Fire Stand-by / Firefighter Rehab

[Dustdevil]

:shock:

Plus 10, Dahlio! You're a rising star here. Wise beyond your years.

Tout, Dahlio said it a lot better than I did, and he caught something that I should have.

If, as you say, we all have a speciaity, then why are you running EMS? Why would you not only venture outside of your specialty, but take money away from the specialists to do so? Sorry, but I can't find a single justification for it that isn't simply a money grab.

[toutdoors]

Dust, and Dahlio you folks make some very good points. If I came across as saying that EMS should just stand back, that was not my intention. Like I said our two agencies work very closely and have some really good relations going on.

As to why do we answer EMS on the fire side? Because there are more fire stations than ambulances in the city. This is the way our system is set up, and it seems to work for us most of the time. There are times we could use another ambulance on the street, but there are far more times that 2 of the 4 on the street are not on a run. Do I mean to say we should cut back on the ambulances? Of course not, just that when you spread all the numbers out, the slow times outnumber the crazy, hectic busy times.

Our ambulance service is a privately owned company. The city has furnished the company with a place to park the ambulances, along with office space, and storage space for supplies. All in the same building. (I find this sort of efficiency quite crazy on account of the fact that government is involved) The city also purchases the vehicles, such as transport ambulances and elderly clinic transport vans and then leases these vehicles back to the company. The company also is lucky enough to purchase their fuel from the city at a lower cost. So the city does help the company out quite a bit, there is already a good amount of taxpayers money going to benefit a private company. Now I will not argue that this private company provides a much needed emergency service to the community, but as firefighters we look at our cut budget and say "Hey, why did you give them something and take something from us?"

I do believe that I will see ambulances in the fire houses in my department, and that the staff on them will be firefighter/paramedics. I know, this opens up a whole other can of worms. There have been talks of this for the past ten years, and I just don't see how much more help the city can give this company without becoming to involved. I do not want to see some of my paramedic friends possibly lose their livelihood that is for sure.

I feel very fortunate that the paramedics I work with are for the most part very professional.

As for medics snubbing EMT's; I did not mean to imply that I was trying to perform an ALS procedure, just doing your basic EMT stuff. Taking V/S applying some O2, maybe splinting, or minor bleeding control. The issue with a medic treating me like crap is more a personality issue than how I feel about medics in general. Like I have said, we have a pretty good working relationship and I value that.

I know medics are looking out for people's best interests, even firefighters. Believe me when I tell you I appreciate what you guys do. I am enrolled in the medic program and have had my eyes opened up a few times these past few months as to why this is happening to my pt. I look forward to continuing my education in EMS and fire.

I do believe that one key element to working on the emergency scene with other agencies in a professional and effective manner is to train with these other agencies at times, and the more the merrier. This way we all get to have a little better understanding of what it is that everyone is there for, and what the primary concern is from the other person.

Now, I can not leave this post without saying that I am sure you have run into some serious macho firefighters, yeah they are out there, and they kinda give the rest of us a bad image. Sorry about that.

[Dustdevil]

Actually, with rare exception, I have almost always seen exceptionally good relationships between EMS and the fire service during my years on the streets. That relationship does not colour my opinion of fire service involvement in EMS. No matter how well we all get along, the fire service brings serious problems and obstacles to the provision and progress of EMS as a service and a profession. For that reason, I maintain strong opposition to fire service involvement. It has nothing to do with who gets along with who. That's a shallow and pointless way to look at it. It is strictly about what is best for the service and the profession, and nothing more.

As to why do we answer EMS on the fire side? Because there are more fire stations than ambulances in the city. This is the way our system is set up, and it seems to work for us most of the time.

But why is that? Why do you allow your community to be lied to? Why do you allow them to believe that they have what they need when they do not? If there were enough ambulances to cover them adequately, why would you need be concerned with those numbers at all? So, because this is the way we've always done it, this is the way we should always do it? That's not very progressive thinking. And a lack of progressive thinking is why EMS is neglected by your community leaders, starting with the fire chief.

There are times we could use another ambulance on the street, but there are far more times that 2 of the 4 on the street are not on a run. Do I mean to say we should cut back on the ambulances? Of course not, just that when you spread all the numbers out, the slow times outnumber the crazy, hectic busy times.

