Fire Deptartment defends using trucks for medical calls

[HellsBells]

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.

Yeah, I agree that there should be more Ambulances. My point is that if you have a paramedic on the firetruck anyway, keep a chase car at the hall, so that when a medical call goes out, he can jump off the pump the pump and respond himself, so that the whole dang crew isn't responding.

[mobey]

Yeah, I agree that there should be more Ambulances. My point is that if you have a paramedic on the firetruck anyway, keep a chase car at the hall, so that when a medical call goes out, he can jump off the pump the pump and respond himself, so that the whole dang crew isn't responding.

Besides a Ford Escort is easier to slip through a budget than a new fully equiped transport ambulance.

[paraloco]

Ok, try this on. You split up all your paramedic crews. Place them all in fully stocked med units, and they respond with the fire dept. FD medics/basics can help on scene, provide an extra attendant if need be. If it turns out to be a transport, a fireman drives you to the hospital, and stays to assist you in unloading. So if you had 5 med units before, you could now have 10. Not the most optimal solution, but I bet it would work. That's how Baytown EMS's shift supervisor operates, or did back when I was there.

[mobey]

Ok, try this on. You split up all your paramedic crews. Place them all in fully stocked med units, and they respond with the fire dept. FD medics/basics can help on scene, provide an extra attendant if need be. If it turns out to be a transport, a fireman drives you to the hospital, and stays to assist you in unloading. So if you had 5 med units before, you could now have 10. Not the most optimal solution, but I bet it would work. That's how Baytown EMS's shift supervisor operates, or did back when I was there.

But the fire trucks are still responding?

[paramedicmike]

You're ridiculous.

Am I? Let's break this down.

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).

So you spend enough time on an ambulance to catch approximately 1500 of those 3000 calls. They're not all ALS calls. So you aren't the primary care provider for probably the vast majority of those 1500 calls.

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.

Ok. So maybe you get there before the ambulance. Maybe you don't. Either way, what calls you do arrive on scene on are spent trying to figure out what's going on (which needs to be done before any interventions are started).

Now, when you're on the ambulance, you're competing with the medic on the engine for assessment and skill proficiency on an already small number of calls because you spend half of your time on the ambulance running, if national trends apply to your area, a majority of BLS calls. But when you're on the engine, you're rusty because you don't get the assessment and skill proficiency because you're "losing out" (a loose term as the patient is the one really losing out) to the medic on the engine.

So you don't get the experience on the ambulance because you're losing out to the medic on the engine. But when you're on the engine, running even fewer calls than on the ambulance, you're proficiency is lacking because you don't get the practice while on the ambulance. It's a vicious circle with no good outcome.

I like to think I have the required intelligence to do both aspects of my job beyond proficiently

For the sake of your patients, I would hope so.

...sorry you can't even understand that concept. Ignorance is bliss.

No ignorance on my part is involved. I've worked in an environment similar to the one you describe. It sucks. Providers stagnate then begin to provide poor care. Patient's lose on a daily basis.

I refused to become a mediocre provider so I moved on to organizations that focus all their energy on providing EMS.

You do know there are fire departments out there that staff ambulances as well -- great many of them.

Yep. I am well aware. And every single one I've come across or had any dealings with spanning eight states (not counting all those I've read about in quite a few more states) and the District of Columbia, including Virginia, fail when it comes to running an efficient EMS system.

-be safe

[paraloco]

Yes, but it could be any apparatus with at least 1 EMT-B. Could be a 2-man Suburban. Even if all your medics are on calls, the rescue unit can respond and initiate some care. I'm sure state rules and regs would hafta be tweaked, but thats where politicians step in during tough times to make things happen. I wouldn't choose this system if I had a choice of something better, but if it saved my job and covered the territory adequately I would do it

[zippyRN]

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?

well other than the resource implications of tying up 5 personnel ( 3 or 4 of whome are extraneous on scene , but the appliance is offthe run becasue it's tasked) and a 250 thousand GBP piece of apparatus ...

a Community FR responding ( at raod speed) in their own vehicle costs the cost of kit, training and comms

a response vehicle costs around 30 - 40 thousand GBP and delivers a provider in the same manner as the fire appliance but with no extraneous personnel , no loss of fire + rescue asset and with a smaller carbon and financial footprint

replace your one misused fire appliance with 4 or 5 EMS response vehicles, a mixture of EMS response vehicles and ambulances or tens of CFRs to provide essential early links ofthe chain of survial ...