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  • Fire-based EMS?

    There are so many private ems folks out there that scoff at fire-based ems, saying knuckledraggers (their term, not mine!) belong in the red trucks and not the ambulance. I'd also heard over the years that the ambulance was historically the punishment assignment. What do the line folks out here think about EMS? Are there many people who feel fire should stay fire, or is there acceptance of EMS along with all of our other duties? I'm quite curious what people think.
    ~Kevin
    Firefighter/Paramedic
    --^v--^v--^v--^v--
    Of course, that's just my opinion. I could be wrong
    Dennis Miller

  • #2
    Do you want a cookie cutter answer or the real one?

    While I would prefer not to do EMS it has become a nessary part of the paid fire service. Some of those reasons for better or worse revolve around what is best for the taxpayer and may or may not have the best interest of the PT. in mind. While many firefighters bitch about doing it, they know that in order to survive they must do what is right for the public. I came from a volunteer ambulance based service into the fire service 18 years ago and have watch the ambulance service change to a 90% paid corp and have seen my fire department change to a paramedic sevice from basic EMT sevice in just 5 years. The winners in this game is the public because are recieving the best possible trained people for thier tax dollar. There will no doubt be more change for the fire service in the years to come and there will be some out there who will buck change, but remember this "the more things change the more they stay the same".
    IACOJ Membership 2002
    {15}

    Mike IAFF

    The beatings will continue until the morale improves

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    • #3
      no cookie cutters here!

      Well that's exactly who the "winners" should be, the public. I can see a much greater versatility in the fire service with most being actively involved (either first response or transporting) in medical calls. The evolution, as you described, of many departments HAS been very quick, some going full ALS in just a few years.

      I actually have an odd position here where I work a municipal fire-based EMS for my town, but the neighboring towns contract us to transport for them as they do first response to calls.
      ~Kevin
      Firefighter/Paramedic
      --^v--^v--^v--^v--
      Of course, that's just my opinion. I could be wrong
      Dennis Miller

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      • #4
        I think the outlook on fire-based EMS is a generational one in many departments. The older guys became firefighters so they could fight fires... not be "cot jockies." Folks hired in the last 10 years (or more in progressive cities) know that fire trucks roll on medicals and accept that role more so. If you aren't yet a firefighter and don't want any part in EMS... your hiring options are greatly reduced.

        However, "knuckledraggers" do remain out there. Look at the recent USE Today report on EMS response. One department (DCFD?) left the station more quickly for a dumpster fire than they did for a cardiac run. Even in my department, where EMS has been a part of our operation for years, there are folks that will hustle to the rig for an AFA but drag their feet when it's a EMS run.
        sigpic

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        • #5
          I think that's called "assdragging"...nothing to do with knuckles. Medical calls, among other things, are the future for the fire service. It's here, and it's staying. Get used to it. There's a lot of sour grapes surrounding this issue. As far as being on the ambulance being punishment assignment, there are a lot of firefighters who see it that way. This is a situation that should be resolved if it exists in one's department. Patient care will eventually suffer if it isn't taken care of, one way or the other.
          Member IACOJ

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          • #6
            Good point-- municipal EMS is not generally something the fire service is given a choice about. Often, I imagine, it hinges a great deal on what the current chief & administration think, but certainly not the membership who could be content sticking to fires & car crashes. I do applaud those who rise up to the patient care arena when it is thrust upon them, as I know it's not what many signed up for 10-20 years ago!
            ~Kevin
            Firefighter/Paramedic
            --^v--^v--^v--^v--
            Of course, that's just my opinion. I could be wrong
            Dennis Miller

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            • #7
              Someone told me that Phoenix makes new firefighters ride the ambulance for a certain number of tours in an effort to make them understand the importance of EMS. Anyone know if that's true? And how long that assignment is?
              sigpic

