is staffed with two EMTs. I don't know if Newark FD has a separate one or not though.
Bullets
Forum Knucklehead
- 1,600
- 222
- 63
Yes, which makes the work they do all the more impressive.
However i feel that two is the ideal number on a vehicle rescue
There is a very easy way to fix that. If fire/ems/police split the budget as needed to run each one based on actual need and not what a union says is needed, a third service EMS could be started which has physical requirements. Which could replace the private company doing 911.
