Who Should Do Rescue?

[e33]

Who should do rescue....(all types)?? Fire depts, police depts, or rescue-ems squads? What works for you? Or should it be a joint effort?

[KenNFD]

Without question, fire departments are the most prepared to perform rescues.

Resources:
Fire apparatus and rescue (not ambulance) vehilces carry or should carry the equipment for rescues that the community may experience. Much of this equipment is used by the FD, i.e. ladders, SCBA, rope, hand and power tools, etc.

Do we duplicate equipment in communities or have the FD transport it for others to use (I would'nt want to be on THAT scene)

Personnel:
With the notable exception of New York City, there are not too many police departments or EMS squads that can field enough members to perform a rescue in a timely manner. If police or EMS agencies were to operate rescue vehicles, how would they be staffed? Pull cars off the street to respond? Callback personnel? Full time assignment?


Training:
Firefighters trained to Firefighter I and Firefighter II levels have at least a basic knowledge of rescue procedures. Rescue training is a natural extension of firefighter training. Firefighters should be trained to at least a medical first responder level, even if we do not provide primary EMS functions.

Firefighters also have the training in other areas that impact on rescue operations: Hazardous materials (operational or technician level), Incident command systems that can adapt adapt to a rescue situation, teamwork that arises from experience on the fireground.

EMS providers around the country do an outstanding job of bringing the emergency room to the scene of an accident.

Police functions should be crowd and scene control, and investigation if a criminal act has occured (MVA's).

This is not to say that EMS personnel should not be involved in the rescue. It may be necessary to get a non-FD paramedic to the patient for treatment. The medic should have at least a working knowlege of FD operations, however his skills are best utilized in treating and saving the patient.




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yes

[SCCARESCUE]

My opinion is that the BEST TRAINED and EQUIPPED agency is the proper one to handle rescue duties. I think that KenNFD has a slightly biased opinion. Maybe in his area the FD is the best agency to handle the situation. However, in different areas the responsibilities change.
In my area, our volunteer ambulance service also has the rescue duties, light and heavy, for 9 other fire departments. We have a heavy rescue and a light rescue. Our rescue squad is very well trained and has significant experience. They handle all sorts of calls from industrial to agricultural to mva to medivac to specialized industrial needs. There are over 40 members on the roster, most of which are active. Our average response to over 150 calls last year was less than 3 minutes.
Of course there are always scenarios that require cooperative efforts. The more experienced you become the more calls require cooperation with other agencies.
As a matter of SOP, we request a FD response to ALL rescue ops, as well as at least one ems unit. Over 35 years of experience has enabled us to forge the relationships that are necessary to get the job done.
So, does it really matter that we decide which type of agency is best suited for the job? No. The only criteria needed is to find out which agency in YOUR area is the best trained, equipped and best suited to do the job. It may well be the PD or EMS or even an independent service. If there is a question, then all agencies should get together and decide who does fit the needs best of all. The really important part comes next - once the proper agency is chosen, then ALL the others need to support that agency and start forging the necessary bonds that insure the cooperative effort is 100% This usually requires setting aside personal bias and the usual stereotyping - not always easy to do, but absolutely necessary. One must keep the original goal in mind in all aspects of this process - and that goal is to render the best service possible to those in need. Period.

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Dan Martelle

[KenNFD]

Dan:

What, me biased for the FD? http://www.firehouse.com/interactive/boards/smile.gif

You brought up some excellent points. Regardless of who is providing the rescue, the taxpayers deserve the best service possible. If I was pinned inside a car or anywhere else, I'd only want OUT. I don't think the patient cares if the rescuer wears a maltese cross, star of life, or police badge.

I started out as a volunteer on a EMS based rescue unit. It worked. Fire department now handles rescue for various reasons. I don't believe there are any PD's in Connecticut providing rescue services.

Stay safe



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yes

[cla123]

Some questions for the group-- If you are saying the agency that has been doing MVA/ tech. rescue work in your area for years should just keep doing it, aren't you falling into the "But that's the way we've ALWAYS done it" trap? Is it really possible that two seperate groups are performing these tasks with no duplication of training or equip. purchases? Can this really be the most efficient use of taxpayer dollars? As far as I can tell, most of these groups formed as a result of short-sighted policies by fire chiefs in the past("we're here to fight fires, not to go to car accidents/sick people/chemical spills,etc.) Isn't it time to put this right and consolidate to give the citizens the most bang for the buck we can?

[Scott Clark]

Ken and Dan, you two need to get together and form your own Fire Department/Rescue/EMS unit. You both had excellent points. When you do form your department call me, I want to join! In my area we operate like Ken described, but I was on a unit like Dans for awhile also. They both have pluses and minuses, but as long as the work gets done who cares who shows up. I found when I was on the Rescue Unit the only reason why we did all the extrication was because the Fire Unit looked at EMS as one thing. The last three letters in the word PROBL"EMS". Go Figure!

[jdhafpd]

Would seem that EMS has their hands full with patient care, this is usually more than enough to keep them busy.

Traffic control and controlling the bystanders at the scene seem to be the perfect fit for our Law Enforcment people.

FD's providing the extrication and rescue equipment. How did we get in this mode of operation? I believe most of it stems from the same old problem of encountering a situation which no one had any knowledge. In this event who usually gets called? Who had the manpower, communications, resources, etc. The FD. Since that time, we've properly trained our people, purchased the equipment, and committed to make the calls. If it ain't broke don't fix it.

This is how it works in our District. Who should do it? Whoever's qualified. I'll remain open minded to any new ideas, but until a more effective and efficient way presents itself, we'll probably be doing more of the same.

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[SCCARESCUE]

To CLA123: I do not believe that our local agency has fallen into the trap of "we have always done it that way". While we have done it that way for 30+ years, it is still the consensus of all the area fire depts that we keep doing it. And NO - there are no duplication of services and equipment purchases - we buy and maintain the rescue gear and the FDs do not have to. We are sharing some equipment - for instance, we do not have any scba - but the area FD's have ALL agreed to let us use theirs - and since they roll on all our calls - it is always onscene. Our rescue members are almost entirely FFs also, so the training and CMEs are already in place. Works fine for us.
And you finish with an excellent point - how about giving the public more bang for the buck?? We did that,too. For 25 years the rescue squad was a county owned department. The county wanted out of the business so my volunteer ambulance took it over - with the total agreement of area FDs. That saved the county thousands per year. At the same time we took over the rescue squad, my volunteer ambulance service went to 3rd party billing and as a result, returned 33% (one third!!!!) of the town tax dollars back to the town. So when you add the county tax savings and the town tax savings, it is MANY thousands of dollars per year saved over the last 6 years.
We are rather pleased with those facts. If you really want to make it work - there are lots of ways to get to your goal.

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Dan Martelle

[Jeff]

Interesting comments all around. I come from a rural all volunteer county with separate fire and rescue services. It becomes very obvious on the scene of an extrication that our systems will stay separate. The VFD has the responsibility for traffic control, crowd control, hazard mitigation, helicopter landing zone preparation and overall scene safety, in addition to providing first in BLS care. Now in some areas membership may be proliferating, but most any department in my area would have a problem putting enough manpower on the scene to accomplish all these tasks, in addition to the 5-10 members for a major extrication. I don't deny that in metropolitan areas fire-rescue combinations work, but in many rural areas multiple departments/agencies are needed to get the sufficicient manpower to do a job safely.

[Kim]

I have been in this business for a number of years and concur that it is the Fire Dept who SHOULD be responsibile for the extrication. But what happen when they don't want to do it or aren't trained to do it. I work in rural South Carolina for an EMS system where we have been doing the extrication for 20 years now because we don't trust anyone else to do it. It almost sounds "territorial" of a response but the "good old boy" is alive and well in the south. It is also volunteer systems that respond so you can't always depend on their response being prompt. Yes, I know you shouldn't begin an operation without a charged hose line present, but sometimes you do what you have to do. I not picking on the "south" because I know that my problems are not isolated.

[FrankG]

In are area Extrication is done by Fire Co. only. Ems work closely with us knowing what job each are capable of doing. At times we arrive first and do what we can to stablize the victim until Ems arrive. Upon there arrival they take over Ems and we inturn concertrate on Extracation and taking charge of the scene.

[Ed D]

RESCUE IS PATIENT CARE!!!!! Most of the firefighters I know Career and Volunteer don't want to do patient care - EMS - ,But they love to come out and cut up a car. If you are not there to treat,package and get the patient ot he hospital in the golden hour, don't come to the accident.EMS is the best choice when it comes to the patient and to rescue. The same holds true for all other types of rescue. If I don't have a viable patient it is not a rescue. There are a few large cities where EMS does the rescue (Pittsburgh PA, Newark NJ) you have to wonder why? Patient care must be a primary concern, I don't need Mongo getting off the ladder saying "Mongo here, Mongo cut car". Cross trained rescuers in departments where fire/ems are the same whould and are probably the best rescuer. I have met many medics and firefighters in my day and the ones who scare me the most are the ones who do not want to know anything about anyone elses job. A rescue technician needs to be a multi functional person. rescuer one minute, medic the next, because the rescue scene is always changing. The Engine fags should stick to their job of hazard mitigation and pulling a protective handline, in the world of minimal staffing that should be hard enough.

