MVA's

[Mags]

This oughta be good since we have both Paid and Vollies on here...lets get everyone's opinion.
Also should they attempt extrication before the FD gets there, what if the vehicle is on fire
Feel free to elaborate on your choice

[Karl Childers]

IMHO EMS should always and without fail assume command on any MVA with patients. And this is only concerning patient care. But, I for one, like to work together. This way, I learn more about extrication and the FF's may learn more about patient care. And this should be the same for everyone, paid or vollie. :cool:

[jonnyboy5_12]

If the fire dept is not on scene, and the pt is trapped, and the car is on fire, you yank. Its called a rapid extrication. It is not the ideal solution, but you do what you have to. The pt's life is more important than possible injuries. However, if the fire dept is there, let them do it.

EMS and FIRE should share command. Everyone gets tunnel vision. If EMS had command, depowering of vehicles probably would not get done, fire suppression would not be a priority, and people would get hurt, because EMS is all about the pt's. If fire had command, the vehicle would be stabalized, roof taken, dash pushed, all 4 doors removed, and the pt would still be lying in the bush alongside the rd where they had been ejected. (that was supposed to be funny) EMS and FIRE have different responsibility's and they are both crucial to safety and efficiency. We all have the same goal, and we should work together.

[IPimpDaShortBus]

The Fire Officers and the EMS Personnel on Location should have Joint command, and the decisions that are made on Location of the incident should go through both sides. It's not the job of the EMS to extricate patients, thats why the Fire Dept. is due also on MVA's, however, in the circumstance of a vehicle on fire or some other life threatning event, than I believe EMT's are taught to do whatever it takes to get the pt. out of the vehicle.(But remember, you are ALWAYS #1!!!)

It's a Team Oriented Job, therefore, everyone has to work as a team. I think the number one priority on any MVA scene is Patient Care, therefore the Fire and EMS personnel must cordinate themselves in a many that lets everyone perform the job that they are there to do.

[IPimpDaShortBus]

Second paragraph..."Many" should be changed to "Manner"

[Copper]

The highest, most qualified Officer on scene is in command and uses the resources available to make his/her decisions.

"Share" command between Fire and EMS is BS, one person has to be accountable for the outcome and have final say. That being said, the IC should eat crow and admit they do not know everything and use the personnel on scene for their particular expertise.

Now that I may have ruffled some feathers, Have a nice day!:D

Shrek2 coming soon to a theater near you! / Dino

[Mags]

Now I have to play devil's advocate, Johnny Boy, you say rapid extrication and injuries matter not, but first of all what about your safety? What if the fire is contained to the engine compartment? And what if you yank... and kill the patient in the process or what if it causes them to become quadrapalegic, do you think you'll win in court...nope you won't. I think a little more thinking needs to go into that before you just YANK!!

[jonnyboy5_12]

I never said that injuries matter not. But you have to prioritize...you dont let a pt burn to death because they may have a neck injury. Being paralized is better than being dead. Yes we have to look out for our own safety, and sometimes we cannot get to the pt to save them. That is unfortunate. I am sorry if i sounded flippant in the wording i used when i referred to "yanking" the pt out of the car...i was meaning that sometimes, it is in the best interest of your pt to pull them out of the vehicle in order to keep them from certain death. Also, you dont always have time to sit around and strategize...sometimes you just have to react to save your own ass as well as your pt's. It is the nature of our business. The first priority we have is ourselves, then our partner, then our pt. If you go through the EMT program what is the first thing they teach you? Eliminate all hazards..if a vehicle catches on fire, get you and the pt out of there asap..of course you try to be as careful as posible, but sometimes a rapid extrication is needed.

peace out 512fire all the way

[LostOnScene]

fire and ems should always have joint command at this type of a scene.
i think it is best in the interest of the patient and crews.

