fire based EMS

[ncmedic309]

To answer the question by the original poster...

They want to take over EMS because they are putting themselves out of business. Take a look at the technology that's came along with fire prevention over the years, they are rapidly decreasing the amount of "fire related" runs that they make each year. It's costing them money in the long run and they need to make up for it somewhere, that's when they look at doing EMS. The saddest part of it is, a lot of fire departments do a half ass job at running EMS at best, so instead of doing a good job, they do just enough to get by and put that money in their pocket. It's a recipe for disaster either way you look at it...

[Dustdevil]

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.

If you live in one of those small pockets of America where this is not the norm, then congratulations. However, my assertion holds true in the majority of the country, and especially the urban and suburban centres. It's a shame, but it's true.

[ncmedic309]

If that's the case here, then I must be oblivious to it all. We have a few people that come and go with the main intent of being on the fire department, but most are just basic EMTs and they are in and out as soon as they can get through the hiring process with FD. It's very rare that I see the same with a paramedic, most who choose to do it, do it for a career and hang out a while, and usually when they leave, it's because they are heading to PA or medical school...

[Dustdevil]

Wait, you are seriously telling me that the majority of the medics who leave the field in your area are actually headed to medical or PA school? I call BS on that one.

[ncmedic309]

You can call BS on it if you like, but your wrong. Believe it or not, we've had more people leave to head to PA or medical school than to head to the fire department, and a couple more that are currently waiting pending acceptance to a school of their choice. Come check out the stats for yourself...

Just to clarify...I'm speaking of mainly paramedics...we have had a few EMTs leave for PA or medical school..

[Dustdevil]

Come check out the stats for yourself...

You can't post them here?

Come on, dude. Medics been BSing about medical school since before Mother, Juggs & Speed. I've known less than half a dozen to actually do it in all this time. Damn few medics ever even finish pre-med. I don't want to know how many did it. I want to know what percentage did it. That is the point you are attempting to make.

[ncmedic309]

I know for a fact that at least 5 have left over the last year and are currently attending either PA or medical school, however I think that number is slightly higher. We've had several that have completed school within the last 5 years and are currently working as PAs or MDs. We employee roughly about 250 full-time field EMTs/Paramedics, you do the math...

[Dustdevil]

That's one damn picky and lucky service, is all I'm saying. :?

Your numbers are very definitely not even remotely representative of EMS nationwide.

[K9kazoo]

Katz demands amalgamation 'common sense'

Mon Mar 20 2006

By Mary Agnes Welch

MAYOR Sam Katz returned yesterday from a whirlwind tour of American fire halls more committed than ever to merging the city's fire and paramedic services.

But he faces the toughest test yet: two steadfast collective agreements that could foil amalgamation.

"We have a dilemma -- the firefighters can't go on the ambulances and the paramedics can't go on the fire trucks," said Katz. "I mean, come on, people! It's time to use some common sense."

Katz toured merged fire halls in Los Angeles, San Diego and Tucson with firefighters' union president Alex Forrest and Fire Paramedic Chief Wes Shoemaker.

What firefighters and paramedics do:

Fire call breakdown

Of the 48,088 call in 2005:

28,451 medical emergency or vehicle extraction, up 27 per cent since 2002

11,382 miscellaneous calls such as alarms, airport standby or hazmat

4,694 cancelled by dispatch

3,374 to fight fires

187 rescues such as citizens stuck in elevators or in water

EMS call breakdown

Of the 69,966 calls in 2005:

42,098 required transport to hospital, up 32 per cent since 2002

11,166 were cancelled by dispatch

8,693 required no transport to hospital, patient treated at the scene

8,009 were interfacility transfers

While they were gone, though, snubbed paramedics mutinied, saying they were angry about being excluded from the American junket and announcing they were washing their hands of amalgamation. That sparked another round of bitter debate about the nearly 10-year-old attempt to merge emergency services.

This time, though, it's the paramedics on the offensive.

