Fire Als transport vs other..

[46Young]

...except for all the places where the FD medic is the only medic on scene and the only FD vehicle is a fire engine. Again, that fire engine is going to do a great job responding to that fire when it's 2 cities over retrieving it's medic from the trauma center.

Fire departments: "We created an abomination of an EMS system to secure our jobs, but we need more funding now because the system is so messed up that it's reducing our response capabilities."

Those types of systems are abominations, IMO. That seems to be a West Coast thing. There must be some financial benefit to running EMS that way, instead of having their own ambulances and EMT's. I suppose having two $10/hr private EMT's is more cost effective than having to supply their own FF/EMT and FF/medic, having to maintain the ambulance fleet, etc. That's the only reason I can see the department using privates in that way rather than running EMS exclusively.

 

[46Young]

I don't think it is so much cognitive dissonance as it is how the fire service views prehospital care.

They see it as a collateral skill set, similar to hazmat, tech rescue, aircraft rescue/firefighting, and any other number of technical "skills" that can be learned as part of the greater all hazards vocation.

In their mind they are providing the best in prehospital care. (though I personally vehemently disagree with their definition of it and their performance)

So it is not perceieved as "raping the EMS budget" so much as it is using the EMS budget and revenue source as a means to fund the "all hazard" mission.

What I think makes it very flawed is that common human disease is mostly chronic, not acute, so a majority of patients don't fit into their "life or death" skill based intervention philosophy. Thus rendering their care over-valued and under-effective.

But like I said, they don't see it that way. Look at their selling point of delivering life saving medications in an emergency. They use cardiac arrest as the example, with a successful code being delivering textbook ACLS.

"The surgery was successful but the patient died" approach.

That sounds about right. I've had to defend against several snide remarks about how FF/medics get about $20,000/yr more than basic FF's with the same tenure. I explain to them that a paramedic is a stand-alone career in many other places. The same cannot generally be said of non fire/EMS Hazmat techs or TROT techs. They get quiet real quick when I point out that the TROT heroes only go to school for six weeks, the glow worms for two weeks, but medics go from six months to two years. They get trained for cut jobs OTJ, but that only takes a couple of tours.

 

[abckidsmom]

That sounds about right. I've had to defend against several snide remarks about how FF/medics get about $20,000/yr more than basic FF's with the same tenure. I explain to them that a paramedic is a stand-alone career in many other places. The same cannot generally be said of non fire/EMS Hazmat techs or TROT techs. They get quiet real quick when I point out that the TROT heroes only go to school for six weeks, the glow worms for two weeks, but medics go from six months to two years. They get trained for cut jobs OTJ, but that only takes a couple of tours.

Through a colossal paperwork error, my medic card expired for two weeks in November. I found out real quick that being a basic on a medic unit is exquisitely easy. I wrote no call sheets, I changed out no drug boxes, I helped my partners out and drove the ambulance. Delightful.

And better watch out for the career dissipation light if you talk like that out loud in the station. We don't disparage our TROT heroes. Not much respect available for guys who are thrilled to be medics, and revel in that role.

 

[Shishkabob]

gives you maybe ten minutes, fifteen tops to get a knock on the fire, otherwise it's just surround and drown.

Then surround and drown. No property is worth life, and Bryan Texas just lost 2 firefighters not heeding that lesson. FD sucks at learning lessons taught in blood, as they keep doing it over and over.

 

[STXmedic]

Then surround and drown. No property is worth life, and Bryan Texas just lost 2 firefighters not heeding that lesson. FD sucks at learning lessons taught in blood, as they keep doing it over and over.

Just like ambulances driving emergent all the time? I'm pretty sure there's a thread right now about that. Glass houses, sir.

 

[Shishkabob]

Just like ambulances driving emergent all the time? I'm pretty sure there's a thread right now about that. Glass houses, sir.

Except I don't advocate running emergent to calls all the time, therefor I will throw the stone.


