Thread: Fire-based EMS?

  1. #26
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    We are in a position where our department provides ALS service but does not transport (when AMR gives us a BLS car the medic hitches a ride the gets picked up at the hosp.) This works out prety well because we make sure the private ambulance treats our citizens how they should. (FD is, by law, in charge until transfer is made)
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  2. #27
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    Alot of what you guys are saying makes sense, I don't doubt that it works well, just pointing out what I thought was a drawback. Like I said my exposure to such systems is somewhat limited.

    I still don't see how you can say you don't lack for training with such a system. You may be getting what you feel is enough, but are you getting as much as possible?


    Take a department with 50 FF/paramedics. The departmnet has a certain budget for training, and lets say it allows for 100 hours per employee per year. Each one will get 50 hours of medical and 50 hours of firefighting.

    Now if you seprate them and have 25 medics and 25 firefighters (or whatever split coems to mind), your firefighters can have 100 hours of firefighting training a year and your medics can have 100 hours of medical training a year.

    Now in what system are you better preparing them to do the job at hand? Even if your department budgets for unlimited training as much as the person wishes to take, you still have to split the time available in that persons schedule for such training.


    Not saying it is a bad way to do things, just that I cannot see how requiring someone to do two jobs instead of one can make them better prepared for either. It may make it easier on the leadership to have more people to fill either role, and be a little cheaper for the department, but is cheaper and easier better?

  3. #28
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    Default hello its 2003

    I am a member of a department that has provided ALS service for THIRTY years now. Fire based EMS is hardly a new concept.

  4. #29
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    MIKEY, YOU ARE RIGHT. EMS IN FIRE IS NOT A NEW CONCEPT. BUT FOR A LOT OF FIRE DEPT.'S IT IS. AND I THINK THE DISCUSSION HERE IS NOT THAT IT IS SOMETHING NEW THAT IS EITHER LIKED OR DISLIKED, BUT WHAT PEOPLES OPINIONS ARE ABOUT THE SUBJECT, AND WHERE OTHER FIRE DEPT.'S STAND ON THE ISSUE IF EMS AND FIRE COINCIDE WITH EACH OTHER OR IF THEY ARE SEPERATED BY INTERNAL BELIEFS. BUT YOU ARE CORRECT, I DO AGREE.

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    RadioGuy,Again I agree with part of what you say but another area that comes into play is experience, now granted you could have a FF/Paramedic show up who has a 100 hours of training a year but has only been playing the game two years as compared to someone who has 50 hours of training a year but has 20 years experience under his belt, I'm still fairly new and have seen alot of things but truth be told I haven't seen everything, that's where my knowledge ends and others Experience takes over...Stay Safe!
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  6. #31
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    OneL1L, I stand corrected, or sit as it may be, I was under the impression that there were some difficulties. THank you for the correction.

    As I have stated in numerous posts before, a blanket statement that it works everywhere is absurdity. There are different mentalities everywhere. I remember a few years ago in Boston damned near fisticuffs breaking out on calls becuase of the problems between BFD and BEMS. In Worcester, the EMS is provided by a hospital based-like system and the fire chief and union are trying to get the dept. an ambulance but many of, if not most, of the union membership want little to do with EMS. My interaction with WFD showed a large dislike for EMS. As with anything, you get exceptions and some good companies and, in my experience, many bad.

    Also a few years ago, WFD's union, refused to put a defibrillator on the engine companies because they were not paid a stipend for them. These are the same guys who they want to put in an ambulance? Are there great exmples of fire based EMS? Yes, but it does not work everywhere.

    Remembering that we are there to provide the best to our citizens, just because it saves money is not the right reason to do it. If the level of patient care is not outstanding, then you should not be doing it. It is not in the best interest of the patient or the citizens.
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  7. #32
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    Talking fire ems

    I thank God for the Fire departments that also have EMS, my mother is a copd pt. and lives on Mowbury Mnt. in Chattanooga and I thank God for the EMS,of the fire trcuk. If it had not been for them my nother would be dead today. They repsonded very quickly and took care of the crisis at needed. The fog on the mountain in the fall and winter time is very bad.
    Hey if anyone out there is from Soddy Daisey, I just want to say thank you. She has had to have you all more than once. Just wanted to let you know I apperciate your great response, and the job you do daily.
    Sharon

  8. #33
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    radioguy, I respect your opinion, but I have to continue to disagree.

