Fire Fighter Paramedics

[fire/medic]

What dores everybody think about the Firefighter/medics on the PEC units. I would like to hear your honest opinion.

[shocker]

I feel sorry for them. They have been placed in a position with a whole lot of responsability resting on them. Most of them came out of medic school, and placed right on an Engine Co. without riding a medic unit, or at least very minimal time. From what I have heard, a lot of them don't want to be there, they are nervous because they are out there alone, with little experience.

If I'm not mistaken, a lot of those guys/gals went to Paramedic school for the promise of Technician pay, any word if that has happened yet?

Once again, they implented a program for the now, and not for the future. DCFEMS doesn't think before they do something.

Good luck to those on the PEC's, I know they are doing the best they can, with what they have. Keep up the good work and stay safe....

[resqsqd]

How is this PEC thing working?

Are these all firefighter/paramedics or are there still civilians? Who are the PEC's right now?

Also - are they rotating these fire-medics off the engine (and onto an ambo) or are they strictly assigned to the PEC?

[fire/medic]

The firefighter medics were not promised tech pay when they started the class. Now that thay are out they get double tech pay. They also stay on the pec unit.

[dccaptain1995]

I hate to put a bad light on this, but they are not supposed to get “Tech pay of any type”, under the local 36 contract they are known as firefighter/paramedic and have their own pay scale. This scale goes from F/F to Captain as long as they keep up their accreditation.

If a firefighter is assigned to an ambulance, Then he receives tech pay and 5 points on a tech exam.

For further information look at a copy of the IAFF local 36 contract, it spelled out pretty clear there.

[ktflame]

The bad part about the Paramedic Engine program is that the department is allowing EMS to dictate policy regarding them. What I mean is in 1996 when the initial proposal was brought to Chief Latin regarding Paramedic Engines it was and never thought of as a primary ALS unit. These companies were to provide initial immediate ALS care if needed and transfer care to paramedic staffed transport units. This keeps the company from going out of service for lengthy periods of time transporting patients to hospitals. When the Paramedic Engines were re-constituted in 2003, these companies ran as a regularly staffed engine company that basically stayed in its local alarm area handling everything from BLS to ALS emergencies and transferred care to BLS and or ALS transport units. This proved very effective in keeping the Paramedic Engines from being out of service at hospitals for hours on hand and keeping these companies in their local alarm areas being able to provide immediate medical or fire suppression duties as needed. But, either the department heads or communications has decided to run the paramedic staffed engines as a primary ALS unit with BLS transport. We all remember when the previous civilian staffed Paramedic Engines were placed in service they were dispatched as primary advanced life support units with BLS transport which caused these companies to run clearly out of their local and box alarm areas which made them unavailable for immediate responses both medial and fire in their local alarm area, affected the moral in all members assigned and caused un-wanted animosity with civilian paramedics assigned to transport units. The animosity that I am referring to stemmed from transport paramedics sitting and running very few calls while the paramedic engines constantly ran as the primary ALS unit on Charlie and Delta medical emergencies. I, a civilian paramedic at the time was thanked on many occasions for running the majority of my civilian counterparts calls which allowed them to remain in service with very little work on-hand. If you looked at the last council hearings and heard the testimony of some of the civilian paramedics it was evident that the way Paramedic Engines were run when staffed with civilian medics was a win, win situation for them. They basically sat while we got beat up! Well now we have 4 Paramedic staffed engine companies in service with firefighter/paramedics and from the looks of things another 2 in service in July. The possible candidates are Engines 6, 10, or 11. I would like to make a quick analogy of a very possible scenario that can and will probably occur while having a paramedic staffed engine and a BLS transport response configuration in place. The initial dispatch is Paramedic Engine 30 and Ambulance 30 for chest pains. Taking into account that Medic 30 is sitting in the firehouse also and in-service. The engine and ambulance is headed to the call as dispatched. After treatment is provided, the determination is made that the paramedic must accompany the patient to the hospital with the ambulance. So now Engine 30 is out of service until the firefighter/paramedic is finished with the patient at the hospital. During that time an assignment is dispatched for a fire with people trapped in Engine 30's area. Unfortunately, Engine 30 is out of service because paramedic had to go to the hospital while Medic 30 remained in service to complete their afternoon nap. I have done a lot of research on Paramedic Engines in the United States and Washington, DC is the only large city department that refuses to send ALS transport units with paramedic staffed companies. So what this means is Engines 6, 10, 11 and 16 can all stand and wait in the hallway at Howard University Hospital until care is transferred to the hospital staff.

[Dean27wood]

A30 has been staffed w/ 1 Firefighter and 1 EMT for about a year now. The 2nd Battalion has been rotating its members for an 8 tour detail, with 12 hours on the Amb. and the other 12 on Truck 17, with the 2 F/F's rotating AM and PM. If A30 needs the medic off of PEC 30, than the FF on A30 gets on E30 until the paramedic returns to Qtrs. I just got off of my detail on A30 and let me tell you that A30 runs its tail off with PEC 30 while Medic 30 collects dust. We still have our partial F/F ambo. and we still cover the rest of them in our Battalion when they are down on manning.

