Fire based EMS

[Ridryder 911]

http://www.massfiretrucks.com/Cambridge_Rescue_1.jpg

Well, we see where the budget ($$) just went. Does the van ambulance respond behind it to transport the patient when it turns out to be a fever call?

Yep, real genius we have in fire services....

R/r 911

[BenDover]

No, they transport with it too. I've seen some interior photos and it is in fact an ambulance.

[Twister_Ems]

The major problem I see with a fire based ems system is that you have personel doing somthing they dont really want to be doing. You have firefighters on the ambulance that would rather be on a truck and ems minded people stuck on the truck that would rather be on the ambulance. They are trying to intigrate the two here where Im at and to be quite honest I think its a money thing. Fire dept makes nothing and trys to work almost totaly off federal grants and ems makes a pretty decent ammount through patients insurance and a contract with the local hospital. If they did intigrate the money we use to keep ourselves paied well (as well as you can get in ems) and to keep our equipment updated and in running order would go to firetrucks and equipment that gets used on a rare occasion. Yeah this whole subject just kinda puts a burr under my saddle.

[StickEm]

Twister, you nailed it. The fire guys dread the days they are scheduled to ride the hook, (rescue,) and so far, here in Gwinnett Co., GA, there aren't too many medics that want to, either. They all want to ride squad.

The county makes them all get EMT-I certs, and foots the bill for it. They actually get paid to sit in class, on top of having the tuition, books, IDs, etc covered. Believe me when I say, I sat in class with 25 or so fire guys, and only a handful were actually into the material and a few even cheated on tests. They only made it through because they absolutely HAD to. They didn't want to do EMS -only fire. This compromises Pt care.

I disagree with the money thing, though. 80% of Gwinnetts calls are "medical", and of those, only a small amount are legit or actually get paid for. I work for a private service that handles 911 for two counties, as well as transports. 911 pays crap. -No money in it.

The critical care transports pay $10.00/mile with a flat base fee of $500.00, plus any goodies like physically lifting a Pt., O2 therapy, any drugs or Tx. The non-emergent transports don't pay as much, but it's a minimum $250.00 from Medicaid, I think.

The county fire services do NOT do transports from hospital to hospital.

It is funny when the crew conducting the "study" played the "What will EMS do if a car is engulfed with flames?!?" card...

In the county I serve in FD is automatically dispatched to chest pains, person down calls, and MVCs. We get dispatched to structure fires for them.

I believe that the FDs that want to take over EMS only want more grant money -period.

I know the FFs don't give a flip for working EMS.

[Sdowler]

Cambridge has a tiered system where the city will transport mostly BLS and then PRO EMS will provide contract ALS. But the city has Medics and will transport ALS on their own. The engine is back up.

[Sdowler]

EMS should be EMS. No fire based or police based. Private service may be able to better cover Rural areas but I do not feel that hospital based EMS should be working in the hospital doing stuff other than EMS.

[CBEMT]

The vans are non-transporting intercept units.

Cambridge started with a decent idea, and then screwed it up.

I believe they started with BLS non-transporting response by CFD with an ALS unit from Pro. Ok, no big deal, lots of places do it. CFD got the run numbers they wanted but didn't have to get their hands too dirty. The main EMS work was done, granted, by a private, but at least you'd be taken to the hospital by someone who probably wanted to be there (its also worth noting that Pro is CAAS accredited, a process not many services volunteer to put themselves through) .

Nowadays, a 911 call could conceivably receive a response of an engine, medic van, and Pro ambulance. Probably the cops too depending what it is. I don't know for sure what prompted that change, but I can't imagine it's been some miracle of efficiency in patient care.

[Twister_Ems]

Nowadays, a 911 call could conceivably receive a response of an engine, medic van, and Pro ambulance. Probably the cops too depending what it is. I don't know for sure what prompted that change, but I can't imagine it's been some miracle of efficiency in patient care.

Thats another thing. Not bashing firefighters but you get too many people on scene its much more difficult to get things done. Now on mva's fire is a god send and are dispatched even before we are. And occasionally we will call them for lift assistance. But in the case of codes I dont want a bunch of firefighters fumbling around. I dunno bout other areas but here they get way too excited and start gettin in the way. Smoothest code Ive ever run was me and one other person in the back with a driver. One handled airway the other chest compressions. The one on airway would pause to push drugs, check rythems, get vitals ect and we would switch. It was so smooth it was almost scary.

[KSEMT122]

Fire Based EMS...I agree with Twister, you have people being forced to do something they have no interest in. I know around here the Box is the whipping post for Firefighters who have pissed a white hat off. Everyone dreads the days they are on the box. Keep EMS out of FIRE Dept's! I don't want them doing First Responding to my calls either. I'm so sick and tired of pulling up on scene to find 6 Firefighters who have been "on scene" for 5-10 minutes already and they are all standing around outside smoking and there may be 1 Firefighter/Paramedic, if we are lucky, who may have found the time to take 1 set of incompetent Vitals. And that is their PARAMEDIC!! It's just been dismal in Kansas and I wouldn't recommend it elsewhere.

[Ridryder 911]

I know of very few F.D.'s that have a successful EMS program. Again, usually it is because what has been mentioned previously. Unfortunately, I am beginning to see and witness more and more of the same attitudes in EMS. The .. "I am here to save a life, otherwise don't bother me" .. type. Yes, some of those are awaiting to be able to get on a F.D.

Until EMS can prove to the public, the powers to be, that we should be an individual service, nothing will change. It will definitely not change with the current education level, the current attitude and activity of the majority of EMS personnel.

Same old song.. and same old verse...

R/r 911