Amalgamation is meant to reduce the number of times an ambulance and a fire truck are dispatched to the same, relatively minor medical emergency, a wasteful phenomenon often remarked upon by Winnipeggers.

It's also meant to speed response times, streamline services and save money as the population ages and medical calls are on the rise.

About 60 per cent of calls that firefighters respond to are medical emergencies, not fires, which is why the city would like to train more firefighters to handle sophisticated medical procedures and even place highly skilled medics on some trucks so they can respond to more complicated calls.

Paramedics would also have firefighter training -- many already do, and more want it -- to give the city added staffing flexibility.

But old-style union rules have essentially ground amalgamation to a halt.

Paramedics have a clause in their contract that guarantees them the right to their work. Paramedics have filed many grievances related to firefighters performing advanced medical procedures. Firefighters have a similar clause in their contract stipulating that any employee who rides on a fire truck is the exclusive member of the firefighters' union.

Generally, firefighters arrive on the scene of a 911 call first and begin treating a patient with basic care such as mouth-to-mouth or attempting to staunch any bleeding. Several minutes later, an ambulance arrives and paramedics take over, delivering any sophisticated care that's needed such as administering pain medication or inserting a breathing tube. They often "package" up the patient and speed to hospital.

Both services tend to work co-operatively in the heat of an emergency, said Deputy Chief Ken Sim. But if firefighters are seen performing more sophisticated medical, paramedics get uncomfortable, in part because they believe they offer the best care and fear becoming little more than truck drivers responsible only for transporting a stable patient.

"If a firefighter is going to turn it up a notch -- do an EKG on someone's heart, administer drugs, put in an IV -- that's paramedics' work," said Sim.

Paramedics attend roughly 10,000 calls a year where they are not necessarily needed, where a patient doesn't require advanced care or a trip to hospital. Sim said he is baffled why paramedics wouldn't want help from medically trained firefighters when 911 call volumes are heavy.

But paramedics' union spokesman Tommy Walsh said, if it's agreed medical emergencies are skyrocketing, why not hire the very best -- more paramedics? They can offer continuity of care from the frenzied scene of an emergency to the hospital admitting desk.

"If there's an increase in demand for flights, Air Canada puts more planes in the air. If there's more demand for the Greyhound, they put a couple extra buses on," said Walsh. "Why don't we do that with paramedics?"

But Sim says the city should use firefighter resources more effectively. Firefighters are scattered conveniently around town, they don't get bogged down in busy emergency rooms waiting to offload patients and they don't have to transport the injured.

The city has just begun negotiating a new collective agreement with firefighters, but paramedics have been without a contract for two years. Paramedics recently pledge not to alter their contracts, and the firefighters have traditionally been just as militant.

maryagnes.welch@freepress.mb.ca

[nwoparamedics]

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

Because they are told to by their leader in an effort to protect jobs.....

Information supplied by the International Association of Fire Fighters web site... loud and clear....

Secure Your Job

Fire/EMS Operations

What We Do

The primary responsibility of the Fire & EMS Operations/GIS Department is to provide comprehensive information on fire departments and fire-based EMS that assists in improving the working conditions of IAFF members. The Department promotes appropriate staffing and deployment for fire suppression and the effectiveness of fire-based emergency medical services systems by providing local affiliates with the tools necessary to develop, enhance and protect their working conditions.

Specifically, the Department:

Addresses the concerns of local affiliates on various components of fire departments and EMS system operations, including staffing, deployment, transportation, equipment, communications, record keeping, public education, injury prevention and quality assurance.

Provides customized assistance to local affiliates including the processing of daily request for printed or video materials; writing, evaluating or responding to request for proposals; and developing strategies to compete with private providers.

Creates and maintains a reference library of fire/EMS operations materials, and assists the Department of Education in developing fire-based EMS educational materials.

Assists with the planning and conducting of the Biennial "EMS in the Fire Service" Conference.

