Fire v/s EMS

[Bobby Boucher]

new topic here folks-

i read in (i believe) last months issue of firehouse magazine where mr. gary ludwig had an article about animosity amongst firefighters who are required to respond with EMS. he stated on several occassions there were firefighters who resented having to go on these type of calls.

he made several points, one being that EMS workers thought firefighters were 'lazy' and that firefighters thought EMS folks were 'undisciplined'.

my question (without detracting from the above statement from the article) is this - do you get along with your local EMS? is there any resentment? do you know of firefighters who don't handle these type of calls well? do you know of EMTs/paramedics who resent the FD coming with them or perhaps ridicule/demean the responsiblity of the FD on the scene?

just a thought. i read the article and thought it might make for an interesting (and non volunteer v/s paid related) discussion.


BB

[Chief601]

Here in my part of the world, the EMS crews are employees of the hospital district. There is no Fire/Ems from the same department. Like everywhere, I'm sure, there are times when conflict does arise and tensions are high. Example, three weeks ago we were dispatched to assist with a heavy patient. It was in the part of our district that was the furtherest point form the station. We responded emergency then were asked to down grade. I advised we would have a 25 minute eta. During this time our second engine was hit to go on the 2nd alarm of a double residential fire. We of course didn't go. However, when we go to our scene we found 2 female paramedics and 6 male neighbors standing around waiting for us. Had they used the neighbors help, they would have been at the hospital before we arrived. Idiot move. On the other side, we have received and written many thank you cards for the way we work together. The most important thing is that we all work for the good of the community. I enjoy a good working relationship with our EMS staff and I hope that they feel the same.

[LostOnScene]

around here fire and ems have an excellent relationship.

the ems scene that i am around most is fortunate to cover the area od a certain fd who has 2 qrs units and they are always willing and ready to help out when we need them. i have yet to be on a call where richland twp. fd has been less than helpful on a qrs. you ask them to do something or get something on occasion with a little explanation but its done no questions asked.

[Chief1]

Lets see if I can post this correctly this time.



I wish I could say the FD and the EMS crews were civil to one another in my little slice of heaven but we aren't. The EMS crews think the FF's are a bunch of "idiot, hose jockeys" and we all think they are a big group of "shit bag, para-quacks". We work together when needed and things may change some day, but its been this way for about 6 years now. So they stay at their station and we stay at ours.

Chief1

[Dep131]

In our neck of da woods EMS is also a hospital based service. We do not run a rescue, per se, out the FD. We are fortunate, I think, that we have a very good relationship with our EMS folks.

[Karl Childers]

our service is together. Most of the fire folks would rather not take an EMS call, but when the shit hits the fan, everyone pulls together. One company in particular is very good about helping when we have a heavy load or a difficult load. I don't really see any animosity, however, there is a good deal of good natured ribbing. But all in all, we have a good working relationship.:cool:

[Dep131]

As I mentioned perviously, we have a good relationship with our EMS folks. We respond with them, when requested, automatic in some cases such as mva's. Everyone respects each others position. They are a paramedic service, we are first aid / cpr trained. We perform the "rescue" work such as extrications. No one tries to tell the other how to do their jobs. We often work in a unified command mode. The service responds automatic with us to structure fires, for the obvious reasons, as well as to man our rehab sector. A pretty good set up for all involved !

[Dep131]

As for resentment towards EMS responses, I was one of those folks, until recently. It has become obvious that it makes little sense to fight the inevitable. A recent report in Fire Chief Magazine showed that as of Nov. 11, 2003, 7943 FD's reported 2.43 million incidents. 56 % of those incidents were EMS in nature. Another report shows those responses to account for
51 % of call volume. A recent comparison of our own activities revealed a 331 % increase in EMS in nature reponses in 5 years. We are not a big operation here, but that is a significant increase in services provided. We too are fast approaching the 50 + % mark as well. I am being paid to do a job, and that job is changing, EMS is now a part of it. I am not being paid to bitch about doing my job !, hence the change in attitude.

