Firemonkey Madness

[1835wayne]

Well, I guess I woke everyone up with that one!!!

First off, I am an old hand at forums, so I understand that it is not meant to be personal.

I am actually torn on the idea of combining Fire/EMS. I work in two systems, one where the FD is used as First Responders and the county runs EMS, and the other where we are Fire based EMS(ALS).

At work(Fire based) we run mostly minor medical and some REALLY hairy trauma (Like earlier this year when the BOF burped and spewed molten steel on 7 people) with the occasional MI. The Paramedic does NOT have to be a firefighter, and on a fire scene is there as the sector commander for the Medical sector. Everything is fairly hunky dory there with this system.

At home, we run BLS out of the FD and the ALS rig comes from a town about 12-15 miles away. This also seems to work pretty well. What would be better would be to have the monies and resources available to put a full time ALS rig at every FD in the county. Would we need the First Responder program anymore? Maybe not, but then you have your REALLY bad days when everything turn to liquid feces in a hurry and then you are glad to have the FD there to run and fetch, help lift the fatties, etc.......

I know I have not answered all the questions, but I have to get to the mill. I am the LT, and some of my FF are bonified axe swinging,knuckle dragging hose jockeys who will get lost without an Officer there to guide them! :shock:

I will try to post from work later.

[DwayneEMTP]

I'll wait until you have time to answer the previous questions before I respond...

But I do want to say this:

I can't remember the last time we had two honest to God firemen in one of these discussions that actually wanted to, were able to, and agressively did, discuss the issues from the fire side.

This thread is turning into a real treat!

Dwayne

[Dustdevil]

I can't remember the last time we had two honest to God firemen in one of these discussions that actually wanted to, were able to, and agressively did, discuss the issues from the fire side.

This thread is turning into a real treat!

Word. We're used to a lot of volunteers and wannabes arguing things they really know nothing about. Mostly the "anything for a thrill" kids who just want to 'do it all'. It is refreshing to discuss the issues with people who are actually committed to a fire career and have a passion for EMS as something more than just a side-job or hobby.

Unfortunately, this topic has strayed far from where it started, and from where I intended it when I started it. Neither I, nor any of the other regulars here start fire vs. non-fire debates, because we already know the issue intimately and don't need more discussion. Somehow, any mention of fire EMS still degrades into that though. I hope you both can see that was not what this topic was about though.

What I'd like to see is for both of our new fire friends to comment on the original topic of the thread. Did you read the original articles? How do you feel about that issue? Do you think that an EMT card should be a requirement for all FD applicants? Why, or why not? I mean, I am all for high standards for both fire and EMS applicants. I just don't think that an EMT card qualifies as a high standard. There are a lot more important things I want in my applicants, if I am a fire chief. What say you?

We're going to disagree on some things here. I'd say it's more a matter of perspective than anything else, though. And the great thing about this place is the ability to share perspectives with other professionals worldwide, which broadens all of our horizons.

Welcome to both of you!

[lfdcaptain]

[/font:1a8272d799] This warrants some pondering....... will respond soon.

Have a safe day!

[speedygodzilla]

I believe that an EMT card should be earn prior to applying for a FD position. It shows that you are willing to earn the appropriate education (not that EMT-B is appropriate, another topic for another thread) along with Fire I, II and Haz Mat. There are not many professions that are willing to hire applicants and pay for them to earn the degree or education they need for the job. Especially when it only takes a semester in school to receive your EMT card. Don't get me wrong I love the fact that many hospitals, FD, ambulance departments, etc. give us a chance to further our career and pay for classes to do that.

[CodeBlueEMT]

Darn. Where's the box to check "other"?

The purpose of attending a fire academy is to learn firefighting. There isn't a requirement to have your FF I and II certification. It's a training school. Students aren't going to come off the streets with experience in most cases. Those same applicants aren't going to have EMS experience. A twenty year old kid has to start somewhere. Some make it, some don't. How many EMT-P's started their career as a Paramedic from day one? EMT-B's are basically useless if you read and believe these threads. What's the big deal over not being EMT-B certified at the time of admission? How much experience and education does a twenty year old EMT-B bring to the table? Not much.

Shayne

[JPINFV]

EMT-B's are basically useless if you read and believe these threads. What's the big deal over not being EMT-B certified at the time of admission?

EMT-B is useful as a first responder certification, not as a solo provider license/cert. This is a conversation for a completely different thread, though, as well as being a dead horse topic here.

How much experience and education does a twenty year old EMT-B bring to the table? Not much.

Shayne

My concern isn't over if they are/aren't requiring it, but the reasons given for their change in admission requirements. If the stated reason was, "We don't see the utility of requiring EMT-B prior to entry to the academy" or "We'd like to have better control over the quality of EMT-B education" then I'd say that it was a good idea. Watering down the requirements to foster "diversity" is just plain stupid. If they're willing to over look a requirement because of the amount of melanin someone's skin cells have, then I question what other requirements and traits that they are willing to overlook.

[Dustdevil]

The purpose of attending a fire academy is to learn firefighting. There isn't a requirement to have your FF I and II certification.

