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Ambulance crew as RIT
Does your department assign RIT to the ALS ambulance crew, and what are your thoughts on this practice?
Replies to This Discussion
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Permalink Reply by Jonathan Danzer on
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Well depends on what you call an ambulance. I use the term loosely to mean the transports we use which are staffed with 2 firefighter paramedics. So we do meet all NFPA 1500.
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Permalink Reply by FETC on
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Well I have never heard of the ALS ambulance being the RIT. I have heard of an ALS unit being assigned to the RIT Division.
EMS is just that EMS. Where I work we dispatch two ambulances to the scene. One on the first alarm, and another on the second alarm. You need to have a bus available to transport an injured firefighter or civilian immediately. We use the second bus as our rehab unit. Gets you out of the heat or cold, check some vitals and get re-hydrated. Works ok for small incidents but when you have a larger incident they are overrun with too many people and not enough space. Thats another post.
Multi-tasking the ALS crew. This should be easy to address with the department administration; riding to the fire in an ambulance and then leaving it unmanned is just a waste of that unit. If the unit was needed and your crew transports you now have no RIT. Vice versa for if they deploy and nobody manning the bus for the transport.
If your ambulance RIT is deployed, you can't expect them to enter, remove a victim and then doff their gear and work as the EMT's on the transporting ambulance.
So you need to either add another unit as the RIT or a second ambulance. I have to ask another question... what is your manning on the ALS crew? RIT needs to be far more than just 2 cross trained firefighter/medics...
www.fetcservices.com
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Permalink Reply by Michael Beyerstedt on
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I agree with you as long as they get out of the bus, are fully geared up and ready to go,have all the tools with them ready to go, are in close proximity to the fire. In my reading of the original post, none of these items were even mentioned. YMMV, Mike
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Permalink Reply by Greenman on
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Not only no, but Heck no.
The Ambulance and its crew are their in their EMS (doing medical interventions) capacity. Period. That bus is there to save my life once the RIT team pulls me out of the fire building. If they are on RIT, they can't be doing their jobs as Paramedics at the same time regardless of training, certs, or anything else.
Greenman
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Permalink Reply by Ben Waller on
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The EMS crew should be assigned to Rehab and to medical treatment of any injured or heat-stressed firefighters.
RIT should be a seperate crew. If your department isn't big enough to staff it's own RIT, think about mutual aid/automatic aid for the RIT function.
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Well not sure if we are big enough or not but we have 32 stations and 230 firefighters a shift including the firefighter/medics. The point being on any given fire scene the ambulance crew serves many purpose depending on the needs. On any given fire I can start as a RIT crew member, then move to search and rescue, then move to rehab and then move to overhaul. Just depends on what is needed at the time. If you feel that all the paramedics are there for is to play hero to the firefighters then maybe they they should turn in their turnout gear.
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Permalink Reply by John Crabbe on
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The Ambulance and its crew are their in their EMS (doing medical interventions) capacity. Period. That bus is there to save my life once the RIT team pulls me out of the fire building. If they are on RIT, they can't be doing their jobs as Paramedics at the same time regardless of training, certs, or anything else.
I'm going to disagree with Greenamn here with the claim that the ambulance crew is there for EMS and basically EMS only.
I know of several departments, including my own where the ambulance crews are also firefighters and can be called upon to act accordinly. The can be the first in rig many times and can fulfill any number of roles on the fireground besides strictly EMS.
The reality is the fire will grow if left unmitigated, it takes about 15 to 18 personnel to successfully mitigate a room and contents fire (per the NIOSH staffing report). This means if an ambulance crew is involved in the initial response they may be called upon to perform as a fire crew and not just strictly EMS.
However, I will concede that if an ambulance crew is being utilized that a second ambulance is called in to perform EMS and perhaps rehab. Although, just because one may be on an ambulance does not mean they are strictly that role of EMS either.
As for the original question, we have had the first in ambulance crew be an IRIT (initial RIT) if arriving before the next due companies to satisfy 2 in 2 out.
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Permalink Reply by Roy Walker on
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I am a Canadian f/f and am amazed by how many crosstrained people are in your ambulaces . I really had no idea how common this is. In Ontario the ambulance crews work for the ministry of health and do not perform firefighting evolutions. Non the less this is an eye opening piece to read . Do most of your ambulances belong to the fire service or how does that work regaurding command ?
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Do most of your ambulances belong to the fire service or how does that work regaurding command ?
It depends upon the dept. In many career depts, they do run EMS with crosstrained FF/Paramedics and will fall into a command structure. In other depts, especially volunteer with no EMS, the EMS portion may come from another agency or a private service. When there is an incident, such a service would be told where to stage and stand by, much like it is done in Canada.
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Permalink Reply by Shareef Abdu Nur on
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There have been times when the IC has assigned RIT to the ALS medic crew but this is because in our area, all of the ALS medic ambulances are equipped for such a detail. They are Firefighters first and paramedics second. They are equipped with as many hand tools as the average Eng Co and SCBA's. with insufficient manppower, it is not uncommon for the ALS medic crews to arrive and have to fill out an Engine or Truck crew as well.
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In our area, most of the departments are staffed by crosstrained firefighter/paramedics and they operate on the ambulances on a rotation or by seniority. They are full functioning members of the departments. As a matter of fact, at most departments around here, one has to be a firefighter and paramedic to even sit for the test to get hired.
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When the ambulance and it's crew are dispatched to the fire as an Ambulance unit, that is their sole purpose for being there. Just like the Incident Safety Officer; he may be very well trained in several fire ground functions, but his sole purpose on that incident is to serve as the Safety Officer.
You're ambulance may be staffed by Firefighter/Medics, and they should certainly work both sides of their jobs, by being assigned to other apparatus, such as a Truck or Engine, part of the time. If there's four ambulances on the scene and no victims, then go ahead and assign three ambulance crews to RIT, or any other job, but one ambulance crew needs to remain on standby specifically to treat anyone who becomes injured on that scene.
Let's say for argument's sake that you have one ambulance crew on scene, and you use them as the RIT during a structure fire, and one of your Firefighters has a heart attack. Do you pull the ambulance crew off of RIT to begin ALS and transport, leaving the interior crew without a RIT backup, or do you forgo ALS for the cardiac patient so your interior team has a RIT backup? What if one of the interior crew members falls into a basement just after the other Firefighter collapses outside?
Then there's this...let's say the Ambulance/RIT team have to go in and rescue a Firefighter who fell into a basement and it takes 5-8 minutes (Maybe longer) of heroic effort to locate him and then drag him out of the basement, out to the yard and now your RIT team is exhausted from that effort; you then expect them to provide the highest quality care for the burned and/or seriously injured Firefighter? Wouldn't you want your Medics ready to provide the best medical treatment the moment the RIT team gets that Firefighter outside, instead of having to change gears from Firefighting to Medical?
RIT team needs to be exclusively RIT until all Interior Ops are completed, and at least one ambulance crew needs to be exclusively there for Firefighter Safety.
There used to be a thought in the Fire Service that "Everybody Goes Home." If you think it's OK to not have a dedicated ambulance crew for Firefighters on a structure fire by employing them as a RIT team, then you're not even paying lip service the idea that Everybody Goes Home.
Greenman
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