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  • Paramedic Engine companies or not?

    I have heard many arguments about this, but what do you think. Do Firefighters need to be trained as paramedics?

    [ 08-04-2001: Message edited by: pfr172 ]

  • #2
    Not all Firefighters, but having two at each Firehouse is a good idea.

    Comment


    • #3
      Do you mean two out of the entire company or two per shift? I don't know if two per shift is economical, and you know thats how your chief is looking at it. If every FF is trained as an EMT(as is now required by most departments) and you do First Responder, isn't that enough? Just my thoughts on it...

      Comment


      • #4
        Not everyone no. However, if your dept. transports patients, the more the better. If you only first respond to EMS calls, having one on each truck is good PR, makes the public think you are real busy going to "emergencies" all day long.

        We staff our rescue squad with medics only, and the other trucks usually have at least one (we use 3rd party ambulance). All of the trucks are ALS, and about half of the dept has a medic license, including all three chief officers.

        We generally only hire medics, but the bottom line is, it is different everywhere you go. In the Mid-West / West FF's are usually medics in paid depts. In the East / N-East it is not as prevelant, but it seems to work just fine for them.

        So, NO not everyone has to be a medic, but it dosen't hurt.

        Comment


        • #5
          I am happy to say we only run first responder engine/ squad companies...besides the city would hate to spend money on our education because we might leave to go to another department or to the county system( they run 911 medics) ...i graduated medic school in 96 and i have no desire to do it again........But, i do think its a good idea to have the ability to do so if the nearest medic unit is 15 min out as in alot of cases
          stay safe
          Its not something you do,
          Its something you are.
          "Whether we bring the terrorists to justice, or we bring justice to the terroists...Justice WILL BE DONE"... President Bush
          Engineer
          Engine Co. # 1
          THESE ARE JUST MY OPINIONS AND OPINIONS ONLY!!!

          Comment


          • #6
            I guess it depends on where you live. In New York City, they respond to EMS runs at the CFR or EMT level. It often takes a "bus" a while to arrive. I know some guys that have said they hate "babysitting" the patient until the ambulance arrives. When they say babysitting they mean that they are often CFR level and they can't really do anything more than give oxygen, first aid, or defib. They feel it takes them away from the job they signed up for...FIREFIGHTER. A lot of guys are getting burned out on EMS. Counting down the days to retirement. They used to love the job.

            With that being said, I think that we need to do what is best for the patient. In my opinion that would be to hire more paramedics, put more ambulances on the streets, and reduce response times in NYC's case. Reality though tells me that won't happen. Too much $$$$. Easier to send an engine company. Upstate, paramedic engines work out well. The ambulance may be 20 minutes or more away on a snowy day. It is a great comfort to the patient to see someone show up. I'm lucky because our district has 2 paid ambulances available at the paramedic level and if one is out of service the other one is available. They get there in about 7 minutes.

            So I guess what I'm saying is that whenever possible increase the amount of paramedic ambulances instead of using engine companies. Paramedics should be paid more than they currently are. In areas where it is slower and you want the added calls, go for it. Just keep an eye on your guys and make sure they don't get burned out.


            Stay safe everyone!
            Tom

            Never Forget 9-11-2001

            Stay safe out there!

            IACOJ Member

            Comment


            • #7
              In Plano,Tx. we try to have at least 2 paramedics per engine and truck, and one EMT and one paramedic per ambulance. All of the other firefighters are certified EMT's. And yes, our dept. transports patients to the hospital. With this policy we usually have about three paramedics per call or run and everybody else are EMT's.

              Comment


              • #8
                Does having a medic on your engine mean that it's an ALS unit, responding as such, with all the required equipment to do so? If it is, what firefighting equipment has the dept left off to acomodate all the ALS equipment and supplies? Is running 250,000 dollar engine the best unit for the job or can you run a stand alone unit more efficiently?

                Comment


                • #9
                  NO.

                  You shouldn't have to wait 20 minutes for an ambulance. The patient should only have to wait 10 minutes from the time of call, so the fire department first responders should only have to wait less than 10 minutes. During that time they should be able to, give o2, defib, secure an airway (ETT?), cpr, monitor vitals, and other "first aid".

                  A suppression unit should not be detailed to provide primary healthcare in the prehospital setting, nor should it sit idly in a station while someone chokes to death around the corner.

                  This Paramedic Engine Company idea is the wrong fix for a problem that lays with the mismanagement of EMS resources (or failure to provide those resources). It is espoused by the IAFF for several reasons...1) higher pay for current members as they become paramedics = more dues 2) more members as FDs take over EMS = more dues 3) FD control over the slice of the public safety pie left over by the police = more dues.

                  Unfortunately most EMS systems are so poorly run, they are easy targets for FDs attempting to improve service.

                  ********* Disclaimer...if by becoming a PEC, your department will then staff you 24/7, no splitting crews, with an additional person per company/platoon, it's probably a good Idea. Be wary of plans where all or part of the company will be unavailable several times a day because they are dealing with the TRANSPORT of a patient.

