Role of Fire Departments in EMS

[ABMedic]

An interesting question often is raised regarding the role of Fire Departments in the provision of prehospital emergency medical services. Unlike the USA where a significant changes have occurred over the last 15 years with regard to IAFF direction to incorporate EMS within Fire services. The same can not be said for Canada. Although there are excellent examples of Canadian ALS Fire based providers - they are the exception rather than the rule and are typical based only in the Western regions of the country - specifically within Alberta.

Really can the two countries be even compared? Intrinsic to canada is the concept of universal health care. This medical model in theory perhaps supports the division of ALS from most Fire based systems?

What do you think?

ABMedic

[canuckemt]

hey ABmedic
I think it is good and bad. In some cities like Red Deer it works very well but I find the biggest problem with intergration is that the Paramedics dont want to do fire and the firefighters don't want to do ambulance. In time I think that you will see alot more intergrated services, because it saves the municipality money.

have a good one
canuckemt

[KVFDCAPTAIN21]

Hey Gents...I know our dept runs maybe 1 medical a year...we're 100% vollie with 4 Career Paramedics with EHS Nova Scotia...When or if we get a medical call we usually just assist the paramedics with patient care and removal from residence..only time we get hands on is if ambulance is delayed...and most times this seems to be when our Paramedics are off duty..Thank God

Stephen
Capt/MFR
KVFD Fire/Rescue

[firefighter26]

Originally posted by ABMedic
Really can the two countries be even compared?

From BC, there is certainly no comparison. In my opinion, the EHS system is about as dysfunctional as we can get. Now, I might be wrong, but the best I can tell:

BCAS Paramedic II

BCAS Paramedic I

FD First Responder

Public with First Aid Training

The First Responder Course, while it does give us some training, isn’t, in my opinion, enough (only 32 hours, with 8 additional hours for spinal certification); especially considering that in my corner of BC we can wait upward to 30 minutes for a BLS unit, and that an ALS unit has to come from even further away.

I don’t think that any FD in BC wants to be downloaded onto. And I am especially sure that not many of them want to transport either. BUT, there is no reason why we in the FD can’t at least train up to the same levels. I have always liked the basic modeling of the American System, where firefighters can train to be full Paramedics, but still ride the Engine or Rescue. Combination FF/EMTs or FF/Paramedics. Same training and same equipment would certainly make things more streamlined.

How many times do we bust our asses to get a PT extricated, only to have them sit in the back of the ambulance for 5-10 minutes while they get checked out prior to transportation?? Talk about cutting into the golden hour!! Firefighters can more effectively start EMS care and have a smoother transition with paramedics if we had equal training. It certainly isn’t a good use of time when I work on a patient for 10 minutes, hand over to the paramedics, only to have them do everything that I just spent the last 10 minutes doing.

Times are changing, and I believe that Fire and EMS are only going to get closer, not separated. The bottom line is that we are all in this business together (saving lives), so we should at least all be on the same page when it comes to training and certification. Break down the barriers and not only will the Fire and EMS service become more efficient, and but the public will benefit.

[KVFDCAPTAIN21]

Our System Is Ok Here In NS....Kinda Like Most Others

Start Off:
First Aider
MFR
P1 or Primary Care Paramedic
P2 or Intermediate Care Paramedic
P3 or Advanced Care Paramedic..

Pretty Easy To Follow

[resqtek]

I also think the two services will start to work closer. Finally, the larger cities are starting to consider having the NFPA 1001 as a pre-requisite for hiring. Alot of the people coming out of this program are coming out with their EMT-A certification. I see it, in Calgary, that the working relationship between fire and ems is getting better as more firefighters today have a higher level of medical training which helps garner a mutual understanding and respect for one another.

[firefighter26]

I am not saying that the chain of EMS in BC doesn't work, because I have seen it work very well at calls, but I have also been on calls that are 20 minutes longer because each of us (FRs, BLS, and ALS) do the same things when we all get on scene.

I guess what I am trying to get at is that we get on scene and start our initial assessment, and are into our secondary assessment when BLS shows up. We give them the information we have gathered, and they start off their initial assessment. BLS is into their secondary assessment when ALS shows up. BLS briefs ALS and they start on their initial assessment and when they finish their secondary assessment they transport (this seems to be a standard process)

Yes, new procedures and tools get used at each level of initial and secondary assessments, but wouldn't it streamline the process if some things are done right from the beginning?

The hand-overs always go smoothly, but it just feels like a lot of time is wasted by each level, including us as FRs, when it could be more efficient from beginning to end.

From what I have heard, the BC Paramedic Academy is going through some changes in procedure, protocol and training; and that BCAS is currently re-working a lot of their operations and procedures. I hope that whatever they come up with will sort out their internal problems, and help bring us into the circle so we can all be on the same page.