EMS Lobbies To Take Over Fire Department

[aussiephil]

Crotchity, remember what I said about not being an amateur? Look at this link:

http://www.fireserviceems.com/index.php

Now, I'm being sincere, this is one of the many things EMS needs to do to rally against FD takeovers. I'm sure you can find plenty of BS and half-truths in the videos and downloads. EMS ought to be putting out it's own media to oppose the fire service's views. Any EMS response to fire takeovers has been after the fact, typically right before the takeover, when the writing is already on the wall. This is calculated by the FD, think about it. There's little time to organize an effective resistance effort. Even if you work for a good third service agency, history has shown that it can be taken over at any time, typically with little advance warning. Be more proactive in advocating seperate EMS. I've heard much about the shortcomings of various depts and of takeovers under false pretenses. Why isn't anyone composing media and organizing campaigns to educate the public about these issues? Just calling your legislators or writing letters isn't going to do jack. I keep preaching of organization (with or without unions if you want, although unions will get a more effective response IMO) to enable you to reach your goals.

Many on these forums form very well thought out arguments against fire based EMS. But they are doing nothing sitting on an anonymous internet forum. why is no one taking these things public, through the media and such? Contact your local reporters and TV stations if you have a problem dept you know of. Document witnessed incidents and bring it to them. Let the reporters do an expose or something. Start there. I want to hear less internet bashing of FBEMS and more articles of EMS going to the media in opposition to FBEMS, where it actually counts.

I have looked at the link & found it to be nothing more than propoganda for the fire depts. If I may I would like to address some things I found on the first page of the propaganda web site.

Prehospital 9-1-1 emergency response is one of the essential public safety functions provided by the United States fire service in support of community health, security and prosperity. Fire service-based emergency medical services (EMS) systems are strategically positioned to deliver time critical response and effective patient care. Fire service-based EMS provides this pivotal public safety service while also emphasizing responder safety, competent and compassionate workers, and cost-effective operations.

Why can stand alone EMS systems not have the ability to

provides this pivotal public safety service while also emphasizing responder safety, competent and compassionate workers, and cost-effective operations.

To think that this is only available through a combined service is niaive to say the very least.

It is critical that policy makers understand the importance of having emergency medical services provided through the fire service. Fire service-based EMS is prehospital emergency 9-1-1 medical response provided by the nation’s firefighter EMTs and paramedics. Due to the training, expertise, and equipment of fire service-based EMS responders, they are capable of simultaneously securing a scene, mitigating the hazard, and triaging, extricating, treating, decontaminating (if necessary), and transporting the patients who have been injured to an appropriate medical facility. Time efficiency is a key component of the best designed EMS systems. There is no service more capable of rapid multi-faceted response than a fire-based EMS system.

I find this statment interesting. Interesting that they mention

they are capable of simultaneously securing a scene, mitigating the hazard, and triaging, extricating, treating, decontaminating (if necessary), and transporting the patients who have been injured

. The patient, the whole reason for being is mentioned last. To me this shows the priority is not on patient care as a primary function, but a secondary role.

There are a lot of broad statements that are unsubstantiated.

& finally,

As the federal, state, and local governments consider their strategic plans for an ‘all hazards’ emergency response system, EMS should be included in those considerations and decision makers should recognize that the U.S. fire service is the most ideal prehospital 9-1-1 emergency response agency.

Where is the evidence. The PASG used to be an EMS standard, but we no longer use them because the evidence does not support it. Look at the discussions on the Golden Hour, the changes in fluid replacment therapy in trauma. All have changed, treatments for cardiac arrest. Changed. Were these changed cause someone said so? No. They were changed because the evidence that the change provided positive outcomes said so.

If you want to be taken seriously, do provide this propogana as evidence that what you say is right. I could write a web site with broad statments like this one, with no evidence, to argue against what they say.

EMS works on Evidence Based Practice. If an inquiry finds that EMS services are inadequate in an area, then it needs to be remidies, if it is a private company, then there operations need to be reviews. That does not mean that the fire department should jump up & down to demand it so they have more to do.

The goal should be increased patient care. Improving patient outcomes. I have asked you for evidence on this before & never received it. Now you want to pass this self serving propoganda up as evidence???????

Lets get serious.

