EMS a cancer on the fire service

[Double_Local]

EMS is a cancer on the fire service, the delivery of which, though embraced by our leaders, has, in no small part, lead to the deaths of firefighters.

Instead of fighting for sufficient budgets to properly train (live burns at least monthly for every member), equip, and deploy our firefighting forces (five man companies), our leaders have suckled the greasy nipple of EMS and claimed "it's good".

They've allowed city managers cut our daily staffing by almost 50% and we've said "no problem, we can still handle it". They've started to send our companies on every possible EMS run, leaving the decimated few to protect the citizens. We're a proud breed, none of us are going to stand idly by while someones home burns. Too bad it costs more of us (in LODDs), per fire, than it used to, despite advances in notification, PPE, equipment, etc. But hey, we're happy, give me 10% paramedic pay, and I won't mind.

We've allowed EMS to take over 80% of our workload, despite the fact that 80% of that 80% is 100% pure BS. Despite the fact that we are of NO BENEFIT to anyone on 80% of our EMS runs. Despite the fact that, typically, busy companies are unavaliable ONE SIXTH of the time on EMS runs. Would you let someone cut your number of companies by one sixth without a fight? I hope not.

How did we let ourselves get here?

[This message has been edited by Double_Local (edited 04-22-2001).]

[SAY_WHAT]

I blame most of our EMS problems on those "Warm and Fuzzy Fire Chiefs" and those "can help you off the curb miss so you can get into the liquor store," politicians. The real problem with EMS is that no one has decided to lay down the law and say if you call 9-1-1 for nonemergencies you will not get service and if you continue to call you will be arrested.
The fire department does not consist of social workers, cab drivers, AA counselors, and people who enjoy taking persons with the 5 day old headaches to the hospital because they don't feel like working that day. EMS is destroying the fire department, firefighters want to run fires not drunks.
We need the authority to say no, don't call when your drunk or want someone to talk to because we're not taking you to the hospital.
Finally, those who want to provide EMS should ,those who don't, shouldn't have to.

[This message has been edited by SAY_WHAT (edited 04-23-2001).]

[gah74]

Say what??? Last time I checked no one was being forced to provide EMS. If you don't like your job....Quit.

I can't speak for your exact case Double Trouble, but in this region, EMS has actually allowed us to keep staffing and in several cases increase staffing. We were doing so well w/ our fire safety/education programs that I know you're a fan of that we are signicantly reducing the number of fire calls we go on (and this is a relatively older, lower socio-economic suburb w/ over 250,000 people) and city council was taking notice of our inactivity...After taking over EMS our run load has dramatically increased...as has our pay, benefits, staffing, and public image. So EMS is not a cancer for us, but a life saver.

[Fire Eater 07]

A cancer?? i agree and disagree. Agree because a city should NEVER shut down a station or get rid of any suppression personnel...But to train firefighters with possibly life saving interventions...im all for that...as long as they wanna pay for my education, granted it does take an engine,squad,truck,etc... out of service, but what if they are going to your parents house, or your home with a pool because your little 3 year old boy or girl was found in the pool??
hey brother i know what you mean by a cancer but i say they can train me
stay safe

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Engine / Squad Co.# 7

[Double_Local]

So which one are you short-changing? Fire or EMS? Does your fire response suffer when the EMS units are busy? Does your EMS coverage suffer when your Fire units are busy? Where are your training priorities...in EMS or FIRE? You protect 250,000, your government should be able to provide its citizens with the BEST fire department, and the BEST EMS system. One shouldn't have to prop up the other. From your statements it sounds like EMS is carrying the Garland FD. Which means to me that somewhere, somehow, resources that should be spent on EMS are beign diverted to Firefighting.

Of 250,000 people, with no fire protection service, you could reasonably expect that 10 - 20 would die in a fire every year.

With 250,000 people, I'll bet you protect more than $10B worth of property. With no fire protection, you could reasonably expect that on average, you'd lose $30M, per year in fire losses.

Could you run your fire department on $30M? I'll bet you could. It's only about 2.5x what you get now.

With 250,000 people, I'll bet you run no more than 45,000 ems runs a year. I'll bet you could cover that with 12 transport units over 57 sq miles. Probably cost about $10M, depending on salaries. Hell you could probably pay for that out of the FD budget.

[Double_Local]

Hey Fire Eater...I hear you as well...I apologize, but I edited my original post for brevity.