[Spfd32]

Ed D
Name calling is not called for in responses. If you have a comment you would like to share please do, if it is educational and does not demean other people.

[EMTNJ1111]

This is a touchy subject. No matter who does extrication, they must be at the MINIMUM First Responder certified as scene size up and patient triage MUST come before cutting the car.

Also, NFPA books state that the team cutting the care MUST perform all the techniques of extrication which includes and is not limited to stabilization cutting AND MOST IMPORTANTLY removing the patient from the vehicle and transfering to EMS transport crew. It is not proper or recommended that EMS crew who are not extrication trained enter the vehicle or remove the patient. Fire personnel who do extrications only like cutting and destoying thinigs but when it comes to the patient - they ignore them completely and let someone else treat and extract the patient. This is not proper procedure.

In addition, ONLY medically trained ppl should be in charge of the extrication including making decisions about how to cut the car. Medically trained rescuers know the patients conditions and will know the best way to help the person get removed. Many fire guys just like to CUT CUT CUT and have no clue about patient needs. This is a serious problem and major liablity.

Also, removing a person from a car is the same principal from removing a person who fell down a flight of stairs. It is up to the medical team (EMS) to decide how to remove the person and use the right equipment to remove them. This includes using stair chairs, reeves, stokes, cutters for chains wrapped around a person, AND the use of jaws.

Further - the fire department MUST have adequate fire suppression personnel and equipment ready BEFORE they even think of cutting a car. Many fire departments who do extrications forget their main function of fire suppression and just focus on cutting a car up. Then they turn around and there aren't enough fire suppression vehicles or equipment avaiable. THEN all the firefighters are doing the cut and not manning their fire suppression stations.

The only reason many fire departments have been stealing Rescue services from EMS is because many fire departments are fire districts and have the money to afford the equipment that, in a bad economy, many local EMS and rescue squads can't afford due to low donations. It's simple economics. Another reason, is that as fire prevention has gotten better, many fire departments don't fight as many fires, and they need something new to do. And lastly, firefighters love to cut, break, destroy, and show off and be in charge. They like glory and destruction. They are ego ppl who want the thrill of the cut but don't want to all the steps of extrication. They only like the cut part and hate the patient care.

Remember - the team working on the extrication itself must do patient care THEN transfer to EMS transport team. If fire departments were forced to do extrications correctly - they'd give it up real quickly when the realize they have to actually do patient care and REMOVE the patient entirely. AThis is a touchy subject. No matter who does extrication, they must be at the MINIMUM First Responder certified as scene size up and patient triage MUST come before cutting the car.

Also, NFPA books state that the team cutting the care MUST perform all the techniques of extrication which includes and is not limited to stabilization cutting AND MOST IMPORTANTLY removing the patient from the vehicle and transfering to EMS transport crew. It is not proper or recommended that EMS crew who are not extrication trained enter the vehicle or remove the patient. Fire personnel who do extrications only like cutting and destoying thinigs but when it comes to the patient - they ignore them completely and let someone else treat and extract the patient. This is not proper procedure.

In addition, ONLY medically trained ppl should be in charge of the extrication including making decisions about how to cut the car. Medically trained rescuers know the patients conditions and will know the best way to help the person get removed. Many fire guys just like to CUT CUT CUT and have no clue about patient needs. This is a serious problem and major liablity.

Also, removing a person from a car is the same principal from removing a person who fell down a flight of stairs. It is up to the medical team (EMS) to decide how to remove the person and use the right equipment to remove them. This includes using stair chairs, reeves, stokes, cutters for chains wrapped around a person, AND the use of jaws.

Further - the fire department MUST have adequate fire suppression personnel and equipment ready BEFORE they even think of cutting a car. Many fire departments who do extrications forget their main function of fire suppression and just focus on cutting a car up. Then they turn around and there aren't enough fire suppression vehicles or equipment avaiable. THEN all the firefighters are doing the cut and not manning their fire suppression stations.

The only reason many fire departments have been stealing Rescue services from EMS is because many fire departments are fire districts and have the money to afford the equipment that, in a bad economy, many local EMS and rescue squads can't afford due to low donations. It's simple economics. Another reason, is that as fire prevention has gotten better, many fire departments don't fight as many fires, and they need something new to do. And lastly, firefighters love to cut, break, destroy, and show off and be in charge. They like glory and destruction. They are ego ppl who want the thrill of the cut but don't want to all the steps of extrication. They only like the cut part and hate the patient care.

Remember - the team working on the extrication itself must do patient care THEN transfer to EMS transport team. If fire departments were forced to do extrications correctly - they'd give it up real quickly when the realize they have to actually do patient care and REMOVE the patient entirely. Many EMS units have the extrication crash trucks that someone claimed ambulances don't have...

There is tons more info...

[IronsMan53]

Nothing like digging up a 6 1/2 year old thread. :D

Have you met BVFD1983? :D

[FFTrainer]

Wow, my mom always said if you keep digging you're going to reach China... she never mentioned a 6+ year old post. ;)

Further - the fire department MUST have adequate fire suppression personnel and equipment ready BEFORE they even think of cutting a car. Many fire departments who do extrications forget their main function of fire suppression and just focus on cutting a car up. Then they turn around and there aren't enough fire suppression vehicles or equipment avaiable. THEN all the firefighters are doing the cut and not manning their fire suppression stations.

Just had 3 extrications in 10 hours and we (FD) had an average of 22 responders between rescue, scene engine, lz engine and command. EMS... 2 3 person BLS rigs.

So in return the EMS agency MUST have adequate patient care folks. Maybe it's just me, but we can actually work TOGETHER with our EMS provider. We have 5 EMT/FF's to assist if the squad is not on location yet however if they are, one of their EMT's is in the vehicle monitoring and performing patient care and giving an inside the car view of what is going on while we are cutting or more importantly moving metal.

In addition, ONLY medically trained ppl should be in charge of the extrication including making decisions about how to cut the car. Medically trained rescuers know the patients conditions and will know the best way to help the person get removed. Many fire guys just like to CUT CUT CUT and have no clue about patient needs. This is a serious problem and major liablity.

Yeah OK. Patient Needs??? The only thing that patient needs is to be removed from that vehicle with NO further injury so that they can get to a trauma center in time to make a difference. Again we have an EMT inside monitoring however FD makes all decision on where to cut, etc. We continually inform the interior EMT what we are going to do next and he informs us if something is not working or has potential to create more injury. You know TEAM effort!

Remember - the team working on the extrication itself must do patient care THEN transfer to EMS transport team. If fire departments were forced to do extrications correctly - they'd give it up real quickly when the realize they have to actually do patient care and REMOVE the patient entirely.

We do extrication correctly and would NEVER think of giving it up... as a matter of fact we are going from a rescue-engine to a full heavy rescue vehicle as soon as the Emergency Services Building addition is done... notice emergency services not firehouse or squad building... we are 2 separate agencies with separate names, funding, etc yet we can live and work together seamlessly which last I checked was the most important thing at ANY incident. I can actually one up you... we do NOT transfer patient care to the EMS transport team. The interior EMT stays with the patient from initial contact through extrication through turn-over to ER or Flight staff.

Also, NFPA books state that the team cutting the care MUST perform all the techniques of extrication
Ahh yes NFPA books... see that they said TEAM which is the key here. Our TEAM consists of an EMT interior with the patient and FF's operating tools... working, dare I say it.... TOGETHER!

Also, removing a person from a car is the same principal from removing a person who fell down a flight of stairs. It is up to the medical team (EMS) to decide how to remove the person and use the right equipment to remove them. This includes using stair chairs, reeves, stokes, cutters for chains wrapped around a person, AND the use of jaws.

So I guess EMS should be in SCBA on their hands and knees because its a dwelling fire with confirmed entrapment. Your argument doesn't stick. Working TOGETHER is the only way to safely and efficiently get a job done and a patient cared for. This us vs. them BS does nothing for the patient.

The only reason many fire departments have been stealing Rescue services from EMS is because many fire departments are fire districts and have the money to afford the equipment that, in a bad economy, many local EMS and rescue squads can't afford due to low donations.

Actually our reason is staffing. With EMT requirements as they are... we simply have more members and I don't want to say it but its true... younger members. Having the FD handle tools and EMS handle the actual patient allows both of us to focus on our roles and know that TOGETHER we will get it done

[Bones42]

IronsMan53 but is it a Pierce? ;)


Teamwork. Plain and simple. Work together, regardless of what vehicle you road to get there.

[EMTNJ1111]

Just had 3 extrications in 10 hours and we (FD) had an average of 22 responders between rescue, scene engine, lz engine and command. EMS... 2 3 person BLS rigs.