[Mags]

I have been through EMT class... but you didn't fully answer my ? What if the fire is in the engine compartment? And are you gonna go up to a ball of flames with no gear on and try to get to a pt. thats already half scorched. And do you think tht if you cause the pt. to be paralyzed without following protocall (which is not yanking) that you're not goin to get sued? Its unfortunate that our world works that way but... Believe me I understand your reasoning of doin what yuo have to do and yanking, but that is not always the best choice, and so you know, you're not dealing with a rookie, I have been at this for a while and honestly want to see some other opinions, I'm am not trying to butt heads.

[jonnyboy5_12]

All i am saying is that there are occational times in our jobs, that we have to react quickly and risk injury to our pt's to save their lives. You cannot dispute that, and you cannot get sued for that. You have to use common sense, obviously, if the fire is in the engine compartment, our ambulances have fire extinguishers in them, and also if the fire dept is there let them put it out and you concentrate on your pt. However, i ask you this, you have a pt with a possible neck injury, there is fire under the hood, but it is spreading, and you can smell gasoline...what would you do??

rock on people

[Chief601]

EMS can have full control over their patient and fire should have complete control over the incident. I say this becasue how many times have you all been on a working rescue where there is twisted metal and debri, cut edges and complete chaos while you are extricating? And of those times how many of you have seen EMS providers wearing proper protective clothing? For me, never. They may have had the foresight to wear a helmet. If it's cold they may have a coat on. I'm not bashing EMS but when we have protocal regarding our safety and EMS does not.....it's only a matter of time before you become part of the problem and not the solution to the problem. IF EMS wants overall command, I'm all for it. Wear your gear, provide a safety officer, learn proper extrication techniques, and above all, know the layout of the extrication team and how they work. Since this is all but impossible, let fire command the scene and look out for everyone's safety and you do what you do best...patient care.

Everyone be safe and remember...even if you don't think it needs to be cut..do it anyway. You may never get a second chance!

[regs1]

I agree with Capt621;

The senior firefighting officer will be in command of the incident. He/she will deferr to the EMS side on all medical dicisions on patient care.

[Mags]

If I am workin on the ambulance....I'm going to see if the fire can be contained first, just because there is a smell of gasoline, doesn't mean the vehicle is leaking gas ( I have had this happen several times with older GM models) and once again if its under the hood, most cars have a firewall between the engine compartment and the inside of the car, also in my town the FD may beat the ambulance their and if not they're right behind us, so I am still waiting, unless the car is already engulfed in flames I am not trying to get to that patient, its unsafe for me, and I am not going to injure myself, if the car's ablaze, and it is certain then the patient will burn to death then I'd pull them out by any means neccessary, but not when there is a fire under the hood that isn't endangering the patient immediately, Then I'm gonna wait a few minutes.

[jonnyboy5_12]

Ok, we agree...my point was that there are times you have to risk injury to the pt to save their life. in my area, the ambulance can beat the fire company on scene by 5-10 minutes during the day....a lot can happen in that time..also, you obviously have to use common sense...if it is only in the engine compartment, yes you have to speed up extrication, but it may not be life threatening yet.
peace out people

[EverydaySchmuck]

Ok, first of all, when then initial units arrive on scene, they should assume command. As the higher officers arrive. Still even then, the initial command has to rendevous with the Lt, Capt, Chief, or whoever to relay vital info. The officer in charge does not need to handle pt. care. In fact they should separate themselves from the actual hot-zone completely. Command should be set up in a neutral location, away from the other apparatus, with clear visibility of the incident. To ensure that proper communications occur, the initial commander of the incident should assume either rescue or medical operations, depending upon their status.

The idea of a "joint" command can only be accomplished, if the individual operation sectors work hand in hand. Unfortunately, the two services bang heads on who should have control, and the incident usually becomes a power trip to see who gets command. While they are gritting their teeth at one another someone has to care for and extricate the pt.(s) The only control an EMS chief officer should have on a PIT is the actual operation of pt care. I know this sounds harsh, however, under normal circumstances the span of control ratio is much higher for Fire. Line officers and firefighters will be the majority on the scene. (The engine or squad carries more than an ambulance).

