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  1. #1
    Lt Overmyer
    Firehouse.com Guest

    Red face Paramedics! What do they ride on your department?

    Hello Everyone,
    We are having growing pains in our department. I came on 13 yrs ago, and there was only 50 paid members, and 4 stations, with 1 ambulance. Now we are over 130 men, 5 stations, 3 ambulances, and getting ready to build a 6th station house. We just started a paramedic program. All the firefighters are Emergency Medical Technicians. My question for you is, What do your paramedics ride out on? Ambulance? or Engine? or Heavy rescue? Thanks for your response ahead of time. Stay Safe!

    Brett


  2. #2
    benson911
    Firehouse.com Guest

    Post

    Lt -

    My department is now to the point where every unit has at least one medic on it. We only have 2 stations, 8 men and 1 Medic Ambulance on duty each day (14 man shift, if 10 are working we staff a second Medic Ambulance.)

    ALS (paramedic) level of service began in 1989 after they had a test where only paramedics could take the exam. At that time the "rescue," a 1978 Ford Type III ambulance was staffed by a paramedic and a Lt.

    By the time 1993 came around, we tried to keep at least one Medic per unit - 2 Engines and 1 Ladder combo'd with the Medic Truck.

    It sounds like you have more units, and more manpower than my department. Are you going to train the whole department to EMT-P? If you train in stages and require new hires to be paramedics then you should start to provide ALS service on at least one truck per shift and progress until all your first arriving units had at least one medic on board. A tiered response with a BLS unit arriving first followed by the ALS unit will work in the beginning, but the ALS unit will be responding to everything and it will become old quickly.

    Phoenix has succesfully created ALS engines with paramedics. The sooner you can arrive with defibrillation, advanced airway and drugs the better chance a patient has of surviving. That alone should justify the ALS level of first arriving units.

    Good luck - it sounds like you want to go to the next level. I hope your department embraces this change as good for the citizens and not a punishment of extra work for the men.

  3. #3
    Res4cue
    Firehouse.com Guest

    Cool

    Well, Lt. Overmyer, my dept. contracts Wishard Paramedics, with a change to the combination Dept, we may have our own Paramedics, who knows. Keep up the good work with Carmel, which is a great department!

  4. #4
    Romania
    Firehouse.com Guest

    Post

    Lt.,

    Our department runs paramedic engine companies (EP units). This works well for us. Ladders out here do the heavy rescue work, because of that most ladders are BLS because they have enough duties at MVAs, fires, etc. Some departments have all their units ALS, this reduces the number of calls the engine gets and spreads them out evenly. I don't like the idea of ONLY having medics on the ambulances. Typically there aren't as many as there are engines, and response times of ALS on scene can really suffer.

    I work in the Phoenix, AZ automatic aid system. THis system works great, a total of over 100 ALS engine or Ladder/LT companies fuction like this with both ALS and BLS transportation (depending on where in the system). Typically each ALS unit has two medics and two EMTs. All BLS units have AEDs (except BLS transport units). Phoenix Fire (Big Red) has a little more than half of their Engine Companies as EP units and the remanider as BLS engines. Some of the other local agencies have all of their aparatus ALS. Average 1st unit onscene time for the entire system was 4:20 last year.

    ------------------
    Alan Romania, CEP
    romania@uswest.net
    IAFF Local 3449

    My Opinions do not reflect the opnions of the IAFF or Local 3449.




    [This message has been edited by Romania (edited October 26, 1999).]

  5. #5
    Boothby
    Firehouse.com Guest

    Post

    LT.
    Out here medics ride ambulances, trucks, pumpers, rescues, and snorkels. The way it works is that the city has 48 engine houses. Of those there are 26 houses with emergency units(ALS ambulances). Each paramedic is assigned to a company ie pumper,truck etc. The medic is then detailed to the unit on a rotating basis. The same goes for the EMT privates. Drivers and officers don't get detailed unless they are riding out of rank (driver riding lieutenant, or lieutenant riding BC). The companies with medics assigned are designated ALS companies and carry ALS equiptment and have a lock box for narcotics. The remainder of the companies are BLS companies and carry BLS level equiptment. All companies make first responder calls based on the type of call or the responce time of the unit. Minimum staffing is 4 personel per apparatus 2 for the unit.