Does the BLS team have a heavy rescue truck in their fleet? If not - it's only obvious why they only had 2 three person rigs.

So in return the EMS agency MUST have adequate patient care folks. Maybe it's just me, but we can actually work TOGETHER with our EMS provider. We have 5 EMT/FF's to assist if the squad is not on location yet however if they are, one of their EMT's is in the vehicle monitoring and performing patient care and giving an inside the car view of what is going on while we are cutting or more importantly moving metal.

The squad should NOT be in the car unless they have full tunrnout gear AND extrication training. NFPA guidelines. PERIOD.

The fire departments that do not have EMTS - and - have first aid squads with out extrication trained EMTs are doing things WRONG. You must have a first aid squad or fire department with extrication EMTS cutting the car and inside. If you want the fire dept to cut - they better be emts and if you send a first aid squad person in the extrication HOT ZONE - they must be extrication certified.

Yeah OK. Patient Needs??? The only thing that patient needs is to be removed from that vehicle with NO further injury so that they can get to a trauma center in time to make a difference. Again we have an EMT inside monitoring however FD makes all decision on where to cut, etc. We continually inform the interior EMT what we are going to do next and he informs us if something is not working or has potential to create more injury. You know TEAM effort!

The EMT inside should ONLY be a rescue certified EMT. PERIOD. Otherwise, a FF EMT MUST be in the car - not a regular BLS crew member.

We do extrication correctly and would NEVER think of giving it up... as a matter of fact we are going from a rescue-engine to a full heavy rescue vehicle as soon as the Emergency Services Building addition is done... notice emergency services not firehouse or squad building... we are 2 separate agencies with separate names, funding, etc yet we can live and work together seamlessly which last I checked was the most important thing at ANY incident. I can actually one up you... we do NOT transfer patient care to the EMS transport team. The interior EMT stays with the patient from initial contact through extrication through turn-over to ER or Flight staff.

You missed something I wrote: "It is not proper or recommended that EMS crew who are not extrication trained enter the vehicle or remove the patient. Fire personnel who do extrications only like cutting and destoying thinigs but when it comes to the patient - they ignore them completely and let someone else treat and extract the patient. This is not proper procedure."

When i say ems crew-i am talking about a crew non-affiliated with fire department .... like a First Aid/Rescue/Emergency Squad or paid service. If they aren't extrication trained and don't have turnout gear - they shouldn't have anything to do with the rescue operation at all including being in the car. The FF EMT's should be in the car. PERIOD.


Ahh yes NFPA books... see that they said TEAM which is the key here. Our TEAM consists of an EMT interior with the patient and FF's operating tools... working, dare I say it.... TOGETHER!

EMS units and Rescue Squads should not just be forced to sit in the car if they are trained in rescue. What should happen if the Rescue Squad HAS the rescue truck AND the personnel? And the fire department also has EMTs? Whats wrong with sending a FF EMT into the car?

So I guess EMS should be in SCBA on their hands and knees because its a dwelling fire with confirmed entrapment. Your argument doesn't stick. Working TOGETHER is the only way to safely and efficiently get a job done and a patient cared for. This us vs. them BS does nothing for the patient.

This goes back to the question of whether CAR EXTRICATIONS are the role of a fire suppression unit or an EMS unit. Your statement doesn't make sense.

Actually our reason is staffing. With EMT requirements as they are... we simply have more members and I don't want to say it but its true... younger members. Having the FD handle tools and EMS handle the actual patient allows both of us to focus on our roles and know that TOGETHER we will get it done

Do you still agree with NFPA regulations that the group who is involved in extrications needs to be medically cerfitied or not? I repeat: A rescue team is SEPARATE from the fire unit AND ems unit. It is a standalone group that MUST be medically trained. This includes the person operating the jaws. PERIOD.

[FFTrainer]

Do you still agree with NFPA regulations that the group who is involved in extrications needs to be medically cerfitied or not? I repeat: A rescue team is SEPARATE from the fire unit AND ems unit. It is a standalone group that MUST be medically trained. This includes the person operating the jaws. PERIOD.

Sort of. If this makes sense I liken it to hazmat training. All team members need some sort of awareness level of patient care training(which we have as First Responder or EMT)I do not agree that all personell on the team need to be medically trained to a EMT level. Do they need an EMT on the team... there is no question on that. And actually you make a good point that I did not mention and that is that the interior EMT needs to be adequately protected PPE wise. Likewise... I do not feel that all members need to be EMT's... it defeats the purpose of a team. A baseball team is not all pitchers is it? We all have our strengths and levels of training we combine them into a team effort and get the job done.

EMS units and Rescue Squads should not just be forced to sit in the car if they are trained in rescue. What should happen if the Rescue Squad HAS the rescue truck AND the personnel? And the fire department also has EMTs? Whats wrong with sending a FF EMT into the car?
Absolutely nothing. We assign the first arriving properly trained EMT to patient care. And conversely we have added properly trained BLS crew members on the tool end of the operation as needed.

I guess I am fortunate that although totally separate organizations, we have a BLS organization and an FD that trains together and unfortunately for the public... plays together frequently.

Does the BLS team have a heavy rescue truck in their fleet? If not - it's only obvious why they only had 2 three person rigs. My mistake on forgetting the rest... they needed a third rig and it sat in HQ and a mutual aid squad covered the third rig. Again.. I'm lucky since there are ALOT of towns in my area that wouldn't have had a daytime crew for one rig let alone 2 so I guess I am greedy expecting 3. Its always been that way for whatever reason...

I think in some way we are on the same page just looking at it differently.

[firemanpat29]

Wow .......... wow Team work. I (EMT -Paramedic-Truck nurse whatever you
call em) are incharge of patient care. What ever your line about Medicaly
trained person running the tools, In my opinion that is just plain wrong.
I know how my tools work best. I dont need some one telling me how to do
my job. We have a great relationship with the guys driving the white bus.
They do great at their job and I do mine. If a plan does not seem to work
we will try some other way. but I call the shots on who cuts ,spreads,lifts
and moves PERIOD. The saftey of my crew,the saftey of myself then the
saftey of the patient in that order.

[hcm1827]

EMTNJ1111...what part of jersey are you from?

[valley3]

Best equipped does the rescue. My service provides EMS, ALS/BLS and non-emergency. Also Rescue, SCUBA,and Rapid Intervention, Air & Light. We also have an EMS Bike Team. Based on the border of Pennsylvania and New York we provide these services to multiple towns and fire districts on both sides. The majority of EMS is paid with volunteers evenings and weekends to supplement paid. Most of the rescue services are provided by volunteers, many who joined our organization that belong to the fire districts we serve. We have a great relationship with the various districts making it one big team effort.

[EEResQ]

Best equipped does the rescue. My service provides EMS, ALS/BLS and non-emergency. Also Rescue, SCUBA,and Rapid Intervention, Air & Light. We also have an EMS Bike Team. Based on the border of Pennsylvania and New York we provide these services to multiple towns and fire districts on both sides. The majority of EMS is paid with volunteers evenings and weekends to supplement paid. Most of the rescue services are provided by volunteers, many who joined our organization belong to the fire districts we serve. We have a great relationship with the various districts making it one big team effort.

TERRIFIC!

However, in many parts of this great land the battle lines have been drawn. Most commonly, these lines separate the "City Fire Department" from the "County Rescue Squad" in more rural areas. While EMS agencies actually have the statutory mandate to provide extrication in our state, most provide "rescue" through mutual aid or inter-local operating agreements with either the local FD or the county RS. While a few EMS agencies actually still operate a "Rescue Squad" as a regular part of their MVA response; their numbers are steadily falling. While this information identifies who is doing rescue, it does not address the question of "WHO SHOULD DO RESCUE?"

IMHO: The question, "WHO SHOULD DO RESCUE?" is best answered by this statement (heard in an emergency management seminar way to many years ago for me to remember who the speaker was):

"RESCUE is the province of the local agency MOST CAPABLE OF PROVIDING SPECIALLY TRAINED PERSONNEL and SPECIALLY EQUIPPED VEHICLES in response to the real needs of the community served."
(Author Unknown)

Be SAFE out there!

