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  1. #1
    vtach
    Firehouse.com Guest

    Post Please Help Us!!!

    Is there anyone out there who can suggest something we can do to have our city fire department take the extrication tools back from us? Let me explain...we are a hospital based paramedic level ambulance service that carries extrication tools with us because the city fire chief refuses to be involved with extrication. Unfortunately, the mayor supports his decision not to do extrication. As a result, we are forced to spend $23,000.00 for turnout gear, when we could be spending that on much needed patient care equipment. In addition, we run as a two person crew. On nights, we have only one ambulance operating. If we get a roll over crash, that involves more than one patient, we do need to gain access. However, we also need to attend to the patient(s). We are forced to forgo patient care just because there was no one there to run the jaws. What if we have a critical load and go situation? What do we do with the extrication equipment? Occassionaly, we do get assistance from rural departments and they will run the jaws but the city fire department will not do extrication. They have the turnout gear and they have the trucks to haul the equipment, plus the manpower, yet they refuse. I should also point out to you that we get absolutely no money for extrication. We spend money! In the form of fuel and upkeep for this equipment. Our administration will not support us either. Further, many of us don't feel we have had adequate training nor do we want the training to be qualified to run such a valuable piece of equipment! It 's hard enough to keep up with paramedicine!

    Please help us with some suggestions on how to approach this situation. I look forward to your response. You may post either here or email me directly at Banister@ unbounded.com. Thank you in advance for your suggestions.

    Gary W. Banister, NREMT-P


  2. #2
    721
    Firehouse.com Guest

    Post

    Sounds like the public need to be made aware of the attitudes of the fire chief, and the city council that supports him.

    Educate the public, and let them changes the faces on city council, then the council can change the fire chief for someone that places the citizens of area ahead of what ever agenda he appears to have.

    Does the city FD run first responder?

  3. #3
    FFtazUFC3
    Firehouse.com Guest

    Angry

    This is not a good situation.

    Like 721 says get the public involved, contact the local news media and tell them your story, you would be surprised how much public opinion can sway politions minds. Second if all else fails, hit the city in the pocket book, you are a hospital based service, and most hospital based EMS services bill either the Pt or the City, I would start charging for every extrication. Either the citezens will get fed up and demand extrication from the city or if you bill the city directly they will demand that the fire chief pick up extrication. Either way you win.

    ------------------
    FF/EMT-B Paul Cullen
    Frederick MD.

    http://ufc3.wworks.com/
    http://www.angelfire.com/md/resqu/index.html



  4. #4
    ConSpaceTL
    Firehouse.com Guest

    Red face

    I am periodically amazed to here of such dinasors still in existance in the fire service.

    Our department took over the ambulances from a hospital that could no longer provide the service, performs confined space rescue, low and high angle rope rescue, heavy rescue and auto extrication, hazmat, aircraft crash rescue all in addition to ordinary structural fire fighting.

    The days of just firefighting are over but some old chiefs just haven't done themselves, their personnel, and their community the favor of retiring.

    I must agree that using the media is your best solution and swaying public opinion in your favor. It will not be easy but this guy has got to go!!!


  5. #5
    vtach
    Firehouse.com Guest

    Post

    Thank you for your suggestions.

    The city fire department only responds on MVA's within the city limits. No medical calls.

    The news media is very anti-hospital. The reasons I don't know but they never mention us, in the newspaper, when we respond. They don't like us.

    The cops like us and respond to almost everything we do. We share a great camaraderie.

    Please give me some more suggestions. Let's hear from some officers. Thank you.

    Gary W. Banister, NREMT-P


  6. #6
    smokeater
    Firehouse.com Guest

    Post

    I feel for you. Every emergency service is straped tight on manpower and funds.

    First question is Does the state require you to have extracation capabilitys or is it because the fire chief refused to take responsibility for the public that pays his salery and go to the voting booths?

    I would also like to know the size of the city.
    Where I am we make over 5,000 runs a year.
    Out of all them we only have about 200 house fires, A 1,000 or so other types and all the rest are EMR runs. I thank the city every year when it comes time to renew our union contract because our department is responsible for Fires, rescues,MVA, hazmat, fire prevention,rope rescue, and any other emergency that can come up.

