Flasurfbum

Honestly, I feel that I am just banging my head against a wall, arguing with all the ignorance here. Fires just don't go out. One house burning will impinge on either side, and then one house becomes 3, 3 becomes 5, 5 becomes 7, until the whole block is gone. It takes no less then TWENTY firefighters to mitigate a single family dwelling fire. Where are all those people going to come from? You choose to take your anger and frustration out on the WRONG source. In a perfect world, Fire, EMS, and PD would all be well paid, highly motivated, and highly trained. Guess what, this ain't utopia. EMS already has problems retaining people. How do you think that they will be able to attract, and keep more quality people? Bring people over from the interfacility side? Most of them are just competent to pass the test, let alone take care of a critical patient. Dept. Public Works, Sanitation Dept, city administrators, why are you not going after them? Fire has been providing first response EMS since before EMS even existed. I am NOT in favor of Fire transportation. I am not in favor of Fire providing full ALS care. I am in favor of EMS getting more funding, and cutting Fire Dept ambulances, in favor of a third party EMS agency. I am in favor of ILS, and ACLS certified firemen on Engines, or even better, a Squad 51 type vehicle, to provide first response care for the patient. Cutting fire apparatus to fund EMS is NOT the answer. Get off that idea. Quit being a cry baby because you can't get on a fire dept, or a fireman stole your girlfriend. If you do not under stand fire behavior, in both the wildland/urban interface, and structural firefighting, how can you in good conscious advocate cutting resources? I mean, you haven't had a car crash in years, (if ever), so why wear your seatbelt? Or pay car insurance? Or even have that expensive health insurance? The absolute ignorance that is being displayed here is staggering. I can fully understand wanting more resources, and funding. So, how about we educate the legislators, do more public relations, stop letting privates and vollys do 911 (there are circumstances for everything, so I am not 100% against either in all circumstances), but we are our own worst enemy! How about we get the word out that hey, we aren't just people standing on the sidelines, when to call 911, and when to call a cab, and push BACK against the IAFC and IAFF when they want to fully take over EMS operations. But be reasonable, and understand that there needs to be a comprimise when it comes to EMS operations.

Not disputing that. However, I presented that example to prove JP wrong.

That would be Squad 41, PFD. Its an Engine Co. assigned special duties.

I have yet to see an ambulance put out a fire.

No arguements with the first part of what you said. Pts with inabilities to normally get around would need the extra assistance that only an ambulance could provide. Employer? Union Firefighter? I don't think so. I am a volly on a combo dept, and in Medic school. And yes, there are cuts in Palm Beach County, and many stations are being put on hold in my area, because they can not afford to build and staff them, despite rising call volumes, and population. How can I grasp it so well? Because I have held a Florida address for almost 7 years now, with one year spent back in Jersey so I could get experience as an EMT that I would otherwise not be able to get here, so I can be more experienced, and become a better medic. Once again, I have no employer. Unless you want to count that cardiac monitoring company that called me for a job interview today. Him and I are rather tight. You might even say I know him as well as I know myself.

If you have been a fireman, you know how many men it takes on the first alarm to bring a fire under control, establish a water supply, do a primary search, ventilate, and overhaul. Show me a community that can meet the standards of first alarm assignments and within the required time, and I will show you a place that is safe to live.

Congrats. You saved what, 250 dollars on a feel-good amendment that did nothing more then cut stations, and funding for Fire Dept operations. If Charlie would have actually given a rats arse about us, he would have pushed that bill if it had clear writing that specified what was being cut. Not just give carte blanch to cut whatever the morons felt like. And of course, its NEVER the pet projects. And then he has the nerve to come down to the wildfires and shake our hands, and call us heros. Maybe if DoF was better funded, we wouldn't have lost 60 something homes!

Medic- Sir, why did you call 911 today? Mutt- I need a ride to the hospital. I have a surgery tomorrow morning, and I need a ride. Medic- Sir, are you having any chest pain, shortness of breath, head ache, nausea, blurred vision? Mutt- No, I just need a ride. Can you take me now? Cop- He won't. But here is a ticket. If you were to subtract Medic, and add EMT, and take the cop out of the equation, I am quite sure that every EMT, B, I, P, or anything in between would have at least one story similar to this one. In fact, this story is based on one of mine.

It seems to be the consensus to gang up, and hate on Fire. That is not the solution. How about we look at the real root of the problems. The MUTTS that abuse EMS heavily, the nursing homes that call at 0darkthirty for "abnormal lab values", and insist the pt be transported, despite the pts. pleas to the contrary. The calls for a ride to the hospital. Educate the citizens, SNFs, and homeless population about calling 911 for emergencies. And enact tougher legislation about the abuse of the system. You show up for a chest pain call, and the pt. is standing at the doorway with bags packed, and ready for a ride, he gets a civil summons. Next time, misdemenor jail time. And no ambulance ride. For too long we have just accepted these BS calls as a part of the job. I think it is time we took a cue from FD, who has taken leaps and bounds to eliminate malicious false alarms, and aggressivly enforce alarm maintence.