EEResQ
KY

[EMTNJ1111]

Unfortunately, in NJ, many FD's are NOT medically trained, yet they do extrications. They skip patient triage, patient assessment, patient contact (holding head, etc), and patient removal. These NON-medically trained FD's only cut the car and skip ALL patient care. This is obviously on the assumption that the ambulance is enroute. For those out of NJ, most all EMS are independent non-affiliated organizations that have no association with fire departments and most fire depts in NJ do not h ave first responders or EMT's running rescue. THIS is the problem. We also have "rescue pumpers" that run with 3 guys who supposedly run fire supression, patient care, and the cut itself. In NJ, EMS is only being relegated to TRANSPORT. If this is the case, a non-extrication EMS organization or individual must await in the COLD ZONE awaiting arrival of EXTRICATED patient. If a FD is willing to do the ENTIRE extrication, from START to FINISH, which includes removing patient from vehicle and transfer to EMS transport team, then i guess it's ok. But another major problem is that many FD's in NJ run "heavy rescue" with one power unit, a multitool, and 4 step chocks and claim to do extrication, and are putting "true" heavy rescue teams which have historically been EMS (first aid squad) based in NJ to the role of transport only. As a side note, it is NJ state law that an EMT's responsibility is to be able to extricate a patient, and when the FD is NOT staffed with EMT's, it MUST be up to the EMS organization to step up and do the extrication. Also, NFPA regulations state that the RESCUE team, be it Fire or EMS, must be able to medically assess, stabalize, and remove the patient from the vehicle AFTER scene safety, fire protection, stabilization, and de-energization (summarized of course). Also, how can a non-extrication trained EMS provider be in a hot zone? Lastly, it is the EMT rescuer that is supposed to be calling the shots, and NOT a NON-medical firefighter. As long as there is a patient involved and there is no fire present, and first aid squads have EMT's and FD's do not, it must be the EMS organization that runs the extrication. If the FD is medically trained, and has the capability to perform the ENTIRE extrication, and not just cutting, then it does have the right to co-exist with an EMS doing a cut.

[EMTNJ1111]

Someone wrote: "RESCUE is the province of the local agency MOST CAPABLE OF PROVIDING SPECIALLY TRAINED PERSONNEL and SPECIALLY EQUIPPED VEHICLES in response to the real needs of the community served." I agree, but it it must actually state the following: "RESCUE is the province of the local agency MOST CAPABLE OF PROVIDING SPECIALLY TRAINED EMT's and SPECIALLY EQUIPPED VEHICLES in response to the real needs of the community served." Notice inclusion of EMT. This can be an EMT from a FD or from a First Aid Squad. But the Rescue team MUST be medically equipped. Too often in NJ, where a FD arrives before the First Aid Squad, the car is cut to pieces and the patient is still in the car while the Firefighters are done cutting - waiting on the curb for the ambulance to show up. This is dead wrong. If you run rescue - you MUST be medically trained. In NJ, many FD's run rescue with no medical training, nor with enough rescue equipment. One firefighter with ONE multitool does not constitute a rescue team. It is a bad and sick trend that many FD's are bumping "true" heavy rescue First Aid Squads out and replacing them with their own light rescue FD multi-trucks. Many FD's actually are making their engine or truck companies act like a Squad company. If your truck has 80% truck or engine equipment and even a liberal 20% rescue equipment staffed with one or no EMT's - you cannot claim to be "heavy rescue". If there is a patient involved, you must have an EMT. If a person was not involved, there would be no need to cut. Since there is a person in a car, it is the EMT responsibility, not a Firefighters. If this EMT happens to be on the FD, then ok...otherwise...leave it up to the First Aid Squad. And some FD's actually do have "First Responders", but I ask you this: Would you like having an EMT from a First Aid Squad who deals with patients 5 times a day, or a Firefighter who deals with one patient once a month on a minimal level? You gotta be silly to not see the point here. I am obviously making these assumptions when your FD and EMS are totally separate and not cross-trained. For historical purposes, extrications started in NJ with First Aid Squads in the early 1940's using hand tools. It only recently (in the past 10 years or so) has started switching over to Fire Departments only because First Aid Squad calls have almost tripled leaving EMS Squads shorthanded, and with Fire Protection (sprinklers, detectors etc) improving and increasing, leaving many FD's half the number of real active fires, leaving Firefighters bored out of their mind.

[Halligan84]

EMTNJ1111... you continually rant at what you believe to be fact and regulation. Would you please cite actual references to anything that you are talking about. What regulations call for extrication to be done by EMT's? Rescue services are designated at the local level via the LEPC.

Some history from South Jersey, there are still some EMS organizations that do extrication, 2 that I am familiar with have had to initiate agreements with FD's due to lack of manpower, a third is strong and regularly has crews for both care and extrication. EMS got out of the extrication biz in the early 80's here and really hasn't had any regrets since. Regarding EMT's being trained in extrication... your kidding, right? My extrication training in EMT (20+ years ago, when supposedly EMT's did extrication) consisted of some basic glass removal, cutting sheet metal with a lawn mower blade and not much more. The main focus, and proper in my mind, was stabilizing and removing the patient once access was gained

You paint with a broad brush on untrained firefighters. The majority of our 40 plus active members are EMT or first responder. Our rescue training always includes the appropriate patient care, including firefighters acting as inside rescuers. The extrication curriculum in the fire academy is heavily weighted on patient care. Most career departments, mine included are 100% EMT or first responder.

You also view rescue as only auto extrication. Should the EMS squad do the trenches, water rescues, building collapses, high angle rescues and fire rescues?

There are MANY outstanding fire department rescue companies in NJ, that do more than just cut cars. They have assumed rescue services primarily due to need, not out of boredom and they have the resources to do it correctly.

[EMTNJ1111]

halligan 84 wrote "You also view rescue as only auto extrication. Should the EMS squad do the trenches, water rescues, building collapses, high angle rescues and fire rescues?" I believe that the organization that handles patients on a daily basis should do all aspects of rescue. Many FFs who happen to be an EMT only uses their EMT skills rarely, compared to an EMS organization. Again though, I was focusing on FD's that are NOT medically trained as well. Once a non-medical FF gains access to the patient (no matter what the TYPE of rescue), then what does the FF do? Nothing? This is why an EMT (whether they are on a FD or EMS Squad) should be doing rescue. As for the NFPA regulations, classifications of performing "rescue" include being able to medically assess and treat the patient. These are just SOME of the regulations (paraphrased): Section 6-33f of NFPA 1670 and Section 3-3.1 of NFPA 1006 require rescuers to follow procedures for accessing victims trapped in a vehicle. Section 3-3.2 of NJFPA 1006 requires that rescuers be able to medically assess a trapped victim to determine the natures and extent of any injuries. Section 6-3.3 d and e of NFPA 1670 require that rescuers have performed a thorough and complete medical assessment in order to determine how to properly PACKAGE any injured victimes trapped in wrecked vehicles. Section 3-3.2 and 3.4 of NFPA 1006 require that rescuers stabilze and package injured or ill victims which includes providing on-scene treatment of the injured to prepare them for transport. Section 3-3.6 of NFPA 1006 require the rescuer to be able to transfer injured victims to EMS transport team and be able to properly prepare/package victime for transfer AND be able to pass on critical info about patient condition to transport team. Further, a IFSTA book has the rescuer checking how many people are in need of extrication, victim triage, and medical victim intervention. There are very similar NFPA, NHTSA, and DOT protocols for other types of rescue, whether in the water, moutains, in a car, truck, etc. As long as there is RESCUE of a patient involved, an EMT or at a minimum medical FIRST RESPONDER must be performing the rescue. I believe it should be a dedicated medical team qualified in rescue that performs rescue. Further, you should not send in a non extrication trained individual into a vehicle being extricated, which means, if a FD has sole responsbility for extrication, they must send a FF/EMT into car while it is being cut. Lastly, it must be understood that putting a multitool and power unit on a fire engine is not medium or heavy rescue. It is merely, what i would call, a "RESCUE FIRST RESPONDER" and by no means a rescue team. Further, the primary role of a Fire Dept should be fire protection and suppression which are in the early steps of any extrication, FOLLOWED by rescue (if they don't have a dedicated RESCUE department and truck). I was also pointing out that many FD's don't do ANY patient care, and most never remove the patient and transfer to EMS transport team (assuming that Fire and EMS are separate). Every town is different, but what is common, especially in the northeast is that Fire Departments are trying to "take away" rescue functions of EMS, whether for egotistical, survival, or pure "manpower" reasons, and don't want to perform extrication from A-Z. For those who want to argue - there are exceptions to this rule - obviously. I am merely GENERALIZING, so relax.

[EMTNJ1111]

On a side note: There are THREE divisions. Fire, EMS, and Rescue. THREE. Now, you can have a combo of Fire/Rescue, EMS/Rescue, or Fire/EMS and Rescue, or all three separate. The point here is that a Rescuer is a rescuer. It is really hard for a FF to be holding a hose for fire protection, and holding jaws at the same time. There must be one FD unit for protection and another soley for Rescue...etc. However, in this day and age, a Unified command structure is hard to come by as each division usually has a power struggle. Is a basic MVA a police scene? EMS scene? or Fire Scene? Now add entrapment. Now whose scene is it? Then add in the fact that some departments do all three divisions or a combo of each. Now who is in charge? Then mix in mutal aid agreements and different levels of training...different certs. Now who is in charge? I'm a FF only. I'm an EMT only. Who is in charge? Frankly, no matter what organization the rescuer belongs to, they should always listen to the medical authority, in this case the EMT/Paramedic for instruction, whether that EMT is on a dedicated EMS unit or Fire Dept. The person with the most patient contact should be in charge. Not some non-emt cop directing traffic, or some FF with a hose, or some EMS ambulance driver...