    Most of us are EMTs.
    We have two ambalance services here,one is a County Hospital.
    We have a enhansed 911 system that weeds out all non emergencys but we run on most EMRs.
    When a call comes in we are dispatched at the same time as the ambalance is. We usally get there first because of our 3 min. response area. The ambalance is based in one location so it takes them longer to respond.

    On MVAs we dispatch a pumper and a Heavy Rescue truck. The reason is SAFETY. SAFETY for the victim and for the emergency workers.

    We have 3 men on a pumper and 2 men on the rescue. Plus the ambalance crew of 2.

    Most of the time everybody is real busy.

    Good luck and inform the public with word of mouth. It does work. I teach CPS to the public and 10 years ago we had a bad 911 system so I informed every student to talk to anybody that would listen. We now have advanced 911 and we are getting the cardiac
    AEDs
    The Chief should be fired for not taking care of the public.

    You should check with the Department of Health and OSHA about the safety issue when doing auto extracation.

    Good Luck





  7. #7
    smokeater
    Firehouse.com Guest

    Unhappy

    Me again, I never realized that CPR could be mispelled. But I did.

  8. #8
    DD
    Firehouse.com Guest

    Post

    Does your hospital spend much money with the news media for advertising? Do your marketing and public relations departments try to improve your relationship with them? Are they notified, well in advance, of any open houses or special events which involve your crew? Have you made any effort to get to know the reporters and especially the news editors? They all need to be greased occasionally. Be sure to thank them every time you get a good story reported.

    The place for the pressure is the Mayor. The
    fire department and chief will do what he tells them to do. They may be doing exactly that now. Besides, the ordinance that authorized the creation of the fire department may say that it's duty is only to fight fire. It has happened before and the city council can amend it if they desire.

    In my area the fire service handles all rescue and extrication. That includes both
    the career and volunteer departments. Most also provide first response emergency medical services.

    I have seen both sides. I am a firefighter and I used to work for a hospital ambulance department. The ambulance and fire services
    must work together for your community to receive the maximum protection that it deserves.

  9. #9
    vtach
    Firehouse.com Guest

    Post

    The news media is only interested in publishing dirt on the hospital, which will be coming soon enough. We are in the process of going union. I have no idea what the relationship is with the hospital and public relations department but so far it doesn't look good.

    Is there anyone (chiefs?) that can put pressure on this chief, on our behalf? This is different teritory for us that's why I am approaching the subject in this forum. Is there another forum I should be in?

    PLEASE HELP US!!!

  10. #10
    smokeater
    Firehouse.com Guest

    Wink

    I mentioned teaching CPR as a good way to spread the word but as stated by others on this form you need to be seen as often as possible and in a positive way such as teaching CPR and having open house.

    I have found that the public does not really know what the fire dept.funtion is or the role of the ambalance service.

    Starting a Union can be hard on a dept. but in some states there are laws to protect members trying to unionize.

    Remember that a citizen may only come in contact with the emergancy service once in a lifetime so get out there and publisize your hard work and desire to help the public.

    The citizens probely think that thier tax dollers are going for more than house fires.

    Good luck and stand out.

  11. #11
    E1114
    Firehouse.com Guest

    Post

    Unbelievable! In todays fire service we are constantly having to justify our existence. I am a captain in a department of 11 paid personnel. We do it all, firefighting, extrication, haz mat, EMS, cats in a tree etc. I can't imagine a Chief of a department choosing not to do extrication. I sympathize with your situation. I couldn't imagine spending the time to extricate a pt. and then being responsible for their well being especially if there is more than one pt. I would consider billing for the extrication possibly to help increase your staffing and keep the public aware of the situation. Hang in there.

  12. #12
    iwood51
    Firehouse.com Guest

    Post

    I've been following this thread in utter amazement, I'm probably among many others that are just flabbergasted that a Fire Department doesn't want the responsibility of auto-extrication. You guys have enough on your plates with the medical end. You mentioned that you have a good rapport with the PD, perhaps you can get the PBA on your band wagon as they do a lot of work with the public through their charity work. The problem with the media is age-old, they never want to publish the good news, it just doesn't sell, the public is inherently consumed for the desire of other people's mis-fortunes. As far as the FD end, is it just an issue with the Fire Chief? Do you guys get along with the firefighter's? Is he elected by the public, appointed by the Mayor? There has to be some way to influence the decision to re-appoint or keep him there. Everybody answers to somebody, and when you get high enough, they answer to everybody, that's why it's called democracy.

