Private 9-1-1/ALS Opportunity

Mike Hughes

Forum Ride Along
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Correct me if I’m wrong, but Falck has private fire resources in other countries and whatnot right?
I’m not too familiar with private fire departments in the US. Can somebody enlighten me?
In the UK Falck have an ambulance wing and do a lot on behalf of the NHS but they do not provide fire services
 

PotatoMedic

Has no idea what I'm doing.
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Falck is the largest private ambulance service. They also do a lot of fire fighting in Europe and in South America I believe. They also do a lot of industrial safety training. Their parent company also owns Lego!
 

Medic496

Show strength when weak, and humility when strong
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This is not a new idea. If I remember correctly, this is how ALS was started in Santa Ana. Many ALS programs ran out of hospitals at first. I believe the old Santa Ana program was a hospital based ALS program and later the City adopted it and ran their ALS ambulances. I believe it was in the 1990's that the SAFD folded the ALS program into the department. Where is SAFD now? The model they moved to broke them. Back to medic squads and a BLS ambulance. Four personnel on scene is enough. If the patient is on fire, a fire engine will be sent.
 

Peak

ED/Prehospital Registered Nurse
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Anyone know what gas mileage is on a ladder truck, or quint?
Its hard to calculate because of all the time spent on scene idling, 4 MPG is a very good day. Fuel economy is only a small fraction of why custom cab fire apparatus are so expensive to run.
 

EMT Rookie

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Its hard to calculate because of all the time spent on scene idling, 4 MPG is a very good day. Fuel economy is only a small fraction of why custom cab fire apparatus are so expensive to run.
Thus further perpetuating the insane logic of sending a 40,000 pound million dollar rig with a million dollar crew riding on it to tend to Uncle Roscoe’s chest pains.
 

DrParasite

The fire extinguisher is not just for show
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Thus further perpetuating the insane logic of sending a 40,000 pound million dollar rig with a million dollar crew riding on it to tend to Uncle Roscoe’s chest pains.
Because other than fuel, you're paying them the same amount whether they are at the station playing cards or going to help uncle Roscoe who has chest pain.

Plus, if you want to short change the local EMS system with available EMS resources, you can just send the FD to stop the clock, so when someone complains that the ambulance took too long, you can say "but you had a trained fire truck with EMS personnel on scene in 4 minutes."

I happen to like the idea of sending the FD in a QRV instead of the BRT.... but looking from the fire side, there are some advantages to everyone being on one truck.
 

EMT Rookie

Forum Probie
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Because other than fuel, you're paying them the same amount whether they are at the station playing cards or going to help uncle Roscoe who has chest pain.

Plus, if you want to short change the local EMS system with available EMS resources, you can just send the FD to stop the clock, so when someone complains that the ambulance took too long, you can say "but you had a trained fire truck with EMS personnel on scene in 4 minutes."

I happen to like the idea of sending the FD in a QRV instead of the BRT.... but looking from the fire side, there are some advantages to everyone being on one truck.
There’s a much simpler solution: allow the EMS professionals to respond to EMS calls and allow the fire professionals to respond to fires. A medic, EMT and your run of the mill ambulance is all you need - it’s all that’s ever been needed.
 

Peak

ED/Prehospital Registered Nurse
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Thus further perpetuating the insane logic of sending a 40,000 pound million dollar rig with a million dollar crew riding on it to tend to Uncle Roscoe’s chest pains.
Because other than fuel, you're paying them the same amount whether they are at the station playing cards or going to help uncle Roscoe who has chest pain.

Plus, if you want to short change the local EMS system with available EMS resources, you can just send the FD to stop the clock, so when someone complains that the ambulance took too long, you can say "but you had a trained fire truck with EMS personnel on scene in 4 minutes."

I happen to like the idea of sending the FD in a QRV instead of the BRT.... but looking from the fire side, there are some advantages to everyone being on one truck.

That's a whole soapbox I could preach from all day, but the thing that gets me going the most is that it isn't even functional.

