fire based EMS

[MEDIC_ONE]

Would you agree with me that most paramedics could care less about running into a burning building? And would you agree that most firefighters could care less about decompressing the chest of a trauma victim? So why are certain fire departments so dertermined to run or take over local ambulance services? What are your ideas??

[JakeEMTP]

I'd hazard a guess it's all about the almighty dollar. If the Fire dept. takes over the EMS, then they have extra money for all the toys they want. You know, a new engine so they can take it out once a day and polish it.

The Fire services have done such a good job influencing building codes and promoting fire prevention, that they almost have put themselves out of work. That is why we see Engine co.s arriving at EMS medical calls, it gives them something to do. Their idea is if they take over the EMS, then they can hire more ppl, or give their own ppl Paramedic training and have at it.

The service here is cross trained. Every piece of fire apparatus has a least one medic on board. I have several friends on with GFR, from what they are telling me in the not to distant future, EMS and fire will be separate. That is good news IMHO, then they can focus on the EMS instead of having to train for both occupations. They are 2 separate and very different jobs and should be treated as such.

[zippyRN]

'fire based EMS' is often a reverse take over, certainly in terms of call volume and chargable services ?

In the uk where the fire service is run by local councisl and the Emergency Ambulance service is run by the NHS< the fire service are desperately casting round for ideas on how to justify the (lean by USA standards ) resourcing and staffing establishment ...

[Ridryder 911]

Years ago, I studied Fire Science and was very active in Fire Rescue, an became very discouraged when I realized that most Fires Services did not want anything to do with EMS. Department after department routinely told me the same thing , that they did not "want to be in the ambulance business, and sure did not want any pretend Dr.'s ". After, discouragement I focused my full attention into EMS and the medical side.

It was not until a little over 10 years ago, that Fire Services started paying any attention to EMS. Most recognized the potential of public relations and productivity. Yes, there are more EMS calls in lieu of fire responses. With the decreased number of fire responses thus less productivity = less need of budget = less manpower.

Now, after all these years, EMS becomes the savior and all interests are pointed towards EMS to save the Fire Service Systems. This are the same systems that a few years prior snubbed their nose to accept this services. Not only, they have found it is a public relations tool, but can be profitable business as well, actually maintaining itself and not "dipping into the budget".

I believe there are very few Fire Services that have ever really wanted to provide EMS, rather felt it was either a non choice to again provide the needed verification for maintaining the fire service and its personnel or was EMS was dumped in their lap. This definitely is still seen in the attitudes across the nation from Fire/EMS services.

With the world as it is now, and the need of prevention WMD, MCI and fires of different caliber, fire service is a specialty of its own. It is difficult to be proficient in every thing and EMS is one thing less they should have to worry about. Money, attention can only be focused on very few things, and as history has shown EMS will be treated as a step-child.

EMS which is medical should be treated as such, There is no correlation of fire suppression, in EMS. The same would be like placing law enforcement in the fire service. EMS needs to recognize we are a health care profession that provide these services to the community outside the hospital setting. Some new keywords are even replacing the term EMS with Mobile Health care, which is more accurately showing the trend we are moving towards. We are not public servants, but provide a service to the public.

As EMS matures, we need to encourage independence from fire services, and encourage private, or third party services. I used to recommend hospital based EMS, but with the restraints of reimbursements hospital EMS based services are short lived. Again, we are medical and should represent that in our studies, behavior, dress, and professional organizations. EMS should not and cannot be one of the many hats that someone wears....