[46Young]

I have looked at the link & found it to be nothing more than propoganda for the fire depts. If I may I would like to address some things I found on the first page of the propaganda web site.

Why can stand alone EMS systems not have the ability to To think that this is only available through a combined service is niaive to say the very least.

I find this statment interesting. Interesting that they mention . The patient, the whole reason for being is mentioned last. To me this shows the priority is not on patient care as a primary function, but a secondary role.

There are a lot of broad statements that are unsubstantiated.

& finally,

Where is the evidence. The PASG used to be an EMS standard, but we no longer use them because the evidence does not support it. Look at the discussions on the Golden Hour, the changes in fluid replacment therapy in trauma. All have changed, treatments for cardiac arrest. Changed. Were these changed cause someone said so? No. They were changed because the evidence that the change provided positive outcomes said so.

If you want to be taken seriously, do provide this propogana as evidence that what you say is right. I could write a web site with broad statments like this one, with no evidence, to argue against what they say.

EMS works on Evidence Based Practice. If an inquiry finds that EMS services are inadequate in an area, then it needs to be remidies, if it is a private company, then there operations need to be reviews. That does not mean that the fire department should jump up & down to demand it so they have more to do.

The goal should be increased patient care. Improving patient outcomes. I have asked you for evidence on this before & never received it. Now you want to pass this self serving propoganda up as evidence???????

Lets get serious.

Did you even read my post? I gave that link and said that you could find a bunch of BS and half truths. It's in the second sentence matter of fact. My point was that opponents of fire based EMS could pick that apart, respond to it, and put forth it's own media to compete. That's one of many things that need to happen. Nowhere did I say it was valid evidence of the effectiveness of FBEMS. You picked it apart. I'm saying that others should do the same. Not on an internet forum where it doesn't matter, but rather in real life. Take the time to reread my previous post. You got so aroused when you read the link, picking it apart, that you missed the whole point of my post.

[Just Plain Ruff]

I agree with the statement about the fd versus EMS argument.

When someone in the community calls 911 they expect an ambulance and maybe a fire truck. Do the give a flying F if it's a firefighter medic or a single role paramedic.

the community just doesn't care who comes but what they do expect is that they get a competent provider to help them in a situation that they can't help themselves.

When my fire department came to my house when my wife thought my 2 year old wasn't breathing and I was in Michigan, did she or I care if it was a fire medic or a single role medic. My son was just having a adverse reaction to a cold medicine given to him(Hypersensitive to the medicine in Pedia care). Did I care if the paramedic was a firefighter or a single role medic. NOT ON YOUR LIFE.

I expect that the responder is competent and good at what they do and I believe the crews at our fire/ems service are competent.

I am hereby boycotting any fire versus EMS debate on this forum. It is counter productive because the same people say the same thing. Some say Firemedics are the worst thing that has ever happened to EMS while others defend them. I for one don't give a rats butt who comes to my house, as long as they get there and are competent. I have read more about accidents and bad patient care on single role providers on this forum than I have read about bad patient care of the firemedics. (not withstanding the entire group of firemedics being told they can't practice in that florida city). More private service paramedics/emt's have been featured here as bad drivers or inappropriate care than fire service providers. correlation? don't know? but the majority of errors in calling someone dead and then their actually being alive I believe the majority have been single role medics. Coincidence? Who knows.

It's time to end our constant bickering about firemedic/Fire departments versus EMS. It's old, it's tired and it's counterproductive.

Just my 2 cents.

for the record, I know just as many firemedics as single role medics and I'd put my life in each of their hands.

Edited March 1, 2010 by Ruffems

[aussiephil]

I agree with the statement about the fd versus EMS argument.

When someone in the community calls 911 they expect an ambulance and maybe a fire truck. Do the give a flying F if it's a firefighter medic or a single role paramedic.

the community just doesn't care who comes but what they do expect is that they get a competent provider to help them in a situation that they can't help themselves.

When my fire department came to my house when my wife thought my 2 year old wasn't breathing and I was in Michigan, did she or I care if it was a fire medic or a single role medic. My son was just having a adverse reaction to a cold medicine given to him(Hypersensitive to the medicine in Pedia care). Did I care if the paramedic was a firefighter or a single role medic. NOT ON YOUR LIFE.