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              • #8
                I think this question depends on the city's size, density of population, socio-economic conditions, history of fires, non-medical emergencies and medical reponse's . This is especially true in todays needed and sometimes required training in technical rescue responses related to high angle, trench and confined space rescue, not to mention RIT and HAZ-MAT which in my department is solely handled by the Firefighting Division and not the EMS Division. The only area in which we have Medics completly involved and trained in but not in charge of the situation is level 3 HAZ-MAT incidents. I feel that larger viable and well run urban areas and larger cities with lower socio-economic conditions (a politically incorrect phrase) should have a separate EMS based system as a division within the Fire Department. The Firefighting Division in my department doesn't do first responder but are trained to that level (long but interesting story). A Firefighter is a Firefighter and a Medic is a Medic. This allows for each one to be highly efficient at the duties they perform and yet still allows them to work together effectively when necessary (MVA's etc). In smaller cities, townships and villages, I can see fire personnel doing both.

                To add a little to this we don't do meds and they don't do fire. The Medics actually belong to a separate union and not the DFFA and IAFF.
                Last edited by FireLt1951; 09-11-2003, 09:57 AM.

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                • #9
                  We Already Do It All.........

                  No Question here. We have had a Fire based EMS service since 1929, and we're damn proud of it. We believe that ours (PG Co Md) was the first County Wide, Volunteer, EMS service in the world. We also believe that we are the largest System in the world to use volunteers extensively. Our county has a population of 830,000 and a land area of 430 Square Miles. EMS Transport is handled by 12 ALS and 49 BLS ambulances operating from 47 Fire stations. Those same Fire stations house the usual array of Fire apparatus, 22 Ladder companies, 91 Engines, 12 Heavy Rescues, and a whole herd of other stuff. CY 2002 provided us with a run total of 308,000 responses. We wouldn't have it any other way.

                  Stay Safe......
                  Never use Force! Get a Bigger Hammer.
                  In memory of
                  Chief Earle W. Woods, 1912 - 1997
                  Asst. Chief John R. Woods Sr. 1937 - 2006

                  IACOJ Budget Analyst

                  I Refuse to be a Spectator. If I come to the Game, I'm Playing.

                  www.gdvfd18.com

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                  • #10
                    The career Fire Department I work for does not run Ambulance or transport in any such way. It staffs a BLS ambulance with reservists on the weekends in a ski resort community during the winter. That is as close as we come. The paid guys run no ambulance.
                    The department is in the process of trying to obtain a BLS license from the state. The older guys don't support the ambulance, feeling as if it is a punishment. They have no ambition to ride on the ambulance. The thing is, the older guys are Captains and Engineers. They have virtually no chance of riding the ambulance. It is the young guys, the firefighters and some engineers, with less then 5 years on who want to run the ambulance.
                    I, myself, personally do not want to run the ambulance day in and day out. A shift or 4 a month would be ok, but I don't want to be assigned to ride an ambulance until I'm promoted to Engineer. I knew the layout and how this department operated when I hired on. That was more incentive for me to pursue a career with this department.
                    This isn't to say I don't support this ambulance deal. I support it whole-heartedly. I will work on this ambulance and make the program work when we get it. It will take the FD forward, make us more progressive. That is the only way this department can go. I will do what it takes to better the department I work for. I love running good medical calls but would take a fire any day....

                    *Mark
                    FTM-PTB-RFB-EGH

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                    • #11
                      I'm enjoying all of the feedback, and I certainly didn't want to push my OWN agenda here! It's good to hear the point of view from people in the fire service about EMS, as I so often hear people of EMS complaining about fire-based systems. Some departments, such as the city of Keene (NH), regularly rotate assignments from ambulance, engine, and rescue or ladder, whether a paramedic or not. Granted, the paramedic might get bumped off the BRT if the department is down a medic on ambulance that day, but the system sounds pretty fair and quite diverse that way. Keep the ideas flowing!
                      ~Kevin
                      Firefighter/Paramedic
                      --^v--^v--^v--^v--
                      Of course, that's just my opinion. I could be wrong
                      Dennis Miller

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                      • #12
                        I have to say that I have come to be against fire service based EMS. Now I come from a fire service background. I have worked for two career departments, both of whom operate a BLS ambulance.

