EMS in the Fire Service: Train to Be a 'Hero'

The majority of those who enter the fire service do so with a true desire to help others in their time of need. With courage, compassion and integrity, members of the fire service save lives and property with a goal of promoting a positive image as public servants. The term “hero” is often used by appreciative citizens after firefighters, performing their duties, rescue victims from burning buildings or prevent further destruction to a family’s home from a fire. For most members of the fire service, the opportunity for heroic efforts on the fireground may only occur a few times relative to the daily call volume for service. With EMS being the lion’s share of calls for most agencies, we need to make sure we aren’t missing opportunities daily to be those “heroes.”

Opportunity for impact

Getting off the engine or truck on the fireground with an axe strapped to our side or a hosepack slung over our shoulder gives a firefighter a sense of purpose. We have trained hard and prepared ourselves to perform the skills that we have honed, so that we can save those lives and protect that property. But a question can be asked, do we feel the same way on a rescue call?

If we are an EMT or paramedic, are we just as excited to grab our drug box, monitor or airway bag to go into that home or business to mitigate someone’s medical problem? This situation happens multiple times a day for the majority of agencies. We regularly run calls dealing with life-and-death situations as well as non-critical medical situations. While seemingly routine to us, to those requesting our help it can be far from commonplace. We have the opportunity to impact their situation on what may seem to be one of the worst days of their lives.

Training and leadership

In fire-based EMS systems, we need to make sure that we strike an appropriate balance in our training and operational focus between our dual functions as firefighters and EMTs. Just as we need to have regular training on skills such as ventilation, laying hose and ladder work, proficiency in patient assessment and treatment modalities need to be practiced on a regular basis. While many firefighters may not see these medical calls to be as glamorous as a raging structure fire, it is essential that members in leadership positions work to change that way of thinking. Our focus should be more on how much we impact the lives of those we serve as opposed to the specific type of emergency.

When they enter the EMS field, first responders train for many types of medical emergencies. We need to be just as ready to mitigate these situations as we are the everyday chest pain or difficulty breathing call. Excellence in these areas needs to be a goal, and the performance of the personnel needs to be recognized by supervisors. Fostering a positive attitude toward these medical emergencies can be a challenge at times. As leaders, we need to instill an organizational atmosphere that recognizes the importance of being those “heroes” in all situations. When employees exhibit behaviors that exemplify the departmental goals of excellent patient care, with compassion and professionalism, we need to encourage more of the same.

Developing a firehouse atmosphere in which quality EMS is a focus can begin with the training calendar. Patient care needs to be a priority, just like fire attack and ventilation. Regular EMS training placed on our schedules expresses its significance. Training officers and fire department supervisors can be creative in how they deliver this training. Fire drills can be turned into dual-function EMS drills. When you conduct a search and rescue drill, don’t just end the training when the victim is extricated. Work through full patient assessment, treatment and transport. Finish out over-the-side rescue calls with a medical emergency component. When EMS drills get postponed due to calls, reschedule them. It is important for your crews to see that these drills are a priority. 

Professionalism matters

On the scene of an emergency medical incident, we need to ensure the highest levels of professionalism are being exhibited. We are being watched or videotaped every time we enter someone’s home or perform a service on the street. If we are doing what we should be, then that fact should be of little concern. Supervisors should demand high standards, at the same time recognizing outstanding effort. This will cause the members of the crew to up their game, positively impacting the public by providing selfless compassion for complete strangers, and becoming that “hero” in their eyes.