sent to me by a physician

[firecoins]

There are often more fire dept personnel than EMS so they usually can have some forst response vehicle there quickly but not necessarily an ambulance.

 

[281mustang]

What's with the stigma against fire based EMS?

 

[MMiz]

What's with the stigma against fire based EMS?

The argument that fire-based EMS systems are firefighters first, and then use EMS to rationalize their existence. When I call 911 for a medical emergency I want the best medic, not a firefighter who practices medicine in order to get/keep a job.

The argument is that either a third (separate) EMS service or private EMS can do a better job.

 

[Hockey]

In many Michigan communities it is common to have Public Safety Officers who are trained as Police Officers/Fire Fighters/EMT-Basic.

mmhmm

And you should see the fight that both sides put up when they try to do it anymore

I was in the process for Kzoo DPS but they did a freeze around a year ago now.

 

[Hockey]

The argument that fire-based EMS is a way for fire departments are firefighters first, and then EMS to rationalize their existence. When I call 911 for a medical emergency I want the best medic, not a firefighter who practices medicine in order to get/keep a job.

The argument is that either a third (separate) EMS service or private EMS can do a better job.

Firefighters can multi-task dontcha know? Regular private based EMS can't!

Jeez MMiz what is wrong with you!?

 

[HotelCo]

mmhmm

And you should see the fight that both sides put up when they try to do it anymore

I was in the process for Kzoo DPS but they did a freeze around a year ago now.

Of course, because the Fire and Police Depts want to be the only ones to do wht they do. They know that if they are all crosstrained, that there can/will be cuts. I don't blame them for wanting to keep their jobs.

 

[emt_angel25]

What's with the stigma against fire based EMS?

There is nothing wrong with fire based EMS services. but that video makes it seem like fire based EMS is the best thing since sliced bread. and in some cases its the truth. but for those of us who dont work for a fire based service (like me) it hits a nerve to say that the rest of us dont know what we are doing and that our response times are slower. not the case for around here. we do just fine with out having fire personnel on the scene all the time. i love our firefighters they are great when we need them. but we dont need them all the time.

 

[trevor1189]

I have no problem with fire based ems as long as the ems side is properly funded to provide the best possible patient care. Also, if someone calls 911 for medical emergency there is no need to send a rescue engine and an ambulance just so the fire side can make some money off the call.

If I remember correctly there was a story about DC Fire that billed for a fire truck that was parked in front of the patients home while the ambulance handled the patient.

 

[Sasha]

The argument that fire-based EMS systems are firefighters first, and then use EMS to rationalize their existence. When I call 911 for a medical emergency I want the best medic, not a firefighter who practices medicine in order to get/keep a job.

The argument is that either a third (separate) EMS service or private EMS can do a better job.

Sometimes the best medic IS also a fire fighter. Being a fire fighter is not synonymous with bad care. Being a third service EMS provider is not synonymous with good care. You have good and bad providers on both sides of the spectrums.

EMS based fire service is a necessary evil in some areas and if that's how their city or county chooses to provide their citizens with EMS services, so be it.

 

[EMTinNEPA]

Since when did we settle for "necessary" evils?

 

[firecoins]

Sometimes the best medic IS also a fire fighter. Being a fire fighter is not synonymous with bad care. Being a third service EMS provider is not synonymous with good care. You have good and bad providers on both sides of the spectrums.

EMS based fire service is a necessary evil in some areas and if that's how their city or county chooses to provide their citizens with EMS services, so be it.

Yes someone can be a firefighter, plumber, soldier, business owner or anything else and be a good paramedic. It has nothing to do with it.

This is about EMS systems being run by people interested in running an EMS organization. EMS should not be sold out to Fire or police so they can justify and finance their firefighting or law enforcment budgets which is what is being done. As I said, there are fewer structure fires due to fire prevention. Firefighting budgets are being cut so EMS is being added so firefighting can be fully financed.

 

[Jon]

The entertaining thing is that in many of the images they are showing, there are private/3rd service EMT's there - including lots of AMR folks. Sillyness.

