Thread: Question!

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    Question Question!

    First off my name is Garrett Livingston. I am currently a volunteer firefighter and am attending college classes at Chemeketa Community College. For one of my classes I have to write a paper on a question from a subject area that I am comfortable with and require feedback from different individuals/sources. My question is "Should there be such a thing as a firefighter/paramedic?" If I was in an accident that required medical attention I would rather have a regular paramedic working on me than a firefighter/paramedic just because I would think a regular paramedic would be devoting his time only to medicine rather than a firefighter/paramedic who would be devoting his time to both firefighting and medicine. Anyway let me know what you think, feel, would like to see, etc. Any little thing helps.

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    A firefighter/paramedic IS a regular paramedic. They both have the same education and certifications, have to attend the same recertification classes and require the same number of continuing education credits. The only difference is the paramedic/firefighter is crosstrained to operate as a firefighter as well. This allows them to enter hazardous materials "hot zones" or certain rescue situations, such as confined spaces to render care, as well as allowing them to assist at fire scenes, as firefighter/paramedics are generally found on fire departments. In most places, they are busy enough functioning primarily as paramedics, and at a fire scene they may only be responsible for rehab, fighting fire only when manpower needs dictate.
    They may have been firefighters first, then trained to paramedics, or they may have been hired as certified paramedics, then cross-trained as firefighters.
    Either way it does not matter ... medical skills are the same.
    Last edited by LaFireEducator; 01-19-2005 at 01:41 PM.

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    I as well as many others in my dept are FF/EMT's. I know it isn't paramedic but the concept is the same. We'll use your crash example. Usually, 2 of us that are FF/EMT's will take patient care. We do patient care and only patient care. We don't put down the BP cuff to cut battery cables. There are plenty of other FF's there to do the other jobs. In fact, we are often more aware of safety issues than a regular medic or EMT who isn't trained in MVA's like we are. Either way, there is definately no less patient care with a FF/EMT than just an EMT.
    Even the burger-flippers at McDonald's probably have some McWackers.

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    Oh boy...prepare for the hornets nest to be stirred...

    I for one, have been a fire/paramedic, a third service agency paramedic and a private sector paramedic. Private sector was the worst. I would never do it again. The third service agency was outstanding. Aggresive, well educated and the bosses required CE above and beyond state and NREMT requiremeents.

    The fire service agency I currently work for has a lot of problems. If I knew then what I know now, I would never have came here.

    BUT....

    I know third service government agencies that are P*ss poor. They come to work sit on their *****es and do the minimum required to maintain CE. Training??? Check what's on TV first.....don't want to miss that episode of ER. Can we count that a CE this month?

    I know third service agencies that are outstanding (see above).

    I know fire departments that there's no way in hell they should have an ambulance. The members hate it, and it shows in thier patient care.

    I know other fire departments that operate EMS and their members go above and beyond to maintain ALL thier skills at a high level, and they ENJOY what they do and provide excellent service.

    As far as private companies, I am only familiar with one, and can't comment further.

    The quality of the service depends on the people involved in it.

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    Originally posted by Tiredoldman


    The quality of the service depends on the people involved in it.
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    It's all about scope of practice. If I am sitting at my house having a heart attack ya sure I would prefer a well trained paramedic that only is a paramedic to show up and try to save me. If I am in a car accident sure send the firefighter/paramedic. Not many ER paramedics I know can lay on their back in a ditch in full bunker gear at midnight and start a IV on a patient in an overturned car while waiting for the extrication. Most are crosstrained in both now but some are better in certain situations then others.

    Rigin

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    It doesnt matter if you are a fire/medic or a "regular" medic or who you work for. A good medic is a good medic period. I have seen quite a few non fireservice medics that could stand on their heads on start an IV on you in an upside down car. It all boils down to the person. And why would a fire service medic be bad at non traumatic patient care?????

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    Because... The fire medic doesn't have the experience of having to run into Mcdonalds every time he needs to p!$$. HA HA...

    Sorry,
    KC

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    I don't care if I am having a heart attack at home or in a ditch about to die. JUST GET ME A FREAKIN' PARAMEDIC!!!!! Who cares what other titles he/she has, as long as the can help me.

