Firemonkey Madness

[Dustdevil]

In MI, where I still hold current certification, the Combitube is a BLS device...

Umm... no. It is not.

It requires a physicians order. Therefore, it is an ALS device, even in the hands of EMTs.

[DwayneEMTP]

Is EMS understaffed? Well, duh. Is Fire? Again, duh.

As you asked before, I'll ask now, that you have faith my questions are genuine and not meant to be antagonistic.

I don't see the underfunding in fire. I see fancy trucks, huge fire houses, new, first rate equipment, for a group of well paid men and women that are rarely (in most places, certainly not all) called on to perform the duties they are trained for. Where would I notice the underfunding for fire? None of these things have I regularly seen in EMS.

Is it your opinion, as it seems to be, that simply "someone" showing up is acceptable? So if your house is on fire, you'll be satisfied if they send an ambulance immediately, while you wait 10 mins for fire suppression professionals? I mean, after all, the ambulance has a fire extinquisher! (akin to the firetruck having an AED)

:roll: :roll: :roll: no. Oversimplification.

How so? If six firement with basic training are good enough for my wife and child when they need ALS interventions, why is an ambulance with a fire extinguisher not good enough to save your house? After all, we're talking about my family's life, and just your house. Which is more important? I don't get it.

As long as you come with the same, tired, "you need us because we fight what you fear!" nonsense...this conversation will go nowhere.

Your words, not mine.

We crawl into burning buildings while the rats are crawling over us to get out...

Not exactly the same quote, but you have to admit more or less in the same dramatic vein?

As long as you look down your nose at the FD based EMS...

I don't really, I think I explained my experience with fire based EMS students, but I don't have the experience to pass judgement on the profession as a whole.

and the FD in general..........this conversation will go nowhere.

Again, I've know perhaps...a dozen firemen personally. About half were truly inspiring, the other half just macho knuckle draggers. I'm neutral on firemen in general.

What confuses me is this. The odds are overwhelming that if my family has an emergency it will be medical or trauma and not fire related. So when my son has a seizure, or my wife suffers from a tension pneumo or ecclampsia or I have an MI, why is it so hard to understand that I'd rather have two...or God forbid, four medics show up instead of six firemen trained to the BLS level? We can have the former for less money than the latter.

We have I think...eight fire houses in my town, yet at any given time there are two medics on duty in two ambulances. How does that make sense? Wouldn't the money be better spent to add ambulances and medics, while subtracting firemen (that are rarely used for their stated purpose) assuming that the funding is unmovable, when we have the certain knowledge that medicals are going to outnumber fires approx. 10/1? How do we justify the latter, which mostly involves loss of property while allowing the former, when we know that it involves mostly loss of life/limb?

I missed your FD knowledge? Do you have any? Not an antagonistic question, just curious.

Fair question. None really. Two years as a Hotshot when in my twenties, in Santa Barbara County in fact! That's where I got my first bad taste of engine crews...I can tell you why another time if you want(We called them 'engine slugs'), though I've grown up a bit since then and started thinking for myself. Now it's more a practical matter for me. What's best for my family, my community, and EMS as a profession.

Also, I think you and I might have met. I went through the AHC basic program when it was still an academy. I'm not trying to put you on the spot if perhaps it was a differnt person, I just thought I'd mention it. (You'd remember...I was the only old, fat, dumb, homely guy within ahout a six year stretch I think!)

Hopefully it's obvious now that I'm passionate about this subject, but ignorant in many ways as well. I've seen it from the outside looking in, so I know there is a lot I'm missing. That's why it's so cool to have you here.

Thanks for taking the time to stay invested in this conversation! Pretty cool.

Have a great day!

Dwayne

Edited for phrasing that might have been misunderstood to be insulting. No change in the message context.

Ok, fine. Edited about 30 more times because I pasted in an old edit without noticing 'till later...Still nothing that should cause anyone issues if they posted after my original post. No major messege or context changes.

To Whom It May Concern: Evidently brandy and 8,000 word posts don't mix. Please post responsibly.

[Don1977]

Fire monkey???

Didnt know I was an animal. How about "firefighter"

[kristo]

From what I can gather, this is a global thing. In short, even though large fires are rare, when they do happen, we need a lot of people very fast. That's why we have all those fire houses, engines, hoses and fire-primates (let's all just decide for ourselves which primate...).

Now, we've got all those responders, and nothing for them to do. This is very expensive. So we try to find something else for them to do. At some point someone asked themselves, hey, we have all those people available 24/7, and we need something like that to take sick people to the hospital. Yay. Without a lot of extra cost, we have EMS, and it's less difficult to justify all that rarely used, expensive, fire response. Maybe not the best EMS, but I bet the people who make those decisions don't know (or even care?).

A good example of this (and one that I know perhaps best) is Iceland. How that system basically works, for better or worse, is that the government is responsible for basic healthcare . That includes EMS. Fire suppression, however, is the responsibility of the municipalities.

Now, the government has money. They contract EMS out to a local agency of some sort at each place, give them ambulances and a negotiated amount of money each year to take care of EMS. The municipalities, well, not all of them can afford a good fire department. A town with a population of maybe 500 really can't have that big of a fire dept. just for putting out fire.