[Chauffer6]

EMTNJ1111,

No offense intended, but I think you should stop worrying so much about what it says in books and manuals and standards, and concentrate more on the real world field work. It's all fine and well to quote all these different NFPA standards and IFSTA books, but in the end the only thing that really matters is that the job gets done the right way, safely and efficiently. Now before you pounce on me with one of your tediously enormous, full page rants, understand that I'm not saying all standards should be ignored or thrown out the window, I'm not. I'm saying open your eyes and stop being a victim of tunnel vision.

Perhaps where you live and work (or volunteer), things are done a certain way. That's all fine and dandy. It doesn't mean that's how it's done all over though, nor should it be the same all over. Where I'm from in NY (which, incidentally, borders Bergen County, NJ), the FD handles all manner of rescue operations. Be it a simple door pop extrication or any type of technical rescue like high angle, trench, confined space, structural collapse, etc. Yes, EMS assists with patient care as needed, but there are also plenty of firefighters who are crosstrained and can certainly handle basic BLS needs until EMS can take over, which is generally once the victim has been extricated from whatever entraps them. Guess what? It works perfectly fine for us and has for decades.

The bottom line is that patient care is NEVER compromised in our system. Unfortunately, your posts seem to keep making some attempt to convince us all that unless we're doing it your way, or letter for letter by the book, we're not doing it correctly...or worse, that you think we're jeopardizing the victim's safety and compromising patient care. Sorry, but you couldn't be more wrong. Take it down a few notches and open your mind up a bit.

[Bones42]

My little slice of NJ heaven...

Up til the late 1970's, extrication in my area was performed by a guy that owned a body shop, with his own tools and equipment out of his own vehicle. He was not affiliated with anyone, he just knew what he was doing and did it. My (non medically trained) FD did "extrication" as well using porta powers, air chisels, and other hand tools. At the end of the 70's, my local EMS agency (not fire affiliated) purchased a set of Hurst tools. (We still have them and they still work great). At that time, they took over extrication duties. FD would respond and make the scene safe. I will also note, back then, extrication training existed in the area. When I first took my EMT, back in late 80's, extrication was part of the training. We spent a whopping 3 hours on extrication, if you want to actually consider that training. :rolleyes: In NJ, extrication training has disappeared from the EMT curriculum. Extrication training also does not appear in MOST FF1 classes. It has become part of FF2. Also realize, there are 0 requirements to be considered an Extrication Instructor, as it does not exist as a certification in NJ. It's red-headed B@$t@ard Stepchild of the state. It's not EMS, it's not FD, it's somewhere between and NO ONE wants to set any standards/requirements for it. So, in a nut shell, a small part of what EMTNJ1111 says is true.

I fail to see what this arguement is really about. It's simple to me. "Who should do rescue?" - The people that are trained to do it, whether they are fire, EMS, PD, or anywhere between. Put the egos away and get the job done.

[BC79er]

Seems like part of his argument is that non-EMS training FF's are performing extrication and they shouldn't be because they are trained to treat the patient. Which is somewhat true: whoever had the tools is performing extrication, and whoever is the EMS agency should be treating the patient hands-on while the extrication is happening, holding C-Spine and whatnot.

If the FD is telling EMS to stand back while they're cutting then it should only be because EMS has no PPE to enter the vehicle while extrication is happening, or the scene isn't safe for them to be in there even with PPE. Otherwise they need to be in the vehicle assessing the patient. If patient access can't be made, then they stand back until the patient is brought to them.

As far as who is in charge of the whole scene, depends on the laws. In PA it was the PD utlimately in charge, but FDs are in command of the entire scene, EMS was/is a sector within that command structure. In TX, law says FDs "own" the scene and any involved property until we clear the scene or turn it over to a Fire Marshal who is a law enforcement officer here. We can't turn over scenes to sheriffs deputies, DPS Troopers or any other LE, otherwise the chain of possession is broken and they'd need to get a warrant to enter the property. But again, in most areas of the country when the FD responds, the FD is in charge and EMS/Rescue is a sector. Basically FD runs command regardless of the scene because EMS's only priority is the patient or patients, FDs are responsible for everything else, with the possible exception of crowd and traffic control.

[Chauffer6]

If the FD is telling EMS to stand back while they're cutting then it should only be because EMS has no PPE to enter the vehicle while extrication is happening, or the scene isn't safe for them to be in there even with PPE. Otherwise they need to be in the vehicle assessing the patient. If patient access can't be made, then they stand back until the patient is brought to them.
Absolutely. If EMS doesn't have proper PPE and we feel their safety will be jeopardized by them being inside the hot zone, we will first try to get them geared up (we carry spare gear on the apparatus) or we just won't let them in the hot zone at all. That's where it's nice having a few EMTs in our dept, as they can generally fill that role until the victim is in the warm or cold zone.

As far as who is in charge of the whole scene, depends on the laws. In PA it was the PD utlimately in charge, but FDs are in command of the entire scene, EMS was/is a sector within that command structure. In TX, law says FDs "own" the scene and any involved property until we clear the scene or turn it over to a Fire Marshal who is a law enforcement officer here. We can't turn over scenes to sheriffs deputies, DPS Troopers or any other LE, otherwise the chain of possession is broken and they'd need to get a warrant to enter the property. But again, in most areas of the country when the FD responds, the FD is in charge and EMS/Rescue is a sector. Basically FD runs command regardless of the scene because EMS's only priority is the patient or patients, FDs are responsible for everything else, with the possible exception of crowd and traffic control.
In NY, generally speaking, if the FD is on the scene, we're in charge of the overall incident. This would also include EMS activity at the scene of a fire, rescue or hazmat incident. In the case of our jurisdiction, because we aren't a NYS certified BLS/EMS agency, we usually let EMS handle their business as they see fit with almost no interference from us. As long as the right thing is getting done, and life safety for all involved is always priority #1. There are times we will interrupt EMS operations if we feel there is any risk being posed to either the EMS personnel themselves or the victim(s).

In any case, we've had such a long and healthy working relationship with EMS and PD in our jurisdiction that all of the silly arguments in this thread are basically non-issues for us. We have drills together, training together and are fortunate enough to have quite a few members that are local EMS or PD, which obviously helps tremendously.

I fail to see what this arguement is really about. It's simple to me. "Who should do rescue?" - The people that are trained to do it, whether they are fire, EMS, PD, or anywhere between. Put the egos away and get the job done.
Exactly. http://forums.firehouse.com/images/icons/icon14.gif

[Halligan84]

GENERALIZING is the problem. You can't generalize. IF you have firefighters tearing cars apart with no regard for the victim, then YOU have a problem. It sounds like you have an ax to grind with being relegated to a position you don't like. I can tell you that we work together here, ALS and BLS working right along with fire doing the rescue work. The medics tell us the general condition of the patient and the priority (basically whether we are doing minimal cutting and a rapid take down or opening the car wide.

Regarding who is in charge, again you show a lack of understanding on incident management, if you are in NJ, the police are in charge. It works fine if you put the time into it. EMS has complete control of patient care. Amount of involvement with the patient is probably the least likely reason to have command, you are focused on the patient and not on traffic, rescue equipment, fire suppression activities or haz mat situations. It's a team sport.

[EMTNJ1111]

So the question remains though. Who should actually DO rescue? Let's start with a clean virgin slate and back track to the early 1940s. Then, it was usually only the First Aid Squads that did it. No one else. Fire only fought fires. Now speed ahead to the 1970's. EMS still primarily did it. Then for some reason, in the late 80's early 90's, Fire got involved on a nationwide level. But let's erase history for now and let's pretend that jaws were invented in 1926 which is about the time when most First Aid Squads were officially forming. Now you have a choice to make. Do you give these tools and the capabilities to the medical providers who understand patient care, or to the firefighters who know nothing about patient care? Who do you give it to? Ppl who are trained at fighting fires or to those stabilizing and treating a victim? Rescue should be an EMS operation. Period. And for the person who was upset i listed NFPA standards...well, first someone asked me to quote them, and second - what's the point of having NFPA standards if you don't have to follow them? Screw it...i'll just fight fires as a plain old EMT, because who cares about standards or rules? The point is this. If the FD is going to rub out EMS from rescue - it is a FD responsibility to have FF/EMT's performing rescues. End of story. Not only is this NFPA regulation, but it is common sense. So....WHO should do rescue? An EMT or Paramedic. Period. This EMT or Paramedic can be part of a FD, but the point is that an EMT/Medic should do rescue, no matter what affiliation they have. And all my other points were obviously ignored too. A Full EMS Rescue truck staffed with rescue members should not be replaced with a pumper with one multitool and power unit. The major point is that a FD cannot simply just cut a door and walk away and say they are done with rescue. Extrication specifically includes removal of patient. Many FD's just cut and walk away and let someone else do that part. They are skipping the very reason they are there. To EXTRICATE.

