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  1. #1
    Chief 50
    Firehouse.com Guest

    Question Who's in Charge ?

    I am curious to find out how our situation is handled in other jurisdictions.

    We are an independent Volunteer ambulance service. We respond to calls in five Volunteer fire districts. Covering about 10,000 people. We run EMS, Paramedic level. FD's provide extrication and suppression. We try to use the incident command system for good coordination of an operation. Because we run 1200 calls per year, we almost always have crews on duty in station. The FD's run an avg. of 150 calls a year (Mostly EMS assists) so they come in from home. Naturally, our units are almost always on scene first. ICS says the first arriving unit will establish command. The new Maryland Triage Plan states the same. The FD's are saying EMS is not to assume command, or to make any decisions. They are saying the FD is always in command and EMS has no authority to make decisions and should never establish command. It is possible to have an untrained FF in command as opposed to a Chief Officer of the EMS unit. If EMS wants something they are to go through command. Here are my questions.

    1) Who's in charge at an auto accident ?
    2) Does your unit assume command if first on
    scene ?
    3) What happens if there is a delay in FD
    response, is there no command ?
    4) Do you think this is an ego issue, a
    power struggle ?
    5) Suggestions ?

    Now I'll give you my opinion. For what its worth...........

    1) If qualified to do so, the first arriving unit establishes command, no matter if its EMS or Fire, and makes the necessary decisions. (Example: An ambulance crew with no fire training would never assume command of a house fire)
    2) As other units arrive, there is an orderly transfer of information i.e:Command to a higher ranking, or higher trained officer (i.e: Best qualified to handle command)
    3) The ALS provider is responsible for all patient care decisions.
    4) The "EMS Sector" Officer is filled by the ranking EMS Officer on scene. The "EMS Sector" then appoints the staff under he/she. i.e: triage, transport, treatment, etc.
    5) The "Extrication Sector" Officer is filled by the ranking Officer arriving on the first extrication unit.
    6) The "Suppression Sector" Officer is filled by the ranking Engine Company Officerof the first arriving Engine.
    7) Expand the operation as needed, or just get the job done in a efficient, professional manner.
    8) Eliminate Rocket Science as a requirement for ICS !

    Feedback is greatly appreciated.




  2. #2
    Ledbelly
    Firehouse.com Guest

    Thumbs up

    Chief- I'm not volly but couldn't agree with you more. Ditto all 8 of your points. To me your points are the rational, sane answer/application of the ICS. As to question 4, it sure sounds like one (ego-power struggle) from here. I wish I had a/some suggestions for you... it's too bad a "sitdown" with the FD couldn't hash out these needless, pointless "power struggles" on their part.

    Good luck to ya and watch yer topknot, Capn Lee

  3. #3
    BFD22
    Firehouse.com Guest

    Post

    Here in Transylvania County N.C. the medic
    units are county run and never assume command.The fire dept. always is command on auto wrecks.The rescue squad is rescue ops and the medic units do patient care.The reason is with only 2 paramedics on the medic unit if they did IC who is left to do patient care their main priority.They only check on scene and will give a size up to the responding f.d. All traffic to communications is through the IC.
    All the fire departments and rescue squads are volunteer.My dept Brevard reponds to 650
    calls a year and we only do medical when
    everyone else is tied up (about 20 year).



    [This message has been edited by BFD22 (edited April 01, 2000).]

  4. #4
    benson911
    Firehouse.com Guest

    Cool

    1) Who's in charge at an auto accident ?

    We are the FD and EMS, so we're in charge of the scene and the patient. In your case, the FD is in charge of the scene and the extrication, but not patient care.

    2) Does your unit assume command if first on
    scene ?

    N/A

    3) What happens if there is a delay in FD
    response, is there no command ?

    N/A

    4) Do you think this is an ego issue, a
    power struggle ?

    Power struggle.

    5) Suggestions ?

    ICS is not meant to assign "power." ICS exists for the safety of all personnel operating at an incident. If the EMS unit is first on scene they must establish a command system, for their own safety. When the FD unit arrives, they must report to the EMS unit and get a report before assuming command. This transfer can be as simple as a wave from the EMS crew if the FD can clear, a quick radio message of the number of patients and vehicles involved, or a full blown report on the incident.

    To avoid the "power" struggle, I suggest the EMS crew not call command on the radio. A single EMS unit response only requires the unit to call out on the scene to establish command. Since the FD is a separate agency, the EMS command structure is separate until the FD arrives and then the EMS crew is the EMS branch of the overall ICS. For example, the PD doesn't "report" to the IC, but they do fit into the ICS. If needed, The IC coordinates their efforts to support the Tactical and Strategic objectives the IC wants completed.

    Let the FD have their "power." It keeps their egos happy and minimizes your headaches. Just make sure they understand the patient's care is YOUR responsibility and their efforts in extrication are to support the patient's care. When the FD arrives, their senior officer/FF is in charge - that's federal law. That does not mean they can usurp your authority as far as patient care goes, it only means they have the RESPONSIBILITY to provide safety and control to the emergency scene and the emergency workers, ALL the workers.

    Let the FD know you want them to command the scene - they're already responsible if they were asked to respond. Just make sure they know you have the ultimate obligation to the patient and the FD has the ultimate obligation to you, to help.

  5. #5
    Adze
    Firehouse.com Guest

    Cool

    1) Who's in charge at an auto accident ?

    Technically, the FD. However, if we do not have medics on the scene, we let EMS run the show. We are a team which is there to do a job. Only through cooperation can this be done efficiently.

    2) Does your unit assume command if first on
    scene ?