 

[Mountain Res-Q]

$$$ money $$$

There are less than hald the fire calls there used to be. Fire prevention has been very successful.
Fewer calls means politicians may want to reduce fire dept jobs. But they can reverse that if they do EMS. Notice how they don't want FDs merging with Police because doing 2 jobs would make them worse at both all of a sudden.

Careful, I'm tired, I will rant a little here...

I think firedcoins hit the nail on the head. This isn't the first time I've seen this arguement. Consider... It is called the FIRE Department. They/You are called FIREfighters. Why? Because the original purpose of Fire was to... FIGHT FIRES. Now consider all the things your local fire departments respond to: Vehicle Accidents, Rope Rescues, Water Rescues, Dive Calls, Public Service Assists, Haz Mats, Confined Space Rescues, and (yes) Medical Calls. If you look a the history of the Fire Service this didn't come about in one day. Fire was a VERY serious concern once upon a time; i.e. Chicago, etc.... Fire did a GREAT job in education, prevention, and protection... so good that the number of Actual Fires that they respond to has been greatly decreased. From a monetary and political stadpoint the justification for maintaining so many fire departments wasn't there after a while. So they started branching out into rescue. Hence the title often heard "Fire/Rescue".

The problem was that most of those rescue techniques were pioneered and the domain of volunteer rescue squads, volunteer search and rescue, and other volunteers specialty teams. So fire "pushed" out those service agencies and now (in many areas) have a hard time coexisting with them. That is a problem that I have personally seen in California. There has been a push for years (behind the scenes) to do away with Search and Rescue Teams in California and hand all responsibilities (except for wilderness search - becasue it ain't glamerous enoguh I guess) over to Fire. Steps have been made toward that for years. Rope Rescue and Swiftwater Rescue were all originally developed by old SAR farts back in the day. They developed techniques and standards that are still the bases for all we do today in those fields. But now Fire has to put an NFPA stamp on them and call the service their own, leaving SAR folks to either follow along or risk being viewed as irrelivant. Example: The internationally recognized "Father of Swiftwater Rescue" was also one of our teams 13 founding members. He invented the craft and was still teaching it up until his death over 2 years ago. He taught our team everything, certified them, and built this team up to one of the most renowned swiftwater rescue teams in California (if not the U.S. for awhile)... that is until Fire decided to NFPAize the craft and the state of California told us that we needed to conform to their standards; which meant hundreads of dollars a year per person and masive amount of time to stay current in a craft that was so butchered by the NFPA that while the basics remain the same, there was so much unnessisary crap (in the opinion of those original founders and pioneers in Swiftwater Rescue) by the Fire Guys that our expert team dropped from having 30-40 SRT-A's to only 8-12 SRT-1's and a couple SRT-A's. That' just one example, I have others.

Now the problem is expanding, because in order to continually justify their Fire budgets and their "need" they needed to expand into medical. First it starts out as being first responders, then they start pushing out private ambulance and transporting patients, then they start putting their own standards on EMS which they call "better", and then we see private ambulance going away.

Here's my problem with that: In order to be the best at what you do, you need to focus on that. Now, there are a lot of great Fire/Medics out there and a lot of realy bad Pure Medics, but my general observation has been this in California: EMT-1 is now pretty much required for every firefighter in order to be hired on a regular fire/first responder department. So every FF I know also has their EMT and 90% of them suck at EMS. I know that the debate rages that the EMT level of training is inadequate, but the vast majority of FF's I know and have worked with don't even met those low standards; hell they shouldn't even have a first aid card. They barely pass the class because they don't really want to do EMS, but feel that they must. They get tutored by their Fire Buddies so that they memorize just enough to pass the lame testing that any idiot could pass. They do not want to have any involvement in patient care and it shows in their training and their care. Get an inacurate BP, throw on the Non-rebreather, and stand around waiting for the Ambulance? That's the justification for maintaining their budget? Now this is not a reflection on all you Fire/EMS folks. I know a few Fire guys that I would entrust the care of my family with... but just a few. I hope you Fire/EMSers here actually care about the EMS portion of your job, as evidenced by your presense on an EMS forum, but I have seen what happens when Fire is forced to accept any EMS role. They want to fight fires and rip into cars with the Jaws, but most I know have no interest in EMS. So all that Fire Based EMS will do, at least in my area, is force out the good Pure EMSers that have no interest in Fire, hurt the good pure Medics who chose to stay with the new FIRE/RESCUE/EMS, and limit the options of the community when it comes to EMS - a service that might do well in some areas, but (IMHO) Fire based EMS will lower the standard of care in a lot of cases (my area as an example)...

