Rig staffed with Medic and EMT

[gaelicfirefighter]

We have three different types of ems service here in Chicago.

One is the BLS rig staffed with two dual-role ff/emt-b's.

The second is an ALS rig staffed with 2 single-role medics.

The third is an ALS truck/engine staffed with a dual-role ff/medic and a dual-role ff/emt-b.

A dual-role medic or cross-trained medic can start as a medic and after a prescribed amount of time can cross over into FS&R. Firefighters, Lt's, Captains, Engineers and Battalion Chiefs who have their emt-b get paid more than their counterpart who does not. Same if they have their medic license. The only difference is that ff/emt-bs have to work the ambo. Everyone else can use their license on an ALS engine or truck and spend no time on the ambo.

I apologize to the people I know and who's opinions I respect. You know who you are. MRSFA would not be one of those people. I have no idea who you are or where you are from. All I know is that I am glad I do not work with you if there is such hard feelings between ems & fs&r. Sucks to be you.

I get really irritated when certian medics think that us firefighters sit around all day. I for one do not. I work at a one of the busiest houses in a large urban area and in the busiest still district in the city. But I am not better than anyone for this. I am just lucky to have spent 19 years in a busy area.

I also happen to work on a very busy bls rig. Because I am a ff/emt-b I get detailed to the busiest houses in the city and I work the busiest engines and trucks. I have received 33 unit citations on the bls ambo alone and many more on a fire apparatus. I have shared these citations with many firefighters and many medics and emt's. They are not my citations. They are for the guys and gals in my house. We all share them. We all earned them. We all cherish them.

I don't know where some of you are from but we are a very strong brotherhood here in the city of Chicago. We work, eat, sleep and socialize with eachother. Regardless of position or rank. We do this out of mutual respect. Respect for one anothers skills and abilities. I cannot do what a medic does and he or she cannot do what I do.

I have medics show me how to do things when they have time and I appreciate this time. I also show medics how to do things at car accidents, confined space rescues and at fires.

When was the last time a ff had a junkyard car dropped off in the parking lot of your facility to show the medics the hazards of electric motors, alternative fuel cells and air bags. A couple of medics at my house had some concerns, so I had the car dropped off and had a class just for them. They in return have allowed me to ride the ALS ambo on my off days and set up ER time so that I may become a better EMT.

We share knowledge and experiences. We take pride in our department and work WITH eachother.

We don't sit around and worry about titles, certificates, skills.......etc. We are not comparable. We augment eachother. We back eachother up and help eachother.

So if you show up at a scene and YOUR FS&R is not doing their job, don't assume all firefighters are like this. We are not. It's your department. Look internally, not outward.

And for that person that wondered why I am paid more? I am paid more because our medics are on 24 and off 72. I am on 24 and off 48. I work more days in a year. Taking nothing away from their skill and knowledge, but I am trained in many more areas than a single-role medic. A dual role medic makes more than me.

Not saying the training is more or less important or difficult. Its just that the city can use me in many different ways where a single-role medic can only be used one way. Once again, not that it is right or wrong, but that is the way the city does it. From an employer stand point it makes some sense.

I could also sit here and rip on some medics for the amount of time they take on runs and at the hospital. But I do not. I can also question their field assessments as they are not doctors, but I do not. I could also comment on their attitudes towards patients, like they had something better to do than take the run, but I do not. I don't because I do not do their job and I do not walk in their shoes. I do not generalize as this is ignorant and disrespectful to those of us who do a good job. I am lucky to work with some of the best medics in the city.

There are "dogs" in all our fields. But please don't sit here and disrespect people who do a different job. A job no more or less important. We are here to serve the public. Not rip on eachother and make fun of eachother.

When a medical emergency comes across the line, the medics are the most important. When a fire comes across its the firefighters who are most important. When its an MVA, a confined space or a vertical rescue we are equal. Don't compare firefighters to medics or emt's. It's not important. It cannot be done. Its foolish.

I suggest that all medics who have a general dislike for ff's ask them for help in the areas you feel delinquent. I would also suggest you have a class for them and show them what you need and require of them. Don't wait for your respective departments to do it. Take it upon yourselves. Be professional. Instead of sitting around bitching, do something. But some people just like to bitch.

When one of us screws up we all screw up. The public does not differentiate medics from the fs&r. Make sure your department and your house compliments eachother in your offerings, knowledges and trainings. Be well-rounded. If you took the time, you might be amazed at what happens. I did and it has turned out great.

I have even had medics come in on their off days to ride the rig to fires. I had a 12 year medic veteran on the pipe at a fire once. He said it was the best day of his life. He in return has taught me more about the ems field than any training, class or book. See what you can accomplish when you think out of the box.

Once again, for those of you I know and respect, most of this rambling has nothing to do with you. For those narrow minded and ignorant people who do not try to improve themselves and those around them please refrain from reading or commenting on my posts.

Until you show me instances of true brotherhood I could care less about your comments. The EMS and FS&R field should have no room for people like this. People out for themselves in this field is the mot dangerous thing you will encounter at a scene.

Thank you and have a great day.

[DwayneEMTP]

So, now I have no idea if I'm supposed to respond or not.... :wink:

Dwayne

[stcommodore]

My ideal staffing if we are sticking to single tier response

P/P Units in high acuity/high volume areas

P/B Units in Lower Acuity/Lower volume areas

Also, guys we all go to school longer and learn more so we make the big calls to me it sounds like your all afraid to do it!

[Dustdevil]

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[Mateo_1387]

We do this out of mutual respect. Respect for one anothers skills and abilities. I cannot do what a medic does and he or she cannot do what I do.

