LOL @ Pueblo, CO AMR/Fire Response WHY??????????????

[medicKristina]

I worked with AMR in Vegas and they run a dual response system too. I left for the same macho bru ha ha that was mentioned in another post....you get tired of it and yes, frequestly the driving was not within safe limits with some of my partners and those nights, I was always happy when the shift ended. AMR, in my personal opinion, isn't the best company and staff...I was happy to leave and come back to Ohio.

[Flasurfbum]

Okay, but even acknowledging the value of extra hands on scene, why should it be firemen? That is the real question.

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.

[jsadin]

Why not just roll another ambulance? At least then you KNOW you have medics that probably want to be medics. As has been discussed in here ad nauseum, most fire fighters want to fight fires, not run ambulance calls. This is reflected in some departments policies that allow a fire fighter to drop their medic after a few years and spend the rest of their career on a fire truck.

I have friends that are fire medics and they are very dedicated, educated people, so I understand they are out there. I also know that the top medic services around here are NOT fire based.

[Eng542ine]

Okay, but even acknowledging the value of extra hands on scene, why should it be firemen? That is the real question.

Dust... I think the easy answer here is availability. They're usually available, they're usually close, they come in groups of 3-5, and (at least here) they're usually happy to assist. I truly don't see many other viable options. You wouldn't want to take 2 additional EMS units out of service to get 4 more hands for the 5 story carrydown of the 200kg unconscious patient, would you? I'm a firm believer that many hands make lighter work and if someone's help adds years to my career (read: back/knees), I'm all for it!!

That said, I don't believe that Fire should respond on all ALS jobs (somedays I'm not sure ALS should respond to most of the purported ALS jobs!). I think the application of a little common sense could eliminate most of the responses. Known obese patients, cardiac arrest, unconscious, AMS, MVA, ped/auto... sure. A diff breather on the outside... no need.

Remember, all of this falls on proper call screening and semi-informed callers. In the case cited at the beginning of this thread, if the facility called... who knows what information the call taker did or didn't get. People have, by and large, figured out that the more serious they make things sound, the quicker someone will come. So, the upset stomach becomes a heart attack and the job gets upgraded. Drawing in more resources and bumping potentially sicker people, all because this one has a better "story."

Let's not forget that as ALS providers, WE are a limited resource that should be preserved. There is no justification for unnecessarily risking injury to ourselves or our patients when assistance is so readily available.

[edogs334]

I guarantee you they were running that fast because they were trying to beat each other to the scene (whomever gets there first cosistently can claim better response times). Sending a non-transport piece of fire apparatus to a medical call is wasteful and dangerous.

In my experience, it's not always wasteful and dangerous to send an engine company to a medical call. I've personally seen a cardiac arrest patient saved because the local engine company was on scene in 5 minutes with their AED. The medic unit in this particular case was coming from the other side of town and had an extended ETA. That being said, however, sending them on EVERY medical call may not be a good thing.

[DwayneEMTP]

In my experience, it's not always wasteful and dangerous to send an engine company to a medical call. I've personally seen a cardiac arrest patient saved because the local engine company was on scene in 5 minutes with their AED. The medic unit in this particular case was coming from the other side of town and had an extended ETA. That being said, however, sending them on EVERY medical call may not be a good thing.

The common argument here is that we should simply cut the fire services by about half, and then use those funds to street more ambulances.

The fact is, there are a lot of medical emergencies and very few fires, so the system is broken. The reason that the firemen can get there so fast is that there are fire houses on nearly every block, filled with firemen that have nothing to do but run medical calls.

Remove the unecessary fire labor, and replace it with the necessary medical labor and you'll have medical professionals responding in the same time frame as fire.

Of course, that then makes it necessary to overcome fires insistance that you need a lot of firemen sitting around so that you have the necessary resources for when the "Big One" hits...I'm not even going to attempt to argue that here...

At some point it will become time to be realists...Lose the labor we seldom, or never need and replace it with the labor we usually, or always need and you'll have six pairs of hands on each medical scene if you need it....all medical professionals.

Dwayne

[Dustdevil]

Exactly. There is zero common sense in funding fire trucks to get to medical emergencies faster, when the problem is that EMS is underfunded in the first place. It's called robbing Peter to pay Paul, and there's simply no credible way to justify that. You'd be laughed out of any college business management or economics course for even suggesting it.

If we're going to double somebody else's numbers just so they can be EMS helpers, I'd choose cops hands down. Doubling their numbers would actually create a positive benefit to the community.

But yeah, the correct answer is to put enough ambulances on the streets in the first place so that you don't have to find helpers.

As for the 2000 pounder, how often do we really run those? Certainly not often enough to justify fire response on the number of runs they currently respond to. And if overweight patients was what they were really for, then why don't they respond to all EMS runs, and not just the sexy ones? If I have a 2000 pound patient, you don't have to worry about me forgetting to call for help, so just stay in your recliner playing dominoes until I do.

[CBEMT]

At some point it will become time to be realists...Lose the labor we seldom, or never need and replace it with the labor we usually, or always need and you'll have six pairs of hands on each medical scene if you need it....all medical professionals.

Dwayne

We bust Fire's balls all the time about how little they do versus how busy EMS is

So how are we justifying taking 3 ambulances out of service instead of 1 engine? I agree, keep them out of the normal stuff. But if they're "not doing anything else," why not use them?

I suppose the chest pains and strokes can wait while 2 ambulances do a lift assist so that we can keep Fire in their place and feel better about ourselves.

[DwayneEMTP]

We bust Fire's balls all the time about how little they do versus how busy EMS is

So how are we justifying taking 3 ambulances out of service instead of 1 engine? I agree, keep them out of the normal stuff. But if they're "not doing anything else," why not use them?

I suppose the chest pains and strokes can wait while 2 ambulances do a lift assist so that we can keep Fire in their place and feel better about ourselves.

As we can afford several ambulances/crews for the cost of one engine/crew, this would lead me to believe that we should be able to afford at least as many ambulances as engines...why should anyone have to wait?

You're right though, it makes no sense to have the same number of each and then double up on ambulances...that is why my post was very specific about cutting the dead weight and adding additional necessary resources.

And as you've seemed to have read my post as "just another bonehead bashing fire", then don't take my word for it...remove your emotion, do the math, and see if you don't reach a like conclusion...

Besides, when you or yours is in dire need of ALS and transport, wouldn't you prefer the arrival of an ambulance rather than a pumper?

That whiney response isn't like you CB...

Dwayne

[Flasurfbum]

: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.