05-27-2004, 04:02 PM #1
Benefits of Running Medical Calls
My fire department was recently faced with the question of whether or not we want to run medical calls. We currently run around 30 calls per year doing just fire related calls.
Our area has at least 1 or 2 medical calls per day. If we started to run medical calls, how would it benefit our department? Would we be eligible for more state and or federal funding?
Some of the people on the department seem to think going on these medical calls will run us ragged. I personally wouldn't mind doing medical calls, except the dumb ones. When I say dumb calls I mean stuff like 'my tooth has been hurting for a week', 'my hip went out 3 days ago and now I want to go to the hospital', 'I stubbed my toe', and stuff like that. I guess going on medical calls that aren't actual emergencies just comes with the territory.
I wouldn't turn down a call if I got one; never have, never will. Can anyone provide me with some of the pros and con of running medical calls please?
05-27-2004, 05:56 PM #2
Since you asked...
First, a question.
How did you reach your 1 or 2 call a day estimate? That sounds like a ton of calls for a department that only gets 30 fire-related calls a year. For comparison, we protect a population of 3,500 over a 50 square mile area. We catch about 80 full department responses (fire, MVA, etc) a year and about 120 EMS calls.
We started responding to medical calls in 2000 and faced many of the concerns you're facing, with volunteer burnout being the most common one. Our experince was just the opposite. Running traditional fire-only calls, we sometimes went entire months without having a run. It was difficult to keep folks motivated, The additional calls actually increased participation and has helped us recruit a few new members.
The biggest benefit to the department was in public exposure. You simply get a chance to interact with more people. On a side note, people appreciate you when you come to help a loved one. Yeah, they're happy you put out the pasture last year but it just isn't the same as helping momma when she fell. After a year or so you will probably see a big increase in donations. We did.
In Alabama, there were (most died with the state's 2003 budget) a few more grant opportunities with EMS. As a whole, we've got about $3K in stuff over the years. The increased call volume and additional service you're providing can't hurt on ANY grant application.
That's the good, now for the bad.
You've got to ask yourself if the service is really needed. In our case, transport EMS was 20+ minutes away and sometimes completely unavailable. In my opinion, if you're gonna struggle to beat the bus to the scene by a couple of minutes it isn't worth it.
You've got to determine if you've got enough trained people to meet the need. It's pretty hard to muck up the typical pasture fire us rural guys see, but the same can't be said for a medical emergency. At the lowest level, you're gonna need many Certified First Responders and probably some EMT-Basics. When you get on-scene those folks are going to look to you for help - you've got to know what to do and not do.
Unless you've already got the equipment, there will be a noticable startup cost and increased fuel and maintenance costs. You will also have to constantly restock consumable supplies.
I worked very well for us - so well that earlier this year we added Transport EMS to the services we provide. If the need exists and you've got the resources, go for it but make sure you decide based on facts and not emotion.
05-27-2004, 06:46 PM #3
Get to practise your first aid a lot...
80% of my depts calls are medicals..We get paid a certain amount for each call....Personally I think it helps us get known even more that we are there for our community when they see us on medical calls....Also It helps us and the Paramedics get a better working relationship with each other....If someone with multiple personalities threatens to kill himself, is it considered a hostage situation?
05-28-2004, 12:17 AM #4
The combo department which I work for and volunteer with has provided First Responder, non-transport services for several years now. ALS treatment and transport is provided by Acadian Ambulance Service which will send ground units or AIRMED from Baton Rouge. Their station is about 20-25 minutes away by ground but based on where the closest unit is the ETA can be much longer.
We too were getting burned out by the 'dumb calls' from people who could have taken a POV to a hospital but wanted a ambulance transport because they beleive it will get them in to see a doctor faster. Some calls to 'frequent fliers' weren't even getting any responce when there was no paid person at the station to run the call. The volunteers would hear the adress and turn off their pagers instead of going to a house they had been to dozens of times. Our department is not 'required' to provide EMS responce and we get no tax dollars for EMS services. All of our EMS is paid for through donations which have been drying up. Volunteers are only required to run a certain percentage of FIRE calls per year to stay 'active'. You can skip all of the EMS runs and as long as you turn up at house fires or grass fires then you can keep your pager and dashlight.
