1. #1
    e33
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    Default Who Should Do Rescue?

    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?

  2. #2
    KenNFD
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    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

  3. #3
    SCCARESCUE
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    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.

    ------------------
    Dan Martelle

  4. #4
    KenNFD
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    Dan:

    What, me biased for the FD?

    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

  5. #5
    cla123
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    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?

  6. #6
    Scott Clark
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    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!

  7. #7
    jdhafpd
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    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.

    ------------------


  8. #8
    SCCARESCUE
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    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.

    ------------------
    Dan Martelle

  9. #9
    Jeff
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    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.


  10. #10
    Kim
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    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.

  11. #11
    FrankG
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    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.


  12. #12
    Ed D
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    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.

  13. #13
    Spfd32
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    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.

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    Default Who should do extrications? EMS or Fire?

    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...

  15. #15
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    Nothing like digging up a 6 1/2 year old thread.

    Have you met BVFD1983?
    I can't believe they actually pay me to do this!!!

    One friend noted yesterday that a fire officer only carries a flashlight, sometimes prompting grumbling from firefighters who have to lug tools and hoses.
    "The old saying is you never know how heavy that flashlight can become," the friend said.
    -from a tragic story posted on firefighterclosecalls.com

  16. #16
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    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

  17. #17
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    IronsMan53
    but is it a Pierce?


    Teamwork. Plain and simple. Work together, regardless of what vehicle you road to get there.
    "This thread is being closed as it is off-topic and not related to the fire industry." - Isn't that what the Off Duty forum was for?

  18. #18
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    Default EMS and fire

    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.

  19. #19
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    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.

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    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.

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

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    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.

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    Quote Originally Posted by 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 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

  24. #24
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    Default Fire V EMS

    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.

  25. #25
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    Default

    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.

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