1. #1
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    explorer478's Avatar
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    Post First Responder Program

    Hey,
    I volunteer with a small volunteer fire dept with about two stations in a rural area outside of a medium sized city and im not for sure how many square miles we cover. Currently, we do not run any type of emergency medical care. I have thought about trying to talk to the Chiefs and other officers and also our Board of Directors about starting a First Responder Program. My reasons why I want to see this happen is because there is an EMS service for the whole county but the closest ALS unit is all the way in town and most of the time the ALS units are tied up with calls and another unit will have to be dispatched from farther into town. With a First Responder program in place, we could provide basic medical care to the patient till an ambulance arrives, this could even possibly save some lives. I was wanting to get some tips from you guys and gals that have had expericence in these type of programs on how to start one.

    Thanks

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    If done right, a medical first responder program can be a valuable asset. It's easier to list who doesn't have one in our area than it is to list who does.

    If you're looking to convince the powers-that-be that you need one, you may be in for a hard time. Those departments that don't run medical calls are reluctant to start for a variety of reasons.

    In order to accomplish this, you're likely going to have to gather a lot of information. What are the statutory requirements in your state for such a program? Do you have to have your own medical director? How many runs do you anticipate? Do you have the personnel with the appropriate level of training to handle whatever level of care you want to provide? Are you going to have immediate burnout or issues responding to all your medical calls due to the volume of calls? How much is it going to cost to get the guys trained? What is it going to cost for equipment (bags, oxygen bottles, regulators, disposables, AED, etc)?

    My vollie department is set up as an ALS-level provider, which required a lot of legwork and work with the state. BLS-level agencies don't require that much. For BLS response agencies, they simply coordinate with the ambulance serving the area. Whatever minimal training that ambulance wants to allow is what the minimum standard is. Some respond with only CPR training, some require a 40-hour first responder class.

    During your information-gathering stage, inquire with the ambulance agency about their feelings toward it. I would imagine you'll find them receptive, as it helps with the overall care of the patient (who can argue that as a bad thing?). At the same time, you might see if they'd be willing to provide at least the disposables (oxygen masks/rebreathers, gloves, BVMs, etc), as they are billing for that stuff anyway. You might even find them receptive enough to set you up with some old (or even new) bags and oxygen bottles. They may even help with training and CEU's. You never know until you ask.

    If you can get the ambulance agency on board and have them help you find out how many calls to expect. If your chief is anything like I am, he will appreciate good ideas, but will also want the information to go with it. A guy that comes well informed with an idea gets my attention. I may implement what they're after, but I'm sure going to give it more thought than someone who doesn't come with the info.

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    I think it would be worthwhile if for no other reason than to be able to provide care for your own people if they got hurt on a fire. Whether to expand to providing care to others is another kettle of fish as catch22 indicates.

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    Default Ems

    Here are several considerations when looking at adding a First Responder (FR) service:

    1. Since your fire department (FD) is already established, having the FD operate the FR service will save your community alot of hassles from starting from scratch.

    Trying to get acceptance, funding and cooperation will be easier when everyone knows an established and trusted organization is looking into offering the service. Also, using part of the FD's resources (meeting room for training, insurance coverage, etc.) to operate the FR service will cut down on the need for duplication of a separate organization.

    2. Working with the ALS service is essential. Since the FR members will need training, working with the ALS service will help you obtain training. If the ALS service offers training and/or brings in instructors, this is a plus. Rather than sending FR members outside the area (cost of time and money) for training, having training with the ALS service will be a win for your FR service. The expertise an ALS service can give a FR service is priceless.

    3. When looking at setting up the service, look at the response times that it takes for the ALS to respond. By having a FR service respond, minutes are saved for those having medical emergencies (heart attacks, diabetics, etc.). To justify the establishment of the FR service, it is essential to show the time saved for the patient that has a medical emergency. If you have any special locations (nursing home, school, plant with large worker populations, major highway with MVA'a, etc.) show the population of those locations that you will respond to. You need to justify how you can start medical treatment earlier for the patients and how many people will be served.

    4. Community support is essential. If you have senior citizens living in your response area, ask for their support. Seniors, in my experience, are the most supportive of emergency medical services, as they desire the service because of their health conditions.