Be safe,

R/R 911

[Ace844]

Hi All,

My opinions and statements on this topic are clearly documented and stated in these threads here::

http://www.emtcity.com/phpBB2/viewtopic.php?t=2947

http://www.emtcity.com/phpBB2/viewtopic.php?t=1726

http://www.emtcity.com/phpBB2/viewtopic.ph...&highlight=

Thus i will refer our readers to them... :shock: 8) :!: :!:

2 Studies which have been conduncted some what recently and are related to this discussion can be found here:

http://www.ci.tracy.ca.us/departments/fire..._of_cover/1998/

http://www.cityofmemphis.org/pdf_forms/assessmentOfEMSS.pdf

Hope this helps,

ACE844

Sadly in some areas this is the state of things::

[rescue25]

The fire department here started first responding on calls with their engines in the late 80s. At the time, EMS was entirely volunteer. Beginning about 7 years ago, fire started adding ALS ambulances to some of their stations. Part of the problem was that the call volume had increased such that the volunteer squads couldn't cover all of the calls for service. Instead of pursuing a 3rd service or other model, the county decided that it would be easier to roll it into fire since they were already somewhat involved in EMS anyway.

Of course, a lot of the reasoning behind that is as described above: fire calls (particularly "real" calls for working fires) were and are way down, so the department has to have some reason for their rather handsome budget.

The saddest part is that many of the firefighters I've talked to who got their ALS certs and ride the ambulance don't really want to be doing EMS. They'd rather fight fires, but becoming an EMT-I or paramedic and doing "rig duty" is the only way they can get a raise and move up. Forget management if you're not ALS - the department requires it to become a battalion chief or higher.

I know that I would certainly apply for a paid EMS position - and even go back to school to get my NREMT-P cert - if I could do so without having to become a firefighter in this county. As Ridryder said, there's just no real correlation between the two careers.

[Ace844]

The fire department here started first responding on calls with their engines in the late 80s. At the time, EMS was entirely volunteer. Beginning about 7 years ago, fire started adding ALS ambulances to some of their stations. Part of the problem was that the call volume had increased such that the volunteer squads couldn't cover all of the calls for service. Instead of pursuing a 3rd service or other model, the county decided that it would be easier to roll it into fire since they were already somewhat involved in EMS anyway.

Of course, a lot of the reasoning behind that is as described above: fire calls (particularly "real" calls for working fires) were and are way down, so the department has to have some reason for their rather handsome budget.

The saddest part is that many of the firefighters I've talked to who got their ALS certs and ride the ambulance don't really want to be doing EMS. They'd rather fight fires, but becoming an EMT-I or paramedic and doing "rig duty" is the only way they can get a raise and move up. Forget management if you're not ALS - the department requires it to become a battalion chief or higher.

I know that I would certainly apply for a paid EMS position - and even go back to school to get my NREMT-P cert - if I could do so without having to become a firefighter in this county. As Ridryder said, there's just no real correlation between the two careers.

Unfortunately for both career fields though the binding factors between us are these:

1.) Large Amounts of Budget money

2.) Jobs and staffing levels...

3.) Lossley related and historical belending of public safety-first response missions.

Until we both overcome the incessant need to squabble and grapple for adequate money and resources these problems will continue to plague us both.

out here,

ACE844

[Dustdevil]

Would you agree with me that most paramedics could care less about running into a burning building?

No. I would completely disagree. Most paramedics are fireman wannabes who chose EMS because they couldn't get hired by a fire department, or hoped EMS experience would get them hired by a fire department.

And would you agree that most firefighters could care less about decompressing the chest of a trauma victim?

Nope. I believe that so long as the run is a sexy, bloody trauma patient, firemen love making EMS runs where they can play doctor and shore up their failing image as lifesavers. It's all those routine runs without the promise of ALS intervention and aeromedical transport that they could not (sorry, pet peeve of mine) care less about. Of course, after bedtime they don't care about those either.

So why are certain fire departments so determined to run or take over local ambulance services?

Money and wackerism.

[Juice]

Here, you must be a paramedic by the end of your first year to be a fire fighter.

You must be a fire fighter 1 by the end of your first year in order to be a paramedic.

So the paramedics leave to make better money in another town after the city paid for their schooling because they don't want to be firemen.

[ncmedic309]

No. I would completely disagree. Most paramedics are fireman wannabes who chose EMS because they couldn't get hired by a fire department, or hoped EMS experience would get them hired by a fire department.

I disagree, most paramedics want to be fireman? I think it's fair to say that a small number of paramedics would rather be fireman, but not most. Hell, I don't have any desire to be a hose monkey...