What a bunch of crap!!

If paramedic ambulance response times aren't up to snuff, then that's an indication for more paramedic ambulances, not putting paramedics on fire engines. Similarly, while I do understand that not all calls are coded dispatched appropriately for a variety of reasons (not enough information, information not provided, caller misinterpeting what's going on, so on and so forth), designing an emergency medical system around cardiac arrests is just stupid.

Engine responses instead of more ambulances is like saying that fire departments could do with a slower response time to structure fires if we throw some hoses and a hydrant wrench on an ambulance or police car. After all, what's the worry as long as someone's putting water on a fire?
 
Last edited by a moderator:
JPINFV said:
If paramedic ambulance response times aren't up to snuff, then that's an indication for more paramedic ambulances, not putting paramedics on fire engines. Similarly, while I do understand that not all calls are coded dispatched appropriately for a variety of reasons (not enough information, information not provided, caller misinterpeting what's going on, so on and so forth), designing an emergency medical system around cardiac arrests is just stupid.

Engine responses instead of more ambulances is like saying that fire departments could do with a slower response time to structure fires if we throw some hoses and a hydrant wrench on an ambulance or police car. After all, what's the worry as long as someone's putting water on a fire?
Click to expand...

Actually, since we're all crosstrained to both suppression and EMS, we can and do help on a structure fire.

Two EMS units get dispatched initially to a fire, one for pts and one for rehab. If there are no pts initially, one person will load up the cot, and the other will help the engine driver hook up, or help the truck driver throw ladders. Seconds count in these situations.

If, on the rare occasion that only one suppression unit is onscene, and there's need for a search or a VES, the medic crew can get dressed and function as the outside crew (initial RIT) for a few minutes to satisfy the "two in/two out" requirement until help arrives.

Having everyone crosstrained definitely has it's advantages.
 
So you would have no problem if the fire department had trouble meeting response times for structure fires, that they would add ambulances with hoses on it instead of new engines? This isn't about cross training (which is, in the end, it's own issue. You don't see psychiatrists doing heart surgery). It's about offering the proper resources instead of a band aid.
 
Last edited by a moderator:
JPINFV said:
So you would have no problem if the fire department had trouble meeting response times for structure fires, that they would add ambulances with hoses on it instead of new engines? This isn't about cross training (which is, in the end, it's own issue. You don't see psychiatrists doing heart surgery). It's about offering the proper resources instead of a band aid.
Click to expand...

There's currently no way to fit a water tank, pump panel or hoses on ambulances. Nor are they needed. 70% or so of call volume is EMS. As such, EMS units ought to be dedicated to EMS only roles, where suppression units can assist given relative downtime. On the flipside, our engines can respond to ALS calls without risking a lack of suppression coverage. Good depts plan effectively for these situations.

It's already been established that dual role personnel can function well on both sides. Crosstraining isn't an issue at all for good depts that train their members properly. Crosstraining psychiatrists to do heart surgery is an unfair analogy, as the time and resources necessary to train dual role fire/EMS is but a small fraction of what would be needed for your failed analogy. Many on the forum agree that an assosciate's would be adequate for a 911 field medic. Add a suppression academy of approx 20 weeks or so. You're only at three years. For sake of argument, add two years for a fire science degree, which is redundant, in part, for someone who has completed a professional academy. So maybe you're at five years of prep, tops. How many years of pre med, med school, residency and fellowship do you need for your specialty? What about that of a psychiatrist? How much total between the two?
 
46Young said:
How many years of pre med, med school, residency and fellowship do you need for your specialty? What about that of a psychiatrist? How much total between the two?
Click to expand...

Psychiatry is a medical specialty and as such psychiatrists go through the same medical school as other physicians. Psychologists, on the other hand, are not physicians. The total amount of post graduate training (residency) for emergency physicians (since you said "my specialty" and EM is what I'm currently working towards) is 3-4 years depending on the program. Psychiatry is a 4 year residency. So you're looking around 7 years to do more. Probably 6 since the off service rotations are going to be the same in many cases.

Now, sure, you're engines can respond, but what exactly are you going to do if you have a time sensitive emergency requiring, say, surgery? Your engine is now useless because it can't provide the ultimate hospital treatment for the patient, transport. Any EMS system that is substituting fire engines for ambulances are doing their citizens a grave disservice.
 