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    What title does a paramedic who graduated last in his medic school have after his/her name?

    Paramedic.

    I find it ironic that you pose this question, Garrett, as the paramedic program began with the fire service to begin with!

    I wish Jim Page were still alive.... he could give you the story of how it all began (and probably dress you down for making such a statement! )
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    I am an NFPA FF 1&2. I am also a NREMT-P. Each for a different agency, but both as paid staff. Trust me when I tell you that the paramedic training that I go through each year to keep the National Registry of Paramedic certification is 5 times more indepth and regulated 10 times more than anything I go through in the fire service. The sheer number of hours is probably greater on the fire side but I go through more formal classroom training and many more practical exams in the medic side. If you feel you are getting a bad medic during an emergency call, that is just a combination of your current perspective, your opinion and the luck of the draw.
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    Originally posted by engine4cLT
    It doesnt matter if you are a fire/medic or a "regular" medic or who you work for. A good medic is a good medic period. I have seen quite a few non fireservice medics that could stand on their heads on start an IV on you in an upside down car. It all boils down to the person. And why would a fire service medic be bad at non traumatic patient care?????
    This really isn't a true statement anymore. it used to be this way but with the current nationwide shortage of nurses alot of hospitals are allowing paramedics to work in the hospital setting doing nursing work. Atleast around my area alot of paramedics have gone through the NREMT-P course and went straight to a hospital setting and have no "hands on" field experience. This is what I meant by scope of practice. Some medics scope of practice differs from anothers.

    Rigin

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    Valid point Rigin. Around here though, you have no shot at all of a hospital job unless you have AT LEAST a year of field experience. With the competition for those relatively well paying jobs, most have several years experience. I work part time for a hospital in surgery, working with post operative patients. It pays almost what I would make at the time and a half overtime rate at the FD job. All of the medics there are part time and 90% are fire based medics. That is what I meant by at least some medics being very adept at sorting out non-trauma related emergencies. I see all sorts of medical conditions and am able to learn the underlying causes and the effects on the body system. I think this has made me more able to work the difficult medical calls.

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    I might be a little sheltered for this question but here it goes.

    I work for a large metro department of around 1,000 members. We are around 90%+/- EMT-B's as a job requirement(some are grand-fathered), AED on every rig with more than 50 front-line companies. We also have probably 5% FF/EMT-P's on the job.

    I work in a district were my first in reponse is about 4 squre miles or usually around 2-3 minutes. That's 2-3 minutes to put a minumum of 4 FF/EMT-B's on every scene, 8 at an MVA. The ambulance service in our city is on an average of 8+/- minutes reponse time.

    To answer your question of who do you want working on you? Any of the above. From my perspective, each reponse is new and different. Our MVA call is a pumper, a rescue or truck and a battalion chief. We do show up as fire/extrication/ems, not neccessarily in that order as the call will dictate what actions come first.

    Who do you want working on you? These crews that I work with will have 1000+ MVA's/year. Experience? You bet ya! To say you want a 'paramedic', is misleading to me. To say you have 8 very experienced FF/EMT-B's 5 minutes prior to arrival of your ALS unit, yeah, that's what I want.

    If it is a serious extrication where the 'golden ten minutes' is the #1 priority, I sure want these experienced crews on the scene prior to the arrival of an EMT-P/ALS unit. Or if a FF/EMT-P is on one of the fire crews that respond, everything is task oriented, what needs to be done will get done.

    I have seen many people that aren't 'booksmart' that are many times better at what they do than their book-trained counterpart. Don't take that out of context.

    I am the member of a team. We act as one unit with various tasks. At an MVA, we do what we are trained to do and provide BLS until relieved by a higher trained authority. I am the captain of a truck company, our task is extrication/stability and hazards. After that, we will assist as the EMS crews need.

    So, who do you want?