Department Goals

Provide project-specific technical assistance to local affiliates (as provided for under the Custom Technical Assistance Policy) seeking to reconfigure, absorb EMS services, change staffing, or change station location, inclusive of GIS mapping.

Handle project development, maintenance and support of the GIS mapping program (ArcView).

Work with the Labor Issues/Collective Bargaining Department to develop strategies for supporting the collective bargaining process as it pertains to EMS providers and, under the direction of the General President, develop position papers promoting the fire-based EMS concept.

Act in coordination with other IAFF departments to educate federal, state and local government agencies on EMS-related issues. Additionally, the department will work cooperatively to seek clarification of laws pertaining to the public provision of EMS, and seek state and national policy to protect fire-based systems.

Develop customized presentations for local affiliates pertaining to technical assistance provided.

Write articles for IAFF publications and provide consultation for media efforts concerning fire and EMS operational issues. See the Fire & EMS Operations/GIS Current Events page.

Collect and maintain information covering various types of fire departments and EMS systems. Identify and plan for trends in the industry that impact fire fighter wages, working conditions, pensions and job security. This information will be used in conjunction with customized technical assistance.

Survey, handle data entry and maintain IAFF databases on technical information and data for researching and responding to local affiliate requests. These databases include the contract database, the economic database, the Death & Injury (D&I) Survey database and the Phoenix Survey. The D&I database will be handled in coordination with the Department of Health & Safety.

http://www.iaff.org/secure/content/ems/index.html

21st Century EMS: Challenges and Opportunities

June 12, 2003 – More than 650 IAFF members, public officials, medical professionals and others gathered today in Hollywood, Fla. for the opening of the 7th Biennial IAFF EMS Conference.

The three-day event will feature the latest developments in emergency medical services, as well as the broader issues of overall emergency response, including fire suppression, HazMat and weapons of mass destruction.

What was clear from the beginning is that the swirl of recent events – the war on terror, the economic downturn, and the tough political atmosphere in Washington among them – has profoundly affected the emergency medical services. In his opening address IAFF General President Harold Schaitberger dealt with each of these issues directly, and confronted the host of challenges and opportunities that EMS providers face.

He began his remarks by saluting the leaders, members and staff of the IAFF for their tremendous record in promoting fire-based EMS.

“Professional fire fighters – IAFF members – now provide the vast majority of pre-hospital EMS care in the United States,” Schaitberger said. “In most cases it is not viewed as a separate service to the fire department. Citizens are no longer surprised when a fire rig pulls up to their homes to handle a medical emergency. Today's fire fighter is an integral component of the health care system in most communities.”

General Secretary-Treasurer Vincent J. Bollon.

Despite this success, the downturn in the economy threatens some of the gains the IAFF has made. The General President hit the economic challenges facing fire departments head-on.

“I don't have to tell any of you that the faltering economy here in the U.S. has put incredible pressure on many fire departments, creating the worst economic crisis for the fire service in many sections of the country in more than two decades,” he said. “Some cities and counties are in desperate financial shape, but in other places elected officials are using the failing economy as an excuse to make foolish and dangerous cuts in their fire departments.”

Schaitberger ticked off examples from coast to coast – Worcester, Mass., San Francisco, Houston, Minneapolis – where cities are taking the knives to their fire departments. One conclusion from the brutal fights the International has waged to protect jobs: “Those fire departments that don't provide EMS are taking the worst hits right now – and that is no coincidence. Like fire suppression and the other specialized rescue jobs performed by fire fighters, EMS is a vital service. It is a highly visible service both to public officials and to the citizens of a community.”

Assistant to the General President Lori Moore, who coordinates the EMS Conference, served as the master of the ceremonies.

That message came through loud and clear just one day earlier, when the International, along with many South Florida locals, hosted a first-ever training event for public officials and media. FIRE OPS 101 was a rousing success, and conference attendees watched as a video from a local television station was played on giant video screens. The event was covered by all Miami network television affiliates and both newspapers.