[Dep131]

The numbers don't lie ! Here in my hometown FD :

Week #1

7 days / 7 calls

4 EMS / 2 so far today

1 MVA

2 Fires


5 (EMS in nature) - 7 Total Calls = 71 % EMS in nature

Are the numbers trying to show us our future ???

[Karl Childers]

It sure is good to see you got the message. Trust me, this is not a trend. This is the future. And it's only going to get better (or for you nonEMS'ers, worse). Might as well be prepared.:cool:

[Chief1]

KC,

Your right, and I dread the day the para-quacks rule the roost.

:D

Chief1

[Karl Childers]

I do not want to rule the roost. I just hope we can all do this together. :cool:

[closet ff]

The problem with ems is the nature of the calls any more. When I started in the fire service my dept was just fire, we added ems a couple of years later. What I've noticed and has turned me off to ems is in the last five years the type of ems calls we run. We have become a taxi service for rich people, because its free and they don't want to wake up there spouse to take them to the hospital. Also they think if they go to the hospital in a ambo that they will get seen right away, which doesnot happen. Don't get me wrong, when someone really needs a ambo, it's a great service to provide, But about 50% of the time they didn't need us, just wanted a ride to the ER. :cool:

[LostOnScene]

are us ems people really that bad to work with?

[Karl Childers]

Don't hate the players, hate the game. If all we hauled were true emergencies, we would only need about 10 ambulances period. It is the nature of the beast. We don't like it either, but you lays down your money and you takes your chances. :D

[Fghtng5thFemale]

It's a nice break from the pro versus volly threads or the "here are my pics guys. giggle" thread.

In my department we are lucky on this issue because it's both fire and ems in one. It's a requirement by all members that you have to be at least an EMT. This way we always have an BLS crew.
Plus a good majority of our members are BVR and SVR certified too. The moral in my station is good and we make a great team regardless of what the call requires.

[ChiTown]

I must hate myself...

[Chief1]

I should specify, when I talk about “para-quacks” I am referring strictly to the primary EMS crews that work in my area. We also run mutual aid calls (a lot) to the adjacent county and their EMS crews kick ass. They don’t mind asking for our help, they will listen to us as we give them the preliminary report and they will actually talk TO us and not AT us.



Good Day
Chief1

[SickofDaBitchin]

EMS is the cancer of the traditional fire service.

[ChiTown]

Wow,the argument against fire-based EMS sounds like a timely one ....For 1972 or so.

[jonnyboy5_12]

sickofdabitchin, why dont you stop your bitchin. If you have so much trouble withe EMS where you live, then why dont you talk to them about it and make suggestions. The point is, what are you going to do..put your pt on the hosebed and take them to the hospital? fire needs ems just as much as ems needs fire. A LOT. Fire is going to hate ems though so it doesnt matter if we talk about it or not...at least until some firemen get burned and EMS saves their asses.
In our area, ems responds on quite a few more than fire. Fire very rarely responds on ems calls. out of the 370 firecalls last year with the fire dept, our ems had over 4000. overall though, we get along on scene..its back at station that the bitching and pissing contests start..on scene for the most part it all ends and we work together as a team. FIre protects property, and helps ems, ems takes care of pt. WE NEED EACH OTHER.

peace out everybody.

[SickofDaBitchin]

Who's bitchin? That was my second post. You act like I have Hundreds of posts on here. I said EMS is the Cancer of the Traditional Fire Service. It is true. How many guys, Paid or not, truly want to go out on EMS runs? Let's go over some of your quotes:

what are you going to do..put your pt on the hosebed and take them to the hospital?