This is where some confusion will enter this discussion, because there are indeed some states and locations where fire certification is required to even apply. In some places, it is, I guess, just a little hoop to jump through to give you a very basic foundation before they send you to a real academy after you are hired. I think Floridia does that. However, in a lot of other places, mostly small towns, the department requires a full certification to be eligible for hiring so they can put you right to work without having to spend any time or money on training you.

I think most of us are more familiar with the big city departments that just hire you based upon civil service scores, regardless of prior experience or training, and then send you to their own academy. It is in those cases that it doesn't make a lick of sense to hire somebody, pay to train them in firefighting for four months, and not toss 120 hours of EMT in there too. That is the kind of system I originated in. Hiring only people with certifications was a podunk suburb kinda thing, and I'm surprised that any big cities do it.

Incidentally, EMT certification is an integral part of Texas firefighter certification. It is part of the fire academy, or a prerequisite for others. If you are a certified professional firefighter in Texas, you are (or were at one time) an EMT. They put that in there sometime in the late 80s, I believe.

[1835wayne]

Well Dust, as for the original post topic. I did read the article and the entire thread before posting.

My answer? It varies. If the FD is in need of EMT-B's or P's, they should hire them. As a blanket requirement for any FD, no. It is one of those questions that has no clear cut single answer for all locales and systems.

My career FD requires it, but we have extremely limited staffing and it is crucial(Speaking as a Supervisor)that they all have the certification so that calling in someone for a call off, or setting up the crew roster for the shift much easier.

My VFD does not require any training to join(Fire or EMS), however our Chief is a Fire instructor III and a EMS Primary instructor for all levels and we can do our training in house as we have several other Instructors also. Our Department requires that all new members attain FFI and II, and First Responder within two years of joining.

I'll bite. Are you defining saves as "made it to the hospital with a pulse" or "walked out of the hospital with limited neuro deficits?" There's a big difference and one of those options is not a save.

Returned home and limited deficits.

Also, what is a BLS non-transport unit going to do for a cardiac except O2?

By our protocols we can of course do CPR, OPA-NPA or combitube if needed, Defib and O2. The idea is NOT to replace ALS care, but simply to initiate BLS care and attempt to stabilive the patient until the ALS rig can make it there.

Furthermore, how does providing a BLS service help a county win ALS of the year? That kinda of seems bass ackwards.

The FD(BLS) are part of the County EMS(ALS) in most cases(We are "Stand alone" do not need EMS approval to run calls in our jurisdiction.) and are part of the same system with the same medical director.

I do agree that early defibrillation is key... but a First Responder with an AED/CPR cert can do that very easily. As for the Combitube, there are many schools of thought on that particular airway adjunct... and many people have expressed a preference for trying to get the ET tube *first* and using the Combitube as a backup device.

Personally, I think I'd rather see my cardiac arrest patient being managed with BLS only airway devices (NPA/OPA) and good BVM technique, rather than a medic having to pull the Combitube to establish that definitive airway. The less we screw with the inner workings, the lower risk of trauma to that airway. Just my opinion, however!

First off, in Indiana, the combitube is a EMT-B skill. I prefer the OPA-NPA myself, but the combitube is nice when in a rush and limited on manpower on a full arrest, and the NPA-OPA is not working.

Why is it better to have fire lift the "fatties" instead of other medics?

It isn't really, but isn't it nice to have more hands to lift the fatties??

As further clarification, I would NEVER advocate a reduction in resources on EITHER side. Is EMS understaffed? Well, duh. Is Fire? Again, duh.

Is it your opinion, as it seems to be, that simply "someone" showing up is acceptable? So if your house is on fire, you'll be satisfied if they send an ambulance immediately, while you wait 10 mins for fire suppression professionals? I mean, after all, the ambulance has a fire extinquisher! (akin to the firetruck having an AED)

:roll: :roll: :roll: no. Oversimplification.

If we didn't have a firehouse every few blocks (but very few fires) then the money 'might' be available for the training of medical professionals to respond to medical calls.

True enough, but when those "few fires" happen it will still take the same number of firefighters and apparatus to mitigate that incident with a good response time. How about we station an ALS rig at every Fire Station in the country with full time staffing? Will it make it better?

As long as you come with the same, tired, "you need us because we fight what you fear!" nonsense...this conversation will go nowhere.

Your words, not mine. As long as you look down your nose at the FD based EMS, and the FD in general..........this conversation will go nowhere. I have a great deal of respect for Paramedics, and what they do. I have been EMT on an ALS rig long enough to know that. I missed your FD knowledge? Do you have any? Not an antagonistic question, just curious.

[Eydawn]

Well stated points! In MI, where I still hold current certification, the Combitube is a BLS device... I'm just leery of it due to studies finding increased necrosis to the esophagus and higher incidences of airway trauma due to having to PULL the Combitube in order to drop an ET tube. Ergo, the way I see it, I'm glad I can't do it in CO because in the long run it may do more harm than good. But that's just me!

Wendy

CO EMT-B