Our board met to discuss the situation and came up with several options.
1-Continue to respond to EVERY medical, many of which resulted in our people showing up just to stand around for a stubbed toe. As you called them, the 'Dumb Calls'. In some cases nobody showed up at all.
2-Arrange with the 911 dispatch and Acadian Ambulance that we would only respond to 'urgent' medical calls such as those which Acadian would be running 'Code' to.
3-Stop running all medical calls. We would still have First Responders in the department so provide care at Structure fires and MVA but we would not respond to Chest Pains, passouts, etc. Basically you had better be on fire or hanging upside down from your seatbelt for us to treat you.
We discussed the issue for quite a while. Questions like "What if it was your wife?" "What if it is one of our Firefighters who falls painting his house?" were discussed.
In the end we voted that the department could not guarantee to provide EMS service to the district anymore due to lack of manpower so we would stop all responce. It would be worse to tell the public that we would be there and not show up than to stop altogether. After the Board voted on the new policy I went home and, as the department EMS Coordinator, typed up a letter to the 911 center supervisor to detail our new policy. The next day the Chief faxed the letter to the 911 Center. By the end of the day the supervisor of 911 had contacted the Chief and then the Parish (county) President, who is over all government services in the Parish, had contacted the Chief. Within a week the Parish President and the Chief had a closed door meeting to discuss our decission to stop running EMS. A month went by and we were still getting paged for EMS runs. When the board inquired to the reason why we were told by the Chief that we would have to notify the public by putting a public notice in the local paper for 3 weeks telling them not to expect us to respond after a certain date. Cool. We discussed this and voted to notify the public. A month later we met again. This time the Board wanted to know why there had been no Public Notice in the paper and why we were still being paged out. The Fire Chief told those of us on the Board that he had decided that we had made a bad decision and that we would continue to run EMS calls. He said that without the EMS calls the paid guys working days at the station didn't have enough to do. He also felt that without running EMS we would loose what little donations we still get from the public. When we reminded him that the entire Board had discussed this and had voted not to respond to EMS calls he said that he would have 911 continue to page and if we didn't want to respond then that was up to each member but that those who stopped going on those calls should not expect to be sent to any future EMS training through the department. BLACKMAIL.
As a result, I resigned from the Board which I felt had no power since all actions could be overriden without notice or reason by the Chief. Another member quit the Board and the department and moved out of town to go back to college. And the FD eventually arrainged to run ALL EMS calls during the day when there is a paid man at the station and only 'Emergencies' at night so our volunteers can get some sleep instead of going to the 'dumb calls'.
I hope that you have fewer problems than what we have had recently.
Taking on EMS with an estimated 2 calls a day will put your call total over 600 runs a year. Make sure you have the manpower, training and equiptment to take on the responsibility. Once you start providing the service you may find that you are unable to stop.
Last edited by cellblock; 05-28-2004 at 12:24 AM.Steve
05-28-2004, 12:50 AM #5
We've run 249 calls this year, and 168 of those have been medicals (not counting MVAs). That's 72%, which is above our annual average of 60%, but it's early in the fire season too.
We do bill for EMS, so that's a source of income for the department. Unfortunately, once we started getting that income, the city felt justified in cutting our budget. We also have a subscription program where residents can pay an annual fee in order to not get billed, but not too many use it.
We get a few of the BS calls (there was one last week for a woman who cut her finger and already had a bandaid on it by the time we responded and refused transport), but the majority are legitimate.Chris Gaylord
Emergency Planner / Fire Captain, UC Santa Cruz FD
05-28-2004, 09:15 AM #6
We have separate fire and EMS. Fire averages about 250 calls per year, EMS is 1500+ per year. No one, anywhere, runs as many fire as they do EMS. If we ever had to do EMS, we would end up closing our doors as we would not be able to handle that call volume and no one has much interest in it. If they did, they would join the EMS. Neither of us bill for any services, we are a burden on society.