No, I am gonn wait for the EMS unit to get there and transport, like they are supposed to do. Personally, I don't see why Fire Apparatus is bing taxed on Low Priority EMS Calls in the first place. It is a waste of resources for the local VFD/Jurisdiction or whoever is purchasing the suppression apparatus. I am sorry, I was hired by a "F-I-R-E Department," not a commercial EMS service. All of this we gotta help everyone who calls 911 BS is turning the service into a freaking 411 for every schlepp who doesnt have insurance. Fire Based EMS is fine and dandy, but don't make fireman ride EMS units unless they want to or you are gonna pay me more. Hire people separately who want to do EMS. There are plenty of them out there. Fire/Medics are a Noble Idea, but when that Engineis stuck at the Hospital waiting for the Medic and misses a 1st due house fire, what good is the Firetruck doing? You can't dump the medic or you might be short staffed. Assign Fire/Medics to suppression based Medical Units and if they aren'ton an ALS run, they can run the fire with the Engine. If they are on a run, oh well, they are medics first (since everyone says EMS is so much bisuer than suppression)

[jonnyboy5_12]

i didnt mean any offense...i was more talking to everyone else than you about the bitching....i just put your name there cuz it rhymed. Also, i run wiht volly fire, and paid ems....ems runs a hell of a lot more calls and fire is only called for lift assist unless its a wreck or a fire. Fire very rarily ends up on ems scenes. (unless the fire dept has a QRS unit. I wasnt talking about fire based ems. i was talking about fire assisting ems or vice versa. peace out..

[1014engine]

Originally posted by SickofDaBitchin
EMS is the cancer of the traditional fire service.
EMS is the cancer of the fire service.

[ChiTown]

What year did you start your fire service careers?

[closet ff]

The reason ems runs more calls is if someone stubs thier toe they call 911. Putting fire pieces on ems calls is pure politics, when budget cutting started to happen to the fire service, the chiefs had to justify thier budgets to the mayors, so look we'll send a fire engine on all ems calls, to show the politicians the service we provide and not to cut our budget.;)

[1014engine]

Originally posted by ChiTown
What year did you start your fire service careers?
1980. You?

[regs1]

The EMS system is basically the stepchild of the fire departments, depending upon the department; the EMS system either grew with the department, or inherited
If evolved with the various departments, you see a completely different attitude that firefighters have towards the EMS system than if the system was forced upon them. Example of this is Seattle Wash, and LA County. The EMS is part of the job, and the proper training has always been provided.

I see the major problem is when the system is forced upon the fire department. Many of the problems that exist today is because some type of system was forced upon the firefighting system, in many cases a new civilian, non-firefighter in now part of the department, and in many cases not subject to the same rules as a firefighter.
In many cases a second social problem beyond the control of firefighters, the Emergency room has become the family doctor, the ambulance has become the taxi to take them there. In Washington Dc, engine companies respond to EMS calls because of the delay of ambulance response, or in some cases to give security to the two ambulance workers. In some cases the engines in a 24 hour period might run 5 fire calls, but also respond to 10 ems calls and up.

Is there a solution, yes but not a simple one, first you need to know what type of service is the fire department going to give the community, if it is a combo system, EMS/Fire, then hire, educated and assign people to the EMS and fire sides, Give a clear policy, also pay for the added education of being a para-medic. Firefighters seem to do things for the extra bucks, make it worth their time for this type of training.
But a clear policy is needed, many department change policy almost monthly, the firefighter have no clue on what going on, the EMS people in some cases do not even know if the have a job come monday morning.

EMS leaders - have not meet to many good ones, they always seem to forget the firefighting division, and solly focus on EMS issues.

The same could be said about many department chiefs, they often do not have a clue about EMS problems, thus fail to put out some type of policy.

The EMS social problem, here I do not have a clue to give a solution. With welfare, Social security, Medicare many of these people do not pay for the ride, so charging a fee is not the solution.

Lastly, national standard, have about we have a set that last more that 3 years, many department just meet the last set, then the rules change on them.

Just an opinion on EMS.

[ChiTown]

1981. EMS was already around back then.

[jonnyboy5_12]

okay okay enough of the pissing contests..check this one out....

