Why is EMS mixed with FD?

T

thatSPIKYflip

Forum Probie
Messages
22
Reaction score
0
Points
1
This is a simple question. Many towns mix their EMS with their FD. Why can't they just keep the two separate? Isn't it how the "public safety triad" works? PD deals with enforcing the law; EMS deals with medical emergencies; FD deals with fires.

On a side note: Are there any law enforcement agencies that employ EMS personnel?
 
Yes there are so called public safety agencies that do FF, EMS and PD.

A lot of TEMS crews are PD staffed.

And they do it because it saves money in some instances. Only have to pay for one firehouse and can staff both your crews there. Other places its union mandated. Most places EMS is a lot heavier than FD so it gives the FFs something to do so we're not just paying them to sit around. We have so many fire station sin our city that some only run once every two days or so but the guys in the medic average 6 calls a day.
 
Last edited by a moderator:
Yes, Maryland State Police MedEvac is staffed by Paramedics who are also State Troopers who also do patrol work as well. I believe California has some Sheriffs departments that provide MedEvac with Paramedics as well.

I agree, Fire and EMS should be separate.
 
thatSPIKYflip said:
This is a simple question. Many towns mix their EMS with their FD. Why can't they just keep the two separate? Isn't it how the "public safety triad" works? PD deals with enforcing the law; EMS deals with medical emergencies; FD deals with fires.

On a side note: Are there any law enforcement agencies that employ EMS personnel?
Click to expand...

They have Public Safety Officers (or as I like to call them FireMediCop) that are trained as FFs, Paramedics and Police officers. Some PDs also have tactical medics.
 
I think in some places it is a one word answer: POLITICS.
 
To the OP. CAn of worms, you have just opened it.

I agree with seperation. I won't deny that there are tempting benefits to be had working as a fire medic out of a station vs. an EMS service that works out of the truck (like all of the services here for the most part). Although some crews do hang out in the station while not on a run.

The benefits you tend to hear in some systems are better pay, better budgets and subsequently equipment, retirement, benefits, quarters, etc. Not like that everywhere but I do hear those benefits often. (As to the not like that everywhere, here for example fire medics get quarters, work the truck/engine on a 50% split, pay is less than the local EMS specific services though.)

Our PD/Swat employs the local county service medics in 'detail shifts'. There is a pool of medics who are trained for the duty and will run with various 'PD' agencies serving warrants, traffic stops for drug trafficking, etc.
 
Last edited by a moderator:
re

Really is a matter of local economy and if the area had a FD in place first. In area's where there was an existing FD as the areas grew the FD maintained providing in some fashion or another ems services, mostly to fluff call numbers to justify the FD existance, wages and cost to the local area's general fund as over the years with the increased fire awareness the number of actual fire calls a FD responding to is a drop in the bucket in comparison of EMS calls in the same areas. In area's that did not start with a FD they are mostly seperate as monetarily it's not justified to pay fire system wages to run ALS EMS services.
 
The volume of suppression calls has decreased substantially in recent years. However, there still needs to be adequate staffing for suppression units - for response times, expedition of fireground tasks, and RIT duties should a FF call a mayday. Remember, a typical EMS incident is for one or two pts. A structure fire can involve many victims at once.

So, this can result in fire companies having significant downtime, even with driils, other training, public service/public ed, and station duties.

A municipality may decide to assume EMS responsibilities for several reasons - to utilize otherwise idle personnel, to boost call volume for staffing issues, to collect revenue from EMS billing, to provide adequate coverage to the area not being provided by the previous provider.

Many would have you believe that striving for proficiency in both EMS and suppresion is spreading onself too thin, and therefore unrealistic. It is not, based on my own personal experience and observations especially if the recruit has prior experience in either discipline before crosstraining in the other. Neither discipline is rocket science, believe me, although some may not be cut out for one or the other. Both disciplines require real life field experiences to build on classroom/practical training to be solid anyway. Dual role personnel, who are crosstrained in both EMS and suppression are versatile, and can by used in either role, which helps with staffing, to reduce OT and holdovers. Medics on apparatus can initiate timely ALS care when a medic unit has an extended ETA. The engine medic can also assist the EMS unit, and ride to the hospital if needed.

Whether it be single role or dual role, fire based providers, at least in larger depts, enjoy superior working conditions, benefits, pension, 457 deferred comp, higher pay, DROP, prestige, relative lack of burnout compared to private or hospital based third service providers (typically, as ther are exceptions). Collective bargaining, good PR, and strong political support will do that.

Our dept runs EMS like a third service, except that the personnel are crosstrained and can jump from EMS to suppression as staffing requires.

Having worked private IFT, hospital based 911/IFT, third service 911 prior to firemedic, I could never go back long term. Many from similar backgrounds here have said the same. Life is sweet on this side. I can't see doing 25+ years under the working conditions/lower pay/inferior retirement(defined contribution! I'll have to work until I'm 90!) that non fire based EMS provides.
 
Another example of how services interact with each other. Here in Louisville until the mid 70's the EMS was run from the PD or private service. Sometime around the mid 70's the services split into Louisville EMS and Jefferson County EMS with Louisville being the 'city' service and Jefferson County being obviously the county service.

Again in the 90's LEMS merged with Louisville Fire Department and LFD began running medics and basics within their service, this was still considered to be the city service with JCEMS being county.

Then again in 2003 the city and county governments merged creating Louisville Metro. This effectively made the city border continous with the county border. (Jefferson county and Louisville are essentially the same despite having smaller neighborhood cities still)

In 2005 they took the LFD and JCEMS and merged each into what is now being run, Louisville Metro EMS (LMEMS). LMEMS provides 911 for Greater Louisville with only two exceptions. In the small area of Anchorage and Jeffersontown.

