Mass. City Says Firefighters Can Go on EMS Calls

On Monday, Fire Chief Ronald P. Therrien reviewed the emergency medical calls his department responded to over the weekend and he came up with zero.

That worried him, he said, especially when he saw the types of calls his department was missing.

Typically, there are eight or so medical calls a day, he said.

The weeklong hiatus, which lasted through Thursday, Chief Therrien said, came after a decision March 21 to stop firefighters from joining the private Wood's Ambulance at emergency medical calls.

The blanket no-response-by-firefighters decision came after a state official told the department the interim "red dot" system - devised by firefighters to restrict the number of ambulance calls they go out on, and launched early in the winter - violated the terms of the city's private ambulance contract and opened the city up to liability. The city concluded it could either have firefighters respond to all ambulance calls, as it used to do, or have them go to none.

But on Thursday the city learned from PowerPhone, which oversees its dispatch service, that it could have firefighters go to certain high priority calls.

For around three or so months, Chief Therrien said, the Fire Department was using the "red dot" system, literally placing red dot stickers on cards used by dispatchers in the Police Department to indicate which calls dispatch would hand along to firefighters.

"Before that, they were responding every time an ambulance was (sent) - for constipation, back problems, flu-like symptoms - they were calls that needed an ambulance response, but didn't need a Fire Department response," Chief Therrien said.

"We don't have a dedicated EMS unit here. Sometimes they would respond with a ladder truck to calls for constipation and hangnails," he said, though the city has a contract with Wood's Ambulance to handle emergency medical calls.

Every 911 medical call transferred to the Fire Department was either responded to with a command car, fire engine or sometimes a ladder truck, he said.

"It makes absolutely no sense to send a fire crew in a 15-ton, $700,000 firetruck to someone who has a hangnail," he said. "We were rolling out of the station sometimes eight times a day on calls that an ambulance and police cruiser were also responding to. It made no sense to send a third entity to something like that. It was a waste of resources."

It was also risky, he said, to send large equipment out at high speeds through the city for medical calls.

So, firefighters came up with the red dot system. Only, the state's 911 commissioner told them they had no authority to do it, Chief Therrien said.

"It put the city in a liable position for three to four months," he said Thursday. "We were violating the protocols of the vendor we were in a contract with for Emergency Medical Dispatch, and the state 911 commissioner told us to stop immediately last Thursday. But, before that, we were responding willy-nilly all over the place."

So the city decided to stop having firefighters go out on any ambulance calls.

The order to stop upset people, including the 30 union firefighters who are all trained as emergency medical technicians.

Though the "ban" was lifted yesterday by the city's EMD service, and firefighters can now respond to high priority calls such as cardiac arrest and chest pains, local firefighters union 2215 President Guy "Butch" Sharron said it is vague which calls police dispatch will hand down. The state said it is OK to send "additional support" to the emergency medical calls the city's EMD service has outlined for dispatch, he said.

"We found out about an hour ago we could respond to priority one and two calls," Firefighter Sharron said at 1 yesterday afternoon at the station. "It is vague. We're not sure what to respond to. They call down and tell us to respond and we go."

He said the union will meet Tuesday night to discuss what action to take.

"We're totally against it," he said. "We were told by the chief and the mayor they were cutting back some and it turned out to be all. We had no idea. And, then we were informed an hour ago we can respond on a limited basis. As a union and as firefighters, we're totally set against that."

He said firefighters respond to about 1,500 medical calls a year. The department doesn't charge people for response to medical calls. There are no firefighters trained in Advance Life Support or at the paramedic level. In July, dispatchers in the Police Department were trained and the Police Department was designated the "primary answering point" where all 911 calls come in.

Although Wood's does a great job for the city, Firefighter Sharron said, if the ambulance company has to handle everything, response time will be affected.

Additionally, certain medical calls require more than just two people, he said.

"This is not something firefighters want," he said. "The public is the only one hurting not getting the response they had in the past and as many hands available as possible. Wood's is nice, but if they are delayed, at least somebody is there to do something. We want to apologize to the public for not being able to be there."

But, Gardner Mayor Mark P. Hawke said the way the city was doing things before with the red dots was improper.

"The Gardner Fire Department is not an ambulance service or emergency medical service," Mr. Hawke said. "They are a fire department. This all came to light last week during a meeting when we were told the (red dot system) was borderline illegal and against protocol and were opening up the city to incredible liability, unbeknownst to any of us."

The city started using the red dots because there are intrinsic problems with sending fire equipment out on medical calls, he said.

"The basic problem with all this is sending fire equipment racing through the streets of Gardner on medical calls when they are a Fire Department," he said. "Over 50 percent of their calls are medical calls. That puts wear and tear on the streets, equipment, costs gas-the whole thing needs to be looked at and we need to be following protocols and procedures that weren't there before and we have to make sure we use the Fire Department's resources wisely, efficiently and effectively."

Chief Therrien said the mayor instructed him several weeks ago to incorporate into the Fire Department's capital plan his request for $70,000 to $100,000 for an all-purpose rapid response vehicle that could handle such calls.

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