bled12345
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We're in a war with the fire department - national post
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jjesusfreak01
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Interesting Article. Brings up some good points, some good ideas, and makes some bogus statements.
Fire is increasingly faced with the task of legitimizing themselves when the number of fire calls is decreasing and the number of medical calls is increasing. I don't think they should be working so hard. Fire departments are necessary for the protection of the public. They need to be community based to have low fire response times, which are often more important than our response times to medical calls. They are necessary for rescue and extrication for MVCs, which only increase with population growth, and ideally they should be involved in community activism and fire prevention.
That said, they are not EMS. They provide medical care to sustain until a transporting ALS unit arrives. Putting a paramedic on a fire truck to lower response times doesn't increase efficiency or quality of care when most life-saving interventions are BLS and ALS care will need to be transferred to another agency (I know some agencies have paramedic firemen that ride in on BLS trucks).
What needs to happen is a decreased response of fire to medical calls and an increase in the number of als level ambulances in every area. We should have as good of response times as fire has to medical calls in just about every case. I also cannot disagree with the notion of co-locating ems with fire or police stations. If the city or county runs both services, it seems like a no-brainer. If every station had fire and EMS, you wouldn't consider sending fire to any ems call just to try and get a medical resource there faster. EMS would almost always be as fast as fire to any given scene, so fire response would be restricted to calls that could use additional personnel, such as cardiac arrests or unstable cardiacs (Where you might want to have an extra hand or two in the back of the ambulance), massively obese patients, severe traumas (high potential to code), etc.
Fire is increasingly faced with the task of legitimizing themselves when the number of fire calls is decreasing and the number of medical calls is increasing. I don't think they should be working so hard. Fire departments are necessary for the protection of the public. They need to be community based to have low fire response times, which are often more important than our response times to medical calls. They are necessary for rescue and extrication for MVCs, which only increase with population growth, and ideally they should be involved in community activism and fire prevention.
That said, they are not EMS. They provide medical care to sustain until a transporting ALS unit arrives. Putting a paramedic on a fire truck to lower response times doesn't increase efficiency or quality of care when most life-saving interventions are BLS and ALS care will need to be transferred to another agency (I know some agencies have paramedic firemen that ride in on BLS trucks).
What needs to happen is a decreased response of fire to medical calls and an increase in the number of als level ambulances in every area. We should have as good of response times as fire has to medical calls in just about every case. I also cannot disagree with the notion of co-locating ems with fire or police stations. If the city or county runs both services, it seems like a no-brainer. If every station had fire and EMS, you wouldn't consider sending fire to any ems call just to try and get a medical resource there faster. EMS would almost always be as fast as fire to any given scene, so fire response would be restricted to calls that could use additional personnel, such as cardiac arrests or unstable cardiacs (Where you might want to have an extra hand or two in the back of the ambulance), massively obese patients, severe traumas (high potential to code), etc.
terrible one
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Out of curiosity how do the systems in NC work - jjesusfreak?
The thing is that the Fire Service in Canada is not just able to push Firefighters through some patch factory for loser cookbook retards and churn out "Paramedics" in five months who don't know their head from their arse and are just barely educated enough to kill somebody.
Ontario has the highest education standards in the country, with a Primary Care Paramedic requiring two years of full time University education and an Advanced Care Paramedic requiring an additional year after getting around 2,000 hours of experience.
Ontario has the highest education standards in the country, with a Primary Care Paramedic requiring two years of full time University education and an Advanced Care Paramedic requiring an additional year after getting around 2,000 hours of experience.
jjesusfreak01
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Can't speak for many counties, but in Wake, fire gets dispatched to bravo level or higher calls if the dispatcher thinks they might be needed (pretty much what this article is talking about). We don't get them for everything, but we do get them for a lot of calls. I ran two calls Wednesday night, FFs responded on one and not on the other. I can't complain though, the Raleigh FFs are all EMT-B trained and will usually have a basic assessment with vitals (including BGL, they always do a BGL) done before we arrive. Whoever got the history gives a very quick report to the EMS Medic or EMT and we take over. They will happily help us package the patient (if they need immobilizing), will carry anything if we need them to, and are generally very helpful.
Now, Wake is in a very very urban area. Whereas we use all medic staffed ambulances, not all of the surrounding counties do. They might have volly rescue squads or first responders who are dispatched to medical calls and show up in POVs. Its possible the firefighters or first responders who arrive onscene might be the only medical personnel for a good ten minutes or more, so they can be more vital to the care and survival of patients in time critical situations. It seems like the rural areas end up with more bad MVCs than the county, but I could just be imagining that.
Too Old To Work
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Wouldn't it make more sense for EMS to takeover the fire service, since most of the fire service's work load is EMS related? Then have a doctor be in charge of both services, with a suppression chief to report to the MD in charge.
jjesusfreak01
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Rather have a non-MD chief over both services with a doctor used for medical direction. It would seem inappropriate to have a doctor running a fire-service, IMO.
Too Old To Work
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Only it's not really a fire service. As Alan Brunacini used to say (and maybe still does), "We're an EMS service that once in a while puts out a fire." If 70% or more of a FD's responses are medical, than it's not really a fire department, it's an EMS department with a fire suppression component. Which is what most FD's don't understand and which is why so many FD based EMS systems are constantly in controversial situations.
About as appropriate as a fire chief running an EMS service...