    If no officer is on the scene, the first apparatus assumes command until an officer shows up (either in the apparatus or in a personal vehicle).

    3) What happens if there is a delay in FD
    response, is there no command ?

    EMS runs command until arrival of FD

    4) Do you think this is an ego issue, a
    power struggle ?

    No. FD is being in charge is actually written down somewhere. Where? I don't know. Not within my FD's constitution.

    5) Suggestions ?

    Learn to cooperate. If you are running EMS, and the FD has no knowledge in the area, then you should talk to the chief beforehand to establish a guide that you are the experts and they are there to help you, not vice versa. I mean, if your ambulance did standby at a structure fire, would you be telling the FD what to do? No, because they are the experts and you are there to help them.

    I am not explaining this as good as I would like to, but basically, if you are on the scene of an accident and the FD has no medics, the officer in charge of the FD should be going to the EMS unit and basically saying "What do you want from us? How can we help you?"


  6. #6
    FSRIZZIO
    Firehouse.com Guest

    Post

    Benson, can you site the Federal Law giving ultimate responsibility to the FD? I've heard of this law, where is it? anyone?
    Be Safe, Frank

  7. #7
    Dalmatian90
    Firehouse.com Guest

    Post

    Adze, in Connecticut Fire Departments have absolute incident command via State Statute. Fire ranks above Police.

    Yes, it's a power play by the fire companies and your ambulance corps...but does an ambulance really need to establish incident command? You want to have formal authority to establish command, and they don't want that encroached on.

    Yes, size up the situation. Report to the responding fire deparment what you find on arrival. Radio ahead hazards, etc. Even make a request "It looks like we need a Hurst tool on the red car, and the blue car is leaking gas so a line should go there."

    Does a formal "Incident Command" need to be established prior to the arrival of Fire? What for? Do you have a fleet of ambulances and ambulance members arriving ahead of the Fire Department? It seems to me a single ambulance crew will be awful busy sizing up the scene for hazards, triaging the patients, and beginning care. The F.D. will normally have more personnel and a broader responsibilty for the safety and operations of the scene.

    Work out with the FDs that you expect their initial arriving members to report to the ambulance crew and receive a briefing on the situation and status. You know -- just like your passing command If the FDs have a problem with you "calling command," then don't -- just do it and don't tell them what you call it.

    Our neighboring town is almost identical to your situation -- 18,000 pop, 6 Fire Departments, 1 Ambulance Corp which is staffed 16+ hrs/day. I've never heard them establish command...but I have heard them give a size-up and request additional resources before the arrival of FD.

  8. #8
    Adze
    Firehouse.com Guest

    Post

    Dalmation: We are always command. Bottom Line. However, in certain situations we just assist the EMS and let them make decisions regarding the patients. As far as actual command of the scene, I don't recall the ambulance ever being in charge. Perhaps I wasn't clear in my earlier message, or I just explained it wrong.

  9. #9
    benson911
    Firehouse.com Guest

    Question

    FSRIZZIO - As far as the Federal law designating the Fire Chief being in charge, I don't know where it's listed, but I heard it in more than one class. I'll do some research and get back with you.

  10. #10
    benson911
    Firehouse.com Guest

    Question

    I've done a search and sent out some requests for information regarding the Federal Fire Chief In Charge law. None exists. That designation would be made in State law, not Federal. I found Ohio's law and it pertains to HAZMAT specifically. Since HAZMAT's are involved in most fires, one could assume this law covers most FD responses. Ohio's is ORC Section 3737.80.

    Sorry about the Federal law citation - I was assuming my HAZMAT instructors knew the law. According to the IAFC, their is no such Federal Law.

    Never-the-less, I will continue the search into Federal laws pertaining to FD Ops and look for anything there.

  11. #11
    WHVFC4
    Firehouse.com Guest

    Talking

    We have run into the same problem at times.In SC the law states that the senior fire official on scene of any emergency that threatens life or property is in charge.This is not a power play,it is an attempt to prevent confusion.We are in charge of all accidents.We do not on the other hand think we can tell EMS how to do there job.We expect them to coordinate with command so that we may provide the assisstance that they need in an orderly and safe fashion.We generally do not interfere with patient care unless there is a safety issue.Ems may have an EMS command that should cooordinate with the scene command(Fire Chief).If they are not on scene that does not imply that you may not do your job.In SC the Fire Command is legally responcible for the safety of all personell on the scene.That may be the case in your state.A good meeting with all involved parties solved most of our problems as well as training/live drills .Maybe that would help in your situation.Most conflicts arrise from a lack of knowledge as to why actions are taken.

  12. #12
    Capez
    Firehouse.com Guest

    Post

    Here's a funny thing. I come from an integrated system that runs fire & ems, ALS Intermediate if you really wnat to know. I "Switch hit" playing both fire and EMS. So does a large contingent of the EMS division. However the fire Division stomps and cries evry time the EMS division happens to show up first and take command. I feel that this is a common sense issue. If your people can't figure out that the smoke pouring out of a building needs a fire truck then don't take command. In cases of MVC's I think EMS should be in charge beacouse without the patient(s) the whole damn thing is just a police matter. Besides Even if you take command it doesn't mean your stuck with it. If it's uncomfortable transfer it to an FD officer, who by now is ounding on the ambulances windo wanting to know just what the heck you think you are doing with his accident scene. HEHE

    1) First unit on scene takes command. If it's the ambulance so what.
    2) See question 1.
    3) See question 1.
    4) This is definately an EGO thing. (Give em a reality check)
    5) Cattle prod!

    ------------------
    Alex Capezza BS, FO1, EMT-I

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