Tell me how your opinion about EMS in the fire service, whether you think it is a good thing or a bad thing and why. Personally I think it is a good thing, fire stations are strategically located to provide quick response to fires & rescues, it is logical that they also be used to provide quick response for medical emergencies. As the number of fires continues to decrease fire departments are going to have no choice but to pick up EMS calls to help justify manpower as well. In case you didn't know response to medical emergencies, especially cardiac arrest was used to help justify NFPA 1710.

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That is still better than what your normal private service provides as long as you don't sacrifice staffing on the engine companies to staff your buses. There is undoubtedly a higher level of professionalism among firefighters than EMS.
The way that it is done in my county is EMS is a seperate county department, they are housed in fire stations. This sometimes causes conflict because they tend to be more lazy when it comes to completing station duties, but for the most part everyone gets along better than other places that I have worked where they were housed seperately.
Our department runs both; we deliver fire service as well as advanced life support response and transport. We have 143 employees, of which all 108 line employees must maintain a minimum of NREMT Basic (administrative, logistic, fire marshal, and dispatch staff do not have to maintain EMT) and we provide an incentive of 10% over base salary for national registry paramedics, of which we have 41.

I think it is a great thing; we are strategically located, we have a high level of commitment and professionalism about service delivery, and given the nature of our community, it is a high percentage of our call volume. Our mission is to offer full-service emergency response, so it falls right in there with the delivery of fire, HAZMAT, and technical rescue service naturally.
In our town we have 3 vol. fire companies and 1 vol EMS squad. I think this system works well because the people who want to be Firefighters join the fire companies , while the people who prefer EMS join the EMS squad. Seems like a win win, however the problem comes up that people (like myself) who want to do both have to join the two different organizations and therefore have more meetings and trainings and hence more time away from there families. The other challenge we deal with is when we have a call where both services are dispatched, members need to choose which agency they are responding with.

The squad & fire companies serve a town of about 8000 residents, with the Squad handling approx 400 EMS calls a year and the fire companies with approx 120 calls each a year. I imagine if there the call volume was higher this system may have more problems, but for little town it works rather well.
I think EMS belongs in the fire service for several reasons. The first and foremost is it gets us out and into the community, in to people's houses where we can showcase our values. Second reason is 70% of Fire Dept calls being EMS, it provides a means for us to justify hiring more personnel, and also a means to bring in income so we don't look like such a sponge on the city's budget. And finaly the third reason, in my area we have some counties that use third party, it always seems like the TWO guys that show up are unhappy with thier jobs and pissed off at the world. This make me question the quality of care that you will receive from them, are you just another call or do they really care about your emergency and comfort. When the fire department shows up you get five people "2 on the medic, 3 on the engine" the whole crew loves their job and the people they serve and if something bad should happen you have 5 guys to help out instead of 2. I could cite many reasons, such as better training, better gear, better vehicle, etc., but I will leave it at what I feel are the three most important reason for EMS to be fire based.
Not so sure about this one, it works will like on the FDNY for cost savings, but in small departments I think I can lead to more problems then people think. With vol departments are so short staffed, I do not think they could deal with both mediacal and fire. Paid this works vol not so well.
My department started providing EMS in 1989 and continues today. We have had hire EMS staff to supplement the volunteers, however, they're cross trained and certified in fire. For us, the two go hand in hand. I have worked in third services, and in the private sector. My personal opinion is a combination service is the best followed by the third city/county service, and the last would be privatization. When you get the corporate "Bean Counters" involved, you usually don't get the best bang for your buck. But lets face it, emergency services are not one size fits all.
I am a Medic on a small, rural volunteer FD that provides both fire and ems to the community. We have a good amount of people who are both fire and EMS trained, including myself. Our rescue rolls on MVAs or for man-power/assistance, and our squad rolls on fire calls. I th ink the fact that people are cross-trained is a plus. It helps when we have to work together that we are already used to helping each other out as a whole dept. I think it is invaluable to have an EMT with knowledge of firefighting and the stresses that cause on a body when they are helping with rehab, or when the fire guys are cutting someone out of a car. It also makes perfect sense for the firefighters to know what the EMS guys are wanting to accomplish when they are cutting on a car with victims, or acting as "go-fers" to get things out of the squad. And the real truth of the matter is that the fire service is 95% EMS and 5% firefighting, so it only makes sense that they be combined. I have seen depts who are split, and it causes division and strife.

