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Old 03-26-2011, 7:20 PM
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Default Why Are Firefighters First Responders To Medical Calls In Stamford?

I get calls all the time when they call for example Engine 9 and Medic 1 on a medical call. The FD are first responders to medical calls in Stamford but what do they do? They have no stretcher, maybe a few medical supplies, but nothing else. Whenever they go on a call, they have to go in the firetruck when they just need the firemen (Not all the hoses, and fire stuff) so they bring a huge truck to a medical call. So what the point of being a first responder fire fighter?
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Old 03-26-2011, 10:07 PM
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Default Patient care maybe?

I would guess the idea would be to provide medical aid to the patient prior to the medics arrival. Thats why we do it. As far as the big firetruck responding, thats what they will need if given another assignment (fire) while on the road returning from a medical run. I've heard others before express concern over "wearing out" Engines responding to medical and service calls, umm they are trucks, just like the delivery and local route trucks you see every day that rack up hundreds and hundreds of thousands of miles over the same roads with similar loads. It all boils down to providing the best service to the customers as possible.
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Old 03-26-2011, 10:12 PM
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Firefighters on an engine can typically arrive at the scene of an emergency quicker because they are closer to the scene. They will typically be trained to a basic EMT level, if not paramedic, so they can begin treatment. If the patient is in need of CPR that can be started much sooner. In many places engines carry Automated External Defibrillators (AED) and can initiate that treatment also. If the patient is critical, those extra hands that come on the engine are put to good use providing treatment. You might be surprised at what medical equipment/supplies are carried on engines.

Stop by a fire station some time, I'm sure the firefighters would be glad to show you the equipment they carry and explain what they do.

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Old 03-26-2011, 11:03 PM
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Instead of saying that a Paramedic or EMT on an engine can't do anything you should first find out how the systems work and who does what. Having such personnel on an engine guarantees that whichever unit arrives first on scene there will be a person there who can start patient assessment and take other measures to assist. It's just smart management, that's all, and as was suggested you might want to stop by your local firehouse and learn something about how they manage their work for your benefit.
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Old 03-26-2011, 11:12 PM
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Old 03-27-2011, 10:20 AM
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Run stats.
In theory it is helpful to have a truck full of fit fellas on hand to help carry an overweight patient up or down stairs or to knock down a wall. Some FDs also have excellent medical training and can provide excellent primary care. Some - not so much.
Often times though, mancow is right. Both agencies are chasing the same tax dollars and need to show larger call volumes. Things can get silly with calls becoming races between the two agencies...
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Old 03-27-2011, 10:58 AM
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Run stats.
If only one or ten units respond to a scene it still only counts as one run/incident.

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Old 03-27-2011, 11:10 AM
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I just read in this morning's Lexington, KY paper that firetrucks are dispatched because they can often get to the scene of the call more quickly than ambulances. Here in Lexington, ALL firemen are also EMTs and ALL firetrucks are equiped with emergency meds and other lifesaving devices. Locally, it takes an average of 8 minutes for an ambulance to arrive at a call while firetrucks average just 5 minutes. The crew on the firetruck can stabilize a patient and prepare them for transport when the ambulance arrives.

At least, here in Lexington, KY, that's why firetrucks are also dispatched on emergency medical situations.
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Old 03-27-2011, 12:21 PM
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Quote:
Originally Posted by KR4BD View Post
Here in Lexington, ALL firemen are also EMTs and ALL firetrucks are equiped with emergency meds and other lifesaving devices. Locally, it takes an average of 8 minutes for an ambulance to arrive at a call while firetrucks average just 5 minutes. The crew on the firetruck can stabilize a patient and prepare them for transport when the ambulance arrives.

At least, here in Lexington, KY, that's why firetrucks are also dispatched on emergency medical situations.
Sounds like the residents of Lexington are well served. I really hope they are true EMTs. If so, you are lucky to have them! It has been my experience that the medical capabilities of Fire Departments are often over stated.
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Old 03-27-2011, 12:22 PM
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It is very common in many areas to dispatch firetrucks and firefighters to medical calls in addition to the ambulance and ALS units. The most obvious reason (as already stated) is to get a first responder to the scene as quickly as possible, and the truck obviously goes with them in case they have to respond to another call before returning to the firehouse (which happens quite often in my neck of the woods).

Around here, the police are often dispatched to the scene as well; most times they are dispatched even before the Fire/EMS dispatch goes out, for the same reasons. Even if the responding officer is not a trained/certified EMT (although many police officers are), they can usually get there faster than anyone else to gain entry into a residence and provide additional assistance.
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Old 03-27-2011, 2:01 PM
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Originally Posted by mdulrich View Post
If only one or ten units respond to a scene it still only counts as one run/incident.