It is great that your department gets along. What people are saying though is that both jobs are two separate fields. You even said so in your post. A lot of times thought EMS and fire do not get along. Again, it is great that your department does, but on the other hand what is good for your community is not good for everyone else.

What are your thoughts on having this type of staffing in an urban area with short transport times. I dont necessarily like that idea.

I personally like the idea of having one paramedic per ALS unit for the most part. When you have one paramedic it forces them to be competent. As a single medic you should be confident and have the proper education to care for the patient. A paramedic should be able to make the proper decisions without having another paramedic (a crutch).

I also do not agree with having paramedics out the yin-yang on every emergency vehicle within an area. When there are so many paramedic in the system they reduce the chances of every paramedic to do skills such as intubations, see a variety of sick patients, and the such. There are so many medics that it dilutes the calls/skills a single medic can see and do. This makes for a system with weak medics.

There are things as an EMT I canot do and I thought it would greatly hinder pt care as I could legally not do things to help my partner.

Explain this please? I do not see how patient care would be greatly hindered if you were not a medic.

Until you show me instances of true brotherhood I could care less about your comments. The EMS and FS&R field should have no room for people like this. People out for themselves in this field is the mot dangerous thing you will encounter at a scene.

You make an interesting statement here. There are so many people here who could offer great information that share no brotherhood with the FD. I am an example. Where I work EMS and the FD do not get along. There is no brotherhood like there is on the FD. Yet these people would be able to offer you any help pertaining to EMS.

[towheadedmule]

My system runs one Para and one Basic for the most part. Sometimes to fill shifts management allows double Para trucks. Our contract with the City mandates a Para in the back of the truck with patients at all times.

I find it to work fairly well. With the exception of IV, Intubations, Drugs and other advanced skills, My partners can do most of the others.Most calls are BLS calls anyway. But Vitals, assessments, thinking about what the PTs DX is and BLS interventions can be done by the Basics. And if it is a difficult pt that is taking up time with ALS interventions, then my partner starts with the paperwork. Call them teachable moments.

Its about teamwork, quarterback may call the plays, but that does not lessen the importance of the offensive lineman.

Then again, I am told I work in an odd system. I like it.

Russell

[Scaramedic]

I have to ask a question. Who does get along with Fire. I haven't worked in a city that Fire and PD don't hate each other. I have had some decent relationships with some FF's but for the most part I can't stand a lot of them. So the average relationships break down like this.

PD hates Fire.

EMS hate Fire.

PD & EMS have a great relationship.

So who is really at fault for this lack of Brotherhood?

[Dustdevil]

LOL! I see your point, and it's a valid one. But I'll have to be honest and speak up here to say that it's been nearly thirty years since I have worked somewhere that Fire and EMS didn't get along. Usually, one of these situations exists:

• 1. The firemen don't want anything to do with EMS, and are quite happy to have somebody else doing it.

2. The firemen are all rural volunteers who are quite happy to just run around with their lights and sirens as first responders, without having to actually commit to professional education, as EMS would require.

3. The firemen and EMS are one in the same, so they maintain mutual respect.

• The only time I have worked where there was real problems between Fire and EMS was when fire was actively working to take over EMS, and thus saw EMS as competition for their turf.

However, having spent time in Kalifornia, I do understand that some serious rivalries do exist, even in systems where the firemonkeys really aren't interested in EMS. Although, I have never worked there, and never will.

Of course, there are the inter-systemic problems, where firemen and EMS who aren't even in the same system dislike each other, I suppose for the same reason that blacks don't like Jews. Just because their culture tells them that's the natural order of things, not because of any real, tangible differences. I think that accounts for much of what we see on these forums.

The same thing works in reverse, though. I am called a fire-basher for my stand against fire-based EMS, yet that stand is against a specific concept, not against firemen in general. Yet, that is still perceived as fire and EMS not getting along.

The whole thing actually reminds me of an Air Force vs. Marine Corps rivalry. Marines don't respect the Air Force because Air Force boot camp is only half as long, and a quarter as difficult. But the Air Force doesn't respect the Marines because the Marines let in all the idiots that the Air Force rejected. In reality, those differences are irrelevant, because both have completely different missions, making any kind of comparison invalid. I would say mirrors the fire vs. EMS rivalry.

[mshow00]

Just a couple of thoughts and questions from a basic on a basic/medic truck: As for if my partner wants/needs another opinion/advice on a particular PT thats what medical control is for, and our sups. I have made no secret to the fact that I work in for a private service, we run both basic/basic(mostly for transfers to and from SNF) and medic/basic trucks. My other question is what about people like me who have no interest in FF, where do I go to prep myself for medic school if everyone were to switch to dual medic trucks. I mean I have been working full time on an ALS truck for a couple of months and it is night and day different from BLS. I have just started to learn how to read 3 and 12 leads, learned and am learning a lot of little things I didn't know I didn't know.

[AnthonyM83]

Around here I think everyone actually kind of gets along, for the most part, big picture. Police, EMS, and Fire don't are on calls with each other all the time and rely on each other. No real reason to hate each other.

Ambulance loves Fire because 90% of Ambulance wants to BE Fire.

Fire is whatever about Ambulance, because most of Ambulance kisses their ass.

The 10% of Ambulance who are into it for EMS (mostly) hate Fire (but many still want to BE fire) because Fire hates doing EMS and does a bad job at it. Fire then doesn't get along as great with that 10% because they don't kiss Fire's ass.

YET, in the end a lot of people get along no matter what because they're still personable, but the EMTs really have to make a big effort to be accepted by FD and medics. It's like every single thing you do at work revolves around looking good for Fire.

It's a weird dynamic. Hard to explain. Many variables and exceptions. You gotta experience it to explain it I think.