[NorthSTAR]

Dean27wood: While what you stated was correct as of last month, the new PEC SOPs put the engine OOS until they recover the medic from the hospital. All members should familiarize themselves with this addendum to section "N" of the protocols, as "Episode II- Invasion of the PECs" is coming soon to a station near you. :D

[The BRC]

Ktflame,

Several months ago the Fire Chief walked into E30 during drill and sat down with the troops for an informal bitch session. He was asked why the PEC is coupled with a BLS unit and not an ALS unit. He replied that if a PEC and ALS unit were running together that FEMS dept. was duplicating services and we need to save the ALS unit for the next response should it arise. He was also told about the concept of allowing the PEC to transfer patient care to the ALS transport unit so the PEC could remain in service to handle all emergencies, i.e., fires, med. locals,etc.. He stated that E30 being placed OOS due to chasing the ambulance to the hospital was not an issue because there are plenty of fire trucks in the city to handle what E30 is missing.

[Brooks]

Apparently the only statistic we look at to determine the effectiveness of our "FEMS" system is the dispatch-to-arrival of ALS. It's been a problem in the past, and this is a good statistic to look at. However, not looking at other statistics has allowed that one statistic to drive the design and distribution of our personell and their assignments.

We often come up with anectdotal evidence about how being on a medical local has placed us or the citizens at risk, but we don't have a good, month-by-month statistic to compare our overall performance as we make SOP changes...only the ALS response time. Until this changes, expect more of the same. The powers that be will continue to add PECs, and use fire companies unwisely, until so many of them are unavailable that it cannot be ignored.

Once we (the CAD) start keeping the correct statistics, our resources will be allocated as well as politics allows. My guess is that you'll see fewer PECs and more (hopefully all) ALS transports. Those PECs we do have will likely be at the city edges, and perhaps at a few busy central locations. The argument that "there are plenty of fire trucks in the city to handle what E30 is missing" is shortsighted. First and foremost, the engine companies/ first responders are dealing with a 4 minute window for a large number of calls, while ALS is dealing with an 8 minute window for a smaller number of calls. Second, the geographic nature of emergency response patterns wind up rapidly draining resources from a given area--when E30 is on a run, E27 and T17 are much more likely catch a run, as they are covering a larger area. Also, weather patterns, violence, and other events often cause more than one emergency over a relatively short period of time.

Just my two cents, don't hold your breath hoping for a change.

[ff4-3rdservic]

Brooks is right. All transport units should be ALS before ALS engines are put in service. The purpose of an ALS engine is to first respond with ALS capabilities. You arrive on the scene, provide ALS care if needed, then transfer care to a transport unit so you may go back in service and "first respond" again. Taking the company out of service for a hospital transport should be a last resort. If thats the case, why not put the medic on the BLS unit and make it another ALS unit. The way DC is currently utilizing the "PECS" as they are called is stupid.

[ktflame]

E30LT, Brooks and ff4-3rd servic. You are all correct! The Paramedic Engines are basically in trouble. There is a Paramedic Engine committee meeting 7/7/04 @ 1000 hrs @ Engine 24. We need your help, everyone is invited. If we don't all show support and fight against this stupidity, all of the busy Engine Companies and the citizens of the District of Columbia will suffer I promise you!

[SkyMedic]

I feel the PECs would work well in a system that had enough medics to staff all 1+1 medic units without BLS at all and every engine a PEC. Its supposed to be about quick ALS, not a crutch to support a troubled system. Its ridiculous for a PEC to run an ALS emergency while the medic unit it is quartered with sits in the house. I understand it is a waste of a medic unit if the patient becomes BLS, but is it not also a waste to have an engine out of service to the hospital? Thats 4 employees you can not utilize for that time instead of 2.

Bottom line is for the system to be truly effective you need more medics to go around, and good ones at that if their going to be making decisions alone. DCFD has done great things as far as attracting medics to the fire side, but there just arent that many around here. Everyone has issues with staffing, from DC to Anne Arundel, Fairfax to MSP. What do you think Brooks?

[Loo for life]

Using that theory we should stop running wires down, bomb threats etc.. anything that is not a true fire call cause Companies will be creating larger response areas and times.

Look guys u can not argue that the PEC Companies provide a faster, more efficient and better way of providing immeadiate ALS to the citizens and visitors of our fair City.

Is the department, DHS and city government going about it ass backwards--
YES

But PEC + 1 Paramedic / 1 Firefighter-EMT staffing on all transports is the best way to utilize dwindling resources... All the data in the world will back that up

Fire Trucks are a necessity so this will maximize the active time, EMS units need to be run more effectively and managed better. Our Communications Division could use a complete frickin overhaul esp. the dispatching protocol system

But please stop! The PEC concept is a good one, when u view it in the context of current resources available to the department. All the Fire Chief needs to do is unleash his old take no prisoners attitude on EMS Management, mistakes would be made but it will work alot better then whats going on now...

As for "I have anecdotal evidence" it is just a new and great way of saying " Statistics say what the user wants them too"........