I sincerely believe we save many lives each year providing EMS first response. However, we are shortchanging ourselves by responding to EVERY or even MOST EMS runs. Your jurisdiction may be different. I figure that we (fire trucks) shouldn't even be dispatched on about 80% of EMS runs, because we are not really needed. I think that in any other industry, if a subsidiary of the main company wound up doing 80% of the work, they'd spin it off. (Now I realize that 80% of the runs doesn't neccessarily equal 80% of the work, but bear with me)

EMS is not really _E_MS anymore...it's really public healthcare. Design, Equip, and Deploy a system that recognizes it as such. I have no problem tasking a suppression unit to handle a legitimate EMERGENCY, but I do have a problem reducing my Fire Coverage to babysit someone with a four day old stomach ache. Why is it that the men in the stations can determine that a call is gonna be BS with greater accuracy than the multi thousand dollar dispatch cards?

[gah74]

You're absolutely right, our fire response suffers when our EMS units are busy and our EMS response suffers when our fire units are busy....also, our fire units suffer when other fire units are busy and EMS suffers when other EMS units are busy. So what?? This is real life. That is a fact of life in every department USA regardless of whether you run EMS or not.

You can throw every statistic you want to at this and it will not change the fact that all of us have to work within the resources provided to us. It isn't the cities responsibility to provide the BEST EMS and BEST fire department, b/c what does that even mean?? Have an engine and ambulance crew stationed at every resident's house. Well no, most people wouldn't find that practical, but it sure would be effective. Our cities have a budget and the fire department has a budget. Providing EMS has helped us w/ staffing and funding. Our fire related training has increased also (not necessarily because of EMS, but I state that to show it hasn't hurt our fire training).

The truth is EMS has helped are fire department. You can say it is a crutch or whatever, but I don't know what your point is with that. Let the end justify the means...so be it. I will say that it doesn't necessarily mean EMS is right for every department or that it will help your department. EMS may very well be a cancer for your fire department....that doesn't make it a cancer for everyone else's too.

[gah74]

Just an additional note relating to engine and truck companies...

Our department runs the ambulance also....engine/truck companies are only dispatched on major medical calls (chest pain, difficulty breathing, and unconscious person calls). ...and yes even most of those are non-critical. As soon as the ambulance walks in the door and notices that it's not critical...the fire co's are disregarded and back in service.

[Double_Local]

Do firefighters ride the ambulance?

[Smoke286]

You have some valid points Double, I've never looked at it quite that way. it is true, if we are out helping some old lady up and a structure fire takes place in our district, another station has to handle it, with an understandably longer response time.

[Althea Forhan]

When I walk past an intersection and see your daughter lying there bleeding to death and I decide that scince I'm a firefighter not an EMT I don't have to deal with it, you'd better hope somebody with morals comes along.

Althea
Note the tone of sarcasm.

[gah74]

Yes...everyone in the department is a firefighter and either a EMT/EMTP. The city doesn't use any private ambulances for 911 calls (unless MCI or mutual aid not available).

[res7cue]

I have mixed feelings about this issue. My dept runs both ALS/BLS so it does not impact my house that much.

However we have several depts that do not have EMS in house. Some run EMS assist on ALL calls, while others only run Class 1 calls or if the first due EMS unit is unavailable.

I don't feel that the FD should be running EMS unless it is a Class 1 call, the 1st due EMS unit is unavailable or they have an extended run time.

Running every EMS call just for the sake of running it, generating numbers and so on, just increases our liability exposures and increases the operational expenses. These monies could and should be better used elsewhere.

Just my .02 worth.

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[gah74]

Some of the arguments on here seem more about how the EMS is delivered by the fire department than about having EMS.

...and I don't get this helping a lady off the curb argument. We run just as many BS fire runs as we do BS EMS runs. We can have a fire unit out of service running on a BarBQ pit just as easily as we can on a junk EMS call. Either one of which they can clear up from once they have the situation sized up.

Our firefighter's on the ambulance were added when the department got EMS so we didn't lose firefighter's by adding EMS we gained firefighter's. If they are on a call when a fire comes in, we get the next closest ambulance coming to the scene and they usually respond w/in 4 minutes. So, again, EMS has been good to us.

[Double_Local]

If you run as many BS fire runs as you do BS ems runs, then count yourself lucky. Many of the departments I've looked at have EMS incidents making up about 60-80% of total responses. Using a fairly accurate 80% BS rule of thumb for each, you still wind up with more EMS BS. With Fire BS, if it's truly BS, you can squirt some water from a can, reset a system, radio in "false alarm - good intent", or whatever, and get on about your merry way. With EMS, though, if it's BS , and you still have a patient, and its called ABANDONMENT if you go about your merry way before the ambo gets there.