    I still don't see how you can say you don't lack for training with such a system. You may be getting what you feel is enough, but are you getting as much as possible?
    I don't lack for training. I get at least six hours of EMS training per month by way of formal drills. Add to that the smaller in house training, and the number of calls I run and I am sure it equals more than a great deal of the EMS only providers receive, especially private ambo companies. You see they are profit driven, and you don't make money by holding a training session.



    Take a department with 50 FF/paramedics. The departmnet has a certain budget for training, and lets say it allows for 100 hours per employee per year. Each one will get 50 hours of medical and 50 hours of firefighting.

    Around here, the EMS system provides training to its providers. All the departments have to do is provide a place to hold the drill. The system even provides the instructor more often than not. When they don't, a member of the department who has been authorized by the system does the teaching. It costs the department almost nothing to train us.

    I am held to a very high standard. We must test every six months to remain in good standing. Far more frequently than the law requires for recertification.

    If you extend your logic further, we should have trauma medics, cardiac medics, respiratory medics, etc.

    The key is to monitor and evaluate performance. If a person cannot perform to the standard of care required they should be sent packing.

    Around here fire based EMS is the standard. Ask somebody from AMR what happened when they tried to come to the Chicago area and "revolutionize" our way of delivering EMS. They didn't last long. Apparently it wasn't profitable. So you tell me, who is trying to provide pt. care on the cheap?
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  9. #34
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    Do any of you have Chiefs that are paramedics?

    In my dept., all 3 Fire Chiefs are paramedics, and have been for over 20 years. Needless to say, we just kicked out the private EMS provider and started our own transport EMS service this year.

    Is it better for the taxpayers, I think so.

    Has it destroyed morale in the FD, absolutely.

    Do we hire anyone that has a medic cert and their own car, yes.

    We haven't hired an EMT in 6 years, and the FF/EMT is being phased out slowly.

    The last FD I worked at had their own ambulance in 1929. It is very hard to find a BLS or non-EMS providing FD anymore. I suppose that's a good thing, if you are a medic.

    BTW...we do EMS training on the internet, and don't do any fire training anymore. We're too busy with inspections, hydrants, hose testing...etc. But hey, no one's been hurt yet, besides numerous back injuries from EMS calls.
    Last edited by FHandz15; 09-14-2003 at 08:55 AM.

  10. #35
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    The town of Derry, where I did my paramedic ride time, has a batallion chief who began as a firefighter, got his paramedic, worked his way up the ladder, and with 26 years in the department, maintains his paramedic certification. THAT department is one that truly defines fire-based EMS, and there is no sacrifice of fire or EMS training for the other. Roughly half of their fulltime department (70 strong) are paramedics, and they are among the best out there. Every member is also a very strong firefighter.
    ~Kevin
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  11. #36
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    I still like the way my department has it set up. The EMS division is an entity all in and of itself, although it's still a division of the Fire Department. They have their own Officers and almost all the medics are EMT-A or Paramedics. They're damn good at what they do and they don't want to do firefighting.

    The Firefighting Division does everything else and we don't want to do medical. It works fine for us and there's no fighting between the Firefighting Division and the EMS Division as to whose job is what.

    The only real problem we ever ran into was who's in charge of the Firehouse and that problem was solved. The Senior Fire Officer is in charge of the quarters but not the EMT's themselves, they have their own officers for that.

    We both work together well at scenes when both are needed and thats what counts. Again, EMS does their job (all medical) and we do ours.

  12. #37
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    Smile Again, Good Points.......

    Couple of things I missed earlier. Kevin's example of a good operation, Derry NH, shows how things should be when everyone knows up front what life there will be like, WHEN THEY COME ON BOARD. Lt. details his view of his dept. and shows a strong system that works. One sticking point that I have seen over the years concerns station duties, as in :"I'm a medic and medics don't take out the trash". Clear direction from the top will put an end to these type problems. Stay Safe....
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  13. #38
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    Angry

    i think that today EMS is just associated with the fire dept. neither one is better than the other one. its kind of like a brotherhood.

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