Apples and oranges. Un-wad your knickers and think straight. If Fire staffing were cut in favor of EMS funding, then insurance rates would go through the roof. For the most part, Fire is not overwhelmed with calls. They are the ones providing assistance to EMS.

Oh no doubt, Brother. There are some structure we write off. No questions asked. Evac the home owners, get them to save what they can, and GTFO. But as I can attest to, we saved a LOT of structures so far this year in the Palm Bay/Grant/Malabar, Florida wildfires with lots of apparatus, well staffed at that.

I count 2 ambulances per Engine, including staffing, if they do 24/48. Less if you do 12s. And that is only if the Engine is properly staffed. I see where you are coming from, but at the same time, see our POV. We can provide on scene stabilization of the patient while waiting for an ambulance to get on scene. While I do not see the need for EVERY Engine to be ALS, where ILS would be more appropiate, I just can not support the cutting of Engines to open ambulances.

:roll: Most of the people who hold the opinion that Fire should be cut really have no idea how many Firemen it takes to mitigate an incident. Or that many Firemen don't mind going to med calls, but don't like being forced to become a Paramedic. I don't disagree that EMS is under funded. Severely, in many places. Or that they are forced to become Fire's "beeyotch", and patient care suffers. But there are few, few places that can spare any more firemen being cut. We will see who wants fire cuts when a loved one is trapped in a vehicle, and needs extrication. Or the floor above the fire, and needs aggressive VES. Or the newest one, their new house is being threatened by wildfire. Not to mention the preplans, training, and public education we do. The true solution is better supporting EMS finiancially. But with the down turn of the economy, I do not forsee a tax hike. But once again, robbing Peter to pay Paul will not work.

In many places, that is standard. Example Holmes ER, Rescue 67, Class 3 Medical. Good afternoon Holmes, Rescue 67, Paramedic Jones, we are currently en route to your facility with a Class 3 45 year old female, chief complaint today is going to be nausea and vomiting x3 days. We have a line started, vitals within normal limits, pt on nasal cannula, resting comfortably on the cot, eta to your facility is 3 min, do you require anything further? From the stubbed toe to the trauma arrest, we call them all in. Part of it is a courtesy to the ER to let em know we are coming in, part of it is to just perfect the radio report.

Not just to look for hazards. Having driven both an Ambulance, and a QUINT, I feel that the Officer should be operating the radio, Federal, Airhorns, and siren. That is that much less that the Chauffer has to do.

That is one of the more ridiculous things that I have heard. We will get reamed out if we take a questionable pt to a lesser care facility. The docs, and trauma teams here are excellent. They would rather deal with a hundred drama alerts then have the medics downgrade one true trauma alert, and we are encouraged to call them as we see fit.

Sorry Dust, but I kind of resemble that remark. My school is 12 months long, and I feel that we DONT get the kind of experience, and training that we would with a longer, more in depth course. I have tried to mitigate that with coming here to pick y'alls brains, pick my preceptors brain, and get as many clinical hours as I can to see as much as I can. Some of us can only do as well as the system will allow us....

That is just one of the reasons I would prefer to have an Engine Co. on scene. If its not going to be the FD, then who? My main reason for having them respond is to get someone on scene quickly, get pt contact, and start patient care. If we get Firemen who WANT to be Medics (they are out there, don't doubt it, I am one of them) then we can get advanced providers on scene who care about the patient, and getting them the highest level of care, instead of treating the monitor, and the protocol book.

Honestly, it sounded EXACTLY like OC Fla Scary, huh?

Extra hands, being closer to the call then a Rescue, lifting, moving, some one to do CPR. If an ALS Engine, they can start ALS care, or slow down the rescue. No sense in having them bust up intersections for a B(L)S call.

OCFRD, in Florida? That is true..............for now. Review the latest plans for the removal of Rut/Ro, and you will see that they will be responding to the City of Orlando ONLY starting next fiscal year.

You are correct there. The PALS test kind of spurred this discussion, and I was referencing it. I do not mind the opinions from the learned members here, though. Here is a link to the protocalls for the Fire/Rescue agency I do my clinicals with. Perhaps it is a bit of Firefighter training subconsciously kicking in, but rather then waiting for my patient to go downhill, I would like to stay ahead of the game, and be proactive in my treatments. Of course, I would not intubate a patient who is slightly SOB, vitals WNL, and no abnormal lung sounds, but if their vitals are heading downhill, with severe difficulty breathing, and abnormal lung sounds, at a minimum, I would be setting up to tube the pt, if not already dropping him. (this is if C-PAP was not an option)

Vent, I did pass PALS, but being the anal-retentive person I am, I want to know WHY I got it wrong. I had instructors with decades of experience telling me that I was correct in my answer as far as the field answer is concerned, but to play, I gotta pass first. I will look up the protocall next clinical I am on, but going from R36 to R6 very quickly, to me at least, suggests a rapid downhill outcome for my pt, should I not act quickly, and aggressively. Do you have a link to that study? Not questioning you, or the study, but I would be interested to see the results.

Should a code summary not have been printed out? Or at least available to the QA person? Sounds like all the facts are not here. So, I will reserve judgement.