  13. #13
    T.D / 1122
    Firehouse.com Guest

    Angry

    Well I didn't read all the replies, but sounds to me that the Mayor has a serious attitude problem not to mention the level of incompitence for the fire/ems field!! Common sense tells us that if there are EMS, and Fire both available then the fire dept. does the rescue while the medics care for the patients!!... what's with this guy anyway??.. what an idiot!!... I bet if his loved one was in a serious accident he'd want the medics tending to her, and the fire department doing rescue!.. Maybe sombody needs to explain it to him from the "Golden Hour" standpoint!
    Time is critical when dealing with rescue! My suggestion is educate the public about the situation.. that's who the ultimate boss is anyway!!
    As a Firefighter/Emt-I one thing I learned real quick is that to be 100% effective in rescue you must do one or the other! Operating the Hurst tools then providing medical attention is totally insane!.. If the Fire Chief was half the Officer he's supposed to be then he would fight the issue in your favor. I have no patience for total ignorance!.. sounds to me like both Chief and the Mayor both need to be bagging groceries cause neither one is doing worth a crap at they're current jobs!

    just my opinion..

  14. #14
    FSRIZZIO
    Firehouse.com Guest

    Post

    Amazing story...The mayor and the Fire Chief have some explaining to do, and the Hospital Administration should know when to get out of something that will set them up for a major law suit. How did you get this equipment in the first place? Why did the Administration spend so much on turnouts, gear, etc. then not train you guys properly to use it? And why are you still using it in a manner that undermines any patient care standards and goes beyond your scope of training? Your paramedic licenses are on the line with this situation as well as the Hospitals' accreditation. A good lawyer can find you personally negligent if you keep operating in this manner knowing that you are putting the patient at risk. Your hospital is probably run by a board or management outfit that needs to be made aware of this immediately.
    Don't give up, the changes needed are pretty obvious and can be made rather quickly when the right people find out about it.
    Be Safe, Frank

  15. #15
    RES6TRK
    Firehouse.com Guest

    Angry

    Any fire chief who fails to realize that the fire service is a diversified field and we do more than firefighting is living with his head buried in the sand and is doomed to fail.I work for a metro fire department that performs fire / ems / and rescue with extrication equipped ladder trucks, and an advanced technical rescue team. also part-time with an EMS/rescue department. If we respond to a mvc we let the rescue squad personnel perform the rescue and the EMS personnel perform patient care.one operation or the other.you can't perform both functions at the same time, someone suffers: the patient the providers etc.In order to provide the rescue skills needed to work efficently you need to increase your staffing, training and add a rescue squad to perform this function.maybe you need to do an article in the local paper / tv station in what is required to perform this function.If you need S.O.G.'s on operations for rescue squads, training etc. e-mail me and I will see what we can get for you. Also check out Maryland in the firehouse links for rescue squads, ie. Community Rescue Service, Bethesda Chevy-Chase Rescue Squad, Wheaton Rescue Squad etc. Good Luck!

  16. #16
    FGFD43
    Firehouse.com Guest

    Post

    One idea I haven't seen yet, if there is enough personnel in your service or in the firefighting community, or both, is the establishment of a volunteer rescue squad or service. I am not a member, but there is one in our area that helps my fire station on wreck calls and assists EMS on sick or transport calls as well. However, this option may not recieve much support from the other organizations in your area. Just a thought.

    ------------------
    Kevin Sink
    Fair Grove Fire Dept.
    Thomasville, NC USA
    kevinsink@northstate.net

  17. #17
    emsbrando
    Firehouse.com Guest

    Smile

    I had to look up your profile because I thought you were from a small town in Mississippi that I once worked in. the fire Chief did not want to have anything to do with extrication, except send a pumper in case of fire. we had to take on the task of extrication even with a 2 man crew.
    You say you are down to one unit at night, so that means you nave more during the day. I would contact your Administrator and see if you could do what I did back then.

    Put a crew on call (yes this cost a little money) and once we had a known incident where we were going to our tools, we called the second unit out. The first unit gained access and used the tools, where one crew member would stay with the patient and the other destroyed the vechile (:-))))), and the second in crew took over patient care and transported when they got there.

