Which SHOULD come first FIRE or EMS?

[Mercy4Angels]

EMS last - you wanna get killed or blown up ? if we get hurt then how can we help anyone else

 

[medic417]

Yup blue canarys and red robbins can let you know how far away to stage.

 

[reaper]

EMS last - you wanna get killed or blown up ? if we get hurt then how can we help anyone else

Yep, cause god knows us EMS people can't identify a danger!

 

[JonTullos]

When I worked at my county's 911 dispatch center, we almost always dispatched fire first. Reason was because the fire department could almost always get to the patient first. All of the firefighters in the city are required to obtain NREMT-B cert. and the county firefighters are "strongly encouraged" to obtain MFR cert. Therefore, so the theory went, the FF's could get there, do assessments and get the patient as prepared as possible for transport. The EMS seemed to prefer it this way as they felt it made their jobs easier when they reached the scene. Plus, if the FD is automatically there in most cases, they have more help in lifting the patient and getting equipment from the rig.

 

[Canadian_EMT]

Medics first always. 90% of the time fire gets cancelled and if for some reason they beat us there, we have 20 other people walking around looking for stuff to do. Don't get me wrong, when fire is needed, they are great to have, but if they are not, go back to bed

 

[rr22705]

Fire and Emt should be dispatched at the same time, they are not in a competition, but should be working together to save lives.

 

[LucidResq]

Its all situational. At the rural county service I run with Fire is only dispatched when there is a possible hazmat, 10-50, or fire in the city. EMD also dispatches them as manpower for known or suspected cardiac arrests. Police are dispatched for "Life Alert" tags in case forcible entry needs to be made into a residence.

In the outlying county vollie FD is dispatched as first response due to longer response times.

Ideally the decision to dispatch fire should be made on a case by case basis. EMS should be notified first on EMS calls.

I can't believe this is going on for so long. Try this one.. train your dispatchers to know when he should need to call both at the same time. The winner of the race can always cancel the other if need so be.

EXACTLY.

It doesn't make sense to make such a broad generalization when there are such a wide variety of fire, EMS and rescue agency set-ups out there in such a wide variety of settings. Furthermore, each individual agency will face such a wide variety of incidents in which a wide variety of factors such as the nature of the call, available resources, hell - even the weather, are at play.

In some systems and circumstances it's better to send one over the other. In others, it's better to only send one and reserve the other if needed. Obviously preserving life is of the highest priority for both EMS and fire, and each has their own set of trained personnel, equipment and skills intended to save lives. Isn't it in the patient's best interest to get over the immature rivalry and bickering and just recognize the value of the other side in working towards a common goal?

There isn't much even the most skilled paramedic in the world can do for a patient who's on fire or completely inaccessible, and likewise, once the flames are out or the patient is freed, the firefighter's life-saving tools aren't so life-saving anymore.

So my answer to the OP is neither "fire" or "EMS", it's cohesive dispatch systems with well-trained, efficient dispatchers and the building of a unified public safety community that fosters cooperation, not competition.

 

[JPINFV]

What's amazing is the amount of people who saw the topic and completely failed to read the original poster's post. The question CAN'T be answered by saying "both at the same time" because the dispatch system at the OP's region isn't set up that way. In the end, we're talking about a minute or two difference which most likely won't affect the outcome in any meaningful way anyways.

Similarly, for the "canary" or "ZOMG THE PaTiEnT mIgHt Be On FiRE!!1one" crowd, exactly how many calls have you been on where a viable patient was found to be actively burning when the first responding unit arrived on scene? The example given was an accident, but the theme of the tone of the post indicated all medical calls. Not all accidents require extrication tools (which, even after the patient is extricated, will still have to wait for EMS to be transported) and spontaneous human combustion is exceedingly rare. A structure fire call is not an EMS call.

 

[Jeffrey_169]

I agree with you

If fire is closer, and EMS is farther away, and both are needed (as suggessted by the MOI), then both should be dispatched at the same time. Before I moved here to go to school I practiced in an area for 6 years where standard protocal was to dispatch fire and EMS at the same time.

Fire is an invaluable resource that can often make the diferance between life or death, esp. when speed is of the essence. Fire can extracate, provide more details of the scene, provide pt. assessment, packaging, hazard conttrol, etc. that can provide for a speedier transport for the pt. If EMS is still several minutes out, then fire has done you a great service.

I don't understand why they wouldn't dispatch fire first if they are closer. That makes no sense to me. I am not judging yor service, but from what you are saying, I agree with you that fire should be dispatched either first, or at the least in rapid sucession.

 

[Stephens248]

In our city, this is a non issue. FD is ALS, all paid on call are FF/EMT-B at a min. All full time are FF/EMT-P with a min of 1 EMT-P on duty at station per each alpha rig in service. Typically the alpha with medic will dispatch immediately. In addition, our alphas also have the smaller extrication equipment on board. We run our ambulatory service.

Not saying other set up’s are inferior, obviously it’s a much smaller population than others posting here. It’s just very interesting as a rookie to learn that every state/ county/ city, does things different. If I never got into this profession, I would have had no idea where my EMS were coming from, I would just be glad to see flashing lights if I ever had to call for help.

 

[Ryanpfd]

i believe EMS should always come first, I hear everyone saying they would rather be on a engine compared to a ambulance. I believe a house is replaceable. a person is not! I also believe fire apparatus should always fallow a ambulance for extra support. two EMTs cannot safely lift a 450lb patient.

