Fire Deptartment defends using trucks for medical calls

[Christopher.Collins]

Good point Hells Bells, in terms of how to address that issue. The problem with first responders in general though is this... yes they get care to the patients faster and thats a great thing, but even the ones who need it dont get to the hospital any faster. For the very reasons quoted, that we are busy waiting to hand off care. Regardless of an EMS fly car or an FD R1... we need to address turnover rates as much as we do anything else. We may not be able to force a hospital to make changes and face it, we cant always predict busy days, then factor in the time it takes to finish your paperwork (not always applicable).

One downfall I face as an EMT personally is that I take too much time on paperwork. I am a very detail oriented person and write all reports as if they were going to court. So in other words it takes me a little time. The state of Connecticut recently implimented that all ambulance services must use ePCRs (electronic PCRs). What advantages do I gain? Giving a very thorough verbal report to the hospital staff, I can finish my report after the call and then immediatley fax or email it to them when Im done. I can run 3 or 4 runs back to back and so long as the hospital has what info they need and I have my signatures I can stay on the run. I dont even need to be at the hospital to give them a copy. Usually I take notes during the call and hand them to the recieving staff, so even I forget to tell them or they miss something they still have it.

[CTXMEDIC]

Wow a fire vs EMS debate that is rational, with no personal attacks (so far). I'm impressed.

I think the real solution here is to have a Paramedic chase car at the fire station. There are no hospital waits, he simply hands off to the incoming ambulance crew, he is there as an extra set of hands, and is not tying up an expensive ladder truck. Of course there will be some extra expense to house the chase car at a fire hall, but it will be small compared to the reduced wear and tear on the fire engine.

if youre going to have a medic and a vehicle at a station, why not make it an ambulance instead of a friggin ford escort? the medic will need a driver anyways. i dont see the point to having all these medic chase cars.

[Christopher.Collins]

if youre going to have a medic and a vehicle at a station, why not make it an ambulance instead of a friggin ford escort? the medic will need a driver anyways. i dont see the point to having all these medic chase cars.

Well part of the point is what to do when there isnt enough people to staff ambulances or enough money to buy more ambulances... or buy and staff ambulances, etc. Say you can afford to hire more people but not buy more ambulances, or fuel and maintain x ammount on the road at a time. Would you rather have FIREFIGHTER/medics or an educated medics whos one and only job is patient care? Im willing to make a safe bet it cost more to outfit your Ford Escort with one medic and nessecarry equipment than it does a Type-II rig with 1 medic and 1 EMT.

Im not saying its the best solution. Regardless of who your first responder is, they wont get the patient to the hospital without an ambulance. But its less expensive and still gets care to the patient sooner than later.

[Richard B the EMT]

As for the cross trained Fire Fighter in the FD "Piece", may I cross reference to this EMT City string on non transport ALS:

http://www.emtcity.com/phpBB2/viewtopic.ph...&highlight=

I do feel that the fire guys can be useful for assisting on CPR runs, and patient carries.

FDNY sends a CFR Engine, automatically, on high priority calls, but most definitely NOT the "stubbed toe" calls. If the stubbed toe call is a bariatric, the crew calls for "additional resources" and dispatch decides if an engine, a cop car, or an additional BLS crew will be called on to assist.

[CTXMEDIC]

As for the cross trained Fire Fighter in the FD "Piece", may I cross reference to this EMT City string on non transport ALS:

http://www.emtcity.com/phpBB2/viewtopic.ph...&highlight=

I do feel that the fire guys can be useful for assisting on CPR runs, and patient carries.

FDNY sends a CFR Engine, automatically, on high priority calls, but most definitely NOT the "stubbed toe" calls. If the stubbed toe call is a bariatric, the crew calls for "additional resources" and dispatch decides if an engine, a cop car, or an additional BLS crew will be called on to assist.

If we all had a thumper, autopulse, wtf ever, we could start closing fire stations. we already have a 'nurse on a stick'.

[ericenglund]

Yes, it does. That "ALS provider" on the engine is stagnating as an "EMS provider". I would much rather have someone arrive who provides patient care on a daily basis, who can perform a complete assessment, who can quickly identify what needs to be done, who is proficient and efficient with his/her equipment due to repeated and daily use, who won't fumble with equipment or assessment or treatment interventions because of gained proficiency/efficiency than someone who may, or may not, have checked the equipment on the engine that morning because he'd rather fight fire than provide patient care.

