Our Fire Department is the only one in the county out of 9 departments and the only deprtment around our area that i no of that does not do first responder runs. We used to do them but we stopped because the EMS station grew to be a giant company. They do van, car, and ambulance transports and have a fleet of about ten ambulances(they ran out of numbers for there trucks even). So our thinking was that us doing first responders was about pointless because the EMS station alwalys has a paid crew on station. I think personally that we should do some First responder calls, like cardiac arrest and second out truck calls. But almost all of the opinions up here are the complete opposites. Some people also have stated that it is harder to get Federal and local Grants if you do not do first responder runs. So if you would i would like to know your opinion on our situation, If your department does First responders, and if it is harder to get grants without doing them.

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We are very well saturated with ALS trucks in our county, but I will tell you it is always better to use firefighters than tie up a second ALS crew with a critical patient. Also, multiple medics is often (in MY opinion) a bigger cluster than one medic, his EMT partner, and several FF FR's, or FF EMT's.

We do QRS (medical first response) at my company, and it's a big help to the local EMS. In my EMS service, which covers a city with paid fire, and also most of the county with volunteer fire, I love having fire response in the communities, it makes critical calls SO much easier. And again, it leaves the next due ALS truck available.

Communities benefit when their ambulance service (big or small) is backed up by the fire dept.'s trained medical services.
We run and are certified for what is called BLS Non-Transport. That basically means we will provide at least one EMT-B for a call but do not have an ambulance to transport the pt. in. We run this as a support service to and in conjunction with the local ambulance provider. The system works extremely well as there are certain calls (cardiac arrests, diff. breathings, etc) that we are automatically dispatched for along with the medics. Other times when we are not dispatched automatically, if the medics see fit; they will request us through dispatch and just like that, we are there to support.

I'm sure there are certain instances where it would be harder to obtain grants or federal funding.... for instance; if a dept. that did not run medical calls was applying for a grant so that they could buy an AED, the grant provider is probably going to ask "ummmm.... okay but why do you need it if you don't run med calls?" On the other hand, if applying for a grant for a new engine, there is really no reason (in my opinion) to show that your dept. runs medical assists, after all that new fire engine is going to put out fires, not transport pt.'s.

If the powers that be on your dept. have decided not to run medical assists, I'm sure they have their reasons. The economy is still "crap" (for lack of a better word) and after all, every call we respond to does cost money. There could be other reasons as well.... lack of qualified personel? lack of certified equipment? (what happens if you beat the medics there and do not have the proper equipment to help the pt.?)
We had a few occasions where some council person would bring up bidding the MES service private. We do BLS transport (ALS is a second-tiered service here in NJ currently) and BLS "engine" responses. I have worked in the EMS private sector as well as in municipal services. There are high-calibre people on both sides. But the contracts called for a specific amount of ambulances, depending upon the season here.

Basically an ambulance crew consists of two people. That's all they were going to pay for. It's damn near impossible to provide GOOD patient care during certain trauma calls, cardiac arrests, etc. with a crew of two. There are many reasons for an engine/truck company to assist on EMS runs, especially life-threats. You may get another ambulance crew to assist with a private company, if the municipality contract calls for two or more rigs. Smaller fire departments, especially career companies can often provide a better service as oppossed to a sinle EMS contract unit that responds alone.

Anything from forced entry situations, to having to move furniture to facilitate patient transport, to just having enough hands to fetch equipment and perform CPR are good enough reasons to roll an engine/truck company on specific EMS runs.
We do them. We don't have any ambulances , just aid the county ambulance service. Here's the down side. If you're not careful, you will get sent to all the frequent flyers and habitual callers. Also, you'll spend more funds on supplies, fuel, and more wear on your trunks that have to be replace sooner, that you paid 400 to 500 thousand dollars for.The EMS provider can then save money, hire fewer people, and collect fees for YOUR SERVICES! On the other hand it's good for public relations and you may save lives because your guys are there sooner or to do CPR , FIREFIGHTERS USUALLY PROVIDE THE BEST CPR TO BE FOUND.anyway it's some food for thought.

Neither of the POC FDs I am on do first responder.

My career FD runs ALS ambulances with a minimum of 2 paramedics onboard.  I will take 2 or more meds on scene for a PNB or a trauma incident over 1 and an EMT any day of the week.  More higher skilled eyes, ears, hands and brains are a benefit to the patient and crews that work together all the time become so used to each other that they start to anticipate needs of each other and things flow very smoothly.  For ALL ALS calls the ambulance gets the closest engine or truck for manpower.  If the closest Ambulance is out already the closest truck or engine is sent and the next closest ALS ambulance is sent.

If you're not careful, you will get sent to all the frequent flyers and habitual callers

 

So what are you saying here, Dannie? Are you advocating a selective response? Pick and choose the types of calls you want to go on? If providing such a service, isn't going on such calls an aspect of providing that service?

