What is your Policy regarding an Ambulance being sent to Fire scenes?

Fish said:
No, we don't. I can't speak for every service in the US. But our Ambulances are mainly there for the FF in rehab. Rarely is there a civilian casualty at a Fire, but if there is. Well, there we are.
Click to expand...
What does rehab cover? I thought it was just heatstroke and dehydration?
 
LondonMedic said:
What does rehab cover? I thought it was just heatstroke and dehydration?
Click to expand...

Rehab is requirement. The Fire Fighters are to rotate in and out of our rehab at a Fire Scene to be assesed. We hydrate them, take Full set of vitals and compare them with our parameters, if they have any complaints then those are addressed. The most common cause of death to a Fire Fighter is Cardiac related, and we will be there should that happen. That being said, we do not have BLS units in our County, so pickins are slim! You want an Ambulance, its gonna have Medics.
 
An ambulance is sent to all fires on the initial dispatch. If they have firefighters and SCBAs, they can do fire work. If they do not, they just standby and do rehab.
 
IMO, an amblance, a paramedic ambulance needs to be dispatched to every fire call. If you hold off on seding an ambulance, if someone gets burned, suffers smoke inhalation, or if the occupant has already suffered one of these injuries prior to fire resources arriving onscene, you're already behind the 8-ball. These are two very time sensitive pt care situations. If it's just a room and contents, food on the stove, a light ballast that smoked up the hall or something, that situation will be resolved rather quickly, and the ambulance can be placed in service rather quickly.

Also, half of all firefighter fatalities are due to cardiac related issues. Even if it is just a minor fire, and not a structure fire, a firefighter can still drop out due to heat exhaustion/stroke, dehydration, etc. Again, you're behind the 8-ball if you have to call for an ambulance after the S/Sx have already begun.

Unless, it's a fire/ALS system, then you'll have medics there that can start care in the meantime, and progress to ALS if the bus has an extended response time.
 
We send a medic unit (dual medics) to every structure fire. Fire provides the ambulance, so we're good to go if needed. Also, we respond cold unless there is a report of occupants in the structure or if an interior fire attack is underway.


Sent from my iPhone.
 
Around my neck of the woods, anything that gets a still box or box alarm gets a BLS ambulance as well... Some places will keep the ambulance available and have an EMS Officer response only if no injuries are reported.

Once the fire hits 2nd/3rd alarm, additional EMS resources are usually due, both to assist with medical sector and coordinate rehab sector.
 
Fire comes to half of our medical calls here and stays until cancelled, so it's the least we can do to go to their fire scenes until cancelled.

We get cancelled only if there is no fire onscene (false call) or it was controlled PTA with no injuries. If it is any type of working fire, we stay until its put out with no injuries confirmed.
 
jjesusfreak01 said:
Fire comes to half of our medical calls here and stays until cancelled, so it's the least we can do to go to their fire scenes until cancelled.

We get cancelled only if there is no fire onscene (false call) or it was controlled PTA with no injuries. If it is any type of working fire, we stay until its put out with no injuries confirmed.
Click to expand...

Who do u work for?
 
our agency sends out ambulances for standby once a 2nd alarm is called
 
We send a BLS ambulance to every working structure fire. Well, that's if Fire's dispatch center notifies us that they have a fire. Usually a supervisor will go too.

However, many times we don't have any ambulances available. In those cases, the Supervisor will typically respond solo, and the ambulance will be sent once one becomes available.
 
The 911 contract that my company holds includes an ambulance being sent to every working structure fire. Generally it's a BLS truck so the dedicated ALS truck can remain in service for the rest of town, and there is no way the powers that be would ever take an ALS transfer truck OOS for a fire standby when much money could be made doing ALS transfers...
 
Usally just a BLS truck is sent for stand bys. We acutally just had a 3 alarm fire happen a few weeks ago. We had to bring some supplies to the crews there and they had 1 ALS and 2 BLS doing stand by at the fire.
 
LondonMedic said:
What's the big deal? There's equipment, a para and some techs on scene. 9 minutes, 17 minutes, it's really unlikely that there's going to be any real difference to outcomes here.

And I know American buildings tend to be different to European, giving you different fire conditions, but do you really have casualties who need a paramedic at every structure fire?
Click to expand...

I think the reason that so many systems in North America are sending EMS resources to fires is that many dispatch centers are run by FD's. I'm sure the NFPA has regulations for EMS responses.

My old system used to send us to pretty much everything. We spent a lot of time parked outside apartment complexes while they went in and removed pots of burned soup from the stove. It was total overkill. I remember spending 8 hours one day, as a paramedic ambulance in a busy system, watching a fire crew steam frozen hose off a parking lot ("just in case someone gets hurt"). I could have fulfilled this role just as easily from the station 3 minutes away, but then they wouldn't have a dedicated resource, and would have to roll their dice with the system status at any given moment. It was interesting listening to the radio and hearing trucks get dispatched across the city to cardiac arrests, while we were watching what should be a fairly routine procedure.

Rehab at a working fire usually consists of sitting in a bus (a literal "bus" -- not NYC ambulance slang!) with a bunch of FF, running a set of vitals each time they rotate out / go through an oxygen tank. On an ideal day, with a cooperative Fire DC, you identify people who are fatigued / dehydrated / dyspneic, and give them a longer rest period, food, rehydration, and determine whether they need ER transport, and you send the rest back into the fire once they've had a quick rest break. On a bad day, it's a free-for-all with people walking into the truck grabbing a gatorade, sitting outside having a smoke, and then going back in without any real control. It depends on how well EMS and FD work together, and the given staff in charge. Broadly speaking, a lot of the firefighters don't want to admit to being tired / injured, for fear of appearing weak. A lot of them enjoy the rarity of a working fire, and don't want to be pulled out.

I'm sure there's something published about this, but I'm not feeling energetic enough to go looking for it. My personal opinion is that sending ambulance's to anything where it's (i) not confirmed on fire, and (ii) there's no confirmed patients, is pretty pointless if the response time is short. I think there is a valuable safety role in having a rehab sector at a working fire, but it's effectiveness depends on the organisational culture of the FD and EMS.

[Just want to add, this is my personal experience, primarily drawn from working in an urban environment with a large department that didn't have a good working relationship, and a lot of historical animosity. Other's experiences may vary greatly.]
 
Last edited by a moderator:
You must log in or register to reply here.
Back
Top