And my agency tries many things to prevent that from happening (not fool-proof, but alas), including going to the cities and showing that emergent response shouldn't be what EMS is measured by, but patient outcome. We suspended emergent response for a couple of days during an ice storm a couple of years ago. Granted, limited scope, but there was no difference in patient outcome, and my agency pushed that out to the news agencies.

 

[STXmedic]

Except I don't advocate running emergent to calls all the time, therefor I will throw the stone.


And my agency tries many things to prevent that from happening (not fool-proof, but alas), including going to the cities and showing that emergent response shouldn't be what EMS is measured by, but patient outcome. We suspended emergent response for a couple of days during an ice storm a couple of years ago. Granted, limited scope, but there was no difference in patient outcome, and my agency pushed that out to the news agencies.

And many departments don't advocate on going interior innecessarily, and practice much safer methods at structure fires. If you want to throw blanket statements, then so can I. Your system is the exception. Well, you are one of the exceptions at your system, because I'm willing to bet there are still quite a few people at MS that run emergent.

 

[ExpatMedic0]

Through a colossal paperwork error, my medic card expired for two weeks in November. I found out real quick that being a basic on a medic unit is exquisitely easy. I wrote no call sheets, I changed out no drug boxes, I helped my partners out and drove the ambulance. Delightful.

And better watch out for the career dissipation light if you talk like that out loud in the station. We don't disparage our TROT heroes. Not much respect available for guys who are thrilled to be medics, and revel in that role.

haha ya its fun change. I was placed on a BLS rig for a week due to a staffing issue, it was a blast. However whats even better is ALS rapid response with a basic partner. 9 times out of ten in the fly car all I did was get driven to calls, get out, evaluate, release to BLS, get back in the fly car. No transport %90 of the time from my end, very simply easy paper work

 

[DrParasite]

Really, how many places in the country have well staffed EMS? Not many, probably hardly any. There are a huge amount of predominantly volunteer fire across the country. Even without the burden of funding a career department, EMS still gets understaffed, with only the minimum needed to get by. For EMS, just barely having enough units to get by seems to be the norm. How many EMS employers run with three on the bus? How many grant true OOS meal breaks? The only one that I've seen do this is Nassau County's EMS. How many places use SSM? How many places bid out to a cheap private provider? How many of those private providers play games juggling 911 units and IFT units to boost profitability? Using fire to Band-Aid this reality is clever, and it's also clever for fire depts. to exploit this fact to protect their own positions.

I don't have an easy answer to get around this situation.

Can I quote this for truth? quoted for accuracy? how about for the next time we go fire vs ems staffing, and I say this exact same thing, i can just reference your post?

btw, almost every firefighter wants to do their job, go into a fire, put it out, and make everyone happy. more often than not, it was to save property, and the homeowner is happy. No firefighter wants to die in a fire, and the general consensus is that most will risk a lot to save a life, but few want to get hurt just to save property. but that's another topic.

 

[Veneficus]

btw, almost every firefighter wants to do their job, go into a fire, put it out, and make everyone happy. more often than not, it was to save property, and the homeowner is happy. No firefighter wants to die in a fire, and the general consensus is that most will risk a lot to save a life, but few want to get hurt just to save property. but that's another topic.

Can I jus ask how this is really different from EMS?

Running lights and sirens to every call despite the dangers and the fact it doesn't do anything?

Not having stations and getting fatigued posting in a truck for hours on end without basic necessities of life so the company can make a few more $ while running the risk of a serious MVC or medical error?

Of course, the easy way to solve these problems is for providers not to work at such companies. But that will never happen, EMS providers are a dime a dozen. Why pay more?

 

[sweetpete]

And many departments don't advocate on going interior innecessarily, and practice much safer methods at structure fires. If you want to throw blanket statements, then so can I. Your system is the exception. Well, you are one of the exceptions at your system, because I'm willing to bet there are still quite a few people at MS that run emergent.