[EMTNJ1111]

GENERALIZING is the problem. You can't generalize. IF you have firefighters tearing cars apart with no regard for the victim, then YOU have a problem. It sounds like you have an ax to grind with being relegated to a position you don't like.

How do *I* have a problem? An ax to grind? If someone is doing something against NFPA regulations and protocols, you say that *I* have an ax to grind? If someone is doing something that is completey wrong and against standards and can kill or injure someone, it isn't an ax to grind. I am talking about those that freelance w/o regard to standards at the safey risk to all those around them. Reread what you wrote man...... If FF's are tearing cars apart w/o regard to the patient, then i am having an ax to grind by talking about how bad it is? Your comment doesn't make sense. They are wrong. Whats the point of a forum if you can't discuss something not working? If it was perfect none of us would be debating anything b/c everything would be perfect and equal all around. *I* am talking about things that aren't perfect and it is this very concept that gives us plenty of reason to discuss what *SHOULD* be correct.

I can tell you that we work together here, ALS and BLS working right along with fire doing the rescue work.
I'm happy for you. I'm just trying to state what is happening in other places where we aren't as fortunate as you. As I said, there are always exceptions to the rule. And this is one of the most constructive pieces of commentary you have given. You see, when someone presents a problem, you present a solution. Good job. So what you are saying that is ideal is that all THREE work together like in your area and that neither are in control. So you are making the claim that your area is the model for everyone else. Now that is something we can work from and debate from your commentaries. My point was that in my area and in others I have seen and read about, they are NOT like your utopian society. There are areas, unlike yours, where the FD is steam rolling in and taking it away from other depts w/o regard to NFPA regulations or common courtesy.

[BC79er]

To be honest, you are coming across like sour grapes. You're complaining about why Fire Departments perform rescue. With statements like:

It is really hard for a FF to be holding a hose for fire protection, and holding jaws at the same time.

and

Frankly, no matter what organization the rescuer belongs to, they should always listen to the medical authority, in this case the EMT/Paramedic for instruction, whether that EMT is on a dedicated EMS unit or Fire Dept. The person with the most patient contact should be in charge. Not some non-emt cop directing traffic, or some FF with a hose, or some EMS ambulance driver

Now I agree, this forum is here for people to learn from, post asking questions and seek answers. You came in here stating pretty clearly that you think that FDs have no business performing extrication, and that only EMS squads should. I'm still looking for the question personally.

Take it to the basic piece of your post and let's say the question is who should do rescue. Everyone here posted the agency that's equipped and trained to do it, regardless of affiliation. Rescue isn't just about vehicle extrication, and that's why most EMS transport agencies don't deal with it. Some carry a combi-tool for the simple door pop to avoid calling in the heavy rescues. Great idea, saves on emergency response traffic. A good friend of mine is director of a rescue squad that is the EMS transport and technical rescue for the area. They do it all. They started it, remain proficient at it, and so the FDs in the area don't bother wasting money duplicating something that's already working well.

And just a quick note on NFPA standards and patients: NFPA standards exist for the protection of the rescuer, not the patient. Patient care comes 2nd after rescuer safety. The only patient care required in NFPA is that which ensures no additional harm comes to the patient, like dropping them out of a stokes or pushing a dash into them. NFPA does not care about patient treatment, just removal from the rescue scene.

If you think the way it works in your area should change, don't come here a vent about it saying the way it works in 90+% of the country is wrong. Come here and ask how we think you should approach making the change in your area. For starters if the FD in your area doesn't know squat about basic First Aid to be able to properly package a patient, why haven't you gone to show them how instead of calling them idiots and saying you are the only one that should be doing rescue? If you want respect around these forums, come here and be searching for a solution when you post, don't come here slinging crap because you don't have your way.

[Chauffer6]

Wow, this EMTNJ guy just won't let up. I'm not sure why he feels the need to continue to beat this dead horse. Does he think he's going to convince us all that we're doing it wrong and breaking every NFPA guideline in the process? That my local EMS squad should be in charge of extrication? The very same EMS squad that is comprised mainly of 5' 2" women and is lucky they can get two people to staff a BLS ambulance, much less run a heavy rescue? Yeah...ok then, good idea.

I'm willing to bet he's the same clown who started all this crap here on Wiki:

http://en.wikipedia.org/wiki/Talk:Rescue_squad

[Resq14]

There must be one FD unit for protection and another soley for Rescue...etc.

Jeez, a lot of the world sure does things wrong...

...according to you. :rolleyes:

You should do more observing and less ranting -- I think it would help you understand that there's more than one correct way to skin a cat.

Ok I just read the wikipedia stuff... and I *DEFINTELY* agree with the above Chauffer6! All I can say is... wow. I can't believe people actually spend time worrying and debating stoopid $#!+ like this. *Note, the page seems to have been changed to "better reflect" the history of "rescue" and "heavy rescue." ;)

rescue company - rescue squad - rescue engine - rescue pumper - rescue truck - engine rescue - emergency services unit -... who cares? What is "rescue"? It varies REGIONALLY. If your definition works in your area, or the three states surrounding your area, HOORAHHHH FOR YOU. But please, have some common sense to understand that the world does not revolve around any of our own little "slices of heaven," to borrow from Bones. :cool:

Also, "rescue" as a descriptor of some type of specialty service provided by an agency is a very vague concept, as is "technical rescue." Whether it's incorporated into an agency name or a vehicle descriptor, it doesn't really matter too much. It seems as though you're equating "rescue" with "extrication," and that's fine. But don't be so narrow minded about how things are defined.

Personally, I don't feel that extrication team personnel need to be medically trained, PROVIDED medical care is rendered appropriately and without delay by a different team, division, or agency. It's not rocket science, and it doesn't need to be blown out of proportion like this.

[Resq14]

Example: History of the New York City, NY Fire Department FDNY

1915 - Rescue 1 to the rescue

Incidents like a subway fire January 8, 1915 that injured hundreds when the tunnel filled with smoke - resulted in the creation of Rescue Company 1 on January 18, 1915. The country's first heavy rescue unit, FDNY Rescue 1 was outfitted with the most advanced equipment available, like Draeger Smoke Helmets and tools to release victims trapped beneath heavy debris. The unit was instrumental in controlling such disasters as a 1916 ammonia fire in the cellar of the Park and Tilford Company, a 1917 explosion of hydrogen gas aboard a submarine in the Brooklyn Naval yard that threatened to destroy the entire fleet, and the 1932 explosion in a Ritz Tower Hotel basement paint room that left eight firemen dead and another eight seriously injured.

From FDNY - A History:
http://www.pbs.org/wnet/heroes/print/history.html

God has made it clear that fire trucks are red, and that vehicle extrication is typically a fire service operation. But your mileage may vary. :p

This is a silly thread. Almost as silly as.
Who should fight fires... truckies? Hose jockeys?
I think the serious answer is clear: it takes all kinds. The witty answers, though, are far more entertaining.

[Chauffer6]

Sadly, what it seems to boil down to both here and on that Wiki page is that there is a very small, but very vocal, minority of people who think FDs are trying to "steal" everyone's thunder, and they feel threatened by or jealous of that perception. What these people are failing to realize, mainly because they have emotional tunnel vision, is that we all have the same job to do, which is to SAVE LIVES. So when I read responses like EMTNJ's here and the "contributer" to Wiki, it really makes me sad. Instead of trying to work constructively together to achieve the common goal, this small minority would instead like to go negative and cry foul, kicking and screaming in a tantrum fit for a 5 year old. Grow up. http://forums.firehouse.com/images/icons/icon13.gif

[Bones42]

EMTNJ1111, my FD chartered in 1885. MY FA chartered in 1929. FD handled "extrication" until 1979, when FA took it over. Why did FA take it over? Because there were a few members of the FA (That were also members of the FD) that thought buying the tools would be a good idea. It was excessive of the FD's budget at the time, plus, my FA covers 3 towns. That meant only having to get 1 set of tools for 3 towns as opposed to 3 sets. Luckily, accidents in the area are few and far between and since then, have not had a need for 2 extrications at once (knocking on wood). Currently, FA still has the tools (though FD has bought some) but guess what....%75 of the time, FD is using the tools to do the extrication while FA does patient care. Simple reason....manpower. FA shows with 2 or 3 people that are focusing on patient care (as they should) FD shows with 12-15 people. It's really just common sense.

I have no idea where in NJ you are. If you believe a system like mine and Halligan's are Utopia, feel free to contact us and have some of your people come down. I'm sure Halligan will agree, we are more than willing to show you how it works and why it works so well.

[EMTNJ1111]

Bones42, and everyone else: It is the very reason that there are departments where rescue works well and where it doesn't that is giving us the reason to discuss in a forum. I am talking about the areas where it doesn't work and giving examples. So, stop saying that my area doesn't do it right because THAT is exactly the point I am trying to make. The fact that my area doesn't work substantiates the need to talk about *WHO* should do rescue. So let's stop saying my area works and your doesn't kind of crap and let's stick to an academic level of what should be done. In my area, FD is trying to aggressively steal rescue and not adhere to NFPA guidelines, and this happens to be a very common occurence. My point as to WHO should do rescue - is the team that is willing to adhere to ALL NFPA regulations and do rescue from start to finish and not just pick the "cut" part only.