Mike
Not true. If the units are part of the same department it is one run. If there is a third service EMS provider, or a private contracted company, there is an incident for EMS and an incident for the Fire Department.

Generally in the Northeast, when a FD responds as first responders, it doesn't matter what level they are trained to, they operate at the first responder level. The belief is that since there are more pieces of fire apparatus strategically positioned around a city or town, they can arrive quicker, and provide care until the ambulance arrives. For the person who thinks it's a waste, if you were experiencing shortness of breath, would you want someone there with oxygen in 2 minutes or 6? Just because they can't transport doesn't mean that they can't help, and be of major benefit. As far as taking the truck....it's what they have, and it's designed to take the wear and tear.

Also, check into whether or not they go on every call. In Boston, FD generally only goes on calls where the equipment they carry (Oxygen, Defib) would be of benefit.
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Old 03-27-2011, 2:14 PM
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Simple:

There are many fire units and personnel standing by waiting for fires but nearly 80% of calls are medical in nature.

Dispatching a fire unit with basic life support trained personnel (EMT-Basic) - and in some cases - even more advanced trained (some fire units even have EMT-Paramedics) - allows quicker care to the patient. It also potentially helps get the patient to the hospital quicker and *could* help get the transport (ambulance) back in service faster in the long run.

Basic life support (First Responders an EMT Basic training) includes but is not limited to:
A-B-C:
Opening/Maintaining an Airway
Ensuring Breathing
Ensuring Circulation
and
Controling bleeding

EMT Basic protocols now even include the ability to give or assist with basic drugs to help with breathing and allergic reactions.

...and all of this even before the ambulance arrives on the scene.

Standard Emergency Medical Dispatching (EMD) "classifies" the severity of the medical emergency and in some cases no first responder is sent. Of course, all of this varies dependent upon the jurisdiction's policies, training, and other factors.
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Old 03-27-2011, 4:45 PM
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Here's the deal:

No, they don't respond to every call. It depends on the severity. I heard on my Minitor last night a call right down the block for an 88yr female weak and not eating. I ran there as fast as I can. It was just for a Medic, no engine. Waited a few minutes for the ambulance to pull up and as it was backing in, engine 9 was dispatched because the patient was incoherent. Then the engine floored it to the scene but as it approached the residence, it was dispatched to go back to the station. So no firemen got out and turned right around. So the medic is already there, why did they attempt to get the FD there?
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Old 03-27-2011, 4:52 PM
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Quote:
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Here's the deal:

No, they don't respond to every call. It depends on the severity. I heard on my Minitor last night a call right down the block for an 88yr female weak and not eating. I ran there as fast as I can. It was just for a Medic, no engine. Waited a few minutes for the ambulance to pull up and as it was backing in, engine 9 was dispatched because the patient was incoherent. Then the engine floored it to the scene but as it approached the residence, it was dispatched to go back to the station. So no firemen got out and turned right around. So the medic is already there, why did they attempt to get the FD there?

Many times fire crews are returned without getting off the engine too -- depends on the call.

If you're there and you need help, you'd rather have them coming then have to call and wait--- minutes seem like they go on forever when you're there and help is needed.

"You can always cancel them...." if they aren't needed.

As for adding the engine later - the dispatcher may have received some additional info after the initial dispatch that indicated they should be sent - hard to say. Additional help could be sent just based on where the patient is -- perhaps on a level above the 1st floor for example.... the medics may need help for lifting -- so many possibilities.
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Old 03-27-2011, 7:52 PM
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Since I am a career firefighter who's department runs as a first responder program with EMTs, I'll explain it to you. (Also I am a former volunteer with my local EMS agency)

First it has to do with a person's medical emergency, the severity of it and the need to start patient care before an ambulance arrives. We obtain vitals, put a patient on oxygen if needed (depends on the type of condition), stabilize fractures and of course start CPR (or take over from someone who under the instructions of the 911 operator has started it). Advanced Life Support (ALS) is determined by the proper start of Basic Life Support (BLS).

Second, - LOCATION! LOCATION! LOCATION! In many larger cities, such as Stamford, Hartford, and New Haven to name a few have staffed apparatus (some larger volunteer fire departments also have "duty crews" at the firehouse for medical calls too). A lot of these cities contact out ambulance transport services to companies like American Medical Response (AMR), Aetna, Hunters and American Ambulance, to name a few. Other towns have their own EMS service. But look were there stations are compared to the firehouses. You never know where your ambulance maybe coming from. For example, Stamford has their own ambulance service and the ambulance that services your neighborhood is out on another call or maybe enroute to the hospital, that unit is out of service. So if another call in your neighborhood happens, well the next available ambulance may be coming from the downtown or north end area which could be a 10 minute travel time (give or take a couple minutes because of traffic) from their base to the location of the call. The fire engine's crew members can start patient care before the ambulance arrives, get information to the ambulance and paramedic for the type of condition the patient is.

