Fire Service Based EMS, again.

[DwayneEMTP]

With all due respect, I will never say thank you for the IAFF working to bring down educational standards, for twisting the facts in their addresses to the general public, or for trying to replace me or any other paramedic with a firefighter so they can keep their jobs. The way I look at it, the IAFF is a drowning man who's latching onto EMS to try and keep afloat, regardless of the fact they're bringing us down with them. I feel bad for them, I really do, they've worked themselves out of a job and now they're trying to keep from going under, but that's their problem to figure out--not ours. EMS is emergency medical services, not fire and emergency medical services. I get that they're drowning, but they don't have to bring anyone down to Davy Jones' locker (+1 for using that phrase in an EMS discussion) with them.

Yes they have, but at what cost? This industry is about what's in the best interest for the patient, not "what's in the best interest of keeping firefighter jobs"; and because of that, an organization that exists solely to keep firefighter jobs is NOT working in the interests of the patient but in their own interests.

Yes, I can. And I gladly will. I learned from day one that EMS has to constantly fight for its very existence, and I for one will not give up on a progressive, constantly advancing, constantly improving EMS. I will fight for an independent, high quality, progressive and advancing EMS as unapologetically as the IAFF fights for a fire based EMS. Don't get me wrong, I'm not inherently opposed to fire based EMS--if it's done right. But the fire based EMS that the IAFF endorses and that many fire departments seem to endorse is not the kind of EMS I will ever support.

You're a hundred percent right about that.

I don't know who you THINK your real father is...but....Has anyone seen Dustdevil? And I very much mean that as a compliment.

Every time I find some reason to think, "Screw this nonsense" a Beiber or Ugly comes along and gives hope that the next generation of paramedics will simply refuse to give up, the same way many from the last generation did.

Kudos to you brother.

All of this nonsense is going to continue as long as we pretend that Fireman and hero are synonymous. That is a really hard battle to fight as the unions have all of the money, but as in Florida we're starting to see fire EMS step on their weenies. This battle won't be won tomorrow, or perhaps not in the next generation, but there is never any question that continuing to fight is the right thing, and for all the reasons young Mr. Bieber states, and more.

Dwayne

[tniuqs]

Well dust did spread his seed to the 4 winds ...

[ambodriver]

fired based, single role paramedics are the way to go imo.

[Bieber]

fired based, single role paramedics are the way to go imo.

What do you mean by single role paramedics? And why do you believe that fire based EMS is the way to go?

[Richard B the EMT]

What do you mean by single role paramedics?

Single role, as Fire Fighters fight fire (and effect rescues), and Paramedics (and EMTs) handle and treat patients. Neither does both Fire Fighting, and patient care.

Related: LEO based EMS, we don't arrest them, we just reverse Cardiac Arrests (Well, I thought that was funny, anyway).

[Bieber]

Single role, as Fire Fighters fight fire (and effect rescues), and Paramedics (and EMTs) handle and treat patients. Neither does both Fire Fighting, and patient care.

Related: LEO based EMS, we don't arrest them, we just reverse Cardiac Arrests (Well, I thought that was funny, anyway).

Oh, well duh. Sorry, I think I had just woken up from a nap when I posted that.

[island emt]

fired based, single role paramedics are the way to go imo.

Unfortunately Very few "single role fire services exist in this country. Yes it can work and there are many fire departments that do EMS well.

On the other hand there are many that do it extremely BAD.

EMS is the illegitimate stepchild of many Fire Departments and they are only doing it to bring in revenue and save IAFF jobs as the number of working fires decreases every year.

The IAFF is only interested in EMS as a means to saving union career jobs , so they can collect dues.

Just so you know I am a fire in a fire based EMS system that understands that EMS is our PRIMARY job and occasionally we need to run the big red trucks out the door on real fire calls.

[Timmy]

I see fire responding to medical calls in Australia as a growing trend. While in all states here the emergency services are government funded there still very separate services. The current tend in and around Melbourne is to send a fire truck to all cardiac arrest calls but at the same time the closest ambulance is dispatched.