Ah, numbers! Now we're talking! Let's talk fire truck numbers. Are there times that you need all those fire trucks at once? Sure, once a decade. But the other 3,649 days per decade, all those trucks are serious, expensive overkill. Do I mean to say we should cut back on the fire trucks? Quite possibly! Especially if the numbers utilised to justify them in the first place have nothing to do with fire suppression. Because slow times outnumber the crazy, hectic busy times by thousands-to-one.

Our ambulance service is a privately owned company. The city has furnished the company with a place to park the ambulances, along with office space, and storage space for supplies. All in the same building. (I find this sort of efficiency quite crazy on account of the fact that government is involved) The city also purchases the vehicles, such as transport ambulances and elderly clinic transport vans and then leases these vehicles back to the company. The company also is lucky enough to purchase their fuel from the city at a lower cost. So the city does help the company out quite a bit, there is already a good amount of taxpayers money going to benefit a private company.

Boo hoo. The city does that for two reasons: because no matter how you slice it, it's cheaper, and because it's less hassle. The city knows full well that they can just give money to the private company to run the show, and that the company will have to pay their employees squat and treat them like crap, as well as cut professional corners just to make it work for that amount. But that way, the city saves money on paying what firemen demand and can blame the low wages on the private company. The city sets the company up for failure, knowing that it simply cannot work out in a professional manner at the low-ball money they are providing. But at least, when it all comes crashing down, your city council has plausible deniability, and your fire chief gets to say, "See, nobody but us is capable of doing it!", then taking twice as much money as the company took, and putting forth a service that's not as good and calling it a success. I don't know how much you have observed or studied EMS outside of your community, but this is not a theory. This is a recurring theme repeated constantly across the U.S.

Now I will not argue that this private company provides a much needed emergency service to the community, but as firefighters we look at our cut budget and say "Hey, why did you give them something and take something from us?"

What was taken from you, by whom, and why? Can you give us a clear example? If you lose EMS funds, that's not being taken from you. It's being taken BACK.

I do believe that I will see ambulances in the fire houses in my department, and that the staff on them will be firefighter/paramedics. I know, this opens up a whole other can of worms. There have been talks of this for the past ten years, and I just don't see how much more help the city can give this company without becoming to involved.

Sure, and that has been the plan all along. Milk the cheap service for as long as possible, then -- instead of actually searching for the best solution -- simply take the easy way out and dump it on the fire chief, who is already whispering in their ear how much better he can do it. Costs will skyrocket across the board. Service will be no better. But by this time, the city has been convinced that nobody can do it any cheaper, so it stays in the fire department for all eternity... unless of course, the state starts requiring college educations for their medics, then the fight starts all over again, with the fire chiefs leading the charge.

As for medics snubbing EMT's; I did not mean to imply that I was trying to perform an ALS procedure, just doing your basic EMT stuff. Taking V/S applying some O2, maybe splinting, or minor bleeding control.

But, if there was proper EMS funding and staffing to begin with, we wouldn't need you to do that, would we?

The issue with a medic treating me like crap is more a personality issue than how I feel about medics in general. Like I have said, we have a pretty good working relationship and I value that.

I know medics are looking out for people's best interests, even firefighters. Believe me when I tell you I appreciate what you guys do.

That's why I am confident that your head and heart in the right place. Much respect for that. I just think you do not yet have the big picture.

[dahlio]

Ah, numbers! Now we're talking! Let's talk fire truck numbers. Are there times that you need all those fire trucks at once? Sure, once a decade. But the other 3,649 days per decade, all those trucks are serious, expensive overkill. Do I mean to say we should cut back on the fire trucks? Quite possibly! Especially if the numbers utilised to justify them in the first place have nothing to do with fire suppression. Because slow times outnumber the crazy, hectic busy times by thousands-to-one.

Exactly! Why not have that fifth ambulance, and give more of the EMS budget to EMS? Peak times and large incidents happen more in EMS, more often then large fires that require multitudes of departments. Car Accidents especially, where injuries can tie up 2 or 3 units, leaving only 1 or 2 units to cover the area. And how many times have 911 calls come in simultaneously, and the going just doesn't stop. Makes more sense to be better prepared for the thing that happens more often, rather than the thing that could happen "any day now".