... I'm tired, ignore my ranting. :blush:

 

[VFFforpeople]

Isn some areas, like mine we deal with water rescue,low angle, structure,weather EMS. I am not saying 3rd party EMS crews can not handle it. I am just saying/seeing Fire or PD can get more people to the sence and faster than the 3rd party EMS crew. (I am speaking my area, not saying this for all). We cut our Fire budgets and PD budgets first, before anything else. (I do find this odd). So, not all areas put Fire EMS in to save the budget. I am grateful to have AMR or in my area Mercy show up, it is great to see them and a sigh of relief. We all work well together with them. That is just my thought.

 

[EMTinNEPA]

<---- is still waiting to see one shred of empirical evidence that suggests that fire-based EMS is superior. Until that day comes, the money-grubbing morons who want EMS to be just another public service/financial support for the fire department, as opposed to taking its rightful place in the healthcare industry, can go pound sand.

 

[Veneficus]

said physician replies

http://www.youtube.com/user/drexmedic

and the truth shall set you free.

 

[46Young]

The original video made me vomit, and I'm a firemedic. I've worked EMS in NYC and in SC prior, and I think that the strongest providers were in the FDNY EMS system(like a third service, being seperate from suppression), and the voluntary hospitals operating in the same system. Tons of good jobs, and the ALS units are reserved for high priority call types, resulting in a quick learning curve. Response times were good, since units sit on street corners. My dept fully funds EMS, provides plenty of training, but has several problems. Fire based EMS will always have individuals who "backdoor" their way in with a brand new medic cert, with little to no experience whatsoever. Assuming that they really do enjoy EMS, they'll have an extremely tough time developing a solid pt assessment, and skills base. With most EMS runs, we have 6-9 responders crowding the scene, typically two to four being medics. The medic officer calls the shots, gathers info, and generally determines the presumptive Dx and resultant course of action. It's goofy onscene, for lack of a better term. The new medic basically becomes a "skills medic", gathering diagnostics and starting IV's only, with little input regarding Tx decisions. I'm lucky that my medic officer treats me as an equal, rather than an incompetent. I'm used to just me and my partner getting it done alone, maybe with a BLS unit to back us on an arrest, or to drive a critical pt. The majority of FF's here have a good outlook on EMS, and mean well, but aren't really needed about 75% of the time, and can delay care/removal to the bus. It's tough to gain competence as either a BLS or ALS provider in a resource rich Fire/EMS organization. It's advisable to gain experience elsewhere, then join the FRD when you feel you're comfortable as a provider. I have a side job for a local private agency that does a lot of cath lab runs, and critical care runs. When I suggest that others do the same, they look at me like I'm nuts. This isn't the best place if you're looking to be an aggressive medic, but I also love the fire side, and the salary/benefits/working conditions/career development/perks(hooked up gym in station, for one) are among the best in the nation. I do miss my days serving Corona, Elmhurst, Jackson Heights, and Astoria, truth be told. Just a dismal future there career wise, and a subpar standard of living.

 

[subliminal1284]

Quick response doesnt make a difference if someone lives or dies riiiiggghhhtt.......

 

[EMTinNEPA]

Quick response doesnt make a difference if someone lives or dies riiiiggghhhtt.......

Quick response doesn't make a difference if your quick response gets you halfway to scene really fast.

 

[subliminal1284]

Have to disagree, if someone is bleeding profusely every minute counts and the sooner someone gets there to assist that person the better.