[EMTNJ1111]

To be honest, you are coming across like sour grapes. You're complaining about why Fire Departments perform rescue.



And just a quick note on NFPA standards and patients: NFPA standards exist for the protection of the rescuer, not the patient. Patient care comes 2nd after rescuer safety. The only patient care required in NFPA is that which ensures no additional harm comes to the patient, like dropping them out of a stokes or pushing a dash into them. NFPA does not care about patient treatment, just removal from the rescue scene.

If you think the way it works in your area should change, don't come here a vent

I knew coming into this FIRE FORUM as a sole EMS EMT would be like jumping into a fire with gasoline all over me (no pun intended:)), but it's getting silly now. Stay on topic guys.

I did not come in here to talk about how my area should change. I am talking about what SHOULD be done. Further, when it comes to history, there are plenty of examples of EMS running extrication/rescue in the 1920s, so an example to prove EMS wrong is just childish. Further, I already paraphrased and gave NFPA regulation numbers where the rescuers MUST be able to medically assess and treat the patient - so you are wrong.

I also said that one dept with ONE multitool and a generator should not be calling themselves "rescue" if that's the only tool they have, and there are plenty of other well equipped depts who do it.

Here's the bottom line: Instead of fighting Fire v EMS, b/c i will obviously be outnumbered in here, let's stay focused on who should do rescue. I think the answer is whoever is already doing rescue CORRECTLY from START to FINISH, which includes patient triage, assessment, treatment, and removal from vehicle. So, the EMT can do rescue as part of FD or EMS, but it must be an EMT. THAT is the bottom line I'm trying to discuss here.

[BC79er]

I also said that one dept with ONE multitool and a generator should not be calling themselves "rescue" if that's the only tool they have

I agree completely. But there is still one thing with your whole situation that doesn't make sense. You keep saying whoever is doing it correctly from start to finish. It must not be your organization doing any of it because otherwise you wouldn't be here complaining about it. So if your organization isn't doing any extrication, then the right people are doing it because you obviously don't have the equipment. Want to do it right? Go get the equipment. There's nothing with your department going and buying tools and getting trained, and having a rescue truck. If it ain't being done right, go get it done and stop complaining about it.

And no, as an EMT for the last 14 years, it doesn't not take an EMT to do patient removal from a vehicle. EMS is meant to stabilize and transport, and as long as the patient still needs rescuing, proper stabilization can't take place. Doesn't mean ignore patient condition to cut the living heck out of the car, but it means that for those cutting the car their job is to cut the car. If it's not the EMS agency that has the tools, then their job is patient care. If you want to cut the car and handle patient care then buy the tools.

And I think most of us figured out you weren't in a fire department within your first 3 sentences of the original post. But that's not why you're catching stuff from people. You're catching it because you're making this bold, uneducated, unexperienced statement that vehicle extrication can only be done by EMTs. Are there wingnuts in your area that would have trouble with a wet cardboard box? Maybe so, and in that case drive carefully. But you're not going to get anywhere coming into a forum full of people with a whole lot more experience than you in Rescue (all kinds), EMS, and Firefighting and saying those in fire departments handling vehicle extrication and aren't EMTs should stand back watch because they don't know what they're doing. Bull. Some of the best extrication technicians I know aren't EMS certified, and I'll take them cutting me out of a car over any EMT wearing a red S under their shirt that thinks they walk on water.

In my area, FD is trying to aggressively steal rescue and not adhere to NFPA guidelines, and this happens to be a very common occurence.

How exactly are they stealing rescue? That's about the dumbest thing I've ever heard. Again, it's pretty basic: if they have the tools, then they perform rescue. If you want to do rescue, get the tools and training. Simple solution

If you wanted to highlight your particular situation, and maybe ASK us how to go about making a change because it isn't working in your area, or not working the way you want it to, you wouldn't be in the current position of trying to backpedal and say you want to 'discuss' a topic. You came here to find other people to agree with your opinion of what should be happening. It didn't happen. Oh well. Move on.

[Halligan84]

BC79... that is ALL rescue, he wants an EMT to make the fire grabs too. As a 20 year EMT, I agree with your statement on qualifications as well.

He is a troll... leave him alone and he will go away. The Wiki stuff is definitely him and it is frightening.

[Chauffer6]

I kinda feel bad for him, he seems awfully bitter and jaded. Maybe he should join the local FD so he can pursue his lifelong ambition of running the Jaws while holding c-spine and starting an IV simultaneously. I mean, us lughead firefighters are way too dumb to be able to figure out how a 6 man crew can stretch a line AND pop a door at the same time, so maybe he can teach us a few things about firefighting and rescue. Hey, who better to teach us about all those NFPA standards than an EMT who has never in his life donned a set of turnout gear? I can't think of anyone.

[LeeJunkins]

I know better than to do this, I tell myself every time to stay out, but I have to get something straight in my mind.
FD is not suppose to be involved, according to NFPA books??? Now I have got something wrong in my few years of training. I thought NFPA meant National Fire Protection Ad. but they wouldn't be writing medical standards, So let's see National __aaaaa_____aaaa__ Administration :confused: :D

In all seriousness it doesnt matter who dose it, as long as The crew is safe, the Patient is safe and you get them to AlS in a timely manner. If we teach extrication like it should be taught, every rescuer should be able to handle most patient care until we get them out whether EMT cert or not. I know it is different every where we go, but I find that 80% of todays rescuers are or are in the process of becoming Both.
Every extrication class should be taught with patient care and patient extraction as a main part of it's curriculum.
As was said before I know a lot rescuers that are not EMS trained but if I am ever in need I hope they are around because I know what they can do.

I think this thread may be a hidden Vollie vs Payed Type thing. (I DIDN"T say that) did I?

[hcm1827]

volunteer first aid squads in nj do not have enough manpower to answer a difficutly breathing call nevermind do vehicle extrication for the most part. the fire departments [most of them] have more manpower, more equipment, and have a faster response time. a ems squad that does vehicle extrication first priority should be patient care and that requires a rig to be there first,not the ems rescue truck. what good is staffing the rescue truck then cutting the victim out and have no rig to transport them to the hospital. fire department needs to be there for fire protection. why waste manpower the could be used to transport victims to the hospital. fire departments are more than capable of vehicle extrication and are medically trained. i also belive that if fd is on scene and ems is not there yet a firefighter should be assinged to patient care [this would be a no brainer] until ems arrives. njemt111 what part of nj are you from? i also assume you are talking about a volunteer squad

[BC79er]

Halligan, 10-4K on the troll, like I said about the lack of fire experience I figured that out in the first post.

I was just in the mode to answer the posts. Besides, I find it amusing that none of the certifying agencies for rescue training require EMT either. I got my PA vehicle rescue, trench, confined space, and high angle certs before I was an EMT. I can't say if NJ is the same or not, but if it is and the agency that gave him his patch doesn't think you need to be an EMT to cut a car apart then we just have a Napoleon syndrome on our hands: someone that thinks they're bigger than what they just joined. 2/20 for sure. :rolleyes:

[Resq14]

Chauffer, Lee, BC79er... great posts.

My favorite is this "NFPA" business... I was thinking the SAME thing... why in the world is someone who is pro-first aid rescue trying to justify it using fire service standards???? I also catch a strong whiff of paid/volunteer... "donations are low"... "staffing problems"... yada yada yada

I don't even understand what your point is, bandaid boy. You want an academic discussion, yet you fail to live up to your own standards. I've only had my ems license for 13 years... so maybe that's why I'm having a hard time understanding your "logic"...

"stealing rescue"... lol ya ok :rolleyes: :eek: ;)

My fire suppression/fire prevention/wildland fire control/vehicle extrication/water rescue/ice rescue/rope rescue/haz-mat/ALS transport EMS DEPARTMENT has no charter, charter date, or incorporation date. Not all states have private FD's and private FAS's (or any FAS's for that matter). I think a better title for this is: WHO SHOULD DO RESCUE IN MY SLICE OF NEW JERSEY HEAVEN?, and it should be in the NJ category for state threads. Why? Because you won't pull your head out of the New Jersey sand and consider that things aren't the same everywhere.

[wvffnj]

I've experienced both sides to this argument and I must say, ems doing rescue worked better in these two situations. It seems in the FD based rescue there is always confusion between ems and fd about what needs to be done and what should be done. Obviously there are deeper issues there but in the ems based rescue there is a seamless transition from rescuer to emt. You know the interior emt and they know you and you've trained together so you're typically on the same page. Now I'm not saying one way is better than the other, obviously there are some fd based systems that work correctly as there are ems based, it's just a function of who is trained better, who has the manpower and most importantly, working together. I do agree that whoever is on the rescue should be emt/medic and ff, not only for extrication purposes but also for any type of rescue situation where they could have the primary patient contact.