[ChiTown]

Let me pose this question. If you or a loved one was in serious trouble either medically or injured, who would you want to take care of them, a disgruntled underpaid private ambulance jockey or a firefighter-paramedic? The department I work for went ALS in 1973 because the private sector couldn't or wouldn't provide adequete service to the community. Here in southern Chicagoland, several miles north and several miles south of my firehouse lie 2 of THE poorest towns in the U.S. We run our fair share of bullshit am-bo-lance calls. But we also do a fair amount of fire duty too. It comes with territory. Do I get tired of running bullshit ambulance calls? You bet. Just like I get tired of automatic alarms,CO investigations and "smell of gas" runs. But they are part of a job that I am grateful to have. To somehow say that saving lives is somehow "cancerous" is just plain wrong. The public needs a swift kick in the ass to educate and correct the VAST abuse of the EMS system. But when it really matters..when lives are on the line, I like to think firefighters do THE best job. Keep up the lively discussion. Its healthy to have disagreements.Who knows,we may even meet half way.

[Dep131]

Well Said ChiTown.

[1014engine]

Originally posted by ChiTown
Let me pose this question. If you or a loved one was in serious trouble either medically or injured, who would you want to take care of them, a disgruntled underpaid private ambulance jockey or a firefighter-paramedic? ChiTown: No pissing here either. I appreciate the lively debate.
True, fire based EMS became vogue during the 70’s in many parts of this country. However, there are still a lot of problems - maybe more in some places than others - and it is still a pertinent topic. I would also agree that the private sector typically provides substandard EMS.

First, to answer your question: My choice would be a dedicated, experienced, professional Paramedic who wants to do EMS, is good at what they do and for whom EMS is their only job. This person could likely be a civilian employed by a “3rd service” public EMS organization, or a separate EMS division within a fire department.

I never said saving lives is cancerous or that EMS is cancerous. Like firefighting, EMS is a vitally important job. In fact, it is important enough to warrant a sufficient number of Medic units that are properly staffed with highly trained, dedicated EMS personnel. What I did say (and which comes from the context of my own experience) is that EMS (specifically fire-based EMS) is a cancer on the FIRE service. Allow me to elaborate:

I believe that service diversity breeds mediocrity on the fireground. Firefighters are being forced, often against their will, to become jack of all trades & masters of none. My department has gone so far as to do away with the title of Firefighter and calls the new employees "ERT’s". How demoralizing! How demeaning to a proud profession with great history and tradition! Talk about losing focus! What message does that send about how important they consider firefighting to be?

I have a question for you: If you or a loved one became trapped by extending fire and overcome by smoke on the sixth floor of a multiple dwelling, who would you want to have coming to their rescue - an “ERT” who was hired under lowered standards, was pushed through basic firefighter training five years ago, has a two-year college Paramedic certification, has spent most of her time riding a Medic Unit, who doesn’t really like that fire stuff but has to do her time ‘cause the department wants it that way or she "needs a break"… Or, a dedicated, full-time Firefighter who lives and breathes to fight fire, scored high on a written test and CPAT to get hired, went through a stringent, disciplined probie school, completed a comprehensive probation, drills every tour under the watchful eye of a veteran fire officer, has preplanned most of the buildings in the response district, and has spent the last five years mastering the trade of a firefighter?

[Karl Childers]

1014 Engine. This is what is needed. I myself am a fully dedicated paramedic. This is what I want to do. I will help wherever is needed, but my full focus is EMS. I have friends who only want to fight fires. But, if you switch the two around and force each to do something they either don't or won't do, then will the job be done correctly or safely?? :cool:

[eastshoreoutlaw]

Lets reverse some of what you said. What if you had a person who wanted to provide dedicated fire service but was prevented because that person happened to also have the paramedic patch. Would you be the first to sand up and say "He should be allowed to fight fire only." Or would you be one of the ones to say "Quit whining, you were hired to be a paramedic and that's all you should ever do."

[1014engine]

Originally posted by eastshoreoutlaw
What if you had a person who wanted to provide dedicated fire service but was prevented because that person happened to also have the paramedic patch.
Did I say that? I don't think I said that.

In case you haven't noticed, a lot of departments these days require firefighters to also be paramedics. This is the issue. I don't know of one single department that turns firefighter applicants away if they happen to be a paramedic. If you know of one that does please let me know.

