IAFF versus EMS

[treaux]

Having preset notions that fire can't handle the job only adds to the animosity and detracts from a real solution. Who's to say fire run EMS is worse than private ambulance service? One angle of this is that the FD is created to help the public vs private ambulance which exists to take money from the public.

Fire could run EMS well if the right people were in place. Personally I constantly talk with fire-medics about their continuing education and modern EMS practices. I also have been giving some of their interns some ambulance time as well.

If any given FD staffed ambulances and had high quality control and care review, they could probably do a very good job (and without the overhead of a profit margin they could have better equipment/pay/etc.).

[fiznat]

I work in a city where the are constant rumors that the municipal fire department will someday take over EMS. I don't feel that they would necessarily do a better job, and I try to make that point known every day though the way that I handle myself and my patients at work. There is a big difference in patient care between an EMT or MRT certified first responding firefigher, and the paramedic who arrives on an ambulance. I make sure that difference is obvious to my patients when I arrive on scene.

To be honest I don't really care who or what department "runs" EMS. That argument, to me, is just about turf. What I care about are that individual providers have the equipment, opportunity, skill, and most importantly desire to do their jobs well. I'm not sure if a fire-based model precludes any of that, although I admit that individual experiences do vary.

Edited March 17, 2010 by fiznat

[Lone Star]

Rather than expend all that energy and waste all that time whining, crying and absolutely bitching about 'mean ol' fire taking over EMS', wouldn't that time, energy and effort be better spent realizing a few things?

1. The 'bean counters' that are on the municipalities boards have alot to do with EMS being given to the Fire Service. Once that happens; yes, the Fire Service is going to do what it feels is necessary to protect the jobs of it's members.

2. As long as EMS is under the direct 'control' of the NHSTA (who is under the 'control' of the Department of Transportation), it's not going to become a recognized 'health care profession'.

3. Until EMS can get past the whole 'eating its own' mentality and actually come together to work toward a common goal, it cannot agree on one representative body to make it's voice heard.

4. Another important point that EMS really needs to consider in its quest to become a recognized health care profession, is moving away from the 'minimalistic approach' to education. As long as EMS is allowed to focus on how fast we can get bodies on the street with minimal education and training, EMS will always be considered a 'job' and not a profession.

In my opinion, EMS' worst enemy is EMS itself!

[akflightmedic]

1. The 'bean counters' that are on the municipalities boards have alot to do with EMS being given to the Fire Service. Once that happens; yes, the Fire Service is going to do what it feels is necessary to protect the jobs of it's members.

Overall a great post and I do not disagree with any of it except this statement I quoted.

The bean counters usually get involved AFTER the IAFF(err, I mean FD)starts petitioning said bean counters and council members.

[ambodriver]

IAFF did the Chicago Fire Department medics a lot of good. Both single role and engine based ALS. Not really sure about anywhere else though.

What do all those AMR medics make around the country? 10-15$/hr or so I heard and no pension. Correct me if I'm wrong...The IAFF can do some good things such as help bargain contracts to ensure this can be a good paying career with excellent benefits.

Edited March 18, 2010 by ambodriver

[gemini1030]

First of all, being new to the EMS field, I have not had the experiences that many of you have to base your opionons on. I can only comment from personal use of hte EMS system and observations made during clinicals and the hand full of calls that I have been on.

We have a county run fire department that requires that all fire fighters become at least EMT certified within a year of hire. Many of the fire fighters work part time for the ambulance service. Most of the officers in the fire department are paramedics. The ambulance service is a private company that contracts to run the 911 calls. Fire fighters are dispatched as first reponders for MVC, respiratory distress, cardiac issues or anything that may be a higher priority call. Out in the rural areas of the county (where I live) first responders are generally on scene in 2-3 minutes, whereas an ambulance can take 12-15 minutes. I also know that if the medical call volume is high the fire department will go on scene to begin care due to longer response time by EMS.

Since a large portion of the fire fighters work for the EMS service part time, the level of cooperation is high. I have seem cases where the ambulance will go on scene before the fire department and if the medic did not call off first reponders they start grabbing equipment from the ambulance expecting to find something major since the medic did not have them put back in service. They are also great help for lifting assisstance. I have also seen 2 fire fighters climb into the ambulance to assist the medic with CPR and other procedures when needed. This takes that engine company out of service until the fire fighters can be returned to their stations. I think that this works here, so far. I see no need to really change the system. Maybe in the future my opinion may change or I may have some brainstorm idea to save the world (doubtful, but even a blind squirrel gets a nut sometimes).

Just my two cents worth.

Be safe everyone.

[Seb Wong]

We read on this forum so much about how Fire is beginning to kill EMS.

We rant and rave about how it's not fair or it's just wrong that Fire is coming in and taking over EMS. Everyone knows my feelings regarding fire medics and plain medics. Dual role medics and single role medics. Fire based ems versus private single duty ems and I'm not going to entertain any more bashing of either on this thread. Do so and this thread will be locked if admin will allow it.

My question is this:

There are those on this forum who are Absolutely against fire based ems. They are absolutely against Fire running EMS.

My question is this. What are you currently doing to spread the word and helping people in the communities know which is a better fit for them? Are you just coming here and venting and bitching about this or are you actively doing something about this crisis?

I don't want any bashing of any type of service, I don't want the standard over done lines about how bad fire based ems is. I want real solutions and real ideas.

Hello Mr. Ruff,

Haven't popped up in the past few months since our last email exchange. I hope you are doing well and your new baby is very beautiful. Having worked for a private ambulance company contracted with providing emergency medical services to a city across from San Francisco, a Health Department third service, and finally a traditional fire department that absorbed the Health Department third service; I would have to say that the fire based EMS system in my home town has come through. I can see now that we have the resources that we need to deliver the care to our citizens at a level that they deserve to receive.

The reality is that we have a positive Chief that is supportive of the EMS mission; if that leadership changes, then I don't know what will happen. I don't think that there is any better service delivery model for one versus the other. The key point is that the best EMS provider for any community is the provider that the community wants to have. In many cities, townships, counties, cities or whatever geopolitical entity, it is also the one provider that the community can afford.

It is no secret why the IAFF and the IAFC are interested in doing EMS, but many excellent fire departments have been providing good EMS from the beginnings of our nascent profession. Many of the strong third services like Boston and City of Austin/Travis County have a good track record and demonstrated to their communities the value that they provide. They do it daily with high quality care and positive public relations to their respective constituencies.

I think how things might be different if instead of merging in 1997, the third service I worked for got 30 million dollars from the budget of the fire department and built a very robust EMS System. But the political reality would have never allowed such a shift of general funds. Perhaps when one day, the profession can get unified, the path might be more distinct.

Take care,

Seb

[boeingb13]

Good question ruff, I dont have much input being, and as you know, my area has been fire rescue for a long time.

[CBEMT]

Perhaps when one day, the profession can get unified, the path might be more distinct.

We are being unified, Chief. Town by town, city by city. At gunpoint. By the fire service.