Fire Deptartment defends using trucks for medical calls

[CBEMT]

The massive 42-foot ladder truck, with its 110-foot rear-mounted ladder and 500-gallon water tank, was designed for fighting raging fires and plucking people from burning buildings. But on its recent fatal run, Ladder 26 was on a more pedestrian duty: a medical call for a man having difficulty breathing.

In recent years, such calls have become commonplace for fire departments across the Commonwealth. And firefighters, who receive far fewer calls for fires than they did a generation ago, have welcomed the work. With a declining number of fires to fight nationwide, the medical runs have helped to keep fire departments busy and boost sagging call numbers. Last year, medical calls accounted for 37 percent of the 70,176 runs made by Boston firefighters.

But this month's crash, in which Lieutenant Kevin M. Kelley was killed, indicated the dangers that firefighters face anytime they leave the firehouse and rekindled a long-smoldering debate about why Boston firetrucks, staffed by firefighters, and ambulances, operated by a separate agency, Boston EMS, both need to be responding to the same medical calls.

http://www.boston.com/news/local/massachus..._medical_calls/

[Just Plain Ruff]

this scenario plays out thousands of times a day all over the US. Bad luck fell on Boston Fire this day. But it could have very well have fallen on Chicago or LA or Seattle or wherever else that fire trucks and ambulances respond together.

Maybe something good will come out of this for the rest of the country

[JakeEMTP]

.

In recent years, such calls have become commonplace for fire departments across the Commonwealth. And firefighters, who receive far fewer calls for fires than they did a generation ago, have welcomed the work. With a declining number of fires to fight nationwide, the medical runs have helped to keep fire departments busy and boost sagging call numbers. Last year, medical calls accounted for 37 percent of the 70,176 runs made by Boston firefighters./

This is what we have been saying all along. It is a numbers game. Let the FD do fire suppression and extraction and leave the medical calls to the EMS agencies. There is absolutely zero reason for a ladder company to be responding to a medical call.

My heart goes out to the family of Lt. Kelley.

[iMac]

That is really unfortunate. My thoughts go to the family. So many things play a key into this issue. We have the same dilema here. Some of the bigger cities that have the money and the people to run 2 separate services do so, where as the smaller ones seem to run calls differently by having all personel trained in both areas.

Just to many things come into play into this one and it would be difficult to find a way to have run things differently the day of that unfortunate crash. A risk we shouldn't have to take BUT we choose to risk. Again thoughts go with the family.

[ericenglund]

Perhaps it's your grandfather having the CHF exaccerbation, or whatever breathing problem we're referring to. The ambulance has a 12-15 minute response time, and the fire piece(engine, ladder, whatever) has a 2-3 minute response time. Sounds good.

Now lets say the Engine has a firefighter/paramedic in the jump seat, and a monitor/drug box/cpap/ all that nice ALS stuff on board.

Sound like a bad idea sending the fire engine to the EMS call?

[JPINFV]

Sure, when you have to replace that apparatus sooner due to all the miles put on it running EMS calls? If the fire department is regularly running EMS calls due to response times, then we need more ambulances, not more fire engines.

[ericenglund]

and if you read the article, it says they made it to the scene(ahead of the ambulance, by the way)

and as they were leaving the scene, the brakes failed.

I'd be willing to bet the fact that this was an EMS call vs. a Fire call had nothing to do with the brake failure. At least it wasn't on the way to the grocery store.

Say the difficulty breathing is 400lbs on the 2nd(or 3rd) floor. Or he's in cardiac arrest by the time you get there. Extra hands are nice. should you tie up an addictional ambulance thats probably even farther away than the first one, or send the fire engine from down the street?

[crotchitymedic1986]

Eric, the point is that the mission of the fire department has changed, and they should equip accordingly. There is no reason to send these gigantic engines, quints, and ladders on EMS calls. A smaller first responder vehicle is what is required. Of course the real arguement is why EMS is not staffed at a level to provide the same response time as Fire ?

P.S. I wouldnt work a 400lb arrest on the 3rd floor. Let the coroner extricate the body.

[Doug]

We are going to be truly intellectually honest here, eric, if you are going to argue crosstraining it should be PD and EMS. They are already on patrol no need to get up and out to get enroute, smaller vehicles that won't block streets and people actually pull over for them when they have lights and sirens. Or, better yet, have more AMBULANCES in those stations. I work in an area that does the duel response, on EVERYTHING, literally includeing "splinter in finger", and it's horrible. What's amazing is that in surrounding towns covered by volenteers 2 people often show up and transport. Don't ask me why my city feels the need to send 6 people.

[ericenglund]

Most fire department missions are something along the lines of life/property conservation. The call volume may have gone full circle(more fire, less EMS to more EMS, more fire), but the mission is the same.

I agree a smaller vehicle would be probably more logical. However, that would require buying/maintaining the vehicle and staffing it with a provider 24/7. Where as the Engine(or ladder, whatever) has obviously already been purchased and staffed.

EMS is not staffed to be able to provide the same response time as fire because I'm assuming Boston ambulances(along with the rest of the nation's) are held up at the hospital waiting for a bed for their stubbed toe patient or other nonsense BLS cab-ride to the patients PCP(The ER MD). I can see the argument for police trained as EMS providers, but I don't ever see that happening except for a few very small exceptions.

Dual response needs to be monitored by either dispatch trained accordingly, or the pieces themselves. I know when I'm doing my shift on the ambulance and the engine is dispatched with me and I don't see it neccessary, I'll cancel them before either of us go en route.