I actually have no problem with fire responding to such calls as I believe the chances of survival are greatly increased with rapid response and application of AED ect. The problem I have is recently we’ve been having trouble with ambulance staffing and response times, the media reports the government to promote fire and first responder type services as the gold standard to fix there dilapidated response times. We have a very good ALS/Intensive Care paramedic service in my state, there very educated individuals but at times the recourses are spread few and far between, we really need more paramedics on the road instead of bandaid solutions like setting up fire to respond to medical emergencies.

After the fires of Black Saturday in 2009 that killed hundreds of people the government pumped the fire service with money to cover up there mistakes and to “reassure the public” that every measure had been taken to improve our response if it happened again, this pressure came from the coroners inquest, coronial enquiry ect ect.

Recently the media has been focusing on the ambulance services mortality rate due to limited resources, the government promises more paramedics but I certainly don’t see this happening in the more rural areas, in fact they’ve cut the graduate paramedic program quiet significantly. I’m sure they have increased the numbers in the metropolitan and more larger regional areas but we still have single paramedics working ridicules hours and when they get a job or go on fatigue leave there’s a massive timeframe were the smaller rural towns have no ambulance cover.

Were almost treated like second class citizens in the country, the government is closing hospital beds, we have 1 (sometimes two) ALS ambulances and 1 on call at night for 8,000 people, the ambulance service made no attempt to put on extra crews during the busy summer holiday season when the areas population can boost by 40,000 people camping along the river and our fire trucks are certainly not equipped with AEDs or dispatched to medical calls.

We don’t so much have a problem with fire taking down the education standards for paramedics, it seems using fire is a quick and cheap alternative to putting on more ALS paramedics and makes it look appealing to the media that there equipping fire to cover there ambulance response times. Oh the political games….

[aussiephil]

I see fire responding to medical calls in Australia as a growing trend. While in all states here the emergency services are government funded there still very separate services. The current tend in and around Melbourne is to send a fire truck to all cardiac arrest calls but at the same time the closest ambulance is dispatched.

In thoery, I can't argue with this, however, fire in Australia have a nasty habit of entering into different areas via the back door, appearing to be offering a stellar service. In NSW they have sucessfully taken over rescue, & the Arson squad from the police. These are 2 major examples of wheat they did to gain pay rises through productivity gains. Rescue in this state was founded by the Ambulance Service, & I always thought that criminal investigation was the job of Police (my US friends, I refuse to use the wanky expaned terms like Law Enforcment Officers, they are Police, have been for hundreds of years & the dictionary definition is

police(po¦lice)

Pronunciation:/pəˈliːs/noun

[treated as plural] (usually the police)

the civil force of a state , responsible for the prevention and detection of crime and the maintenance of public order.)

I actually have no problem with fire responding to such calls as I believe the chances of survival are greatly increased with rapid response and application of AED ect. The problem I have is recently we’ve been having trouble with ambulance staffing and response times, the media reports the government to promote fire and first responder type services as the gold standard to fix there dilapidated response times. We have a very good ALS/Intensive Care paramedic service in my state, there very educated individuals but at times the recourses are spread few and far between, we really need more paramedics on the road instead of bandaid solutions like setting up fire to respond to medical emergencies.

This is the same across the country. The problem is in the hospitals, the answer is not to allow fire to take on medical, they will require legislative changes to be able to transport. all that will happen is that people will be waiting with a Big Red Truck out the front of their house instead of a discrete ambulance. Currently only the statutory designated authority are allowed to transport. So do the community want the fire brigade & ambulance resources tied up because the health system cant cope?the fire brigades wont accept it. The answer is increasing funding to public hospitals, enbracing & enhancing Extended Care programs to reduce hospital presentations, not handing the fire brigades a reason to claim they can run ambulance services.

After the fires of Black Saturday in 2009 that killed hundreds of people the government pumped the fire service with money to cover up there mistakes and to “reassure the public” that every measure had been taken to improve our response if it happened again, this pressure came from the coroners inquest, coronial enquiry ect ect.

Recently the media has been focusing on the ambulance services mortality rate due to limited resources, the government promises more paramedics but I certainly don’t see this happening in the more rural areas, in fact they’ve cut the graduate paramedic program quiet significantly. I’m sure they have increased the numbers in the metropolitan and more larger regional areas but we still have single paramedics working ridicules hours and when they get a job or go on fatigue leave there’s a massive timeframe were the smaller rural towns have no ambulance cover.