                        In the first department, the junior men were on the ambulance - period. The bottom 8 guys were on the box, no ifs, ands, or buts. We routinely ran 20 - 24 runs in a 24 hour shift. We were lucky if we got 2 hours sleep while on the 24 hour shift while the other companies - 3 engine and one stick - ran 3 or 4 calls in the 24. No rotation of duties or training for the ambulance crews.

                        The second department was a 5 man per shift department and everyone, except the Captain rotated positions. I actually learned to be firefighter here. Go figure huh? Most of these guys despised EMS but realized that if it weren't for the box, they would not have a job.

                        In many places EMS works when under a fire department. Every time an ambulance service is absorbded by a fire department morale for EMS decreases. FDNY, St. Louis, Seattle, San Fran, DC, they all have tremendous problems with morale and EMS - which actually makes money for the city and department, gets very little money for equipment, training, and the like.

                        I currently work for a private EMS agency as a Paramedic and do 9-1-1 for several communities. Most of the fire departments that I have interacted with and observed doing first responder runs can barely handle that. I was on a chest pain run a few weeks ago and a firefighter told me that will no longer carry patients down on stair charis because their contract does not state this is thier job. This os not the first or only firefighter from this department to do so either. These guys want their own ambulance too. SHUDDER.

                        The days of going to smells and bells is here and the days of workers every few days is LONG gone. Bottom line is it works some places, but not others. I find that the number of places that it does work is smaller than the number of places that it doesn't. Again, my opinions made from my observations in New England.
                        "Too many people spend money they haven't earned, to buy things they don't want, to impress people they don't like." Will Rogers

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                        • #13
                          Originally posted by FireLt1951
                          I feel that larger viable and well run urban areas and larger cities with lower socio-economic conditions ... should have a separate EMS based system as a division within the Fire Department.
                          I don't think having a seperate EMS Division within the fire department is a good idea... Unless you can offer the EMS employees parity with the fire employees. I think NYC has issues between the fire and EMS guys... and I know they aren't alone.

                          You've never seen people more miserable until you tell them, "You are part of our department but you are not the same as us. Your pay is different and you don't have as many promotional opportunities." I know this from personal experience.
                          sigpic

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                          • #14
                            Cozmo brings up a great point. As a firefighter/paramedic, I want the same opportunity to rise up the ranks as a firefighter as anyone else, IF and only if my abilities merit promotion. I don't see myself different than a firefighter who hasn't gone to paramedic-- it's like a module or just another "skill" that I did. Some have high angle rescue, some have confined space rescue, and I happen to have paramedic as something that goes along with my firefighter certs. People should be paid on certification & merit, time & dedication to the department. I have no problem with a firefighter who has training I don't have to make the same pay I do when I have paramedic. I think we ALL could be paid more, but that's another thread! Great ideas, folks. Take care
                            ~Kevin
                            Firefighter/Paramedic
                            --^v--^v--^v--^v--
                            Of course, that's just my opinion. I could be wrong
                            Dennis Miller

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                            • #15
                              The situation here is, EMS doesn't want to do Fire and Fire doesn't want to do EMS. Everyone seems to be very content with this and I personally can't see anything wrong with it. It works well for us. When EMS started up in 1973 we tried to get involved and the Medics they hired(the city didn't want to take the time and pay to train the Firefighters, they just went out and hired certified medics) didn't want anything to do with being Firefighters or belonging to any Firefighters Union, they voted to join a separate union. They got what they wanted and I'm fine with that and everyone else seems to have that same opinion. It's a long dragged out story regarding the beginning of the separate divisions system. What I find funny is we've had many Medics take the test and became Firefighters but we have never in 30 years had a Firefighter take the test to join EMS as a Medic and there are actually more certified medics in the Firefighting Division than the total number of certified Medics in the entire EMS Division.

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