JPINFV said:
Psychologists, on the other hand, are not physicians.
Click to expand...

Yep--they're PhDs. Or PsyDs, who receive less scientific and more counseling training, but still carry doctorates. Both generally take about 5-7 years to get the degree, with PsyDs taking about a year or so less than PhDs and not passing the licensing exams as often. In a lot of states, you also need a year or two under supervision before being independently licensed. So it's 6-9 years from entering the graduate program to practice.

The line's been getting rather blurry, though. Psychologists now have prescription privileges in some areas, and you run across the occasional psychiatrist (usually an older one... psychiatry programs have cut a lot of counseling training, and keep cutting more) who does mainly talk therapy. The current model, pushed mostly by insurance companies, is that psychiatrists do med management and psychologists do everything else, even for the same patient. Who knows how long that'll last, though.

To make things interesting, you also run into occasional neurologists who wind up in more of a psychiatric role. A lot of neurological disorders are comorbid with or cause psych problems, so it's a logical progression, but it's sometimes pretty hard to figure out where a particular doctor started.

It can also be confusing, but PhDs in anything but clinical or counseling psychology (social psych, industrial/organizational, etc.) are also called psychologists. They're researchers, not practitioners, though, at least in the clinical/medical sense. You do find physiological psych/neuroscience types in research medicine pretty often, though.
 
nicolel3440 said:
What about the volly departments that have no emt training any how. What is the point of them responding to a flu call and puting themselves in danger of getting sick and then not being able to help someone when they are really needed.
Click to expand...

Umm I run with a volly company I am an EMT. PA has a Quick Response Program for fire companies. This means that if dispatched for a QRS or Medical Assist your truck will NOT leave with out at least one EMT. Don't use blanket statements please.
 
46Young said:
There's currently no way to fit a water tank, pump panel or hoses on ambulances. Nor are they needed. 70% or so of call volume is EMS. As such, EMS units ought to be dedicated to EMS only roles, where suppression units can assist given relative downtime. On the flipside, our engines can respond to ALS calls without risking a lack of suppression coverage. Good depts plan effectively for these situations.

It's already been established that dual role personnel can function well on both sides. Crosstraining isn't an issue at all for good depts that train their members properly. Crosstraining psychiatrists to do heart surgery is an unfair analogy, as the time and resources necessary to train dual role fire/EMS is but a small fraction of what would be needed for your failed analogy. Many on the forum agree that an assosciate's would be adequate for a 911 field medic. Add a suppression academy of approx 20 weeks or so. You're only at three years. For sake of argument, add two years for a fire science degree, which is redundant, in part, for someone who has completed a professional academy. So maybe you're at five years of prep, tops. How many years of pre med, med school, residency and fellowship do you need for your specialty? What about that of a psychiatrist? How much total between the two?
Click to expand...

our rescues for the county have 200 gallons of water and hose in them
 
RyanMidd said:
If forced entry is required, you kick near the doorknob or break an insignificant window. Problem solved.

These are people with flu-like symptoms, not people who require a third-storey evacuation.
Click to expand...

In many urban environs, those doorknobs and insignificant windows are also equipped with bars and multiple high-security locks. Just my .02...
 
Funniest co-response I've seen lately was a syncope w/palpitations that had FD tiered (as they are in that town on CP's, SOB's, VSA's and the like; for better or worse).

Arrived and met by an FF in front of the building and ask for report. He says "Ummm... there's a Paramedic on scene already you'll have to ask him." Turns out one of our guys who was involved in the H1N1 vaccinations in that community centre was brought over by a bystander. FD still seemed surprised when I cleared them before I'd even made pt. contact, as if their standing watching was necessary.

I love having FF's on scene for arrests and messy calls, but some of the tiered response arrangements we have are ridiculous. Especially when EMS response times in my region are not only dropping, but manage to beat fire most of the time. And getting better as we co-locate more Paramedic stations attached to Fire Halls in new construction areas.
 
I am a little Leary about posting on this issue due the unpopularity of some of my personal views, but hey I'll bite.

We know as clinicians we are going to be exposed to potentially infectious diseases; it goes with territory. Don your PPE and go about it. Wash your hands good, and often.

We do in fact have a duty, as the public is trusting us to be there for them. It is a sad day when someone in America dials 9-1-1 and we refuse to respond. A sad day.
 
You must log in or register to reply here.
Back
Top