As I sat and watched President Clinton deliver his State of the Union address in 1994, I was shocked to hear him vow to put 100,000 more police officers into communities across America to reduce crime. I thought, there goes more federal money to cops. What about the fire service?
Five hundred million dollars was earmarked for numerous programs and grants to police departments for everything from mobile data computers in patrol cars to a new nationwide fingerprint database system. When Congress passed the crime act after Clinton's pledge, Attorney General Janet Reno created the Office of Community Oriented Policing Services (COPS). The COPS program was designed for police agencies and was based on the philosophy of crime prevention, improving relationships between the police and the community, and having the police be responsive to citizens in order to gain their trust.
A Model For Success
Ironically, the fire service accomplished these objectives long before the police did, without a ton of federal money. Through aggressive initiatives, education and prevention programs, the fire problem in the country was improved to the point that today it is nowhere near the magnitude it was 30 years ago.
Now it appears that without a mandate, federal money or a blueprint, many fire departments across the country are taking our success and what we learned from fire prevention programs and applying it to our emergency medical service programs. In essence, instead of reacting to an emergency medical crisis, many fire departments are trying to prevent the emergency medical crisis from even occurring.
As an example, the St. Louis Fire Department recently started an "Are You Okay?" program. Under the program, which is free to citizens of St. Louis, a computer automatically places telephone calls to shut-ins, the elderly and those who live alone on a daily basis. If no one answers the call, the computer, which is located in the communications center, notifies a dispatcher. The dispatcher then attempts to make telephone contact with the person listed as the notification contact, provided by the subscriber to the program. If that person cannot be reached, an engine company is dispatched to check on the well-being of the person.
In another example, the St. Louis Fire Department also recently received a state grant to fund a cardiovascular health screening program. The contract calls for the fire department to conduct health screenings at a minimum of 10 sites per month. Screenings include checking blood pressure, pulse, and glucose and cholesterol levels.
Obviously, when any readings indicate a person is in a crisis, the person is transported to the hospital. But anyone found outside the norms is provided with their information and asked to contact a physician. Two weeks after the screening, anyone who was asked to contact a physician receives a follow-up telephone call to learn whether the physician was called.
Other programs on the drawing board include a cooperative effort with the St. Louis Health Division to offer flu shots to individuals in a drive-through scenario at firehouses and a cooperative program with a local children's hospital to teach injury prevention to day care workers throughout the city.
The key to any successful community outreach programs is to identify prevention needs in the community, either through computer-aided dispatching (CAD) data collection, trauma registries or analysis of medical records from ambulance runs.
There are many opportunities to create community outreach programs. One fire department that experienced a high rate of children drowning in swimming pools during the summer began an aggressive effort to educate the community. Several years later, children's deaths from pool drownings dropped to less than half that from when they started the program.
Other departments have conducted community outreach programs for bicycle safety, fall prevention, prescription drug use for senior citizens, car seat safety checks, safe trick-or-treating, stranger awareness, poisoning prevention, and anti-drinking and driving programs for high school seniors on prom night.
You can be as innovative as you like as long as the goal of the programs is to prevent injuries or illness.
Complaints Vs. Compliments
One fire department was receiving complaints from citizens that firefighters were shopping at a food market while they were on the job. Although is not uncommon in many communities for firefighters to shop on the job for that day's meals, in this particular community it was unfortunately frowned upon. To continue the shopping expeditions and prevent any more telephone complaints, a new tactic was deployed. One firefighter set up a table at the entrance to the supermarket advertising free blood pressure screenings while the other firefighters went shopping. The department received no more complaints, but did receives calls and letters complimenting it on the new service being offered at the supermarket.
Whether you choose to call it a community outreach program, an injury prevention program, an illness prevention program or a value-added service, there is no doubt the success that was obtained by the fire service on fire education and fire prevention is certainly obtainable if it is applied to preventing medical emergencies.
Gary Ludwig, MS, EMT-P, a Firehouse® contributing editor, is the chief paramedic for the St. Louis Fire Department and is the vice chairman of the EMS Executive Board for the International Association of Fire Chiefs. He has lectured nationally and internationally on fire-based EMS topics and operates The Ludwig Group, a consulting firm specializing in EMS and fire issues. He can be reached at [email protected].