On the subject of rapid extrication: A couple reasons for this technique are. 1) Initial units arrive with fire anywhere on vehicle. Yes i know some ambulances carry extinguishers but these are not going to help unless you have and irons pack to open the hood. The fuel lines on todays vehicles are usually ran under the driver seat or frame rail. When these lines bleve, it can be a violent and very unexpected. Also the tires can blow with just 250 degrees of impingement. The patient should be exticated immediately upon visualation of fire. Regardless. 2) Also, if the victim is in extrememly critical shape, where life expectancy is low, and the risk of additional or aggravated injury are not relevant to the actual life saving responsibility. As far as a court case, as long as the report is well documented, and regard for life were your intentions, no court will convict.

These are my opinions only. Take what you want and scrap the rest.

[jonnyboy5_12]

everydayschmuck,
I agree with you 100 percent. It is a pissing match between fire and ems when it comes to command. So you dont think that the ems provider who is in the car with the pt shouldnt tell the firefighters cutting what to do? It has been my experience that as an ems provider, we have to tell them what we need cut, or they will go way overboard..they will take the roof and all 4 doors, when all we need to access the pt and remove them is pop the rear door. let me know what you think.
peace out

[Karl Childers]

I am sorry to hear that you people constantly butt heads. I guess I am very fortunate to work in an area where not only do we get along, but it is also along the lines of career and vollie. We have a partially paid EMS service working in conjunction with the volunteers. All of our fire service is volunteer and every MVA I have participated in has been fantastic. It doesn't matter who arrives first, patient care is immediately initiated and everyone is involved in either extrication or just normal patient removal. We all consult one another in planning the incident. And besides, I would not want to be command and try to give good patient care. That is why I am so fortunate to have the people working with me. Be safe. :cool:

[Mags]

Oh no Karl, In my area the Fire and EMS work extremely well together, I only posted this just to get something else going on here. I guess that some people on here just want to be heroes, and get a patient out of a car as quick as possible who cares if the car explodes in the middle of the process, I was trying to be a hero... bullshit, You want to be a hero, good for you, me personally I'm waiting for fire, to take care of the fire in the car, That pt. isn't enough of a concern for me to lose my life, besides I'll probably be on the engine anyways....
Stay safe guys

[cappy]

As a volunteer fire chief(captain) I feel that the chief should have ultimate command and he should collabarate with ems! remember 2 heads are better than one.

[jonnyboy5_12]

Mags, your last post proved that you dont care much for your pt's. I dont believe anyone including me is trying to be a hero...its called doing your job. If your too afraid to risk anything than your in the wrong business. In this job we risk our lives every day. That is fire and EMS....walking into a burning building is risky. Climbing into a vehicle with a pt is risky too, whether there is fire or not. It seems to me that your just afraid.
peace out

[Mags]

Johnnyboy,
You are utterly retarded! I say that in the kindest of ways. My point is that you can do all the talking you want...but ask around, there's not many of us that are going to jump into a burning car to save someone who is probably dead, and we're not going to risk serious injury to a patient when the threat is not that immediate...simple. How long have you been at this game?? It doesn't appear to be very long judging by the way you speak. Maybe up there in Amish country you have super EMT's and shitty fire protection, so you have to be jack of all trades but master of none. My intention is not to be ignorant with you, you just seem to have the wrong approach, you'd be what we call a maverick, and nobody wants one of those.
As for you last comment about being afraid...that was very silly of you. I was a firefighter well before EMS, so there is NOTHING in EMS that scares me. And I do care about my patients, but not so much that I want to have dinner with them as you apparently do.

Use your head.
Stay safe

[jonnyboy5_12]

So you are saying you have never gotten into a car with a pt and the car start on fire? I am newer at this and never claimed to not be. I am not retarded either. But if you are saying that there is never a reason for rapid extrication then you are nuts. And i am a firefighter also. The fire protection here is not shitty, there is just a longer response time especially during the day for fire because of it being volunteer and everyone having jobs. Also, all because a car is on fire does not mean that the pt is dead....you should know this if you have all the experience you say you have.
stay safe and lager on

[Mags]

I never said there was never a reason for rapid extrication, secondly if the car is engulfed in flames, then the pt. probably is dead, and if its a small fire then you can probably wait for fire, plain and simple.