I expect that the responder is competent and good at what they do and I believe the crews at our fire/ems service are competent.

I am hereby boycotting any fire versus EMS debate on this forum. It is counter productive because the same people say the same thing. Some say Firemedics are the worst thing that has ever happened to EMS while others defend them. I for one don't give a rats butt who comes to my house, as long as they get there and are competent. I have read more about accidents and bad patient care on single role providers on this forum than I have read about bad patient care of the firemedics. (not withstanding the entire group of firemedics being told they can't practice in that florida city). More private service paramedics/emt's have been featured here as bad drivers or inappropriate care than fire service providers. correlation? don't know? but the majority of errors in calling someone dead and then their actually being alive I believe the majority have been single role medics. Coincidence? Who knows.

It's time to end our constant bickering about firemedic/Fire departments versus EMS. It's old, it's tired and it's counterproductive.

Just my 2 cents.

for the record, I know just as many firemedics as single role medics and I'd put my life in each of their hands.

Ruff,

well said, & from the heart. In some ways I doo agree with you. In many others I cant.

Competency is relative & where there are dual roles there will always be a stronger focus on one over the other. It is the nature of the beast determined by who is in charge at the time. The problem is, when Fire envelopes EMS, the managment structure is Fire based so will maintain a Fire based focus firstly, EMS secondly.

When we arrive at a persons house who is having a possible cardiac event, there are 2 of us, in uniform who quietly go about our business. We try to avoid creating a scene & have the patient removed quietly to hospital. This can be & does have the opposite effect when a fire truck pulls into a quiet suburban street. Why, because now with the noise, everyone know whats going on. I have seen it directly increase a persons heart rate & increase the chest pain they were suffering, & we only needed an assist load down some stairs.

If there is an insistance that they be combined, run them completely seperate, no dual roles. Keep the BRT in the shed.

Allow those who only want to be involved in EMS to do so, without forcing fire on them. Dont hinge wages on holding an EMS qualification to those who chose to fight (the lack of) fires. This allows them to concentrate on what their passion is.

By pinning the 2 together, in many ways the lies & propaganda that is out there is being perpetuated. It is only there for fire to justify their existance & FF's are only taking on EMS to bolster their pay packets. Surely this is not in the best interest of the patients out there.

[Just Plain Ruff]

Ruff,

well said, & from the heart. In some ways I doo agree with you. In many others I cant.

Competency is relative & where there are dual roles there will always be a stronger focus on one over the other. It is the nature of the beast determined by who is in charge at the time. The problem is, when Fire envelopes EMS, the managment structure is Fire based so will maintain a Fire based focus firstly, EMS secondly.

When we arrive at a persons house who is having a possible cardiac event, there are 2 of us, in uniform who quietly go about our business. We try to avoid creating a scene & have the patient removed quietly to hospital. This can be & does have the opposite effect when a fire truck pulls into a quiet suburban street. Why, because now with the noise, everyone know whats going on. I have seen it directly increase a persons heart rate & increase the chest pain they were suffering, & we only needed an assist load down some stairs.

If there is an insistance that they be combined, run them completely seperate, no dual roles. Keep the BRT in the shed.

Allow those who only want to be involved in EMS to do so, without forcing fire on them. Dont hinge wages on holding an EMS qualification to those who chose to fight (the lack of) fires. This allows them to concentrate on what their passion is.

By pinning the 2 together, in many ways the lies & propaganda that is out there is being perpetuated. It is only there for fire to justify their existance & FF's are only taking on EMS to bolster their pay packets. Surely this is not in the best interest of the patients out there.

Phil, we've disagreed on this for many times and neither of us will change our minds I don't think.

In the Kansas city Area and many other areas of the country, the public see's the fire truck arriving before the ambulance and they have come to expect the dual response, ambulance and fire truck. I don't see that as a bad thing.

I completely agree with letting those who want to be involved only in EMS do EMS and not force them to put water on a fire. Again I agree wiht the not hinging wages on holding an ems qualification to those who choose to fight fires.

But seriously, no-one gets into EMS to make big bucks. Why not pay EMS the same as firefighter? What a concept. The person who is in EMS in the fire service should be paid the same to keep equity in the ranks.

I think that we have enough agreement on things to overlook our disagreement on the semantics and processes. We can look towards the future and work to make things better for all of us.