Three - Types of calls. Has anyone here ever performed CPR on a person who is in full cardiac arrest? How about helping a very obese or elderly person off a floor who has fallen? I have experienced this as a firefighter and as a person who worked on a ambulance. Certain calls need more than the two people who are on the ambulance. Nothing is worse (and embarrassing) that not being able to lift a person up off the floor and then have to wait five to ten minutes for extra hands to arrive to help the patient. Someone said here you can cancel the other responders who are enroute, and that is okay. I've gone to many calls for someone who fell and and who was not hurt. My crew picked up the person got them situated, looked them over to make sure they were okay and cancelled the ambulance. There have been calls were the ambulance crew got there first and cancelled us, and that is fine. There are certain calls where we are not dispatched or we may be assigned to a different emergency.

I used to work as a dispatcher for C-MED New Haven and I have a decent amount of "road" experience under my belt. I have seen incidents on all sides of the coin. I have seen private ambulance services not have enough ambulances for calls in some of the bigger cities and the fire department first responder program has helped more people that you can ever imagine. What one person thinks is a waste, once they are in that particular trouble medically, their tune changes when they see some one there to help, regardless if its the fire department, the cop or the ambulance arriving first.
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Old 03-27-2011, 8:02 PM
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Weak and not eating is a "Failure to Thrive" Not even an EMS call, but a scheduled transport type call, but since they called 9-1-1 they're getting the EMS response for an illness.

On a callback, or if the calltaker was still on the phone, and the "incoherent" part was learned, the call is then upgraded to an "Altered Mental Status" type call, which could be from several causes...Alcohol, Epilepsy, Diabetes, overdose, underdose, trauma, infection, psychiatric, stroke...and is of a higher priority, one which dictates the response of an engine company. Since the ambulance isn't onscene, they have to start the response to ensure that the proper response is enroute. Since the ambulance was already on the way, they got there first, went in, saw the patient and canceled the engine company since they determined it wasn't needed. The proper response was initiated both at the time of the original call, and at the time of the additional information. Yeah, they probably could have gotten away with not sending the engine, but my guess is that they really don't know where the SEMS unit is coming from, so it could still be a shorter ETA for the engine company.
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Old 03-27-2011, 8:36 PM
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Before moving to Colorado about 20 years ago, I was a FF/EMT in New Jersey. In many parts of the northeast, it was (is) unheard of for fire to respond to EMS calls. FF's were typically barely trained to first-aid level, and would typically only respond to EMS calls when needed for manpower.
The move towards fire responding to EMS calls originated in the western US where populations are sparse (outside of the big cities) and ambulances are few and far between. In many parts of the west, the FD actually runs the ambulance, in other parts the ambulance is a third service, either a private company or a separate city department.
I'm a FF in a city of 105,000 people. As is typical for this part of the country, every member of the FD is required to be at least an EMT-Basic. My department has 10 engines, a ladder and a heavy rescue. Besides the EMT-Basics on each engine and heavy rescue, there is at least one advanced/Paramedic level EMT. We carry a full range of EMS equipment, including drugs, IV's, cardiac monitors, etc. You name it, we carry it.
Ambulance transport is done by a private company, with each ambulance carrying at least one Paramedic and one EMT. There is usually just 4 ambulances available in our city, and they may sometimes be used by the company for inter-hospital transfers, reducing the number available for emergency calls. I can tell you that it is a rare case (night or day) for an ambulance to arrive on scene before one of our fire apparatus. We typically have the patient evaluated and appropriate treatment underway before the ambulance arrives. This is typical for most cities out here. It would not serve the public well for a patient to wait for just an ambulance to arrive at their home when a staffed and trained fire engine is a lot closer and can be there faster/
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Old 03-27-2011, 10:08 PM
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Quote:
Originally Posted by izzyj4 View Post
Since I am a career firefighter who's department runs as a first responder program with EMTs, I'll explain it to you. (Also I am a former volunteer with my local EMS agency)

First it has to do with a person's medical emergency, the severity of it and the need to start patient care before an ambulance arrives. We obtain vitals, put a patient on oxygen if needed (depends on the type of condition), stabilize fractures and of course start CPR (or take over from someone who under the instructions of the 911 operator has started it). Advanced Life Support (ALS) is determined by the proper start of Basic Life Support (BLS).