Anchorage Fire and Rescue provides 911 (fire and EMS) for the small city of Anchorage. One Engine and two trucks which can be Medic/Medic or Medic/Basic depending on the shift. Anchorage also provides backup support for LMEMS. Anchorage calls are priorty assigned to Anchorage trucks unless already on runs. Anchorage Fire has been around since 1910 or something like that, EMS has been in anchorage since the 70's and was established because it's pretty much the edge of the county and about 30-45 mins away from anything depending on traffic.

In Jeffersontown the local private transfer service (Yellow Ambulance) provides 911 coverage EMS while fire support is provided by a smattering of smaller local volly and paid services.

The entire county despite having a paid fire (LMFD) has many volly services that provide support for that community.

Hope that helps your question some on the politics and such of one area. Maybe someone else will care to share their cities history? :)
 
To answer the question regarding PD employment of EMS - Nassau County PD (Long Island NY) trains their P.O.'s to EMT-B, and employs an all ALS EMS division. Most rigs have only one provider. A P.O. will arrive onscene in their cruiser, assist with pt care, and drive the unit to the hospital. Nassau County PD EMS enjoy fire service-like benefits with a 20 or 25 and out pension
(can't remember), high salary, strong union, great work schedule, and many perks and such.
 
I think that EMS should definitely be separate. FDs waste a lot of time and money worrying about EMS duties. That's just my opinion
 
Well it is hard to argue that when a fire or EMS company goes out on a call it is expensive and when they both go out it costs twice as much. And on most minor EMS calls the FD does not need to go, it is pretty easily handled by an EMS company.

Now a larger scale EMS call is a different story don't get me wrong, but i don't think FDs need to respond to everything.
 
The very first Paramedics were firefighters; Eugene Nagel says he used the Miami fire department because had nobody else he could train and deploy out in the streets and out of what I argue was more convienence he used the fire department because they were already there.
 
kecpercussion said:
Well it is hard to argue that when a fire or EMS company goes out on a call it is expensive and when they both go out it costs twice as much. And on most minor EMS calls the FD does not need to go, it is pretty easily handled by an EMS company.

Now a larger scale EMS call is a different story don't get me wrong, but i don't think FDs need to respond to everything.
Click to expand...

Fire used to respond to everything. Now fire no longer responds on medicals unless requested specifically by the crew for assistance. Fire responds on most traumas, there is some secret formula but I don't know it. It's a flow chart dealy on what the FD does and doesn't respond on. Volly stations are different, they respond on almost anything if it's in their district. Paid departments not so much.
 
kecpercussion said:
Well it is hard to argue that when a fire or EMS company goes out on a call it is expensive and when they both go out it costs twice as much. And on most minor EMS calls the FD does not need to go, it is pretty easily handled by an EMS company.

Now a larger scale EMS call is a different story don't get me wrong, but i don't think FDs need to respond to everything.
Click to expand...

Other than gas and mileage, it costs the no more to send suppression personnel on an EMS aid. They're already on duty primarily for suppression duties. As I've mentioned previously, FF's typically have more downtime than EMS, and using them in an EMS capacity is getting the most bang for your buck. Besides, if the pt turns out to be low acuity, the suppression piece can go in service and still remain onscene and lend a helping hand.

Having extra providers to assist pt care can dramatically reduce onscene time, to the pt's benefit. Remember, a firemedic can deliver timely ALS care when EMS units have extended ETA's. The EMS crew's job is made easier with extra hands, and that promotes longevity due to reduced injury potential and less burnout potential.

We don't typically send more than an EMS unit on low priority call types.

I don't understand the comment about "worrying about EMS duties".
 
Being a firemedic is very fufilling IMO, as we're truly full service providers. We can provide ALS and provide safety via suppression duties. Having 9-10 others to joke around with, beds, showers, kitchen/grill, day room, gym, attending public functions and fundraisers doesn't hurt. Good times!

Moving between EMS and suppression keeps things interesting and fresh. I like both equally as well. It keeps me motivated to improve at both disciplines. We do plenty of OOS and inservice training in both disciplines. Maintaining our CME's are a breeze as such. I could do this for 30 years with no problem. We have a blast at the station and on calls everyday. I can't see sitting on a street corner or running 20-30 calls a day for the same 30 years, though.

We promote off of lists based on exams and educational requirements. How many EMS agencies promote for the few supervisory positions available using the "good ole boy" system? Odds are heavily in favor of the typical street EMT or medic remaining on the street for the duration of their career, save a dispatch position.
 
If my local FD only responded to non - medical calls like fires and rescues then they would only leave the fire station like once every 1 or 2 days, so maybe here its a cost issue and since the fire stations are spread out all over the city it lowers response time to get someone medical treatment if the ambulances are far away or are busy.
 
Hey, don't get me wrong, I wish that EMS only agencies could enjoy the same benefits and conditions that fire based EMS does. If that were the case, I probably wouldn't have ever discovered the firemedic position (I worked NYC for a while and didn't know dual role positions existed until someone clued me in) and I wouldn't have had to leave NY to find a career spot that would keep my family comfortable, keep me driving to work with a smile on my face everyday, and a financially promising retirement to look forward to.

Single role EMS personnel should have better options available than those currently in existence. I don't like being slapped around, being in fear of losing my job constantly for no good reason, running a mind numbingly high call volume for 24-48 hours straight, having to work multiple jobs to survive, being one injury from the poor house. Been there, done that.
 
You must log in or register to reply here.
Back
Top