In my area we have volenteer fire depts. and volenteer e.m.s. depts. I know that medical training is becoming more and more meshed with fire training. Should they stay seperate? Should e.m.s. handle all med. calls and fire only fire calls?
And from a volunteer standpoint, no way do I want us to even be called for 1st response medicals. The view here generally is that volunteer firefighters have enough call on their time already. Ambulance service here in Victoria (where Wildfire and I live) is a career service, only one service for the whole State, with only a few volunteer 1st response groups in selected areas.
Why wouldn't I want our Fire Service to take on EMS work? Apart from the call-out volume? Probably the fact that here it's a three year full-time university course to gain the qualification. Also I have no desire to be a medic. The latter reason is probably the most important...
I think the medical basics for FFs are a good thing, but if your EMS Vols and your Fire Vols are training and working well together, why combine. The reason our area sees the fire/ems convergence is financial and we just don't have private or county services to provide EMS coverage, so we handle it ourselves. It is taxing if you are a FF/EMT. The training requirements are increasing and our time is getting slim.
Well the very existance of a Fire Based EMS Department has many advantages especially in training and multi-unit responses and combining the two have been a savoir to many smaller department's within the United States.
Many small town Volunteer Fire/EMS department's who have struggled in recent years to provide Fire or EMS coverage during the daytime. (Now I am NOT saying every department has a problem, but if most of your personnel commute out of your town to their regular paying jobs) then yes, you as a department or organization have a daytime coverage problem. Many of these town's have finally realized that medical insurance companies can offset the costs associated with having two or three fulltime Firefighter/EMT's on duty Monday-Friday (days) These personnel can get your first unit out (fire or EMS) just like a paid department does in 30-60 seconds and in reality may let your backup crew(s) remain at their paying jobs more.
More importantly... the cost associated with paid personnel, if done correctly will impact your taxpayers very little!
Now the magic number I see around here is about 1000 EMS calls to fund some paid personnel. This usually will offset the cost of 2-3 personnel dependant on the salary and benefits you offer.
For those of you who stand strong that we are "volunteer" and will "never" bill for EMS, then I have to ask... why not?
Many of you ask for donations from the very same townspeople that fund and ultimately use your services.... isn't this hitting the taxpayer twice? And furthermore the insurance company laughs all the way to their bank. The insurance companies love the volunteer non-billing services as it increases their porfit margins and profit sharing.... all on the "backs" and "wallets" of the very same dedicated brother and sister's who drop what they are doing, punch out of their bread and butter jobs that provide for your families, and run off to provide professional services for FREE.
Times have changed, and so does the need for the way we fund town, city, municipal township services... for the better.
BTW: My combination department though much busier than what I have described above, in reality pays for (10) paid personnel when all the reimbursement "beans" are accounted for... that quite a few guys.
If it works why not in my town we are seperated and it works out fine for now because we have the man or woman power during the day & night hours but my old depts. the first aid was paid but they ran alot of calls
In my department the EMS and FIre are all one. In the very beginning the fire department and the Rescue Squad were seperate. They came together in 1973 or 74. It has worked out pretty well with having members that do both. I was a firefighter first and then I got my EMT. There are still the little problems that there are in any department. Some of it being the ego thing and the whole they are trying to take us over and all. It is just the normal family type stuff. It is good to have a firefighter who can do the ems thing especially on a mva and they are the first to arrive before the ems crew. You get patient care started right away, but for the most part I think it should be up to the firefighter if they want to do the ems thing. Some people can't handle the ems end of things and that is ok and then there are people who don't want to do the firefighting thing. I have ems members who don't want to put on an SCBA and go into a burning building and that is ok too. There is always something for someone to do on a scene... This is just my thought and what my department does. Hope it helps....stay safe..
It always shows a huge difference whenever one of us Aussies write about this type of thing. It points out the large difference also in our ways of implementing a Federal system.
Our Federal system gives us three layers of government - National, State and Municipal. Municipal is very much the bottom rung on the ladder, is responsible for local parks and roads and garbage collection (amongst other things). Emergency services, Education, come under the State government, the Armed Forces come under the Federal. Funding? For the Police, it's a State matter, totally, with only one Police force in each State. Ambulance in my State is part of a State Govt department running as a pay-for-use service with some tax funding. Fire in my State is two Fire Services only, with most funding coming from a levy on household insurance policies (if you aren't insured and your house burns, you may get a bill) and the remainder from State taxes. I put this in purely as a matter of interest, to assist in general understanding. I'm not saying that the USA should do things our way, so don't start jumping at me! (Although I personally see ours as a less fragmented system) -
Another big difference appears to be in what you in North America call EMS. From my reading on various forums it seems that you have more llevels of emergency medical care than us. Here, in Victoria, we have MICA Paramedics at the top of the trasining list, followed by normal Paramedics (the ones I mentioned above who have to do a three year full-time university degree to get a job). The third level are those people with training in first aid - this includes many firefighters. At an MVA for instance when we the FF's are often first on scene, we can give immediate assistance to casualties whilst waiting for the paramedics to arrive. As I said above, to have the Fire Service take on ambulance services would require us to do that three year degree - not likely to happen!
This is a big discussion, actually, argument that we are having with our companies. It' s nice to have some training on both ends, but I agree with some as to the reason I chose to be a firefighter, not a medic. One of our problems here is that our medics think they are firefighters and sometimes respond to a scene before us and actually put themselves in danger by entering a scene that has not yet been securied by the firefighters. They feel the need to merge for the wrong reasons. They want to do it all and have no help and the funding is just not there and we firefighters do not want to become fireamedics or paramedfighters. I have nothing against the paramedics so plz, don't take this wrong. This is just an issue with our medics up here. If I wanted to become a medic I would have instead of a firefighter. That is to much on one's plate to do it all and the time is just not there. What would come of volunteering then? Would there be enough space to let the community volunteer, you don't need 150 medics? Would funding still be around since many are paid? In my opinion, I wish to keep it seperate. I wouldn't want to do both.
My short answer is whatever best works for the citizens you serve. LA County stil does it the way you see on Emergency! FF/PM with private BLS transport. My city has FF/PM on every engine but also get private ALS for transport. A few cities around here do run ALS with FF/PM ambulances. SDFD has a public-private relationship with Rural/Metro.
While I am not opposed to Firefighters having medical training and EMS having fire training, I think the two departments should be seperate. I don't want to see "cross training" mandatory. I feel it could eliminate too many good firemen that don't want to be EMS and vice versa.
My department has alot of cross trained members..We are a volunteer department with fire and ems together. I think a FF should have some type of medical training. EMS always need a hand on car wrecks. The department (also volunteer) i used to run with was separated. There was alot of confusion on the fire side during a car wreck of not knowing what to do till the squad got there. none of the FF's had any EMS training other than me.. You can never have to much training and we are all here to serve the public..