Coronial inquests will always change policy & action. Especially in the case you described. The problem is the media focus on what sells their news, not what is reality, not necesarrily the full story. They are after sensationalism. The graduate programs are failing, they are failing because in reality, the degree means nothing. I can take a nursing degree & work as a registered nurse anywhere worldwide. The same cannot be said for paramedical sciences. This said, anyone seeing a tertiary education will not look at something that is not as recognised & the disparitry between what is taught in the Uni's is truly varied. Look at how many graduates there are from all the Universities & look at the numbers needed, once you look seriously at some of the graduates you see they will never be ambo's, for a number of reasons. I understand what you are saying about ambulance services in smaller communities, I have been there, but, the answer is NOT fire, in many cases they have less resources readily available than Ambulance Services.

Were almost treated like second class citizens in the country, the government is closing hospital beds, we have 1 (sometimes two) ALS ambulances and 1 on call at night for 8,000 people, the ambulance service made no attempt to put on extra crews during the busy summer holiday season when the areas population can boost by 40,000 people camping along the river and our fire trucks are certainly not equipped with AEDs or dispatched to medical calls.

We don’t so much have a problem with fire taking down the education standards for paramedics, it seems using fire is a quick and cheap alternative to putting on more ALS paramedics and makes it look appealing to the media that there equipping fire to cover there ambulance response times. Oh the political games….

Timmy, you sight AED's as being a positive & we know from evidence based practice that early defibrilation will increase the possibility of a positive outcome, but, lets not kid ourselves, the survival rate is still less than 2%. Cardiac Arrests represent, overall, a small percentage of our role, can you really see our fire brigades responding to spit & dribble? They have said here that they only want the glory stuff, Trauma & Cardiac Arrest. The stuff that looks good on a TV Camera.

Richard, when you said

Historically, that is a bit of a misstatement. In New Amsterdam, what would over the centuries evolve into New York City, they had the "Rattle Watch", a group who would do a security patrol at night. Primary function: if they found a fire, they would sound a "Rattle", a kind of noisemaker, to sound the alarm for all the neighbors to respond to form bucket "brigades" to throw water onto the fires.

As for EMS in the FDNY, I always say, the Fire guys do their job, me and my EMSers do our job, and both of us do those respective jobs well! That must be why the guys from Engine 265/Ladder 121 seem to like me, in the first combined FD/EMS "House" in the city, as I have made that statement in their presence numerous times.

it is an interesting concept, & these were times before the communication options we have today. It is fantastic that you have the respect from you fire colleagues, here, unfortunatley, we do not get the same respect from fire, even the police have issues with them, but that is another story.....

[46Young]

What do you mean by single role paramedics? And why do you believe that fire based EMS is the way to go?

http://alexandriava.gov/fire/info/default.aspx?id=5086

That page makes a good point: The FF's work a 56 hour week on average, just like many in EMS. When you look at it, over a 25 year career, you're working an extra 8.75 years than a 40 hour/wk employee. This will be a valuable talking point if your pensions ever come under attack.

As far as single role vs fire based, I say that whatever the system was originally, it should stay that way. If it was fire based back in 1950, then it should stay that way. If it was third service from 1973, then it should always be so. You shouldn't make moves that negatively affect another's livelihood. Having said that, I'm of the opinion that EMS ought to be municipal, not private or fire based. For profit interests (not-for-profit still runs like a business) can have a negative impact, if not a direct conflict of interest in pt care. Besides, other than the voluntary hospitals in NYC, I can't think of any hospital based, or private EMS that were there from the start. I say this having worked five years at a combo NYC 911 participating/IFT hospital, NS-LIJ. NS didn't do any pt steering, but quite a few other hospitals did. If you were uninsured, you went to the city hospital. If you were insured, you were steered away from city hospitals, and also the other competing private hospitals. EMS should be municipal only. Right now, Bloomberg is demending payment from the NYC 911 participating voluntary hospitals, based on their number of 911 slots, up to two million a year, starting in 2012. NS-LIJ is telling the city to go scratch; they can have their 10-11 911 spots or whatever. They're huge already, and don't need the 91 division anymore. If anyone needs a good hospital based EMS job, apply to NS-LIJ. They're hiring.