This is one of the BEST posts I've ever read on this blatantly anti-fire department website. Finally, someone who knows what they're talking about.

I see more ambulances going emergency traffic than fire trucks on ANY given day down here in Houston. And having been in a number of those ambulances, I can practically guarantee that it's not necessarily an emergency.

Well don Poetic.

Take care,

 

[Shishkabob]

I see more ambulances going emergency traffic than fire trucks on ANY given day down here in Houston. And having been in a number of those ambulances, I can practically guarantee that it's not necessarily an emergency.

Every city we work with, their FD runs LS on every single call they are dispatched to, EVEN if they're going to end up staging around the corner for PD.

This is one of the BEST posts I've ever read on this blatantly anti-fire department website.

No one here is "anti-fire". Some of us just don't think FD should have anything to do with medicine, especially when they use it solely as a way to boost their budget. But you're probably the same thinking when it comes to EMS doing rescue... so....

 

[DrParasite]

This is one of the BEST posts I've ever read on this blatantly anti-fire department website. Finally, someone who knows what they're talking about.

this is far from an anti-fire department website. there are some individuals who are anti-fire based ems (myself included), but I support 100% the FD putting out the fires.

I see more ambulances going emergency traffic than fire trucks on ANY given day down here in Houston. And having been in a number of those ambulances, I can practically guarantee that it's not necessarily an emergency.

probably because the ambulances are going on more calls than the fire trucks. and I'm guessing (just wild guess) that they are going L&S to the hospital becasue they want to take a break to pee or they know they are so backed up the sooner they get to the hospital the sooner they can get back available to answer the next pending call.

oh, and veneficus, one way is the thinking of the line staff, the other way is the thinking of management, at least for EMS, many in the FD think similarly, from upper management to line staff.

 

[JPINFV]

This is one of the BEST posts I've ever read on this blatantly anti-fire department website. Finally, someone who knows what they're talking about.

I imagine I support fire departments taking over EMS as you support EMS departments taking over fire suppression.

I see more ambulances going emergency traffic than fire trucks on ANY given day down here in Houston. And having been in a number of those ambulances, I can practically guarantee that it's not necessarily an emergency.

Well don Poetic.

Take care,

...and I've seen fire fighters out here upgrade transports to lights and sirens simply because they want to get done quicker.

 

[STXmedic]

...and I've seen fire fighters out here upgrade transports to lights and sirens simply because they want to get done quicker.

And I've seen ambos here do the same thing.

 

[JPINFV]

And I've seen ambos here do the same thing.

...and I don't doubt it for a second, but when it's a "The FD is awesome because they don't do D-bag things like go lights and sirens for no reason," it's patently untrue. Unfortunately, if a vehicle has lights and sirens, those tools will be abused.

 

[STXmedic]

...and I don't doubt it for a second, but when it's a "The FD is awesome because they don't do D-bag things like go lights and sirens for no reason," it's patently untrue. Unfortunately, if a vehicle has lights and sirens, those tools will be abused.

Most certainly. It's a problem with both. There's few problems I see that are specific to just one or the other.

 

[Shishkabob]

I'll admit it... I went L&S to the hospital yesterday to get done quicker....

That was after I gave my bradypnea patient narcan who then proceeded to exhibit trismis, clenching down on the OPA we had in, breaking all their front teeth, then exhibited anisocoria and tachypnea. That call couldn't be over fast enough! And before you ask... it was just 0.4mg Narcan. I don't slam it.

 

[Bullets]

I am not anti fire. I am anti period doing things they aren't designed to do. I love my engine company that works in my town, they help us on difficult or man power intensive calls where two providers aren't enough hands. Their charting and patient care are poor but they are helpful for compressions and on mvc. They are also the best company in the area when it comes to fighting fire. However they are 4 professionals in a volunteer department. Our fire companies run code to everything even if there are units on scene telling them to reduce.