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    Maybe I'm looking at it wrong, but I fail to see the relevance of this issue.
    Are you implying with your question that paramedics that are also firefighters aren't devoting as much time to the medical side of what they do and therefore, are not as proficient as a paramedic who works for an ambulance service?
    Apply what you are asking to your own situation. You are a volunteer firefighter who is attending college. Will you get any better as a firefighter if you take those pesky college courses?
    What about the doctor who plays golf in his spare time? Would you want a doctor/golfer operating on you?
    You're asking for too much if you think that you will get someone wholly focused on one activity.
    And for my money: give me the guy who can not only extricate me, but can keep me alive as he does it and provide my care after he gets me out. He can be an invaluable member of a terrorist task force team, an urban rescue team, a RIT member.
    Yep; I'm sure of it. I want the firefighter/EMT-P.
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    Originally posted by ChiefReason
    give me the guy who can not only extricate me, but can keep me alive as he does it and provide my care after he gets me out.
    Yep; I'm sure of it. I want the firefighter/EMT-P.
    CR
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    Originally posted by Rigin1
    It's all about scope of practice. If I am sitting at my house having a heart attack ya sure I would prefer a well trained paramedic that only is a paramedic to show up and try to save me. If I am in a car accident sure send the firefighter/paramedic. Not many ER paramedics I know can lay on their back in a ditch in full bunker gear at midnight and start a IV on a patient in an overturned car while waiting for the extrication. Most are crosstrained in both now but some are better in certain situations then others.

    Rigin

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    Originally posted by Rigin1
    It's all about scope of practice.
    I think what you're really trying to say is experience. Scope of practice is defined as the acts which a provider is allowed (ie. allowed drugs, procedures, etc.). Although it may vary by jurisdiction, but whether a medic is a firefighter or not does not determine scope of practice. Just wanted to clear that up.

    Eric

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    Come to think of it, have you ever seen an MD do CPR? Have you ever had a call to a doctor's office or an ER for chest pains?
    I have and done CPR in both places. I would tend to think that in the golden ten minutes of a life threatening injury/medical emergency, you are going to see a trained FF/EMT-B/D, a lot faster than you will see an EMT-P(unless it is a FF/EMT-P) in most all emergencies. Shout out to all of the trained professionals.


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    A good medic is a good medic period
    A good Firefighter is a good Firefighter period.

    A combination of the above is called more often than not.

    Usually by people in deep doodoos.
    Psychiatrists state 1 in 4 people has a mental illness.
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    Question Thank you all

    Hey this is Garrett (the guy who posted this debatable topic) and I would just like to thank you all for posting your opinions. Your advice will start me off on making a great paper. Though I have one more question to ask. "Where can I find any specific articles on firefighter/EMT's (dealing with medical emergencies)?" Once again I would like to thank you all for the time you have spent posting your opinions.
    -Garrett

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    Originally posted by jerrygarcia
    Come to think of it, have you ever seen an MD do CPR? Have you ever had a call to a doctor's office or an ER for chest pains?
    I have and done CPR in both places. I would tend to think that in the golden ten minutes of a life threatening injury/medical emergency, you are going to see a trained FF/EMT-B/D, a lot faster than you will see an EMT-P(unless it is a FF/EMT-P) in most all emergencies. Shout out to all of the trained professionals.

    We responded to a medical call at a movie theater. On arrival, there was a 55 year old male in cardiac arrest. Two doctors (a vascular surgeon and a neurosurgeon) were doing CPR... and doing it wrong. There was also an RN who worked in an allergists office "barking orders" at my crew.

    We defibrillated the patient... I had to ask the 2 docs if they taught the meaning of the word "clear" in medical school... the "RN"... we had the PD escort her out of the area as she was disruptive as all hell... we got a viable cardiac rhythm back. The paramedics arrived (private ambulance company, but both medics on the unit were firefighters in other communities), pushed cardiac meds and transported the patient to Marlborough Hospital's Cardiac unit. Unforunately, he died later that night.
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    Originally posted by CaptainGonzo


    We responded to a medical call at a movie theater. On arrival, there was a 55 year old male in cardiac arrest.
    We defibrillated the patient..we got a viable cardiac rhythm back. The paramedics arrived (private ambulance company, but both medics on the unit were firefighters in other communities), pushed cardiac meds and transported the patient to Marlborough Hospital's Cardiac unit. Unforunately, he died later that night.
    And you, and those with you that were responsible for the patient arriving at the Hospital Alive, were entitled to go to sleep that night, knowing that you did all you could do. Good Job, Cap.
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