Second, - LOCATION! LOCATION! LOCATION! In many larger cities, such as Stamford, Hartford, and New Haven to name a few have staffed apparatus (some larger volunteer fire departments also have "duty crews" at the firehouse for medical calls too). A lot of these cities contact out ambulance transport services to companies like American Medical Response (AMR), Aetna, Hunters and American Ambulance, to name a few. Other towns have their own EMS service. But look were there stations are compared to the firehouses. You never know where your ambulance maybe coming from. For example, Stamford has their own ambulance service and the ambulance that services your neighborhood is out on another call or maybe enroute to the hospital, that unit is out of service. So if another call in your neighborhood happens, well the next available ambulance may be coming from the downtown or north end area which could be a 10 minute travel time (give or take a couple minutes because of traffic) from their base to the location of the call. The fire engine's crew members can start patient care before the ambulance arrives, get information to the ambulance and paramedic for the type of condition the patient is.

Three - Types of calls. Has anyone here ever performed CPR on a person who is in full cardiac arrest? How about helping a very obese or elderly person off a floor who has fallen? I have experienced this as a firefighter and as a person who worked on a ambulance. Certain calls need more than the two people who are on the ambulance. Nothing is worse (and embarrassing) that not being able to lift a person up off the floor and then have to wait five to ten minutes for extra hands to arrive to help the patient. Someone said here you can cancel the other responders who are enroute, and that is okay. I've gone to many calls for someone who fell and and who was not hurt. My crew picked up the person got them situated, looked them over to make sure they were okay and cancelled the ambulance. There have been calls were the ambulance crew got there first and cancelled us, and that is fine. There are certain calls where we are not dispatched or we may be assigned to a different emergency.

I used to work as a dispatcher for C-MED New Haven and I have a decent amount of "road" experience under my belt. I have seen incidents on all sides of the coin. I have seen private ambulance services not have enough ambulances for calls in some of the bigger cities and the fire department first responder program has helped more people that you can ever imagine. What one person thinks is a waste, once they are in that particular trouble medically, their tune changes when they see some one there to help, regardless if its the fire department, the cop or the ambulance arriving first.
Ex EMT/FF here. coulndnt explain it better my self! Used to work in the boonies, where you were lucky to get 3 people on a call . Had to call other depts. if we had a large person or a house w/ stairs etc. to get a pt. out. I was amazed how many people would give us grief about that big truck you came in , and why do you keep it idiling !!!! youre wasting tax payer $$$ Never mind we were providing lighting for the EMS crews, etc Had the same thing w/ brush fires. "why are you sending 12 engines 3 hand crews, aircraft, etc for a little fire!!!!???!!. I always told them, you would be happy if this sucker gets out of hand, AND, hey. you can always cancel the balance!
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Old 03-27-2011, 11:02 PM
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FD response in some cases is all well and good, but proportion of response is necessary too. A full pumper/tanker with a crew of four is rarely needed. A smaller squad/rescue truck with two on board can render initial aid.

I'd rather have the engine in service at the station in case of fire than out bandaging a stubbed toe.


FYI, Detroit Fire does not respond on EMS runs unless FD services are required (accident, rescue, etc.).
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Old 03-28-2011, 5:24 AM
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Quote:
Originally Posted by wpann View Post
Here's the deal:

No, they don't respond to every call. It depends on the severity. I heard on my Minitor last night a call right down the block for an 88yr female weak and not eating. I ran there as fast as I can. It was just for a Medic, no engine. Waited a few minutes for the ambulance to pull up and as it was backing in, engine 9 was dispatched because the patient was incoherent. Then the engine floored it to the scene but as it approached the residence, it was dispatched to go back to the station. So no firemen got out and turned right around. So the medic is already there, why did they attempt to get the FD there?
I'm a little confused myself. Why are YOU running to this call? I'm hoping it's the same reason why the Engine Co goes to some calls; to help the citizen.

In Connecticut (this is the CT Forum), almost all the career fire departments respond to EMS calls as first responders. They are dispatched according to fairly stringent protocols dictated by Emergency Medical Dispatch programs, all signed off by physicians (somewhere).
While there are plenty of sarcastic and political statements to be made about this practice, there are plenty of times that the firefighters get to a scene to assist our citizens; they deliver babies, perform CPR, help EMS crews lift, drive the ambulance so both EMS techs can tend the patient, perform care until a mutual aid ambulance arrives, all sorts of things.
Does it run up the numbers, and wear down the trucks? Sure, no different than the ambulances picking up the same drunks over and over, or the police car idling at a construction site for days, it's all part of the cost of doing business.
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