[jonnyboy5_12]

As i said, common sense..im not trying to get into a pissing contest with you. You make a lot of good points.
peace out

[regs1]

mags;

you must come from a community that has a great ems response, in many areas I know of the fire units usually arrives first. The fire officer should be in charge of the scene, the ems people in charge of the victim.
The engine company should always have a preconnected line off, and charged if extrication operations is needed.

small fires in cars have a very bad habit of becoming very large fires in minutes, for the person who said the fire wall will protect the passenger compartment, I guess you have not responded to many engine compartment fires that spread into the passenger area. Also I am not going into the air conditioner gas thing, and what happens when water, and heat is applied to the escaping gas.

There is no hard rule when rapid extricate, leave in place, each incident in unique, and must be judged by a case by case method.

An old teacher once told me this, books are written in black and white, life’s is always shades of gray, and usually have zero relationship with what’s in the books.

[Mags]

Originally posted by regs1
mags;

you must come from a community that has a great ems response, in many areas I know of the fire units usually arrives first. The fire officer should be in charge of the scene, the ems people in charge of the victim.
The engine company should always have a preconnected line off, and charged if extrication operations is needed.

small fires in cars have a very bad habit of becoming very large fires in minutes, for the person who said the fire wall will protect the passenger compartment, I guess you have not responded to many engine compartment fires that spread into the passenger area. Also I am not going into the air conditioner gas thing, and what happens when water, and heat is applied to the escaping gas.

There is no hard rule when rapid extricate, leave in place, each incident in unique, and must be judged by a case by case method.

An old teacher once told me this, books are written in black and white, life’s is always shades of gray, and usually have zero relationship with what’s in the books.



We do have a good EMS response, its even as to who gets there first, The EMS is paid the fire is not. Your whole first paragraph is exactly what should be done on an accident scene, good point, And I'm not saying the firewall will protect the passenger compartment long enough to do proper extrication or that on all calls it ever will, but using common sense sometimes it will long enough for fire to put it out.
I also like your quote about the old teacher, very true, here's another one that kinda ties in...
An old Chief told me to always remember "There is no such thing as a routine call."

[Chief601]

I have to chime in here and say, since when does EMS tell me what has to be cut and what doesn't? As a company commander I make the decision on what gets cut. There is a reason for roof removal early on, if your patient goes down hill, we pop them up through the big hole. I will NEVER have an EMS worker instruct me when and where to cut. Not becasue I know it all but becasue I keep up with the latest models of vehicles, where the air bags are situated, the electrical systems and all of the things that are important so that we do not further injur the patient or the EMS team that is not in protective gear. A good rescue head has the game plan ready to go. While we are in the rig going to the scene I talk to my crew, assign their jobs and prepare my stop watch in the event that plan A isn't working. Unfortunately, I do not get to have the same discussions with EMS. So now that I have read a few posts, I'll change my mind....Fire takes command, keeps command and will perform the functions that firefighters perform.

Merry Christmas to you all and have a safe New Year!

[Karl Childers]

Capt 621, that is why you are there. And I for one am damn glad to have you. As I stated earlier, I am so lucky to have firefighters who are knowledgeable and great at what they do. But, they do consult me concerning removing the patient from the vehicle. Remember, you know the vehicle, but I know the patient. That is why it is important to work together. Sometimes there is more than one way to do something. :cool:

Merry Christmas and Happy New Year

[EverydaySchmuck]

Have you ever heard of "Fuel Lines"? Alot of todays vehicles come with great thermal fire walls, made from a blend of insulative fiberglass, and a catalyst/ resin formed at great temperatures. But see heres the problem. Fuel lines are the little things, similar to your IV lines, which carry gasoline/diesel under pressure, sometimes 14 to 15 psi. These lines run, normally directly under the driver's seat, or along the running rail, inside the tubular frame work. What happens is, the engine usually begins to burn, and starved for oxygen, it spreads to the under carriage of the vehicle, where "TA DA", the fuel lines are primed and full of beautiful flammable liquid. While the fire is melting away the brazed joints of the lines, the heat becomes intense and usually the front driver's side tire bleves. Here is an issue in itself, cause what is the tire full of? The same thing you are......"Hot Air". Oh my god. Air<>Heat<>Ignition<>Fuel= more fire.