05-28-2004, 11:08 AM #7
I get the estimate of 1 or 2 a day from listening to the scanner. Some days I don't hear any, some days I hear several. I can't listen all day so the call volume is just purely speculation at this point. We cover approximately 28 square miles of rural, unincorporated Northeast Gadsden County. We serve approximately 1500 people. We also serve a few large manufacturing plants, including a plywood/post/lanscape timber plant, a construction/asphalt manufacturing busniness and a large dumptruck (hauling/excavating) busniness.
The east side of the county is covered by one ambulance (2-3) that is stationed in Havana. There are 2 ambulances (2-1, 2-2) in Quincy (capitol), which is in the center of the county and 10-15 minutes away. There is 1 ambulance (2-4) with a Paramedic only in Chattahoochee, which is on the west side. Whenever 2-3 gets a call and has to transport, the whole east side of county is covered by 2-1 and 2-2 (from there station in Quincy). Whenever 2-1 and 2-2 get calls, 2-3 has to go to Quincy for coverage.
We all know that when someone goes into cardiac or respiratory arrest, an ambulance 15 minutes away is not a very good thing. What if all of the ambulances are called out? Well we're just going to have a dead one on our hands.
Everyone on the department is at least a First Responder. Another firefighter and myself are currently going through EMT-B at seperate schools. I don't know about him, but I would be willing to run medical calls in my spare time.
By the way, this is my 300th post.
05-28-2004, 08:29 PM #8
- Join Date
- Jul 2003
I think as EFD140 said if nothing else it keeps the crew working together. It gives them (family)time together in the fire house if nothing else. We normally run about 300 calls a year both fire and ems combined. We are currently way down (we ran call 72 this morning. The guys are still working together but it is hard to keep the moral up when the guys want to help someone and can't. We currently have 6 "rookies" on the department looking to do what they have learned and it is getting harder to keep them interested.
I think as a officer it is good to run more calls. Being volunteer the more calls we run the closer the "family" is. It is easaier to keep track of if any one has personal problems at home or on the job when you see them at the station more. Course if you do not see them on the calls it could also signal a problem.
Just my thoughts we were hoping to run about 325 calls this year. That sure is not going to happen at the rate we are going. We just try to keep things rolling along without the calls but it is difficult.
Last edited by lmrchief2; 05-28-2004 at 08:33 PM.Les Hartford
LMR Fire Dept.
The views posted here are strickly my own and not of any of the groups I am affiliated with.
05-29-2004, 06:03 AM #9
- Join Date
- Feb 2000
- Willington F.D., CT
Instead of asking "If we started to run medical calls, how would it benefit our department?", try asking "How would the people in my community benefit by our department responding to medical calls?"
If your ambulance service arrives at the scene before the f.d. 99 times out of 100, then you'll probably end up with a bunch of disgruntled firemen....If you can arrive in a timely manner, apply skills and caring to help benefit the situation, then I believe you will feel good about what you are doing and the patient (and their family) will appreciate your efforts as well.
05-29-2004, 12:49 PM #10
- Join Date
- Jul 2003
Good point Stuart. In our situatin we are 15 miles outside of town and the ambulance service. The old service that had the contract was usually about 5-10 minutes behind us. The new contract compnay is usually arriving with us. They still let us help out so the guys still feel helpful.Les Hartford
LMR Fire Dept.
The views posted here are strickly my own and not of any of the groups I am affiliated with.
05-30-2004, 01:04 AM #11
We have run 1st response for at least 15 years. The ambulance service is 10-15 mins away. Most of the time we have someone on scene within 3 mins of call. Some think "what is the big deal of 7-10 mins..." It means ALOT...remember..especially in cardiac, stroke pt's time is tissue. The sooner medical treatment is rendered, the better...especially in cardiac arrest. It takes 3 minutes for the brain without oxygen to start dying.The comments made by me are my opinions only, not of the Fire and EMS services I am affiliated with.
I have lost my mind..has anyone seen it? it's not worth much..but it's mine
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