Ladder trucks are heavy, slow, and have a large turning radius; putting a pump on it makes it even heavier. In my opinion quints are rarely needed, its usually either a way for a district to not pay for a engine and ladder crew or a way for crews to justify having a stick that can still mostly function as an engine.

Look at the majority of departments and you will find that they really don't need custom cab engines, and that commercial would serve the same purpose and save about half the cost. Rarely do groups really need the couple of feet in length saved by a custom, and if we used cab overs like in Europe it wouldn't even matter. Yet so many departments fight to keep that 400K chrome chariot/engine. Can't let progress get in the way of tradition.

I think in some environments that having EMS trained fire personnel make sense (predominetly low volume/low density/rural areas), but in large urban areas it just doesn't. Why should fire run a QRV instead of the 3rd service? I also think that when you start to look at areas where it makes sense for fire to have an EMS role, it usually makes for sense for them to cross staff an ambulance anyway.
 

DrParasite

The fire extinguisher is not just for show
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I could respond, but the post would be 4 pages long, and most of it would involve me agreeing you with on most things (although once you pull up on the ladder to a structure with heavy fire showing, and the engine is tied up on another assignment, you will be happy you have the pump and hose), but also been around the block enough to know what happens in so many places, that it's one of the reasons why i don't work full time in EMS anymore.
 

EMT Rookie

Forum Probie
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That's a whole soapbox I could preach from all day, but the thing that gets me going the most is that it isn't even functional.

Ladder trucks are heavy, slow, and have a large turning radius; putting a pump on it makes it even heavier. In my opinion quints are rarely needed, its usually either a way for a district to not pay for a engine and ladder crew or a way for crews to justify having a stick that can still mostly function as an engine.

Look at the majority of departments and you will find that they really don't need custom cab engines, and that commercial would serve the same purpose and save about half the cost. Rarely do groups really need the couple of feet in length saved by a custom, and if we used cab overs like in Europe it wouldn't even matter. Yet so many departments fight to keep that 400K chrome chariot/engine. Can't let progress get in the way of tradition.

I think in some environments that having EMS trained fire personnel make sense (predominetly low volume/low density/rural areas), but in large urban areas it just doesn't. Why should fire run a QRV instead of the 3rd service? I also think that when you start to look at areas where it makes sense for fire to have an EMS role, it usually makes for sense for them to cross staff an ambulance anyway.
Fire will always have an EMS role - that of an EMT assisting medics as needed and the ocassional patient extrication or technical rescue. Let the medics be medics - and they don’t have to work for public fire departments to do their jobs either.
 

Peak

ED/Prehospital Registered Nurse
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...although once you pull up on the ladder to a structure with heavy fire showing, and the engine is tied up on another assignment, you will be happy you have the pump and hose...
In some ways I wasn't a very good firefighter. I never really cared that much about putting out the fire, I just wanted to make entry and search; maybe I was really meant to be a truckie. Dragging a hose slows down your search so much and all I really cared about was rescue.
 

Peak

ED/Prehospital Registered Nurse
253
117
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Fire will always have an EMS role - that of an EMT assisting medics as needed and the ocassional patient extrication or technical rescue. Let the medics be medics - and they don’t have to work for public fire departments to do their jobs either.
Meh, I don't think that most fire departments need nearly the EMS presence they have. The department that serves the area around my hospital is BLS only, and I can't think of a time when it detrimented care. I certainly do think that there is a place for some EMS in fire, and in some areas this very much includes medics, but I also think that a lot of departments at this point have gone too EMS heavy.

I was a fire medic at a small department, and for us it made a lot of sense. Our group of fire medics were also very interested in giving good quality medical care, something I think many firefighters are not invested in. I also think that the current presence of EMS care in fire is holding back a lot of development of 3rd services in most of the US.
 