    For example at the Mighty 14's were I work we have Engine 14, Truck 3, Unit 3, and Batt 3. I ride truck 3 and we have three medics assigned. The rotation works that during one three day set I ride the truck, the next set I ride the unit, and the third set I am detailed out of the house as needed. The other two medics are on the same rotation. Because unit 3 makes between 12-20 calls a shift the medic on the unit and the medic on the truck will usually swap places after 12 hours. Our Lieutenant allows us to do this so we don't get beat down to bad. Truck 3 makes most of the first responder calls, but if the truck is out then Engine 14 makes the first responder call as a BLS company. The system works fairly well although Memphis has only been doing this for the last 4 yrs. We still have problems primarily with some of the older firefighters and paramedics. My LT loves having medics on the company. If we make a fire and he and I drag out a victim I can immediatly start ALS care. The biggest problem is if we pull out multiple victims then the medic is like a one legged man in a butt kicking contest (been there done that two codes at one time). The system works well but here in a year they will have about 120 lieutenant spots come open and alot of firemedics are going to get promoted. Nobody is sure what the department is going to do then.

  6. #6
    Romania
    Firehouse.com Guest

    Post

    Nothing like having medic officers :-). My Captian just took his National Registy test this weekend. Medic Officers tend to understand us medics better. There are some BLS officers out there like you LT that love medics, but not enough.

    Medics tend to understand medical liability better also.

    ------------------
    Alan Romania, CEP
    romania@uswest.net
    IAFF Local 3449

    My Opinions do not reflect the opnions of the IAFF or Local 3449.


    [This message has been edited by Romania (edited October 26, 1999).]

    [This message has been edited by Romania (edited October 26, 1999).]

  7. #7
    benson911
    Firehouse.com Guest

    Post

    Our Lt's are all now medics. We've already had the Lt turnover and all our old Lt/EMT's were promoted or retired. The Fire Marshall and Deputy Chief are medics but on day shift and off the line. Only the line Captains (Shift Commanders) aren't medics yet.

    It makes a HUGE difference when a Lt/Medic is acting as Captain. The guys on the medic truck don't get beat as much because the Lt knows how it is to run 10-20 calls a day on the "meat wagon." The Captain determines what units respond to calls and some Captains send the Medic truck to everything that's not on fire. Plus the medic truck is combo'd with the Ladder, so on fires they bring the Ladder truck.

    If you're assigned to the medic that day, you're going to respond to every call except a single engine response. IT SUCKS! But I wouldn't have a job if I wasn't a Medic, so God Bless EMS.

  8. #8
    Ledbelly
    Firehouse.com Guest

    Post

    Our department started providing EMS in 76; when I hired on in 85 everyone was required to be an EMT-B (or attain it within year of hire). Now, I would guess that nearly 65-70% of Department are medics. (Medics receive nearly 2 1/2 times the incentive pay that EMT-Bs do) We run 5 1st line ambulances and they are staffed with medics (per SOP); so a lot of FFs are medics but not on a box. So far, engines are only BLS equipped but on "most" calls they respond w/box so we have lots of extra hands/assistance when needed. It also allows the ambulance stations to rotate people on the box ...giving everyone a "break".

  9. #9
    Romania
    Firehouse.com Guest

    Post

    It is an unwriten requirment that the Commander and Executive Officer of my Rescue Squad are both CEPs (Certified Emergency Paramedics).

    ------------------
    Alan Romania, CEP
    romania@uswest.net
    IAFF Local 3449

    My Opinions do not reflect the opnions of the IAFF or Local 3449.



  10. #10
    DED1645
    Firehouse.com Guest

    Cool

    Well Leiut,
    In Southern Jersey the medics in Camden and Burlington Co. are employees of a local hospital. They primarily operate out of Ford Explorers and now are going to the larger Expeditions.In their present form, they still need a BLS squads to transport in these counties. Gloucster and Salem Co. are run by another local hospital. And they operate out of Crown Vic's and now going w/ Explorers. These units in all four counties run out of the hospitals as a base or have come to contracts w/ municipal fire dept's to house the units when not in service.(or down time) These medic units do bill for their services. ALS is not a volly operation. And a rumor(and only a rumor)is that the medics in Camden and Burlington Co. are going to be purchasing rigs for transport. They will also dispatch a BLS unit for assistance since certain ALS treatable calls would be difficult for a medic to handle by his/her self. If ALS is not required then it will be turfed to the BLS unit. The BLS units arrives most of the time before ALS and use their discetion to have ALS proceed or recall.