 

Also, you'll spend more funds on supplies, fuel, and more wear on your trunks that have to be replace sooner, that you paid 400 to 500 thousand dollars for.

 

How is the EMS provider collecting for "your" services? If you are not transporting, then isn't the EMS provider providing their own services? If you are talking about disposable equipment etc, you can submit a bill as well. Even all volunteer EMS services still bill the patient etc, nothing stopping the dept from doing so as well. Another thing, the majority of those depts providing a first responder service tend to have a utility type of vehicle etc as opposed to taking out a pumper or ladder truck.

Nope you have to take what you're dispatched . We don't run utility vehicles, our budget for apparatus is stretched to the bone buying and maintaining 4 engines, 1 quint, 1 ladder truck 4 grass rigs . Plus a back up engine and back up grass rig. Our revenue stream is sales tax, some bond funding for building stations, and some apparatus. We collect outside fire run contracts for property in the county, outside our city limits , but in our response area. We have a billing schedule if they don't have a contract, that is an hourly rate for each piece of equipment. But by statute, we can only do this for fire runs. Why? Because the county has passed a county -wide EMS district funded by millage and billing for their services. We have been on scene, on numerous occasions, where an ambulance is coming from other towns where the county stages vehicles, and has been up to thirty minutes behind us. If we weren't there they would have to more readily answer for the delayed response. We know there are times that any response organization has all resources committed else where, and they, like us have a large call volume. That being said , I know they have millions in surplus that could be used to properly staff the community needs. Is this a good deal? No, but I inherited this problem caused by short- sided planning by administrations , thinking it would get run numbers up.It does this for sure, but the extra runs, especially on poorly maintained private and old county roads can increase tire and mechanical wear, and of course increase fuel usage. All this was to say before a fire department gets into a more advanced EMS service, there are many things that should be considered before you buy ," utility vehicles," and get into the medical response business. Like the political rules and climate in your state and city/county area.

Put 2 or 3 guys in a brush truck with a jump kit, O2, and an AED and BAM!!  There is your first responder vehicle.  It isn't rocket science.

So , in a 100 square mile run area, that made 3000 legitimate calls , 12 guys a day minimum staffing , four stations , over half of those runs are wildland fires, structure fires, has- mat responses,and vehicle wrecks. Not trying to offend anyone, but we don't leave one guy in the station to make emergency responses in an engine Don. No it's not rocket science, you don't break up companies in a jurisdiction that makes as many fires as we do , in the long drought that we are in. We could, but then, it's not rocket science...
Fellas, before you cured all my EMS woes, the whole point of my original comment is there are pros and cons to adding additional EMS responsibilities to your plate that need to be carefully weighed. These are some that the department in which I have thus far put in 26 years career service ( only these last 2 as chief), there are good things too, like the people who are alive today because my fire-eating,butt- busting men are damn good first responders. We are not going back, but things could have been more thoroughly planned and thought out .
Love Always,
Dannie
PS.) by SOP's our engines run with their grass rigs, sometimes we use the pumpers as a water supply or even place them to protect structures.

If you ONLY have 12 people available why do you need  4 engines, 1 quint, 1 ladder truck 4 grass rigs . Plus a back up engine and back up grass rig?

Who is staffing all of that equipment?  Why can't 2 guys go on an ems call if you still have 10 others on duty?  Do you have paid on calls?  Do you do call backs for large fires?  Why not do call backs for ems runs?

Frankly, I think you should just admit all you want are excuses why you shouldn't do ems, instead of making up reasons why you can't when smaller FDs than yours, with less people and equipment, do it every day.

Hey Don, WE MADE 3000 ( that's three thousand runs in 2011) . Not car unlocks, not tours and inspections, 3000 emergency runs. 4 stations , 3 men minimum staffing per station, 1 shift chief per day. Yes in January I usually may have 4 at central and maybe just maybe a fourth guy at station 4 where they are first in to a heavy industrial area and the wonderful skank motels full of meth heads and cooks, prostitutes, and sex offenders. You think I should send two guys there? Our load breaks down to average about ten calls per shift, do you think they never overlap or come in at the same time? You know-it-all jackass, again, these are just cons that EMS HAS made us have to deal with. Fire fighters deal, do it, adapt and go on. You don't know squat about our state, county, city, where we sit in relation to other towns , or what our local political entities give us in the form of statutes and ordinances to work with or around . As I said before , if I sent two guys on an EMS run, one guy would be manning a station ALONE!!! Ok so you'll understand, he would then have two respond in an engine or maybe a ladder truck by himself.... Ok, that isn't safe Donoto. He would have to proceed at like a non emergency trip to get fuel, you know, not hot.i could take the time to explain why we have our SOP's andSOG's but why? You have all the answers and know best. And frankly bitch, I'm tired of you.(BTW, I'd love to have at least two ALS UNITS and provide EMS TO OUR COMMUNITY and let the county just back us up in our district, but our city fathers will have none of it.)

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