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Comment by Joe Brosius on April 25, 2009 at 11:35pm

Thanks to everyone who responded to my query.
Obviously there are not enough ambulances. Some departments are running a rescue or first response vehicle. This is more cost effective. To those who question if I want any response, I would be happy with an ambulance. Thanks again to everyone and I will let this one lie as it is.

Comment by Jay Nicholson on January 26, 2009 at 6:42pm

FETC, I took WebChiefs comment to be a very tongue-n-cheek response to my response. I believe that is how he meant it.

Comment by Joe Brosius on January 26, 2009 at 6:14pm

“Let us tenderly and kindly cherish, therefore, the means of knowledge. Let us dare to read, think, speak, and write.”

John Adams

Comment by Chad Eason on January 26, 2009 at 1:36pm

We currently do not run a lot of medical. I have been trying to make it so that we do run certain calls, ie trouble breathing, chest pains, unresponsive patients. The reason being is that it takes an ambulance 10-15 minutes to get to places in our district and our citizens deserve better service for it tax dollars. How can you place a price tag on lives. If the fire department, who is trained in medical to begin with, can get there and begin life saving techniques before an ambulance can, then we are ahead of the game. I dont see even factoring in wear and tear on apparatus as even a pro or con in deciding to run medical or not. We should look at more important things when deciding, like is it going to make a difference. As for what type of apparatus is used, one question, what does it matter? It is not the apparatus that is going to save a life or provide pre-hospital treatment, but the people occupying that apparatus. I feel this is one of the problems in the fire service today, we have gone away from what really matters, the people. The upper management seems to find a way to put a price tag on everything and thus causing debates as to what level of service should be provided. We need to focus on the citizens and property we protect. Get back to the basics.

Comment by FETC on January 26, 2009 at 10:49am

WebChief, with all due respect, walking or jogging to a nearby district ems call as a first responder affords little protection, or even ems equipment and the national target response time is 4 minutes.

This concept as described by you, also provides no fire protection when a back to back or secondary call comes in for that same district, lets say for a building fire. Then what you have is a few really tired firefighters running back to the station for apparatus...

Most places put the engine or ladder in service upon arrival of the 1st EMS call because if they are equipped with the appropriate manpower, they can leave a single firefighter/emt on scene to await the responding ambulance, without the liability of patient abandonment. The remaining crew can run to the second call with the Unit and their PPE, without any delay in response.

Now, if a secondary call comes in while both the engine and the ambulance are still responding, then the engine can divert to the building fire and the ambulance can still response to the medial aid call without liability of abandonment.

This set-up has effectively provided that specific district with manned fire protection for about 99% of the time, instead of having that same crew respond on a cross manned ambulance and leaving that fire truck unmanned and essentially OOS.

It takes money to run a fire department, we sometimes need to burn fuel and drive big trucks to seemingly minor calls, but ultimately we are providing the customer with the best possible protection.

Sorry but I only walk to my car when my shift is over...

Comment by Dustin J. Millis on January 26, 2009 at 2:40am

My dept. is only certified for BLS non-transport. However, we run approx... 500-600 EMS assists a year with the county medics that are just down the road from us. We have a brand new Expedition that runs on those calls. Its stocked with all your basic EMS supplies and is much cheaper and easier to run then the engine for EMS calls. If the need arises for EMS, we can also roll our rescue. I know dept's that do run their engine for EMS on pri. 1 calls and just an ambulance for pri. 4, reason being; they want the extra manpower that you can fit into an engine

Comment by Jay Nicholson on January 25, 2009 at 10:49pm

Some 20 years ago we used to split a crew for medical aids and respond in a more fuel efficient vehicle. When automatic aid agreements were signed, the minimal staffing on all apparatus was set at 3. I suppose we could buy another piece of equipment, but that would cost $.

Comment by Ben Waller on January 25, 2009 at 10:02pm

I guess I'm feeling lucky on this one...

We operate 8 medics, 7 engines, and 1 truck out of 7 stations. 2 of the medics are full-time staffed, the other 5 are operated by crews that cross-staff the engine and the medic. We also run 1 part-time cross-staffed engine and medic that are housed in our busiest station.

Our staffing and response patterns ensure that we rarely run fire apparatus on medical calls.
When it happens, it's because we dispatch an engine as the medic backup on serious medical or trauma calls. The truck co. is the medic backup for our only truck house.

If the department has a large disparity between EMS/fire call volume and EMS/fire apparatus, then the apparatus are going to get run to a lot of medicals. If the workload/apparatus are in balance, that takes a lot of wear and tear off of the apparatus.

There have been a lot of efforts to reduce the need to run big apparatus on medicals...
Syracuse used to run two-piece mini/maxi engine with only the minimpumper responding to medicals, Phoenix has the Ladder Tender concept where two of the truckies cross-staff a light-duty rescue/utility, etc.

Does it make sense to run fire apparatus on medicals? Sure it does, if you're the patient and you need help right away. Is it cost effective? It varies, but the answer in most places is "probably not".

Comment by Cody W. Nelson on January 25, 2009 at 9:03pm

We run engines and ladders on medical calls. We used to run just the engines, but we started crossing territories a little to often and would miss first in structure responses. The thought behind running the trucks on medical calls was that we had EMTs sitting there with a call in that territory and another engine was coming from further off. The truck can get there quicker and when you are talking lives, who cares about the fuel expense and wear and tear on the trucks.

Comment by Glen Garland on January 25, 2009 at 8:40pm

Oops fat fingers, hit add button too soon. There are times when additional staffing is in order for the more serious calls (cardiac, dsypnea, seizure,trauma) but not every cut finger is a trauma requiring multiple resources either. It should all be starting at dispatch. It is also necessary to have appropriate staffing district wide as well.

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