Point is this. "GET THEM OUT OR GET OUT OF THE WAY"

Allow me to continue for a little while longer. The Captain brought up a very good point; "Air Bags." Do you remember that extrication class you took? They taught you about the dangers to patients and providers by unresponsive air bags. Yeah they can still deploy once the vehicle is turned off, and can even still when the battery is secured. Why you ask. Ever heard of a "power storage cell?" Yep thats it. Just enough juice to maintain immediate power seat and airbag functions. The wiring harness on todays vehicles are coated with a insulative material good up to 250 degrees, and when compromised by such heat, the harness deteriorates and the airbag can deploy.

They are putting "impact disruption devices" "airbags" in quite a few more places now; the head rests, the actual seat itself, windheild curtains, and of course the basic wheel, dash, b post, and so on. If you procrastinate the immediate extrication of the patients, when the vehicle is involved in any fire, you in fact place them at risk of serious, if not fatal, injuries due to secondary problems.

Now as far as your additude, I really dont know what to say. Just understand that you dont sound like you belong in fire/rescue/ems. If you truly believe your life is better than those in need, especially in the situation conversed here, you are in the wrong business. I hope i never drive through your town and wreck, but if i have to, i promise, my eject seat will work, so you dont even need to cut me out at all.

sorry for the length of this commentary.

Happy Holidays.

[Mags]

What are you talking about? Oh, I forgot you must be another anal retard that has to mention every single thing and them ramble on about them. And another thing, I never said anything about fuel lines, where did that come from. And I never said my life was too good to help a pt. This is the last time I am gonna repeat myself.... If you are on the Ambulance and you get there before fire and the car is involved, than I personally am not goin in there with no gear on to save a pt. that is probably already dead. If the car is not involved than yes I'm going to attempt to extricate... bottom line is using common sense.
Schmuck, I am well aware of the dangers that airbags pose also, your post although well written was a feeble attempt at trying to put me down, it was all information that anyone in emergency services should know. And by the way, how appropriate of a name you have....Schmuck.

Happy Holidays

[Chief601]

Karl: I agree with you and the consultation. Most entrapments that I am on or command, the EMS team simply allows us to get in and do our job. Once we extricate, we usually assist them in whatever they need us to do and of course, we allow them to call the shots without question. I read replies here and sometimes I wonder how many of the posters have real experience. I'm not talking about taking a bunch of classes and being book smart, I'm talking about being on a scened, commanding an incidenct, critiquing the incident and preparing yourself to better your tactics. Most of what is written here is text book extrication, sure there are some posts that enlighten you on different techniques and there are some posts that offer very valuable information but there are alot of rescue wannabe's that would probably cut right through a patient becasue they can't tell a B post from a left foot.

Peace to all!

[Karl Childers]

Trust me, this kind of relationship was not easy to come by. Other places I have worked have not been so kind. I am a firm believer in letting the expert do the job. And since this also involves a patient, I expect to be consulted. Never know, once in awhile I have a good idea. LOL

Take care and have a Merry Christmas.

[Mags]

I personally have never claimed to be anything special I just posed the question. And I do see alot of the same things you do. I am not an officer nor do I belong to a rescue company. I do have basic vehicle rescue, I can use the tools and I know how to perform extrication however I'm no pro nor even a veteran. I just get a little up tight when some of the holly jolly vollies get all gung-ho and talk like they are so well versed at what they do. I too am a volunteer and I just don't like someone who wants to be a maverick. There's no such thing as a routine call and these guys talk like they're superheroes and they're willing to risk everyone's safety to be a hero. And especially EMS personell who think the firemen are stupid and should just be ther grunts. In case you did not read previous posts I am in EMS also, I have my ideals of what EMS and Fires responsibilities are on an accident scene. Some of our other fellow commrades seem to be disillusioned.