What would I do with this person? I'd start by making sure they understand that they are firefighters first and foremost. Then I'd train them and work with them just like I would anyone else who walks through the door.

[omahaorange]

Sorry guys, as a dedicated EMS provider I felt I had to comment here. In regards to the "EMS is cancerous to the fire services" comment, EMS is not the cancer, the general public is. This is supply and demand...the public demands ambulance service and the city/municipality provides it. The elected officials in those areas decide how best to meet the needs of the public. Whether the demand is warranted is another debate. In this area, where most of the fire departments are volunteer-based, the majority of EMS is provided through contracts with and licensing of private EMS services. EMS service is selected by the governing bodies of those communities. These governing bodies, be it big city or rural township, may not be the most qualified people to make these decisions.

As far as educating the public, do you really think this will work? Most of the people here who call for EMS know the difference between a true emergency and "I stubbed my toe" but still dial 911 because they can, believing EMS is a public service (which, by the way, it is). I don't mean to sound bitter, I have accepted this as part of the job I have held for 20 years and treat all calls the same. As far as EMS imposing itself on the fire service, blame your local governments.

[jonnyboy5_12]

that was very well said, and you are correct....what is your view on tying a BLS unit up on a nonemergency transport say from the hospital to a nursing home, to their home, or from home to a doctor's office....?

peace out all..

[omahaorange]

Not my favorites, but for most of the private services, this is what pays the bills. Unfortunately, there is little tax support for the private services. The service I work for provides both 911 and non-emergency transport services for the areas we cover and we shuffle a lot of units around to provide the ALS coverage for those areas. The facts are that most of the non-emergency transports we take have been pre-approved by the respective insurance companies so we know we will usually get paid. You take your chances with emergency calls and health insurance; sometimes they pay, and sometimes they don't. The insurance company (Medicare in particular) determines, based on the run report, whether the patient should have gone by ambulance ("True emergency") or POV. We sometimes have money tied up for months in appeals. The patient, on the other hand, usually thinks they "need an ambulance" because they are "sick", and give no thought to whether it's a "true emergency". So like it or not, for the private EMS services, the BLS transports provide the revenue to provide the emergency services.

[Karl Childers]

and that is public education. I realize 90% of the public doesn't really understand emergency. However, we must never stop trying to educate. I usually try and do it everytime I go to a stubbed toe incident. But, I do it respectfully. I will never forget one call in particular. Upon arriving on the scene, I found no less that 10 cars in the driveway and yard. This was for a sick child. When I asked why they called for an ambulance when they had all these vehicles, they replied "all of these are broken". What you gonna do????:rolleyes:

[regs1]

was the house mobile?

[omahaorange]

Originally posted by Karl Childers
and that is public education. I realize 90% of the public doesn't really understand emergency. However, we must never stop trying to educate. I usually try and do it everytime I go to a stubbed toe incident. But, I do it respectfully. I will never forget one call in particular. Upon arriving on the scene, I found no less that 10 cars in the driveway and yard. This was for a sick child. When I asked why they called for an ambulance when they had all these vehicles, they replied "all of these are broken". What you gonna do????:rolleyes:


Can't argue with that. You are absolutely correct.

[FDMedic73]

In response to omahaorange's comment,

The patient, on the other hand, usually thinks they "need an ambulance" because they are "sick", and give no thought to whether it's a "true emergency".

There are also people who go by POV to the ED that should have called an ambulance but don't because they don't think that they have true emergency.

[Karl Childers]

Yes, the house was mobile. We are in West by God. And no, I don't have a vehicle with towing capabilities, but I sure would have tried if I did. LOL

FDMedic73, you are absolutely correct. And this is sad.

[omahaorange]

Agreed...That door swings both ways. And as Karl Childers stated, it is indeed sad.