[Bones42]

Hey! Not all of us in NJ are that screwed up. Some of us even know how to work together... ;)

[Chauffer6]

I've experienced both sides to this argument and I must say, ems doing rescue worked better in these two situations. It seems in the FD based rescue there is always confusion between ems and fd about what needs to be done and what should be done. Obviously there are deeper issues there but in the ems based rescue there is a seamless transition from rescuer to emt. You know the interior emt and they know you and you've trained together so you're typically on the same page. Now I'm not saying one way is better than the other, obviously there are some fd based systems that work correctly as there are ems based, it's just a function of who is trained better, who has the manpower and most importantly, working together. I do agree that whoever is on the rescue should be emt/medic and ff, not only for extrication purposes but also for any type of rescue situation where they could have the primary patient contact.
Ah, you've hit on something that hasn't really been addressed in the thread, but is extremely important and fundamental. TRAINING TOGETHER. If FD and EMS are separate and FD performs rescue functions, then both agencies MUST train together constantly. If this is done, there should rarely, if ever, be any conflict or confusion. There is no reason that if you have good solid training, drills, agreements, SOPs, etc that you can't achieve a seamless transition even when both agencies are involved. Trust me, I know from experience. It can easily be done.

[srvrescue]

I have read some of the posts and it seams that most of you are split on this. I ride for a independent rescue squad that is totally vol. in northern new jersey. We provide all the rescue services along with assisting ems with major ems calls and also provide fire fighting support to TWO fire departments. We have the training we need because we train with both fire departments and the local ems squad. Most of our members and State FF's and also Heavy Rescue Certified, and some are even EMT's. We have 2 major requirements, one is to obtain Heavy Rescue Cert's and any other state and federal requirments before they can come off probation. AFter that they have one year to obtain either FF1 or EMT. By having these requirments puts us at a solid foot for calls.

[Chauffer6]

I have read some of the posts and it seams that most of you are split on this. I ride for a independent rescue squad that is totally vol. in northern new jersey. We provide all the rescue services along with assisting ems with major ems calls and also provide fire fighting support to TWO fire departments. We have the training we need because we train with both fire departments and the local ems squad. Most of our members and State FF's and also Heavy Rescue Certified, and some are even EMT's. We have 2 major requirements, one is to obtain Heavy Rescue Cert's and any other state and federal requirments before they can come off probation. AFter that they have one year to obtain either FF1 or EMT. By having these requirments puts us at a solid foot for calls.
From what I know of Bergen, and Ramsey in particular, they operate pretty seamlessly as far as rescue, fire and EMS. Because, as I said in my last post and you just reinforced, it all comes down to TRAINING. Not just individual personal training or individual company/dept training...but MULTIAGENCY training. That's the key. That along with sharing SOPs and guidelines so there doesn't have to be basic "who does this or that?" decision making on the scene. It also keeps the turf wars down to almost zero because there's a mutual respect.

[Rescue101]

No confusion here.Hospital based ambulance service does medical,we(FD) cut.No bickering or infighting,we train and work as one unit.Oh, the FD will do some medical if all the units are tied up(half the crew works both agencies)but primarily we just do the mechanicals.Very few FA "rescue"crews left in the area,it's mostly Fire crews doing the Heavy Rescue function.My feelings on lot of the overregulation of Emergency services is a lot like my feelings on HIPPA,it's NOT your friend.Businesses are required to post warnings about things contained within that will hurt/kill personnel(in this town)but we're NOT allowed to furnish this information about PEOPLE who pose the same risk? THANK YOU VERY MUCH,FEDERAL GOVERNMENT! My opinion,medics(at all levels)should do medical,FD should do the rest.If you want to do both,sign up with a Dept that does both. T.C.

[JTFIRE80]

In PA, there are still a few EMS agencies that run rescue, usually in conjunction with the FD. Back in the day though, it was the other way around completly. The EMS/Rescue Squad I run with now did some serious Heavy Rescue back in the 60's/70's. We had (and just sold) one of the original Hurst 32's, and I believe it's serial number was 2. Obviously before my time, but they truck was called all over PA, NJ, DE, MD when there was only a few tools around. Now, with prices failt cheap for tools (they are cheap compared to days of 'ol), most FD's can afford to purchase them.

And in PA, it's still the Department of Health that teaches all vehicle rescue related courses, including, Vehicle Resq Technician, Bus rescue, Special Vehicle Rescue, and if you can find it, Basic Rescue Practices, which is a course of all Rescue related topics.

[pumper8032]

WOW, seems like a bit of a free for all in America!!

In south australia we have to apply to our department, who, if there is a genuine case for need, apply to the road crash rescue commitee who then in turn analyze the data, and the needs, and then, and only then, if they agree, then you can become Road Crash Rescue. Now, at the moment , its divided between the Fire Service and the State Emergency Service (spawned from the old Civil Defence units) At this state the fire service does it mainly in urban areas and some remote locations, and the SES does it in a lot of country areas. but as we all know, with volunteer numbers dwindling badly, it won't be long before the fire service in a lot of areas ends up with Road Crash Rescue. Its a simple fact, you are not going to close a fire service are you, so its only natural that you combine the services.

[RFRDxplorer]

WOW, seems like a bit of a free for all in America!!

In south australia we have to apply to our department, who, if there is a genuine case for need, apply to the road crash rescue commitee who then in turn analyze the data, and the needs, and then, and only then, if they agree, then you can become Road Crash Rescue. Now, at the moment , its divided between the Fire Service and the State Emergency Service (spawned from the old Civil Defence units) At this state the fire service does it mainly in urban areas and some remote locations, and the SES does it in a lot of country areas. but as we all know, with volunteer numbers dwindling badly, it won't be long before the fire service in a lot of areas ends up with Road Crash Rescue. Its a simple fact, you are not going to close a fire service are you, so its only natural that you combine the services.

HUH??? I'm not exactly sure what you are trying to say.

[pumper8032]

Ok then, in simple terms, who governs you getting vehicle extrication classification?

[kd7fds]

In Idaho, there is no governing agency that assigns an extrication classification. Its whoever has the equipment and convinces the other agencies to call them. It's a political clusterf**k sometimes.

[Bones42]

In New Jersey, there is no governing agency that assigns an extrication classification. Its whoever has the equipment and convinces the other agencies to call them. It's a political clusterf**k sometimes. Corrected that for you! :D ;)

[EEResQ]

However, in many parts of this great land the battle lines have been drawn. Most commonly, these lines separate the "City Fire Department" from the "County Rescue Squad" in more rural areas. While EMS agencies actually have the statutory mandate to provide extrication in our state, most provide "rescue" through mutual aid or inter-local operating agreements with either the local FD or the county RS. While a few EMS agencies actually still operate a "Rescue Squad" as a regular part of their MVA response; their numbers are steadily falling. While this information identifies who is doing rescue, it does not address the question of "WHO SHOULD DO RESCUE?"

IMHO: The question, "WHO SHOULD DO RESCUE?" is best answered by this statement (heard in an emergency management seminar way to many years ago for me to remember who the speaker was):

"RESCUE is the province of the local agency MOST CAPABLE OF PROVIDING SPECIALLY TRAINED PERSONNEL and SPECIALLY EQUIPPED VEHICLES in response to the real needs of the community served."
(Author Unknown)



I recall who the author of this statement was:
Mr. Norm Lawson.

Mr. Lawson, both a respected attorney and technical (rope) rescue instructor in our state, was speaking to a group of rescuers during a KY State DES (Disaster & Emergency Services -- now EMA) sponsored seminar titled "Rescue Squad Law" in 1988. Attendees included command personnel from fire departments (paid and volunteer), organized rescue squads, ambulance services, law enforcement and the military. Just as originally asked on this forum in 1999, several of the 1988 seminar attendees wanted an answer to the question "Who Should Do Rescue?" While a lot has changed over the last 18 years, all politics aside, Mr. Lawson's response was on target then, as it is now.

"RESCUE is the province of the local agency MOST CAPABLE OF PROVIDING SPECIALLY TRAINED PERSONNEL and SPECIALLY EQUIPPED VEHICLES in response to the real needs of the community served."

MR. NORM LAWSON, LRC Chairman
Legislative Research Commission
State Of Kentucky


Be SAFE out there!

EEResQ
KY

[allison20]

Well down here in the backwoods of Arkansas, where money and GOOD training don't exist, who does the rescue" the person who shows up".
The private ambulance company who does our EMS tends to direct things, but the people doing the rescue are 1st reponders,fire police or bystanders.
Sometimes its just one group and others everyone gets involved. And being on different depts is meaningless.A person can wait a long time for help to arrive out here and the person who needs help tends not to get to picky. And niether do the people doing the rescue. And yes it sounds, and is, stupid, but thats how we roll.