[888]

EMS should stay out of the way until they have a patient. You do not need 400 ems people trying to get at the patient while fire is trying to remove them.

Fire should be in charge. PERIOD

[jonnyboy5_12]

Around here, its usually 400 firefighters and wackers and about 2 ems providers who cant get to their pt.
peace out

[pgtick20]

overall command should be maintained by a fire officer for the reason that he should have a knowledge of all parts of the scene. the EMS people should be given a group assignment and allowed to operate however they choose SAFELY on the fireground. i mean its obvious 6 EMTs with one pt isnt safe with a heavy rescue going on. but there should be at least 1 EMT in the car providing some sort of care. if the EMT cant get in safely then so be it, theyll have to wait. but it should fall down to the person with a working knowledge of all parts of the scene should have command, and who ever does what should do it safely.

tj

[BP1]

In both of my departments that I belong to the fire and ems work as a team to remove the patient from the vehicle.
The bullshit of I'M IN CHARGE, no I'M IN CHARGE needs to go.
Most of the EMS services are paid in my area, and Fire/Rescue arrives after they do, because were volunteer.

Here is how both of my departments do it:

The OIC of fire/rescue reports to the highest ems officer to get a size up, and to see what they need. If they tell us to take the door off, then we do. We may suggust to remove the sides and the roof to make more room, but 90% of the entrapments that I'm on or in charge of. They tell us DO WHAT YOU NEED TO DO.

We also crib and deflate the tires on any vehicle with a patient inside.

We all need to work together for the patient, and not try to be a hero. People that try the hero shit shouldn't be in emergency services.
This is my TWO CENTS!!!
Also stay safe and have a Happy New Year.

[T1Side1]

If its a BS accident with no entrapment then EMS should do their thing and have it since pt care is really the only services needed...
but when there is someone trapped and squad comes to cut them out, there is nothing more annoying and nothing that gets firemen more fired up than when EMS is barking orders and trying to put their 2 cents in while the squad is trying to work the tools, etc. When fire trucks are on the scene, fire trucks should have the command...if there is no need for fire trucks anymore, then EMS can handle it.

[pgtick20]

i have to disagree as i said above, fireman need to listen to EMS because technically you are assisting with pt care in a round about way and if thats there pt, then its there pt, but they really should attempt to get into the car. and EMS should be in some sort of full PPE, dont just come up to me in jeans and a t-shirt or even just a uniform, because now you become a safety issue and tahts the bottom line.

tj

[dpd403]

I've read through the posts and some of you guys are up on the ball. Others are stuck in an EGO TRIP. We are here for the patient.

Were I come from, we call it UNIFIED COMMAND. We try to have Fire - EMS and Police all together in one command post making unilateral decisions. I know it was hard to start the concept, but it started in 1983 here with our training. Since then, it has only gotten better. All three talk together and try to help solve each others problems. It doesn't matter whether is is paid or volly, for the most part, ALL agencies work together. It must work because we just went to another State training center to teach the class... That make the third or fourth state in two years to pick it up... Hmmmmm...

I will agree with the people bitchin about EMS not in PPE. "If your not dressed for the party, then stay back"

Just my 2 cents.
Jeff

[Bullgod]

I think it is equally important for both fire and EMS to work as a TEAM. The job couldn't get done with out either of them.

[HAZWOPER]

IMHO EMS should make all the calls regarding pt movement treatment and extrication. For example, "guys I need the roof off."

[hog]

all emergency services have to work togther @ a scene..........all of them police fire and ems.......the highest officer from each has to get toghter

[HAZWOPER]

I agree that all separate entities should cooperate and mostly do. However, and I'm not budging on this, wherever the movement of a pt is concerned including the tactical choices regarding extrication EMS has the final say as long as those decisions do not place the welfare of other responders at risk. When something with the pt goes wrong the people held most accountable are the medics. Medics are the foremost and final authority on all aspects of pt treatment/movement. I also think most fire company officers would agree with that assessment. I hope I didn't strike a nerve with anybody, that wasn't my intention.