All that "nice ALS stuff on board" isn't going to do anyone any good if the "firefighter/paramedic" can't work the equipment because he's rusty.

and then you called me ignorant? You're ridiculous. You do know there are fire departments out there that staff ambulances as well -- great many of them. At least half of my time is spent on what I consider a busy medic (~3000 911 calls per year, so don't count your dialysis transports). The other half is spent as the ALS provider on a busy Engine doing what we all know 75%(generous number, probably more) of the job is.

I like to think I have the required intelligence to do both aspects of my job beyond proficiently, sorry you can't even understand that concept. Ignorance is bliss.

[VentMedic]

and then you called me ignorant? You're ridiculous. You do know there are fire departments out there that staff ambulances as well -- great many of them. At least half of my time is spent on what I consider a busy medic (~3000 911 calls per year, so don't count your dialysis transports). The other half is spent as the ALS provider on a busy Engine doing what we all know 75%(generous number, probably more) of the job is.

I like to think I have the required intelligence to do both aspects of my job beyond proficiently, sorry you can't even understand that concept. Ignorance is bliss.

When you have 3 more Paramedics on that same engine, another 2 FF/Paramedics on Rescue and maybe yet another 1 or 2 on a Private ambulance that does the actual transport, how much hands on is any one Paramedic getting per call?

One Fire department in my area has over 600 FFs. Over 500 are Paramedics. Even though it is a busy smaller city, how many tubes, IVs or even ALS patient assessments do you think each Paramedic will get per month or year? How many of the FF/Paramedics that became a Paramedic because it is mandatory will be overly anxious to do lead?

[ericenglund]

When you have 3 more Paramedics on that same engine, another 2 FF/Paramedics on Rescue and maybe yet another 1 or 2 on a Private ambulance that does the actual transport, how much hands on is any one Paramedic getting per call?

One Fire department in my area has over 600 FFs. Over 500 are Paramedics. Even though it is a busy smaller city, how many tubes, IVs or even ALS patient assessments do you think each Paramedic will get per month or year? How many of the FF/Paramedics that became a Paramedic because it is mandatory will be overly anxious to do lead?

Ok. When I am on the Engine I am the only firefighter/paramedic on that engine. The rest is firefighter/ (virginia) Emt-Enhanced.

When I am on medic, i am the only paramedic. my partner is an emt-enhanced and i do 100% of the ALS transports, obviously. My department has maybe 400-500 members and maybe 80 of which hold an EMT-I or EMT-P Cert.

What about my skill competency(since I can only speak for myself, unlike some people here)

Thanks!

[Christopher.Collins]

Eric, wow I wouldnt take things so personally. Im a member of a BLS fire based EMS service and Im not getting all pi$$y when people call out fire service providing EMS, even if they are arrogant statements. Yea so what Im only BLS but regardless we all have the same goal, just different ways of accomplishing it. You have every right to defend your point of veiw and opinion but remember this... not everyone operates the same way your agency does.

I go into some of the cities around my area and see a whole fire battalion respond to a diff breather or fall (without need of technical rescue). All I can think of is how much danger it puts pedestrians and civillian traffic in for so much unnessecarry response. And yes there is a number of members here that may not like fire having involvment in EMS... but alot of people just think its rediculous to send a large heavy peice of equipment that dosnt even have transport capabilities to a "routine" medical or trauma. Any vehicle is dangerous sure... so is my bicycle but the big one thats mostly carrying equipment not even nessecarry to the call will hit harder and take more to stop. Thats even with responsible drivers.

Thats also needless to say that alot (IN FAIRNESS NOT ALL) of firefighters become medics because its in the job requirements for MANY fire departments today. I personally have no problem with fire doing EMS care... I have a problem with people who take on a huge responsability and do it just cuz they have to. There are alot of compitent fire medics out there... but there are also alot of people who want to be firefighters becoming medics just for that big job.

Feel free to comment but you dont need to get all defensive.

[Richard B the EMT]

I have to ask: I am a mission specific EMS EMT in the Fire Department of New York, who does treatment and transport. We also have mission specific EMS Paramedics in the Fire Department of New York, who do treatment and transport.

The fire fighters are at the lower level of training of Certified First Responders-Defibrillation, and would only be on the ambulances if either the EMTs or Paramedics needed someone to assist, say, in doing CPR (we will address "rolling codes" in another string, please?). Fire Fighters are not allowed to drive the ambulances, by the way, nor are the NYPD LEOs.

EMTs and Paramedics are not cross trained as fire fighters, and fire fighters, except for the CFR-D training, are not EMS trained, at least within the department. If they are so trained from outside the FDNY, their skills in the other areas are not utilized.

So...as I am in a fire department, even though I am not a fire fighter, am I, by definition, evil?