    ------------------
    David DeCant
    firefighter/NREMT-B
    Originally Mantua,NJ
    Presently Lindenwold,NJ



  11. #11
    rocketboy192
    Firehouse.com Guest

    Angry

    Our department has three ALS units. In our Parish, the protocol requires a paramedic and the driver to AT LEAST be an EMT. Our department "officially" rotates paramedics from engine to ambulance and back again but "unofficially" that does not occur. We have so few paramedics that on your "fire" day, you are usually sent to fill in where a paramedic is on vacation, out sick, etc. Fortunately, I am a driver/engineer and only an EMT so it doesn't really affect me. The medics, on the other hand, are continually run into the ground day and night to a point that many are considering lapsing their licensure just to get a break. Couple that with the fact that our shift commander refuses to let anyone nap during the day because "we are here to put in a hard days' work". The only problem is our day doesn't end at 5PM when administration leaves - we are here until 7AM and we are expected to preform drug calculations and follow ALS protocols at 3AM as if it were 3PM. We'd be fine if we were rested but we were too busy testing hydrants, mowing the yard, inspecting, performing public fire education, etc. to entertain the admin.

  12. #12
    Capt Lee
    Firehouse.com Guest

    Post

    All our Engines (5),Ladder (1) and Rescues (2) which is a non transport type ambulance, that are front line are ALS with a Paramedic. We run first due with EMD doing priority dispatching. As of yet we don't transport and so have to rely on a private ambulance company. We never know what they are going to send (als/ bls) and it's a toss on the eta. So having a medic on each rig works out all around. If we can't turn the patient care over to the ambulance crew and need be the Fire medic rides in with the patient to the hospital and the rescue will get them unless they were off the engine. At last count we were looking at hitting 6000+ calls this year with 75% EMS.

  13. #13
    Brian Pratt
    Firehouse.com Guest

    Post

    Lt.
    Our Paramedic program is in it's first year and we aren't sure where they will ride yet. But I assume they will ride our rescue truck at first and then maybe on the engine co.'s. We are not looking to enter the transportation business. We have a private ambulance co. for that. All we want to do is increase our level of care.

    *This is my oppinion and not the EFD's.

    [This message has been edited by Brian Pratt (edited December 28, 1999).]

  14. #14
    afd767
    Firehouse.com Guest

    Cool

    We currently have 15 paramedics out of 130. My dept. consists of 7 stations. We have 5 engines, 3 aerials, 2 heavy rescues, 3 als ambulances, and other specility vehicles. On A-shift we currently staff 1 paramedic on Medic1, Medic3, and Rescue1. With 2 paramedics on Medic2. On B-shift we staff 1 paramedic on Medic1, Medic2, Medic3, and Engine8. On C-shift 1 paramedic on Medic1, Medic2, Medic3, and Rescue1. Our dept is currently looking into a squad system. That would put 2 paramedics per shift in a blazer with the other paramedics on rescues. The ambulance would be bls with emts.
    ---------------

    Jason Quimby, NREMT-P
    Anderson Fire Dept.
    Anderson, Indiana

  15. #15
    pompanofd
    Firehouse.com Guest

    Post

    ALL UNITS ARE ALS, OUR ENGINES ARE CUSTOM EMERGENCY ONE HUSH RESCUE PUMPERS , ALL RESCUES HAVE FREIGHTLINER CABS WITH MEDIC MASTER BOXES , YOU CAN STAND INSIDE OF BOX...

  16. #16
    mtfd38
    Firehouse.com Guest

    Post

    WE HAVE 2 STATIONS 21 FULLTIME ALL BUT 5 ARE MEDICS SO AT MARION TOWNSHIP THE MEDICS RIDE ENGINES AND SQUADS, AND RESCUE AND TANKERS, AND GRASS TRUCKS. BASICALLY THE LT. MAKES THE RIDE ASSIGNMENTS IN THE MORNING AT MUSTER, USUALLY LETTING THE SENIOR MEDIC CHOOSE WHERE HE WANTS TO RIDE SO LONG AS THERE IS A MEDIC ON THE SQUAD.

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