I also run private EMS for my full-time job. I have worked with people who are polite, courteous, professional and experienced and who love their job... and I have also worked with people who would rather be doing anything but, and are here for a paycheck. That attitude is not limited to private EMS. There are pros and cons for and against private EMS vs. fire based 911 ems.

Brittany
I hate to do it but I 'm going to have to be negative. Don't get me wrong I agree on being cross trained and working together but that is easier said than done. My company is a so called rural company were medical calls are handled by an outside ambulance service. Some in the area are paid very few are volunteer. Of course we have to deal with the volunteer company who built a second station in our borough just so they would not lose any of their run territory when a fully staffed paid company looked into building one.
We were approached by the volunteer company and asked if we would run medical assist calls for them when they are already out and second due would be needed or the unlikely event that they would be out of service. Of course we said yes because at the time we figured it to possibly become a good way to work together. That was around ten years ago. and it has been a trying experience. there has been more turmoil over this than anything else. For the following reasons.
1. They are hardly ever in service. The staffing of the station fell through for what ever reason within their own ranks. Causing us to get dispatched for medical assists
2. We have now been burdened with the expenditures of supplying our own rigs with the necessary supplies and equipment to run their calls and handle them until their unit from their first station arrives.
3. It's like pulling teeth to get replacement supplies from them such as collars , o2 or anything else we use on their calls.
4. We had recently gone out and purchased a Utility to run these calls to save the wear and tear on the larger Rescue. With no support or help from them.
5. We have asked for some type of reimbursement from them per call and the answer was no. "We bill the patient and that goes to cover our expenses" is what they said.

The last reason that really threw me for a loop is that the battery in our AED that we purchased had died and you guessed it when does it get used? Well I will answer it in case you can't figure it out. It gets used on their ALS calls and when they were asked to get us a replacement they did along with a bill for two hundred fifty some dollars. They don't have to buy new batteries for theirs because it does not get used.

We the local fire department which is volunteer also are stuck between a rock an a hard place. We can not just stop running these calls because it has become expected of us and I don't have a problem with that but if we did stop who would we be hurting? Not the ambulance service but the public and isn't that who we are there to serve. But at the same time we cannot keep burdening our selves with the cost and not receiving anything from them. We are not looking to make a profit on this but to at least cover our costs.
I disagree on this one! What happens when your on a EMS call and a working fire or wreck w/ ppl trappted comes in? You cant leave the medical call and respond on the fire call.
I do agree with ffs being trained in first aid but being a vol. dept. depending on the time of day we may only have a hand full of ffs show up.
I guess Im lucky on this one. We have three private services that provide excellant EMS in our area. In big Cities I can see where EMS and fire combined are a good ideal, but, in some rural departments it can be a problem. With all the training requirements for Fire and EMS a person might not last that long. We will provide assistance to EMS such as lift, extracation, rescue and etc, but many of our guys just prefer to let the private companies handle it and help them if they need it. Am I against EMS in the Fire Service, no, But you better be able to cover every call because it could come back to be a real problem down the road.
"I have seen where there would be arguements between fire & EMS about how the rescue should be done."

You are correct, that does happen. But if both are run in the same department, does it not stand to reason they might actually be on the same page? We don't have a problem in my department. The pumper crew does their job, the ambulance crew does theirs, and the rescue crew has their function. But by being a combined department, each knows the others function and we all work together for the common goal... taking care of the patient.

BTW, our people like to rotate from one side to the other. It helps break up the monotony.

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