ITBITB13

Forum Lieutenant
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Its hard to calculate because of all the time spent on scene idling, 4 MPG is a very good day. Fuel economy is only a small fraction of why custom cab fire apparatus are so expensive to run.
I could respond, but the post would be 4 pages long, and most of it would involve me agreeing you with on most things (although once you pull up on the ladder to a structure with heavy fire showing, and the engine is tied up on another assignment, you will be happy you have the pump and hose), but also been around the block enough to know what happens in so many places, that it's one of the reasons why i don't work full time in EMS anymore.
I’m pretty sure I’m not the only one interested in seeing your 4 page opinion.
 

DrParasite

The fire extinguisher is not just for show
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I’m pretty sure I’m not the only one interested in seeing your 4 page opinion.
In a nutshell, there is 0 reason for the for the FD to be on 90% of EMS calls. Fire should do fire, EMS should do EMS. For rough numbers, In a career system, tiered is generally the way to go, so you should have as many BLS ambulances as engines, and staffed ALS ambulances as ladders/rescues, with competent EMD screening, sending the appropriate level ambulance to the appropriate call. If you have a fire based EMS system, and you have more engines than ambulances yet the majority of your calls are EMS, than you're not allocating your resources appropriately based on the call volume.

Fire can be helpful to EMS on certain calls (cardiac arrests, rescues), when additional manpower or special equipment is needed, but if you have a properly staffed EMS system, you rarely need a first responder to stop the clock. ALS engines are stupid, a waste of money, and there is no evidence that they are actually beneficial. If you must have a first responder, downgrade them to BLS, make sure they are good at BLS, and have enough ALS ambulances that ALS can be started a few minutes after the engine arrives.

This also means having EMS as an independent 3rd service government entity, so they get all the government retirement benefits, and the government is responsible for it's operation, and funds it's operations like any other government department, not a private entity who is contracted to provide a service and all too often isn't given the funding to do the job well, and still make a profit.

SoCal is apparently a very special area to work in.... if you are with the FD, you get paid well and know everything, if your on the ambulance, you are a taxi service. not really something that appeals to me, but they have a glutton of providers who are just hoping and praying they get that golden ticket and get hired by the FD. But if you really want to do EMS, it's best to get out of SoCal.

That wasn't too horrible, was it @VentMonkey?
 

ITBITB13

Forum Lieutenant
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I’m not. Just leave SoCal as well...
Sure, consider me gone. Or how about you leave, I stay?

In a nutshell, there is 0 reason for the for the FD to be on 90% of EMS calls. Fire should do fire, EMS should do EMS. For rough numbers, In a career system, tiered is generally the way to go, so you should have as many BLS ambulances as engines, and staffed ALS ambulances as ladders/rescues, with competent EMD screening, sending the appropriate level ambulance to the appropriate call. If you have a fire based EMS system, and you have more engines than ambulances yet the majority of your calls are EMS, than you're not allocating your resources appropriately based on the call volume.

Fire can be helpful to EMS on certain calls (cardiac arrests, rescues), when additional manpower or special equipment is needed, but if you have a properly staffed EMS system, you rarely need a first responder to stop the clock. ALS engines are stupid, a waste of money, and there is no evidence that they are actually beneficial. If you must have a first responder, downgrade them to BLS, make sure they are good at BLS, and have enough ALS ambulances that ALS can be started a few minutes after the engine arrives.

This also means having EMS as an independent 3rd service government entity, so they get all the government retirement benefits, and the government is responsible for it's operation, and funds it's operations like any other government department, not a private entity who is contracted to provide a service and all too often isn't given the funding to do the job well, and still make a profit.

SoCal is apparently a very special area to work in.... if you are with the FD, you get paid well and know everything, if your on the ambulance, you are a taxi service. not really something that appeals to me, but they have a glutton of providers who are just hoping and praying they get that golden ticket and get hired by the FD. But if you really want to do EMS, it's best to get out of SoCal.

That wasn't too horrible, was it @VentMonkey?
Not bad at all. I’m sure everyone knows this to be truth. But whether people choose to accept it or not, is another topic of discussion.
 
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