    5. Funding will be needed. If EMS is provided county wide from tax support (county mill levy, etc.) then request financial support for the service. Best to approach the entity that determines the EMS budget and see if they are supportive. Also see the EMS budget and how the funds are distributed. Are the funds distributed by annual call volume, population served or on a square mile of coverage, etc.? Look at what other FR services are receiving.

    You can always request used EMS equipment from other EMS organizations in the area. As in the fire service, EMS has its "mutual aid" tradition of helping out newly organized EMS services. All you do is ask. You can send out a "want list" to EMS organizations and hospitals in your area. A used ambulance would be ideal for responding with personnel and equipment to medical emergencies.

    6. As far as your FD support, you will need to justify the service, as shown above. You may also show that having medically trained personnel on your organization will also benefit the FD when responding to calls, if something happens to a firefighter on scene. Also, if you respond to MVA calls, there will be FR personnel to deal with the patient until ALS arrives.

    Hopefully, this info will help in your organization of the FR service. Even though it is common sense to start the service, you will still have to justify establishing the service. There are always doubting Thomases that will have to be convinced. Show strong justification and the ball to establish the service will get rolling.......

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    I have to follow along the lines of Catch.
    First you must put it in your depts Charter filed with the state, that you will now provide a first responder service, and check to see if you are rescue as well. If not, you might as well kill two birds with one stone.
    Next I would check with your local medical director. He/She are the ones who put their medical license on the line so you can provide a medical responder program.
    After you get the above completed, I would then seek support from your county, town for funding and then throw the idea out into the community.
    If you get all this done with support, then its probably a good program to get started.
    **Note, above mentioned items are requirements from my local area/state. Some items may or may not apply to you or anyone reading this.

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    Just to clarify to the original post ... We do have BLS and some ALS equipment on our Pumpers however the equipment is on there just for us in the event that it's needed. We also have First responders , EMT-IV and paramedics on our active staff. The county we live in has a great emergency service and is working to better it by cross training agencies to provide better services and spread the service area (this will solve the whole distance of ems unit problem) I do agree that this is needed ... Just wanted to clarify that we are set up and prepared for the go ahead from our County

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    If you get a fire service based ems established in your department, remember to remind the ems personnel that they are fire department based ems and not the other way around. The fire department is your senior service.

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    Quote Originally Posted by Fireman2524 View Post
    Just to clarify to the original post ... We do have BLS and some ALS equipment on our Pumpers however the equipment is on there just for us in the event that it's needed. We also have First responders , EMT-IV and paramedics on our active staff. The county we live in has a great emergency service and is working to better it by cross training agencies to provide better services and spread the service area (this will solve the whole distance of ems unit problem) I do agree that this is needed ... Just wanted to clarify that we are set up and prepared for the go ahead from our County
    If you've already got the equipment you're well on your way. Like I mentioned, you might want to look into what the state requires. In Missouri we can do BLS all day long under the authority of the ambulance district's authority. However, if you do anything ALS (even if it's for your own guys) you have to be licensed with the Bureau of EMS as an EMRA (Emergency Medical Response Agency), which is a non-transport ALS provider.

  9. #9
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    Not sure how to start a program, but my department requires us all to be EMT. About 65% of our annual calls are for medicals. We have three stations, three cities that we cover. My station has a contracted EMS service that assigns an ALS rig at our station but not the other 2. My station almost never beats the ambulance to calls, but our other two stations always beat them to it.

    The pros for us is that emergency care is readily available in all three areas, and it increases the number of calls per year district wide. The con (at least for my station) is that it's hard to keep the skills up when you get to a medical and all you're doing is helping to load the patient in the rig...

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    Hey explorer, 1st let me say some real good advice given so far...

    1) Check with your state agency that regulates Emergency Medical Services (Here in Arkansas it's the Department of Health Div. of EMS.) Find out what their rules and regulations are for 1st responders in your state. You may find out like here there are none...

    2) Check with your States EMS or EMT Association (Here it is the www.aemta.org) They may have a contact person or society that may be able to help you out. As President of the Arkansas 1st Responder Society of the AEMTA I made several presentations to FD's, city boards, county governments as to the benifits of it.

    3) Once you know your local laws and restricions you can develope a plan to present to your Chiefs, officers, and board. Plan on having a lot of negative feed back, but back that with facts and statistics. And from what FM2524 say's you have the equipment and personel, so you are well on your way.

    Let me know if I or the Society can be of any help. Dwayne Aalseth

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