Redundant Fire and EMS response in Florida

[brentoli]

Welcome to Los Angeles County...you get the triple threat...unless it's a station house with an engine and a ladder truck...then it's x4

Wait wait wait wait.....

They knock out half a box there... for a sprained ankle? Or a fall down go boom?

[Schwaa]

Just the fact that this guy interviewed Chief Graves from Seminole Fire Rescue makes me wonder what this author really knows or how much research he has actually put in.

Lets talk to a guy in toronto about Pinellas' EMS system? WTF?

How about when Sunstar runs out of units? Is fire necessary then? Almost all Fire units are ALS in the county, except for a few trucks.

As for Hillsborough: A lady falls down in a nursing home? Guess what? She gets an ALS engine also!

Hillsborough and Tampa are no better off than Pinellas.

Blah blah blah blah blah thanks

[Flasurfbum]

I see alot of, what appears to me, as the usual, undereducated posts about the fire dept.

YES, we need those big ol shiny trucks.

YES, we need 4 on an Engine, and 5 on a Truck/Ladder/Tower Co, and 6 on a QUINT, in order for the unit to properly do its job on fire, and rescue (note, rescue, NOT EMS) scenes.

NO, not every piece of apparatus needs to be ALS. Not on your life. ILS Engines, BLS Trucks and QUINTS should be the norm, coupled with ALS Ambulances.

I do, however, see the necessity for an additional piece of fire apparatus on ALS calls. C/P, SOB, Cardiac Arrest, anything where an additional set or 4 of hands is needed.

Not all Firemen want to be Medics. Not all Medics want to be Firemen. All of us grunts appreciate that fact. It is the upper echelons that order this.

In order for us (firemen) to adequetly staff our apparatus to ensure that all the necessary fireground functions are done, we have to consistantly respond to these BS calls to justify it to the bean counters.

So please, do not hold the line Firemen and Fire/Medics accountable for the policies of the administation.

[thatoneguy]

Unless I am wrong, I thought the NFPA set forth guidelines to justify staffing levels to the bean counters, not responding to "BS" calls. I am not saying that there is no reason for current staffing levels.

I will say that if this system used a priority dispatch system, then nobody would be driving across town with lights and sirens blaring period.

In the end though sadly this all comes down to the typically tired argument of who gets to respond to intersection xy or not. I see this article/argument as the jumping off point for fire to take over EMS.

[Flasurfbum]

Unless I am wrong, I thought the NFPA set forth guidelines to justify staffing levels to the bean counters, not responding to "BS" calls. I am not saying that there is no reason for current staffing levels.

I will say that if this system used a priority dispatch system, then nobody would be driving across town with lights and sirens blaring period.

In the end though sadly this all comes down to the typically tired argument of who gets to respond to intersection xy or not. I see this article/argument as the jumping off point for fire to take over EMS.

NFPA is a joke. Really. But we don't know what calls are BS, and what are not. In my short career, I have responded to several "Activated Fire Alarms" that turned out to be multi alarm structure fires.

But to justify the levels to be bean counters, we have to prove that we respond to xx amount of calls, so we need xxx amount of money for staffing the apparatus.

Bassackward? Yup. But until common sense :roll: is used, we have to play their game.

[thatoneguy]

I won't disagree with the fact that the NFPA is a joke, however it is a great resource for the bean counters. The NFPA bases their staffing recommendations on the population in a given area, not the number of calls.

I also understand that you can never tell which calls are BS, but that has nothing to do with sending multiple apparatus to every call. I too have been sent to routine calls that turn into big ordeals, but all you have to do is call for backup. We are all supposed to be capable of handling things until backup can arrive, especially with so many resources in a given area (as in most munincipal areas in Fl.).

[JPINFV]

I see alot of, what appears to me, as the usual, undereducated posts about the fire dept.

YES, we need those big ol shiny trucks.

YES, we need 4 on an Engine, and 5 on a Truck/Ladder/Tower Co, and 6 on a QUINT, in order for the unit to properly do its job on fire, and rescue (note, rescue, NOT EMS) scenes.

NO, not every piece of apparatus needs to be ALS. Not on your life. ILS Engines, BLS Trucks and QUINTS should be the norm, coupled with ALS Ambulances.