So the end result: We have no volunteer EMS. Doesn't exist. I'm not saying it's perfect, in fact, it's far from it, but at least it's not volunteer. Fire however, outside the major urban areas, varies. In some areas, it's just one (maybe even part-time) firechief that has some people he can call, they will come, if they can (they usually have semi-understanding employers), and get paid by the hour during calls and training. In some areas, there's a good fire dept. with full-time employees. The difference between the two usually lies in whether or not they have the EMS contract. In areas where the fire dept. does EMS, the extra money from that supports having a professional fire dept. Small, but functional. In other areas, usually not.

So, what I'm trying to say is that fire needs EMS. Not vice versa. We can try to justify this from the EMS side, but we would probably not be successful. Looking at the big picture, I think it may be tolerable to have professional fire suppression, though.

[JPINFV]

First off, if at all possible, please include the names of the people that you are quoting in at least the first quote section. You're quoting from multiple people in that response and it makes it a little hard to track who you're responding too.

I'll bite. Are you defining saves as "made it to the hospital with a pulse" or "walked out of the hospital with limited neuro deficits?" There's a big difference and one of those options is not a save.

Returned home and limited deficits.

[Dustdevil]

Fire monkey???

Didnt know I was an animal.

Tell that to all the knuckle draggers out there who thump their chests and call themselves "fire dog." We've got people here who call themselves "stretcher monkey" and "protocol monkey" without getting bent out of shape about it. If the shoe fits, wear it. If it doesn't apply to you, then why get bent out of shape over it?

Now, we've got all those responders, and nothing for them to do. This is very expensive. So we try to find something else for them to do. At some point someone asked themselves, hey, we have all those people available 24/7, and we need something like that to take sick people to the hospital. Yay. Without a lot of extra cost, we have EMS, and it's less difficult to justify all that rarely used, expensive, fire response. Maybe not the best EMS, but I bet the people who make those decisions don't know (or even care?).

There it is. The bottom line. :thumbright:

That is the history of Fire-EMS. That is the one and only reason that fire EMS dominates this country. The fire service does a great job of spinning the facts and building their image on the big lie that they are our altruistic, benevolent saviours, willing to do anything to serve their community. It amazes me how many people are completely ignorant to the historical facts and fall for the non-sequitur logic of the fire service being a natural choice for the provision of EMS. It is neither logical nor natural. It's just cheaper. If the public heard half of the nonsense that comes out of the IAFF and IAFC, and understood it, they'd be burning firehouses down.

:roll: :roll: :roll: no. Oversimplification.

Simplified? Sure. Oversimplified? Absolutely not. In fact, it is a spot-on analogy that breaks the issue down to it's common denominator, making an indisputably valid point. Perhaps you can explain why you disagree?

[Eydawn]

My bad. The Combitube is a strange ALS device that is written into the EMT-B protocols in Michigan. I couldn't even get my license there (and yes, it IS a license in Michigan) until I had "remedial training" and learned how to use the damn thing.

I don't necessarily like the Combitube. Blind pseudo-intubation in the hands of someone like me? I'm smart, but I don't feel educated enough to use that device... hence my statement about I'd much rather use OPA/NPA until a medic can drop an ET tube, or, failing that, use one of their backup devices.

Wendy

CO EMT-B

[1835wayne]

Dustdevil wrote:

Simplified? Sure. Oversimplified? Absolutely not. In fact, it is a spot-on analogy that breaks the issue down to it's common denominator, making an indisputably valid point. Perhaps you can explain why you disagree?

Sure. I have stated repeatedly now that ALS ambulances should be distributed in the same manner that fire suppression apparatus are now to truly serve the people properly. I am not now, nor have I ever advocated I do not think you can accurately describe a BLS or ALS engine company as just "someone". The training is the same, the continuing education is the same and the protocols within the same system are the same. I do not care whether it says FD or EMS on the patch on their sleeve as long as the standard of care is maintained. Isn't that what it should be about in the first place?? The patient??

DwayneEMTB wrote:

Is it your opinion, as it seems to be, that simply "someone" showing up is acceptable? So if your house is on fire, you'll be satisfied if they send an ambulance immediately, while you wait 10 mins for fire suppression professionals? I mean, after all, the ambulance has a fire extinquisher! (akin to the firetruck having an AED)

On a side note, I know a FD that runs an ALS rig that is staffed full time and when there is a house fire, the duty crew dresses out and makes entry with a water can if there is someone still inside, sometimes before the engine company(all vol from the same department) arrives.

[DwayneEMTP]

Hell, just when I'd gotten all excited about this thread it turns out fire doesn't want to play after all...

My apologies Wayne, I didn't notice that this thread had replies. Though, because you still didn't address the most pertinent of the previous questions, I would just be restating the things I asked before if I replied to your latest post here...

Have a great day all.

Dwayne

[Don1977]

Hmm, so as a volunteer fire fighter Im not professional? Hmm, interesting. Try "career" fire fighter.

Volunteers are professional too, get more respect because we don't get paid to do it.