                  Comment


                  • #10
                    PFR, this answer all depends on your dept/municipality etc. As far as do firefighters have to be paramedics...why not? 10-15 years ago they asked if we should be EMT's. Also, being able to provide advanced treatments also has its benefits when it comes to many technical rescue functions we provide. Also our city management (city manager/mayor/council/etc.) does not look at it as being to expensive. And we have 2 or more per shift.
                    Axe, most of the equipment we carry is no bigger then what the BLS engines carry. Also, running "flycars," is not always feasible or likeable, it splits the crew more, and in events like cardiac arrests it makes life a little easier then being alone. Plus I don't believe in the old why are we sending a $300,000 fire truck to a EMS call. A call is a call. Customer service and life safety is what we are here for. I know of combo depts. that complain about the career guys running EMS calls, but its okay for them to take it 60 miles for a parade.
                    Finally, today paramedics provide more and more treatments and services in the field today. Some are instantly life saving, that minutes, and even sometimes seconds make a difference. And even if they aren't always true emergencies, there are still the treatments that affect patient outcome and comfort, ie asthma, CHF, Pulmonary Edema, Heart Attacks, Hypertensive Crisis, etc. And again while these are not "true emergencies," they lead up to resp. arrest/stroke/cardiac arrest. So when treated early and aggressively, they make a significant impact on overall patient outcome, and lessens the patients door to door time at the hospital.
                    Never prevent yourself, or your dept. from advancing itself.
                    ------------------------------------------
                    The above is my opinion only and doesn't reflect that of any dept/agency I work for, deal with, or am a member of.

                    Comment


                    • #11
                      I have found that here in Phoenix, Ald paramedic Engines works out well. We have 2 medics on 90% of our fire engines, all stations have paramedics, there are 6 station with an ALS ambo. our ladder trucks remain BLS since they are fewer and tactically u need them available for structure fires.

                      Comment


                      • #12
                        All of our fire departments' engine companies are paramedic engine companies.
                        Our ambulances run with two paramedics.
                        The paramedic engine company only really needs one paramedic.
                        We do not have a broad descriptive SOG for our paramedic engine companies.
                        I don't think every firefighter is cut out to be a paramedic. I also don't think every paramedic is cut out to be a fire fighter.
                        Our new hire candidates sign a contract to attend and pass paramedic school when they're hired on. The majority of our personnel are fire fighter/paramedics.
                        We have paramedic pay as some sort of incentive to be a paramedic.
                        In an all or majority paramedic fire department I think it ought to be a requirement to be a paramedic to be eligible to take the promotional exam for driver/engineer.
                        Paramedics on the fire department have experience making life and death decisions.
                        Education and experience are a good combination for promotional eligibility.
                        Riding in a jump seat and taking a few fire science classes doesn't exactly help with paramedic engine company functions.
                        If everyone that promoted to driver/engineer had to be a paramedic, that would almost guarantee a paramedic on every engine company.
                        Our fire department doesn't do it this way, but I would like to see a push to do so.
                        joejoe33

                        Comments and opinions are mine and do not represent the agency or IAFF local that I am affiliated with.

                        Comment


                        • #13
                          ALS FIRE, I expect a response like that from someone who calls themselves ALS FIRE. JOEJOE i'm glad you don't make decisions for my dept. As for the statement that medics make life and death decisions, thats CRAP . A medics decisions affect only the patient, who if you make a wrong call are probably no worse off then if you did nothing, and most ems calls are not emergiencies. And any time that a medic is confused on what treatment to provide, they get a doctor on the radio and he tells them what to do. A company officer that cant decide what to do can get his whole crew killed not to mention any possible victims, as well as destroying property. As for the statement that you should be a medic to promote, thats just as dumb. when an engine pulls up in front of a fire the the good operators will be thinking pump operations not iv's and those usless fire classes that you speak of , just may come in handy when making those first critical decisions that will affect the entire operation ( A true life and death decision ) I am not against medics, just the ones who think that ems is everything. We have many medics on our suppression units but only two engines respond as ALS units. I could go on but for everyones sake I'll quit for now.

                          Comment


                          • #14
                            We run an ALS Engine for two main reasons:

                            1) To have ALS equipment on the fireground in case it's needed.

                            2) As a backup to our squad. If the squad rolls BLS, the engine is sent as an "echo unit" as soon as a full crew with a medic gets to the station. Also, if the squad is out on one call and we get another one, the engine can respond ALS.

                            It makes sense for us as a small suburban department that doesn't see much fire. It might not work for everybody.

                            That being said, I don't feel it's necessary for everyone on the department to be a medic. I personally have no intention of ever being a medic. I would much rather take $3000.00 worth of firefighting classes than medic school. We usually have one or two medics per call and even if we don't, a county "Life Squad" is only a few minutes away. With the small amount of fires that we have, we don't have as much experience in that area and I feel I would contribute more by being better schooled in firefighting than being the third, fourth or fifth medic on the call.

                            Of course, this is just my opinion. I don't speak for my department, yadda yadda yadda

                            [ 08-06-2001: Message edited by: WTFDFF10 ]
                            FTM-PTB-DTRT

                            Comment


                            • #15
                              AXEYAZ, you are entitled to your opinion as I am entitled mine.
                              You're probably not a paramedic.
                              I got in firefighting before I was ever invovlved with EMS. EMS is cross training.
                              Fire based EMS is coming, if you don't already have it.
                              My point I make is that paramedics have experience making decisions. What I'd like to see happen with my organization may not work for other fire deparments with paramedic engine companies.
                              I don't know about Florida, but in Texas we have pre-hospital protocols for our fire based EMS. Your arguement of calling doctors for our decision making is not a valid arguement.
                              That's almost like saying engine companies need a armchair chief downtown to make their fireground decisions for them.
                              If you need a second alarm, then you call for it. If you want a doctors opinion about a patient, you have the ability to ask for it.
                              I don't think you can get all the leadership and decision making skills from a fire science class. Education and experience is a good combination in my opinion.
                              I saw a post in here titled " If you throw a book at a fire, will it go out."
                              Our department letters the side of the fire engine read, "PARAMEDIC ENGINE COMPANY"
                              My promotional idea is a staffing idea. I believe most of my collegues agree with this idea for promotion eligibility to driver engineer.
                              But the majority here are fire fighter/ paramedics.
                              joejoe33

                              Comments and opinions are mine and do not represent the agency or IAFF local that I am affiliated with.

                              Comment

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