[Corrigan FF21]

As far as having the FD being told what to cut, where to cut, and when to cut is a bunch of BS. With my company to use the tools you have to be certified. So if you went through the courses to become certified then the operator should already know what the hell he/she is doin.

[ENGINEDUDELT]

EMS should worry about PT care......My Engine and Truck crew will cut or rescue.

[paramedic 35]

I have worked both sides of the situation over the years. As an EMS officer, I always instruct my people that the Fire I.C. has control of the scene. The people trapped in the vehicle are victims until the I.C. decides that the scene is save. Only then are they patients.
If an EMS provider is inside the vehicle with the patient they should have some input into the extrication, but they should only intervene if the extrication, as it is being performed, is a threat to patient safety.
Other than that they should take care of the patient and let the rescue company do the cutting.

[207ff38]

the fd should know when and where to cut. they should be certified in extrication before you attempt to cut the car apart. if you are certified you should know how to extricate without even being told what to do.

[Lontal]

It all seems simple to me...

EMS is absolutely in charge of Patient Care. This also means that they should not be distracted by the other issues relavent to command such as resources, supression, hazards, traffic, etc. If you happen to have a rare Rescue Officer respond seperately from the ambulance/medic who has experience being in command of all these other aspects then by all means they could do the job if they are the senior officer.

However, the fire side of the house typically contains those individuals with this type of experience as well as incident command training and experience.

So let the EMT's and Medics manage the patient, and let the incident commander (or engine, truck, squad officer) worry about the rest. That being said, any officer that doesn't listen to what the people in charge of the patient care need should be canned.

Hey, even on a fire - you may be the IC - but if you put the nozzle in my hand then I am the one in charge of putting that fire out and if I tell you I need something to safely and effectively accomplish that task you had better get it for me or else I'm going to show who is in command while you try and figure out who's in charge of removing that halligan bar from your ass! :cool:

[HAZWOPER]

Lontal...you're the man, couldn't of said it better myself.

[HAZWOPER]

FYI...I come from an area where everyone is cross-trained so I can cut cars up and do pt care dependent on my riding assignment that day.

[esfmmk]

This a lot of talk over simple car wrecks.
The highest ranking fire dept officer or ff meets with the ems. They tell us who the proritys are. Well this is being done the crew is doing it's thing Shoring, streaching a line preparing tools. Once ems has told us who gos first the fire dept does thier thing and hands the victim off to ems. We have three limited access highways in our responce and "normaly" don't have a problem with this. We may halt extrication for a moment so ems can check again on the patient and then we resume. If need be we supply ems with turnouts so they can offer very criticle patients continued care throughout the extrication. However they don't get involved unless they have full turnouts on.

[ENGINEDUDELT]

Suppression and Rescue personnel worry about the scene, rescue, fire, etc.....EMS shud, now this is my opinion, and there is no one job more important than another, but..........EMS shud take total control of PT care. Usually, the Incident Commander ensures the two divisions, let's call them RESCUE Division and Care Division, have the proper resources to conduct work. This will allow the IC to see the big picture, while the EMS personnel focus totally on PT care and the Eng/TRK/SQD worry about all the other stuff. Just some thoughts.

[ohfrmn89]

our dept responds with the rescue engine on all mva's with the EMS units.the EMS crew is in charge of patient,engine crew is in charge of extrication, fire control etc. if needed. if no extrication is needed we assist with patient care playing "gopher" getting any additional supplies that may be needed or getting cot,backboard etc or assisting with other patient care if more than 1 patient until additional EMS units arrive.all our members are emt's or ff/emt's or ff/medics. most of the incidents either the chief (if on scene) is ultimatetly in charge or duty officer or shift captain. in short we all work together as a team....... key word: COMMUNICATION

[NBVFD41604]

Depends on the situation sometimes, but for the most part, they should share command

[SouthsideLadderMan]

If there is still a Piece of Suppression Apparatus on the Scene, they should NEVER take over! From my expereinces, I haven't met an EMS Officer who could run a Dishwasher much less an incident scene.