As a result, FIRE OPS 101 will become standard fare at all IAFF conferences, including the upcoming Redmond Symposium in San Francisco in October.

“These public officials learned first-hand about the risks of the job. They felt the exhaustion. Some retreated from the heat and the confined spaces and all found out how tough the job really is,” Schaitberger said. “And they participated in an EMS exercise that was integrated into the other areas of the pre-conference program, just as it's now integrated into the fire service as a major part of the job for 97 percent of our members.”

Despite the IAFF’s success in promoting fire-based EMS, there is work yet to be done. According to Schaitberger, the next frontier is Canada, where most emergency medical care is provided by a third service.

“Although most of Canada is still locked into a third-service EMS system with workers represented by Canada's largest public employee union,” Schaitberger said, “our Winnipeg local's success in integrating EMS into its fire department has shown that fire-based EMS can and, if I have my way, will work in Canada, too.”

IAFF District 12 Vice President Dominick Barbera.

The General President also addressed the war on terror, the creation of the Department of Homeland Security and the federal government’s schizophrenic approach to funding the fire service.

“We are working within the Congress to get more federal money into the states and cities,” Schaitberger said. “Money like the $10 billion dollars that was amended into the recent tax reduction bill by our congressional friends and opposed by the President.”

“We're also proud that thanks to our work, the federal government has increased aid to the fire and EMS services over the past three years from $590 million dollars to more than $4.3 billion dollars today. Now that's real progress. But we need to make sure that money gets into the hands of professional fire fighters and paramedics so we can truly do our jobs safely and effectively.”

Schaitberger continued: “I like to think that this 700 percent increase in funding is our down payment to fulfilling the commitment we made to build a living memorial after the loss of our 343 FDNY brothers on 9-11. And it is the first time in history that federal funding to the fire service has now surpassed federal money for law enforcement.”

In his remarks, IAFF General Secretary-Treasurer Vincent J. Bollon echoed this message: “Fire fighters and paramedics are a vital component of homeland security. In fact without you there is no homeland security.” Bollon also saluted IAFF affiliates for their role in serving as the EMS system experts in their hometowns.

“You are responsible for making it clear to public officials that the IAFF can be a tremendous resource to them in building an effective and efficient emergency response system,” Bollon said.

James O. Page, one of the architects of fire-based EMS, shared his historical perspective with attendees. In a presentation targeted at younger members, Page traced the development of fire-based EMS and placed the current situation in its proper historical context.

Twelfth District Vice President Dominick Barbera discussed one of the latest initiatives the IAFF has spearheaded: EMS performance measures. He asked the members of the EMS Standing Committee to stand and saluted them for their work on this project, which will be a major focus of the conference. Barbera concluded his remarks by calling the conference “an unprecedented opportunity to meet new people learn and take home new ideas.”

The General President ended as he had begun, with his eyes fixed firmly on the future. He asked tough questions of the attendees, and offered hints at possible answers:

“Are we ready to embrace treat-and-release programs in the field, other home health care services and providing vaccinations and inoculations?” he asked. “We must continue to ask ourselves what elements of the health care system can be provided through our streamlined fire-based EMS structure.”

“We must stay the course. We must look well into the future and ahead of the curve. Our job as a union and my job as your General President is to look forward to seek out opportunities and to protect and provide jobs for our brothers and sisters across North America.”

Leadership will be key to that success, a lesson brought home by featured speaker Michael Fortino.

“Empathy is the most important part of a leader’s personality,” Fortino emphasized. “Focusing on the one individual is part of leadership – and it’s what you all do when you reach the scene of an emergency.”

The conference will continue through Saturday, June 14 with a full slate of technical sessions and workshops. The event is being held at the Westin Diplomat Hotel. Russell Chard, the president of host local Hollywood, FL Local 1375 got a nice round of applause when he announced that the beautiful facility was “union built, union owned and union staffed.”

http://daily.iaff.org/emsconf/061203ems.aspx