    It wasn't the greatest plan in the world, and was really a challenge when there was more than one victim, but that's what we did. And us doing this did cast the publics eyeon the fire depratment, but like your mayor, ours wanted to save money too, and we just kept on going.

    I've been gone from there over 15 years now, and I don't know if it has changed, but I hope so.

    Just my 0.02

    Ed Brando

  18. #18
    Marshal BHG 300
    Firehouse.com Guest

    Angry

    Wow! I, like everyone else, am stunned at what I am reading, but I think I can offer a few things. The good news is that if the chief is only willing to fight fires he is putting his department out of business. Almost every other fire department in the country has figured out that about 80 percent of the calls in their district are EMS. If your city is small enough to only need one ambulance crew at night it shouldn't take long for this to happen unless the FD is all volunteer except for the chief, which would explain a little more about his position.

    I very much agree with DD's response that you have to woo the media. Submit good things, have media mixers, invite to open houses. Thank them with a letter to the editor if they write something positve. Even if they are nasty you have to use the old rule that two wrongs don't make a right. You can't be nasty back. Maybe you need to make these suggestions to your hospital PIO.

    FRSIZZIO is also correct, this is a lawsuit waiting to happen.

    Question: What does the FD do when they get there first? Do they stand there and look at the patient and say "the ambulance will be here soon, just stand by"? If so why even have them come on MVA's? If your area is like ours the ambulance is on scene first only about 1% of the time. Not good for the patient.

    Now politically! I would have the director of the ambulance service send a letter to the mayor and the fire chief stating what you stated in your original posting and that you are now forced to bill for extrication. Also that you will be posting a press release in the paper informing the public that you now must charge for these services. Don't completely tell the public the whole story yet. In other words don't yet blame the chief and the mayor. Keep that one in the bag.

    Now clearly plan a presentation in front of the city council. Again use your points above. Try to get data on as many other FD's as possible and whether or not they do extrication. Explain the liability to the paramedic and the hospital operating outside of their scope. This is definately the scope of a FD not an ambulance service. Explain the fees you will be forced to charge their constituants. Sum it up with the benefit to the patient to have more than two people helping them. Be possitve not argumentative. The city council is a public forum (to your benefit). Then if you are forced to bill people for extrication you can inform them of the situation when they call you screaming or you can simply put a very nice letter in with your billing explaining that due to the FD's unwillingness to provide this public service you are forced to tax them twice.

    If all else fails. I haven't seen one response here that states that the chief is right on, so as a last resort I would send all of these responses to him so he can have a magnified vission of just how pompus and stupid he is acting.

    Hope this helps. Let us all know what avenues you take and what works and what doesn't. Good Luck!!!

    [This message has been edited by Marshal BHG 300 (edited September 11, 1999).]

  19. #19
    jedge168
    Firehouse.com Guest

    Post

    Well, I'm glad to see that my hospital based service isn't the only one with the extrication problem. But ours is the management won't give it up. We run a heavy rescue unit as well as 3 paramedic level quick response vehicles that are extrication capable. As paramedics we've tried talking them into passing this over to the fire departments that don't already do extrication, give them our equipment, let us train them, etc., but they won't hear of it. Good luck to you.

  20. #20
    Sledgehammer57
    Firehouse.com Guest

    Post

    The first question I have is Has everyone involved in the situation sat down together to discuss the problem together ? If you are trying to talk to one group / person at a time it is divide and conquer. Put all parties at the same table and give each a time to state their position without threats and you might be amazed at the outcome. Of course the outcome might be unchanged and that is when you go public. Get on the agenda for the governing body public meeting. Make sure you have your facts and STUFF together. Rest assured the media will be there and if the situation is as bad as it seems THEY WILL SMELL BLOOD and the story will be all over the news. Above all be ready with the facts and ONLY the facts. No opinions, no name calling, no threats. Give the people the facts and if you are in the right you will have more support than you can imagine.
    You really need to determine your liability and just what is required by law and even more important by OSHA. If you can't meet these requirements - it's time to bail out. Inform the public of the short comings and what the results of a lawsuit could mean to the hospital as well as the city.
    The biggest problem the emergency services has ever had is that we want to be non-political but the reality we must face is that we live in a political world and we must learn to use politics for our benifit.
    Enough of my ramblings. Hope something I suggested helps. GOOD LUCK!!!

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