I do, however, see the necessity for an additional piece of fire apparatus on ALS calls. C/P, SOB, Cardiac Arrest, anything where an additional set or 4 of hands is needed.

Not all Firemen want to be Medics. Not all Medics want to be Firemen. All of us grunts appreciate that fact. It is the upper echelons that order this.

In order for us (firemen) to adequetly staff our apparatus to ensure that all the necessary fireground functions are done, we have to consistantly respond to these BS calls to justify it to the bean counters.

So please, do not hold the line Firemen and Fire/Medics accountable for the policies of the administation.

The only blame that I see being passed on to the fire medics is the justified blame against the ones who don't take their EMS job serious. Besides that, I see a lot of the "OMG, someone said something against XXX. I'm a part of XXX. Therefore, someone is saying something bad against ME!"

The problem, though, is when you start seeing engines on every call. I'm sorry, but if I'm calling for paramedics while on an ambulance, a BLS staffed fire engine is not really going to help me out that much (which has happened enough to not just be a fluke). Also, if a system starts constantly sending fire engines to calls because all of the ambulances are tied up, then the solution is more ambulances, not more fire engines. It always seems, though, that the opposite happens. How often are news stories posted here about XYZ adding fire engines or converting engines to ALS to respond to medical calls?

Finally, wouldn't it be more cost efficient (fuel, maintenance) to just split up the crew? Take 4 of the people off the quint and assign them to a SUV or pickup truck. If the quint is needed for a rescue or fire then everyone jumps into the quint. If people are needed for a medical call then 4 people jump into the SUV and off they go. If while out on a call (since the quint would be detained regardless) the quint is needed for its primary purpose then the SUV meets up with the quint on scene.

So, in conclusion, sure, 90% of the problem with EMS based fire suppression has to do with management, but it seems that a lot of base level providers can't disconnect what is said about the system from what is said about them personally.

[Dustdevil]

So, in conclusion, sure, 90% of the problem with EMS based fire suppression has to do with management, but it seems that a lot of base level providers can't disconnect what is said about the system from what is said about them personally.

Similarly, we also have a lot of under-25 EMTs (and quite a few over-25 too) who have extremely limited experience and exposure in EMS -- usually all within one single system or geographic area -- who assume that whatever their system is doing must be the gold standard for the Nation.

Two keys to respect and understanding here:

• 1. Be capable of self-critique. Just because you are an EMT-B or an EMT-I or an EMT-P doesn't mean that you have to defend all persons of that certification to the death. Just because you're a firemonkey, don't be afraid to consider the possibility that there might be a more optimum way of doing things. And vice versa.

2. Be capable of separating yourself from your employer, your school, your system, and your state. You are an individual. Think like one. Blind patriotism to New Jersey volunteers just because you are one is just stupid. And just because somebody says EMS sucks in NJ, or Floridia, or at AMR, or in the U.S. of A. doesn't mean you personally suck, so don't take it personal.

• A good point was made earlier, that most of us are not in positions to directly change the system we work for. Well, that works both ways. If the system doesn't empower you, then don't empower the system by defending it just because you work there. It's just stupid, and it ensures that things will never change.

Of course, one problem is that too many of us are simply afraid of change. Mostly because of laziness.

[HellsBells]

To reply directly to emt's 179 proposal (as it were) , priority dispatch is the solution. If the information gathered by dispatch determines the call to be a Delta or Echo level response, then Fire will be dispatched along with an Ambulance crew.

So, in the proposed scenario with a 500lb man on the 39th floor in cardiac arrest there is a good chance that a pump or rescue unit will have been dispatched already. That said, speaking from long experience, Delta responses (at least in my system) are dispatched quite liberally, as I find myself downgrading or cancelling fire far more often then requesting additional manpower.

[akroeze]

To reply directly to emt's 179 proposal (as it were) , priority dispatch is the solution. If the information gathered by dispatch determines the call to be a Delta or Echo level response, then Fire will be dispatched along with an Ambulance crew.

So, in the proposed scenario with a 500lb man on the 39th floor in cardiac arrest there is a good chance that a pump or rescue unit will have been dispatched already. That said, speaking from long experience, Delta responses (at least in my system) are dispatched quite liberally, as I find myself downgrading or cancelling fire far more often then requesting additional manpower.

Just as a hint, it's a bad idea to use codes without explaining what they mean first. Not everyone uses your codes or knows what they mean.