[ChiTown]

I agree that public education probably wouldnt be all that effective, but we should make a better attempt at it. When is the last time you heard a public service announcement like this ? " If it has red lights and sirens..it's not a taxi". Probably never. I have heard of taxi vouchers given out in some areas. As for "ERT's"..We dont have anything like that here. You are a FIREFIGHTER-PARAMEDIC, note firefighter first. We run about a 60-40 ratio of EMS to fire calls. That is a little higher on the fire end then the national average I believe. Maybe Mike Ward has those figures. I was thinking about the role of fire based EMS as it related to Big Cities. In his book REPORT FROM ENGINE CO. 82 , Dennis Smith related how they would respond to medical runs via pullboxes. Fire based EMS came about because we are centrally located, dedicated, motivated and better disciplined then the "average Joe". I wish we could refuse to take people to the hospital for nonsense, Maybe that day will come and folks will get the hint. I worked for a private ambulance before I got hired fulltime. It was low-paying, yet I learned a lot. I also know that the vast majority of private ambulance employees are on a constant search for "greener pastures". I am proud of our paramedic system here. The "Big Boys"( aka AMR) came, couldnt conquer and left. I am not stupid enough to believe it would work everywhere, but I am reminded of a neighboring department that let their paramedic program go. The story goes that the city was dropping EMS all together. The troops generally were happy....For a while. the promise of "putting more men on fire apparatus" never quite panned out. So instead of the ambulance crews (who responded and fought fires) being placed on fire rigs, those positions were eliminated. Even the old timers say it was a shortsighted move that they have come to regret.

[omahaorange]

I agree with you, Chitown. However, in today's sue happy society, how many of us would be willing to take the chance on saying, "Sorry, you don't really need to go by ambulance. Call a taxi."? And even if we are willing, how many departments and services would be willing to back you up on that call when the lawyers get involved? It's just easier to give them the ride. The general public knows this too. Like I said earlier, it's a supply and demand issue. The public demands it, and the government supplies.

[FDMedic73]

That's why providers should pray to the god of refusals.:D

[jonnyboy5_12]

its easy to talk the bull shitters into signing off.....just mention the huge bill they will be recieving...they usually sign off and drive in. If it is really legit, they ususally wont care about the bill.
Once again though, you have to use common sense, because you could always get sued.
peace out..

[FDMedic73]

Originally posted by jonnyboy5_12
its easy to talk the bull shitters into signing off.....just mention the huge bill they will be recieving...they usually sign off and drive in. If it is really legit, they ususally wont care about the bill.
Once again though, you have to use common sense, because you could always get sued.
peace out..

How very true, luckily we have the freedom to sign off the bs without command consult but certain things reqire it no matter weather it's bs or not.

[jonnyboy5_12]

I thought Paramedics had to get command to downgrade to a different unit or sign off..... Am i correct? jw...i know BLS doesnt need command.

[FDMedic73]

Originally posted by jonnyboy5_12
I thought Paramedics had to get command to downgrade to a different unit or sign off..... Am i correct? jw...i know BLS doesnt need command.

We have the freedom to decide if the patient is BLS or ALS and if so initiate protocol and continue with transport. We don't need to call if we start a protocol; a simple ALS notification to the ED is sufficient. We only need to call if we need further orders or have a problem. We have really good protocols here and are able to do a lot. We really don't have any BLS services around here so if it is BLS the EMT goes in the back and away we go; don't have to talk to command.

With sign offs, unless there is chest pain, sob, altered level of conscious, ETOH, head trauma, bad MVA's or unstable vitals we can sign a patient off without command. We always call if were unsure with anything.

[Dude712]

That is all up to the Command System you have and their Medical Director. I know the Command System for the service I work for requires us to call for BLS Releases and Refusals. Even if a BLS crew is getting the refusal they would like us to call.

[omahaorange]

Originally posted by FDMedic73
That's why providers should pray to the god of refusals.:D

I think we're getting off topic here, but let me comment. Your pagan god of refusals will abandon you when you need him most. Any attorney worth his 40% will shred your refusal form by claiming duress, pain or suffering rendered the patient unable to make a proper decision regarding care, instead following the advice of the trusted medical professional. Your best friend is the goddess of the trip sheet. Too many times I've seen trip reports that state "We went in, I didn't see anything, so we signed him off and went back to station." It is your documentation of the event, not the signature on a piece of paper, that saves you from lawsuit hell.