-dahlio

Thanks Dust, Appreciated your comment!

[CBEMT]

Trout, it sounds like your city has the foundation for a good third-service system. It'd be a damn shame to blow it.

[Flasurfbum]

We joke about taking some ones lid, but you try touching some ones leather lid, and you will be luck not to leave as a Trauma Alert! :shock:

I can really see how EMS gets frustrated about how Firemen treat them at fire rehab. But at the same time, I am guilty of it myself. When you get a large incident, such as the 08 wildfires here, there is just too much fire, and not enough apparatus and firemen to protect everything, and everyone. You go to rehab as ordered, get your IV, and 1000 bag, and want to leave to get back out there. Its not intentional disrespect to the EMS personnel, its the training, and culture that we have. Heck, I was threatened with taking my card after I was caught several times bolusing myself, rather then letting the bag just flow.

If the Fire Dept you are working with does not do EMS, then there is a chance that they are just undereducated to the threats to them. Sit down with an Officer, and see about having a class with them, to explain why you do what you do, and you are not being vindictive or an arse about it, but doing it for their safety.

Chances are, once you explain to them that you are looking out for their safety, and not just being a prick, they will look at you in a different light.

[Eydawn]

If I have someone who is going to put themselves (and by extension, their "brothers") at risk by not obeying medical orders, I will do whatever is necessary to prevent their re-entry to the fire scene until the requirements are met *and* the idiotic attitude is lost.

If that means I take someone's helmet and give it to their chief, so be it. I won't put 6 firefighters in danger of having to go rescue their buddy because he's too stupid to go through rehab like he's supposed to.

Sorry.

Wendy

CO EMT-B

[Flasurfbum]

If I have someone who is going to put themselves (and by extension, their "brothers") at risk by not obeying medical orders, I will do whatever is necessary to prevent their re-entry to the fire scene until the requirements are met *and* the idiotic attitude is lost.

If that means I take someone's helmet and give it to their chief, so be it. I won't put 6 firefighters in danger of having to go rescue their buddy because he's too stupid to go through rehab like he's supposed to.

Sorry.

Wendy

CO EMT-B

There are better, and more diplomatic ways to do things. Enable the rehab officer from barring anyone from returning to service. After leaving the hot zone, and before going to rehab, they must gather their tags from accountability. (this is more for larger incidents, but still happens in some places) so hang onto it. They can't enter without a tag.

Talk to their crew, and explain to them what the deal is. Especially talk to the company officer.

You can take my jacket, gloves, pants, boots, mask, but you lay one finger on my lid, and its a different story.

[Dustdevil]

If the firemen lack the intelligence and maturity to simply be a man about it, that is nothing that EMS can address. If the fire service is serious about rehab, then there needs to be an officer assigned to it. Don't just dump the entire responsibility on EMS and blame them for any failures. We're there to practise medicine, not to supervise your personnel for you while your back is turned because they are irresponsible and you are a poor supervisor. There are always too many chiefs at an incident like this. You're telling me you can't spare the Assistant Chief of Fire Prevention or the Deputy Chief of Personnel Affairs to babysit your own precious men at the rehab station? Puhleeze. This is just more of the fire service cherry picking the jobs they do and do not want to do, and pawning those mundane responsibilities off on us lesser life forms.

Again, if the fire service is so convinced that they are qualified to care for their citizens, then they should be qualified to care for themselves, so do it. And if we don't dedicate a unit or two to babysit your lame arses at the fire you've been praying for all year anyhow, don't blame us. After all, you are the reason we are short staffed in the first place.

[Eydawn]

There are many very diplomatic ways to deal with things. Occasionally, one must use the Dust approach and wield the sledgehammer. Notice how I said I'd take the helmet, and turn it over to the recalcitrant firefighter's commanding officer? That implies a conversation with said officer, and respect for the equipment being removed.

What's so emotional about the helmet? Enlighten me here... I have plenty of FF friends and have never seen this be such an issue.

And I stand by what I said. I don't care *what* it does to your ego, you're not endangering your crew by being an @sshole. Sorry.

Wendy

CO EMT-B