 

[JPINFV]

1. What does a house have to do with this thread?

2. Not every patient is 450 pounds.
2.1 The hospital employees can always help move patients.

 

[Mongoose]

Idk if I'm echoing every other post here or what...but personally I like to have a big@$$ engine angled behind me on any TC (MVA). I'm from a huge metropolitan area. Holding c-spine by yourself, w/your rig parked in front of the TC, you can feel pretty isolated and exposed in the middle of a 9-lane boulevard w/a speed limit of 50mph. However that's about the only time I think FD is really needed, and I acknowledge that it varies from jurisdiction to jurisdiction.

In my county FD responds with EMS. We are toned out simultaneously by state patrol, and I'd say I'm first on scene about 50% of the time. I think ALS should be delegated to the ambulance. Typically county FD provides ALS out here, but one day I was 1-and-1 staffed w/a medic on a designated IFT car. That particular day we were put into the 911 system and got a call for cp. We showed up seven minutes before county FD ALS to an active AMI. When FD got there we were already headed out the door w/a saline lock, nitro, lidocain, and a completed 12-lead. If I had been on my usual BLS shift the only thing I would have been able to do is O2, POC, assist w/nitro, and monitor vitals every 5min while nervously toying with the AED.

Yeah there's always the chance that FD could show up first and be waiting on EMS ALS to arrive, so if fire insisted on responding to all EMS calls, why not keep the county medics and have them work in conjunction with our medics? If they assume patient care up to and including transport to the hospital then they can ride with us (like if they are first on by a significant margin), if not they can assist and be dismissed. The only reason I suggest that is because logistically and politically it would be nearly impossible to suddenly ground all the county medics. I'm also not saying it would be the right decision, it'd just be nice if both could work together.

Yeah...my $0.02 worth, sorry if it's not really comprehensible, I'm tired.

 

[EMTinNEPA]

A structure fire call is not an EMS call.

Working structure fires in this county get an ALS rig for rehab. I know, it DOESN'T make much sense, does it?

 

[EMTinNEPA]

Let me preface this post with the following statement: I am the most militant FD/EMS separatist in the history of mankind.

Now that we've got THAT out of the way...

When there's a structure fire, the FD does its job, and what do we do? Rehab. An MVA is an EMS call. The patient needs EMS. Patient won't always need the Bucket Brigade. Just like a structure fire won't always need rehab.

Bottom line: EMS gets dispatched first because it is an EMS call. GET OVER IT.

 

[Ryanpfd]

1. What does a house have to do with this thread?

2. Not every patient is 450 pounds.
2.1 The hospital employees can always help move patients.

This has alot to do with this thread. Engines are a big help to EMS personal on scene, on scene the hospital employees cannot help you. Because atleast where im from the hospital staff....is busy in the HOSPITAL and are not going to show up on scene. When Im dispatched to the scene Im not told the patients size so in the common case of having a heavy set patient i like haveing atleast three poeple to help move them for those more bulky patients. I also agree the big red engine is very comforting on at a MVA.

 

[JPINFV]

Working structure fires in this county get an ALS rig for rehab. I know, it DOESN'T make much sense, does it?

Never mind, missed the second post.

 

[JPINFV]

Do people forget what they actually post? By the way, you still haven't answered what a HOUSE has to do with this thread.

This has alot to do with this thread. Engines are a big help to EMS personal on scene, on scene the hospital employees cannot help you. Because atleast where im from the hospital staff....is busy in the HOSPITAL and are not going to show up on scene. When Im dispatched to the scene Im not told the patients size so in the common case of having a heavy set patient i like haveing atleast three poeple to help move them for those more bulky patients. I also agree the big red engine is very comforting on at a MVA.

I believe a house is replaceable. a person is not!

If the house is on fire, it's primarily a fire department call, and thus out of the scope of this thread. Last time I checked, houses don't get sick and need the service of an ambulance. They do catch fire, but this thread isn't about building on fire.

I also believe fire apparatus should always fallow a ambulance for extra support. two EMTs cannot safely lift a 450lb patient.

How in God's holy name is that supposed to be interpreted as helping on scene? Where the hell else besides the hospital is the fire engine going to follow the ambulance?

 

[Ryanpfd]

Do people forget what they actually post? By the way, you still haven't answered what a HOUSE has to do with this thread.





If the house is on fire, it's primarily a fire department call, and thus out of the scope of this thread. Last time I checked, houses don't get sick and need the service of an ambulance. They do catch fire, but this thread isn't about building on fire.



How in God's holy name is that supposed to be interpreted as helping on scene? Where the hell else besides the hospital is the fire engine going to follow the ambulance?

OK lets put it this way, Both should be dispatched at the same time. In my district fire apparatus is automatic to any call whether it is EMS or fire. a house doesnt get sick. But at some fire scenes EMS help may be needed. a engine will follow a ambulance to the scene and return to the station once the ambulance is on its way to the hospital. This thread is about what should come first? EMS or Fire right? well fire doubles about every thirty seconds if i remember my fire one training. By the time the first engine gets thier is normaly about five to seven minuites but that changes on your district. also it takes a few minuites to go through dispatch. I called 911 yesterday to get extra personal to my fire dept for a medical transport i was on the phone w. 911 for about three minutes. thats alot of time that fire will spread. And Im still confused where you stand anyway? I think you just LOVE to argue :wacko:

 

[JPINFV]

This is about which should come first on an accident or medical call, not a fire call. Furthermore, this thread is about which should come first when you can't dispatch both at the exact same time. Did you even read the original post or just look at the title? At no time did the original poster even refer to a structure fire.