[FDMedic73]

And that is why I write every tripsheet like it's going to court.

[jonnyboy5_12]

trip sheets suck. I always have trouble doing detailed trip sheets....also, when you get backed up 4 or 5 calls, sometimes it is really hard to remember details about the first ones. Does anyone on here still do the "fill in the dots" trip sheets? Anyone have to do them in the hospital? We use EMSTAT tripsheet program on the computer...

[FDMedic73]

We still use the paper tripsheets and try to do them at the hospital if time permits. Currently we are looking to go to EMSTAT by April with EMSOF.

[omahaorange]

Originally posted by jonnyboy5_12
trip sheets suck. I always have trouble doing detailed trip sheets....also, when you get backed up 4 or 5 calls, sometimes it is really hard to remember details about the first ones. Does anyone on here still do the "fill in the dots" trip sheets? Anyone have to do them in the hospital? We use EMSTAT tripsheet program on the computer...

I carry one of those long spiral note pads like PSP and reporters use. You can fit all your notes on one or both sides of one page, so when you sit down later, all the info is right there. It doesn't take much time to jot down details while assessing and transporting. I can relate to 4-5 trip sheets behind. It's a rare day when I don't start a shift by writing yesterday's last trip. We should be moving to electronic trip sheets in a couple months. Don't knock the trip sheet...it's what bails you out in a pinch.

[eyeofthestorm]

in our county all firefighters are also EMT's, so they have to ride the ambulance all the time. however, if a person chooses to become a paramedic, then some tensions arise between the two, but the issue isnt whether or not either side is lazy, etc.; the issue comes down to whose better then who. in my opinion you cant be a good firefighter and a good paramedic at the same time, and vice versa. also, i think that if you are good at one and bad at the other then you should stick to what youre good at, because in this line of work, no one should be bad at it.

[Fearless_371]

the big problem I see is that many people who are EMS are getting burned out real fast, and become very bitter towards the fire side, because they are carrying 50-80% of our combined calls, and it is only getting worse.

EMS-the last three letters in PROBLEMS!!!

[ENGINEDUDELT]

Fearless, agree with the burn out rate. Also, the animosity from firemen comes from missing fires while running BS med locals and one of the worst things that I have experienced is a lazy medic. When the engine arrives and we asses the PT, i will tell the medics what they need on arrival, cot, stokes, PRI 1 or whatever, and I always tell them to bring their cot. BUT, they don't bring shit here where I work. They are lucky to bring themselves. Then they want my crew to get the cot. BOY, oh BOY, teamwork is one thing, but..............I will quit while I am ahead.

[RES2CUEFF/PM]

I know in the suburbia I Volly in, we run out of the same houses...engine companies are often dispatched as first due BLS units to to assist EMS with manpower. Depending on where the ambo is coming from the engine may be on scene first and do the initial exam (Pt hx *Sample opqrst-an* and baseline vitals) before the medic or basic unit arrives to transport. Sometimes the engine co. will even take a refusal and place the responding ambo in service. I think we work well together within my department and other local departments, paid and volly alike. When you think about it, aren't we all trying to accomplish the same objective of Public Safety? EMS does run the majority of calls...and EMS is where the money and funding is but the Fire service is important to that end as well, as well as suppression ops.

I must confess that when I initially started in EMS I had no desire to become a FF or run into a burning building. That being said, I took a FF class with the idea that as an EMT/Paramedic...I could be dispatched to a fire scene and told to set up rehab..etc. I wanted to know what stresses might be imposed on a FF during suppression ops. I took the class to better my services to Fire personnel and now, I enjoy riding the engine and working in supression as well. The way I see it now, it's the best of both worlds.

