The fire service has a long-standing tradition of providing emergency medical services for our nation's communities. In fact, as far back as the 1920s, some fire departments carried resuscitation equipment on their fire trucks. The Miami, FL, Fire Department puts its first rescue truck in service in 1939 to provide basic first aid for its citizens. We can't look back at the history of fire service-based EMS without remembering "Emergency!" Paramedics John Gage and Roy DeSoto, the stars of the popular TV series in the early 1970s that brought EMS into the homes of millions of people in America.
Today, more than 90% of the 31,000 fire departments in the United States deliver some level of EMS to the public. EMS has evolved into a popular and critical service-delivery responsibility of a fire department. We should be proud of fire service leaders who had the foresight and vision to see how our fire protection-based deployment model and exceptional personnel could become the template for pre-hospital 911 emergency care deployment, response and service delivery.
Fire service-based EMS systems are configured in several ways. These include:
- Cross-trained multi-role firefighters who provide patient care and transport.
- Fire department employees who are not cross-trained fire suppression personnel, but who accompany firefighters to provide patient care and transport.
- Cross-trained multi-role firefighters who provide patient care, but patient transport is provided by a private ambulance through a contractual agreement. This option is most effective in the fire service-based EMS environment where the fire department administers and monitors the performance requirements within the transport agreement.
No matter which of these configurations is in place, the foundation of the system is the use of fire service facilities, apparatus, equipment and highly capable personnel to provide pre-hospital 911 emergency medical services. There is no system better situated for rapid multi-faceted response than a fire service-based system. No system is more capable of securing a scene, mitigating a hazard, and triaging, extricating, treating, decontaminating (if necessary) and transporting patients who have been injured than the fire service-based EMS model. It also provides a significant return on the investment of public dollars.
It is critical that the fire service further enhance the level of understanding of policy makers and the public concerning the long-standing and critical role that EMS plays within our service. Some of the ways this can be achieved include:
- Clarification and education within all levels of government, the medical community and even within our fire service membership concerning the benefits of fire service-based EMS.
- Increase understanding at the federal and state levels of government that grant funds provided to fire departments to improve deployment, staffing, equipment and response to fires also directly and positively affect EMS response in almost every community in America.
- Collect and use data that will continue to define the effectiveness of the fire service-based EMS system and identify areas where improvement is needed.
- Work to ensure that the fire service is represented whenever and wherever policy decisions are made that relate to EMS issues. This includes within government, the medical community and public health.
- Implement and staff all-risk public education programs in fire departments that integrate fire safety and other injury-prevention messages. This serves as the basis of an EMS injury-prevention program.
- Integrate EMS definitively and effectively into the mission statements of fire departments and the U.S. Fire Administration as well as into the curriculum at the National Fire Academy.
- Encourage all fire service professional and membership organizations to clearly communicate the critical role of fire service-based EMS within fire department service-delivery systems.
We should step back to celebrate what the fire service has accomplished through the integration of pre-hospital 911 emergency medical response into our service-delivery systems, then step forward and continually take advantage of opportunities to improve fire service-based EMS. We can't (and shouldn't want to) separate EMS from the fire service.
The late Jim Page and many others dedicated their lives to making fire service-based EMS the model of choice in our nation. They saw the value of this model as a quality-of-life issue in our society — and that is exactly what it has become. Many lives are saved and many others positively impacted every day through emergency medical services delivered throughout our nation by dedicated and capable members of fire departments. Let's stand proud of our tradition, continue to get better, stay safe and tell the incredible story of fire service-based EMS every chance we get.
Dennis Compton, a Firehouse® contributing editor, is a well-known speaker and the author of several books, including the When In Doubt, Lead! series, Mental Aspects of Performance for Firefighters and Fire Officers, as well as many other articles and publications. He is also co-editor of the current edition of the ICMA's textbook Managing Fire and Rescue Services and serves as a national advocate and executive advisor for the fire service and other homeland security organizations. Compton served as the fire chief in Mesa, AZ, for five years and as assistant fire chief in the Phoenix Fire Department, where he served for 27 years. Compton is the past chair of the executive board of the International Fire Service Training Association (IFSTA) and past chair of the Congressional Fire Services Institute's National Advisory Committee. He is also the chair of the Home Safety Council board of directors and vice chair of the National Fallen Firefighters Foundation board of directors.