HERBIE1

In order to understand why EMS and fire have become "married" in this country(I can't speak for outside the US), you need to understand the history and logistics of providing first responder care. Fire Departments have the established infrastructure to handle emergency response. They have the manpower, the equipment, the locations, and the only thing left is the training. When EMS was absorbed into the fire service, they were and still are in many cases-a necessary evil. The fire service would assist with manpower and basic training but never had to completely assimilate EMS into the fold. As fire calls dropped, in order to maintain their budgets and manpower,the fire service became more intimately involved in prehospital care not by choice, but by necessity. Fire budgets are dictated by tax revenue, and with more demands on that finite amount of cash, they realized that EMS generates revenue. That is the bottom line folks-the almighty dollar- it has nothing to do with providing a "better" quality of care or service to the public.

Simple question about the article: Where do you think the firefighters who are complaining get their attitudes from?

I don't think the article was anything but a bunch of firefighters whining. If it was supposed to be even handed, why not interview the EMS providers to get their perspective? Over 80% of 911 calls are for medical emergencies, and as the article notes, fires are way down. As was noted, if it weren't for medical calls, even more fire companies would be put out of service and manning would be further reduced- especially in this economy. Most cities are reluctant to make cuts to public safety, but some places have their hands forced.

Huh?

Not happening to me. Happens when you click on anything or just JET EMT's posts?

Thanks for that link, Richard. Pretty clever- good stuff.

Looks good, admin.

Fire protection districts operate in a similar manner. Often times they provide service for unincorporated areas that cannot afford coverage on their own. I have heard horror stories where a home in such an area burns because they are not "covered", but I think those are anecdotal and hopefully rare.

Let me put it this way. In many areas, the FD is a long established entity that has essentially been in charge of itself, which explains the arrogance of some departments. The national standards they adopt are set by fellow fire personnel, they police themelves, and until now they have been able to operate with impunity. Until relatively recently, they have had no independent oversight, but with the advent of EMS, they now have a new "master" - an outsider who demands accountability and adherence to standards. This does not sit well with the old guard and a battle has been brewing for control. That is why there is such resistance to establishing EMS as a separate entity. Not only do they lose total control over a significant portion of their operations, but they must comply with regulations they may not understand, nor do they care about. Obviously this is a generalization and there are many progressive departments that have embraced EMS, but many of the largest organizations still have an old school mindset. If anyone knows about organizational culture, it explains a lot. Forward thinking departments and leaders DO understand this paradigm shift and have used it to their advantage. Sadly, they are still in the minority. The union issue is another facet of this, but the problems dovetail into this issue since most FD's are organized and operate under a collective bargaining agreement. Unions and their CBA's are used to being the final word in how a department is run. The issues that arise from EMS transcend a contract.

LMAO Good one. That sounds like the type of smart ass answer I'd come up with.

LOL The pucker factor was always huge with a bad asthma- especially with anyone who had a cardiac history. I'm going back 15 years at least now, but I clearly recall the day we got albuterol- it was like a God-send. I don't recall ever actually using the aminophylline- side effects were almost as bad as status asthmaticus. Like I always say- we have a long tradition here- unimpeded by progress.

Mr. Bowman- As you can see, there are many types of EMS systems represented here, with various medical control systems. I'd be more than happy to discuss my big city fire-based system and the problems we have with you but I won't bore the City here with all the details. Send me an email if interested. twems@yahoo.com

Never happen here. We are so far behind the curve I would never see this in my lifetime. I remember how long it took us to get albuterol nebulizers, after seeing years of asthma patients nearly coding because all we had to use was aminophylline and epi.

Like I said, the OP site is not optimal and certainly not in lieu of tape. It gives the added advantage of viewing the site. Sutures? Apparently your system is a lot more progressive than ours.Obviously that's the preferred method but we certainly don't have that capability.

I respect the position, I do NOT respect the man, and it has nothing to do with politics.

LMAO

Well put. Th union's stance is a red herring. This is a labor/management issue.

SF frequent flier...

I would call this an advancement. Any education is a positive. An RN is not a medic is not an RT is not a PT. Everyone has their niche and are supposed to be part of a team. Obviously the MD's have the most education and advanced training, but who would you rather have working on you if you code- a psychiatrist, a podiatrist, or an ER doc? Time and place and the person with the most appropriate training for the situation. Ideally, a team with specialized skills is the best possible scenario, which is what you have in a hospital setting. As we all know, simply having a doctor on scene is not always an asset. They are limited by your equipment and medications and unless they carry their own mobile crash cart, you are probably the best equipped to handle a cardiac arrest. Best of luck in your new adventures- it can only be a positive for you, chbare.

Wow. An honest question, and people get their panties in a wad over this. Nobody is saying we should ignore a human and work on an animal instead. I've given o2 to an animal with smoke inhalation but never attempted CPR, although I would have no problem trying, if the need arose. For those who dismiss the family pet as just an animal or farther down on the food chain, I beg to differ. Ever seen a little old widow who's only friend or family is their dog or cat? That "animal" is the only friend they have and many times I have seen dying patients more concerned about the fate of their animal than the fact they themself may not survive their ordeal. When a beloved animal dies, many of these shut-ins actually lose the will to live. It's almost like losing a spouse to them. Have a heart, folks.

We used this clip- and several others- in our defensive driving class. We have one from our area- an engine crashing into a building and narrowly missing a couple pedestrians. Very sobering. Every rookie needs to see things like this, since when we are new, we simply cannot believe that people don't move out of our way.

I've actually told people I would be happy to move the rig for them-but only if they so go sit with the guy having the heart attack until we get back. That usually does it.

Happens in most big cities. Getting flipped off, cussed out, raced, etc. These would also be the first people who complain that it took so long to get the help they requested. Sign of the times...

I would hope that more than one person heard that medic's refusal to respond, other wise it's he said/she said. Regardless, if this person was on call and did not respond, that's inexcusable and certainly subject to whatever discipline the department allows. Additionally, if this person has exhibited similar behavior in the past, unless it's documented, it did not happen. Tough situation since this person is a Deputy Chief, but clearly he's the wrong person for that job- as a boss or provider.

Don't recall the sex of the 2nd baby. Strangely enough, in both cases, the "baby daddy" was nowhere to be found. I know- a real shocker.