NYTimes on Fire based EMS

[paramedicmike]

Interesting piece in the NYTimes. I think it's interesting the comments some of the FFs are making. I find the balance the article attempts to strike is interesting, too. I don't agree with that balance. But whatever.

-be safe

BTW, can we no longer insert the page so it shows up in the post?

NYTimes story

[HellsBells]

This was a pretty good article, but fails to ask a very basic question: If fire calls have gone down by half and medical calls have increased 213% since 1980, why are there still many more Fire trucks then ambulances?

Edited September 4, 2009 by HellsBells

[joesph]

A good article. For us it is such a different world it is good to see how other people do things. I can agree with both statements that time can be of the essence and tieing up to many recourse's on a call is not a good idea. It would seem a logical jump to position ambulances at the fire halls with EMT's stationed there. I assume this is being done elsewhere and am curious how it is working? I have seen in my area paramedic/firefighters grumble about pulling ambulance duty(the box) on certain days but I think if they looked into the funding problems they may realize that if not for EMS half of them wouldn't be there and all of them would get paid less.

[HERBIE1]

I don't think the article was anything but a bunch of firefighters whining. If it was supposed to be even handed, why not interview the EMS providers to get their perspective?

Over 80% of 911 calls are for medical emergencies, and as the article notes, fires are way down.

As was noted, if it weren't for medical calls, even more fire companies would be put out of service and manning would be further reduced- especially in this economy. Most cities are reluctant to make cuts to public safety, but some places have their hands forced.

[aussiephil]

Many of you who know me know I do not & never will agree with EMS being the poor cousin to the attention grabbing, camera seeking fire departments, but should be a stand alone, autonomous agency. This article backs that up.

It was 3 a.m. and in the past 24-hour shift, Mr. Muyleart, a firefighter, had responded to at least one emergency call per hour.

But only two of those calls were for fires; most of the others involved heart attacks, diabetic sores, epileptic seizures and people complaining of shortness of breath.

This shows us that funding is directed to the wrong service. This is further evidenced

In many big cities, the problem is compounded by budget shortfalls that have led to the elimination or proposed elimination of 6,000 firefighter jobs in the past year, or about 2 percent of all firefighters, according to the International Association of Fire Fighters. At the same time, emergency calls have increased by 1.2 million, or 3.5 percent, compared with the year before.

& yet again

In the next 24 hours, the company took three calls involving asthma attacks, five for chest pains or shortness of breath, two for assaults and six for unconscious people on the sidewalk. The only other fire was a small one in a trash hauling bin.

They also show their ignorance & lack of understanding when they make comments like

“People call and say, ‘I’m having trouble breathing,’ ” Chief Jenkerson said. “Can they afford to wait five and a half, six minutes, for an ambulance? No. Seconds count with most medical emergencies.”

How long has the person waited already.

Fire calls have dropped. Fire jump on medical to justify their existance. This report, if the figures are correct & I have no reason to doubt them, show that EMS needs to be properly funded away from fire, then we can see who the real workers are. I would llove to do 2 fire calls (they musnt have been too serious) in a 24 hour shift & nothing else!!!!!!!!

[Dustdevil]

Well done, Phil.

Pretty damn sad that a rookie Down Under has a better grasp of American EMS reality than most Americans EMS veterans.

[Kiwiology]

“I joined the force to battle blazes, not to be an emergency room doctor,” Mr. Muyleart, 35, said as he and the rest of Engine Company 10 drove back to their firehouse,

This is exactly why Fire Department EMS that use cross-trained personnel generally provide piss poor patient care; the Firefighters just do not want to be EMTs or Paramedics ... it's like forcing people to do something they don't want to so they're going to do it less better (there's good Engrish!) than what they want to!

“Guys complain about all the medical calls, but to me it’s work,”

... and yet again, this sort of comment makes me have some sort of mild stroke or hypertensive crisis reading 'em. See above.

Among the hidden costs of the health care crisis is the burden that fire departments across the country are facing as firefighters, much like emergency room doctors, are increasingly serving as primary care providers.

Oh woe is the poor fucking fire department with thier pig-headed, money grubbing, attention camera seeking union ... no you took over EMS to get more money and make your people look better what a crock of shit!

The shift has occurred as cities realized that firefighters could respond more quickly than ambulances, and more cities trained firefighters as emergency medical technicians.

...but most have determined that it is too risky not to always send the closest emergency personnel.

Can we please, please, oh please stop chasing this ____ minute response target; it's just not clinically significant! I would argue about 1% of EMS' patients would suffer some sort of adverse clinical outcome if the truck didn't roll up in ____ minutes (we use eight). I can think of a cardiac arrest, complete airway obstruction, major arterial bleeding and severe anaphylaxis as the only groups of patients who might DIE if we don't make it there within this arbitrary number.

The language of this article is fairly over-hyped and drummed up to make the Fire Department sound so nice and fuzzy as being the PCPs of all these poor downtrodden people and wow it makes me puke!

[Lone Star]

Oh great! Another fire bashing opportunity!

Look people, haven't y'all beaten this dead horse ad nauseum yet?

I LOVE the posts about the 'whining firefighters' when thats EXACTLY what you're doing!

"Mean old FIRE is making unwilling EMS personnel fight fires to keep a job on a city department!"

"That big bully Fire is taking all our money!"

"The IAFF is putting out inflated/incorrect propaganda to make themselves look better!"

The bottom line remains: Fire and EMS ARE intertwined, and in this tough economy, they will become inextricably intermarried. DEAL WITH IT!

Until EMS decides to move away from MINIMAL training and education, it will NEVER be viewed as anything more than a 'job'! The same thing goes with all the different scopes of practice and all the title hungry whackers!

Until EMS quits throwing it's little 'temper tantrums' and decides to step up to the plate like a 'big kid', NOTHING will change!

[Kiwiology]

"Mean old FIRE is making unwilling EMS personnel fight fires to keep a job on a city department!"

I'd say its the other way round bro

Edited September 4, 2009 by kiwimedic

[STAT]

We see it all the time, the media is full of it: "Firefighters save lives" on stickers and on license plates. Ask anyone why they love firefighters its because "they save lives" Fire prides itself on "saving lives"

First of all, I dont 100% agree with that statement. Yes, you do fight fires, and time to time, you may even rescue someone. When it happens firefighters do a fantastic job, and for that, I give them a lot of credit. But those occasions are rare. Truth is, saving lives and helping people doesn't just consist of being the hot shot and running into fires. It means that yes, if you want employment, if you want to continue to be these life saving icons, you have to do some grunt work. You have to respond to medical calls.

It bothers me when I hear these guys talk about saving lives, but also hear them moan and bitch about going to medicals. These pt's need help too! Sorry, its not as thrilling as running into a fire. Sorry you dont get the same media attention you do for going to a medical calls as opposed to fires..but regardless, its part of your job. And truthfully I think the most "life saving" can be done at medical calls. So let me get this straight, you are "life savers" but you don't want to help people in need of medical attention?

fire has to understand that this is how it is now. Fire prevention laws have reduced the amount of real fires to a minimal. So, like stated before, in order to justify your existence, you need to go to medical calls. Get used to it, or get a new profession. It's not gonna change.

Also, as a sidebar....how can they possibly bitch about doing medical calls? How long does it take them? 15 minutes? carry a few bags, start some o2 and help with the lift and then, back to the firehall for BBQ and TV. We are the ones having to continue pt care, drive to the hospital, traige, off load and do the paperwork...come on! I think they should come ride out with us for a few days, we will show you what real work is.