[Amon]

A question for those in combined stations. How do we talk folks into merging? Yes, there is some issues between fire & EMS. Some of it is good natured though. There are those who screw it up for all involved (picking & choosing calls etc.). It is a reality that most calls now are EMS related. Fire safety has improved, while thanks to fast food etc., the number of medical related calls has increased.

I don't ask the fire guys to hop in the back of the "gut box" and get pukked on. I do try to ask them to come and drive for me at times (when I can't get a driver from my organization).

It is regrettable that volunteerism is falling off. More career folks need to be hired to fill the gaps. (I'm in the boonies and the county budget is tight.) To me a combined organization would be more effecient and be able to serve the public.

[paramedic 35]

Amon,
I can't give you an answer to HOW to get them to merge. Economics is a big issue. The fire service is not a large revenue generator. EMS, on the other hand, can be, if managed properly.
My 100% volunteer combined company realizes that the big red trucks do not make any money, but the two little gut buckets do. They realize that, barring grants, if they want new toys for the big red trucks, the ambulance has to get out the door. Is this motivation enough? Not really. We have recently started an incentive program. It was reviewed by a lawyer who found it to be legal. We award fuel certificates to members weekly based on the number of ambulance calls they respond on. They are limited to the first driver, the first attendant, and the second attendant, or member at large who shows up for the call.
This is not considered payment ( as long as it does not exceed $1,000.00 per year, per member ) but rather, it is considered a means to help offset the cost of volunteering. The most any one member can receive is $20.00 worth of fuel certificates per week. For most of them that is a tank of gas. We base it on the percentage of responses to calls per week.
So far we have seen a slight improvement in our overall scratch rate. There are still those periods of time where we just don't have a crew available, but that is happening less and less.
Just an idea, not a cure all. Good luck with your situation.

[cityboy]

How bout this one.

there is a combo department near me where the paid guys are FF/EMT's but the vollies aren't. AND that have a transport capable rescue pumper!

http://fdnytrucks.com/files/html/otherstates/southnj/Hamilton%20Twp-GrovevilleFC.htm

[dlo]

My department has a medic, me being one of them, on every apparatus sans battalion chiefs. I am an Engineer, work at a two apparatus station, and switch tours working on the Engine Co., and Hazmat Co. Some still don't like us as medics, but like us as people and fellow firefighters. I personally assure you that I can hack a hole in a roof as good as any truckie without a medic licence can. As a department, we get along fine. As a county (Santa Clara County, California), the fire agencies have all accepted ALS fine. Our issues arise with the transport agency (AMR). They think that we are all a bunch of knuckle dragging silverbacks. It's funny, because when they miraculously get hired and come on, they change their tune seeing what is really involved in being a competent firemedic. They shut up real quick. 75% of our business is now medical. If you have the luxury of still being separate entities, enjoy burning while it lasts. In California, we don't have the fire load that everyone east of the Mississippi has. Our job justification depends on diversification. Going ALS is just one of those ways. Don't hate us. We just want to fight fire too. Be glad that just one of your crew members has to do the dirty work and cut paper afterward, and not everyone. Just my observation. Stay low folks.

[hog]

EMS folks like LostOnScene think they know it all.....don`t like to hear everyone`s opinion.........she thinks she knows it all....and i am sure there are firefighters the same way(in fact i know there are)...the problem is nobody wants to listen anymore .....they just want everybody to listen to them

[TwnshpFF]

Lost is entitled to her opinion.
I, myself belong to a combo dept. we have a paid staff 24/7 that consists of two people....one FF/EMT and one FF/MEDIC therefore creating a ALS crew. We also have three stations...because we all merged to form one department. Everyone knows manpower is low, so the addition of the two paid employees helps tremendously. We rarely scratch any ambulance calls(unless the paid crew is busy and the volunteers dont crew) and we have sufficient manpower on fire calls. i think this helps us serve the community 100% better. ;)

[NBVFD41604]

100% Volunteer- Without fireside, we wouldnt have enough manpower, Without ems, we wouldnt have patient care. Relationship between both are iffy. But on scene we work together to get the job done. Outside comments are up for discussion in any fire department.lol. But onscene is more important to the matter.