[HAZWOPER]

Ladderman, put aside your bad personal experiences with EMS officers. Not all of them suck. The primary concern with most EMS personnel is the treatment and handling of the pts. They don't want to run the scene like an incident commander. But they should have an idea about how they want the pts extricated and in which order. They should be free to advise fire companies. That advice should be adhered to, much like an order. The ideas that EMS crews want to take over incident command (with the exception of the overzealous) and that fire companies will tell EMS how they're going to extricate is not only ludicrous but also not in the best interest of the pts. Only those areas of an incident that involve triage/treatment and handling of pts or crew safety would fall under the scope of an EMS officer. Much like fire officers (again, with the exception of the overzealous ones) don't want to lead full arrests. Don't mean to stir shit, I'm just being the voice of reason. :D

[888]

You forgot one option in your poll.........N E V E R !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[Blondiemed2004]

Well "LadderMan" that was a typical Fairfax County response.

[SouthsideLadderMan]

Well Blondiemed, if you did a little research you would know that I don't work or volunteer in Fairfax County. Try again....EMS is the Cancer of the Fire Service.

[LostOnScene]

Well Blondiemed, if you did a little research you would know that I don't work or volunteer in Fairfax County. Try again....EMS is the Cancer of the Fire Service.


cancer of the fire service? oh buddy don't get me started on you again.

[SouthsideLadderMan]

You never "Got Started" on me in the First Place. A couple remote comments that had nothing to do with what I originally said. You are clueless and irrelevant to me. Please save your energy for feeding time.

[LostOnScene]

You never "Got Started" on me in the First Place. A couple remote comments that had nothing to do with what I originally said. You are clueless and irrelevant to me. Please save your energy for feeding time.

if you'd like i could.

so you had a bad experience...we all do. not everywhere is the same, don't stereotype cuz of what you experienced

too bad you think ems is the 'cancer' of the fire service...all the fire fighters at my station are either EMTs or medics...

you should think a little before you run your fingers.

[SouthsideLadderMan]

so you had a bad experience

No, I just don't feel like running a taxi service. I am sure the EMS service you run is not even close to being busy. Try running 6 or 7 EMS calls after midnight and see if you don't have to change the battery in that little pager by morning time.

How many calls did your Ambulance run last year? Mine ran 4000. Thats over 10 calls a day. And that is for one Ambulance, not 3 or 4 coming out of one Station. Sorry, I didn't join the Fire Service to cart people to the Hospital at 3AM for a broken finger.

too bad you think ems is the 'cancer' of the fire service

Too bad it's true. Maybe not in your corner of the world, but down here...they will pull a Firetruck off of a Box Assignment to get an Ambulance out. Do you see a problem with that? Pulling a Firetruck off of a Fire Call to get a BLS Unit out for a minor Medical Emergency?

all the fire fighters at my station are either EMTs or medics...

Congrats...I got a news flash for you....MOST FIREFIGHTERS ARE EMTS OR MEDICS! I had my EMT-A before I had Firefighter I. So whats your point?

you should think a little before you run your fingers.

You should get a clue before you run yours.

[SIXand17]

Try again....EMS is the Cancer of the Fire Service.

I agree with you SSLM.

EMS is the cancer eating away at the most noble profession on earth. ~ Jake Rixner

If you're posting on TWD you don't know who he is, spend more time in a few books or fire service publications rather that F'ing off on the computer.


Here's a quote I don't understand and I've seen quite a few forms of the same comment throughout:
Depends on the situation sometimes, but for the most part, they should share command

Share command? How can you share something that's intended to be done by one person? There's no such thing as "Joint Command" or "Shared Command" or "EMS Command" or "Rescue Command". Period. There's an Incident Commander who assigns Division/Sector Officers depending on need. If the Incident Commander decides that handling the EMS portion of an incident is within his Span of Control, then there should be no person assigned to oversee the operation.

[LostOnScene]

No, I just don't feel like running a taxi service. I am sure the EMS service you run is not even close to being busy. Try running 6 or 7 EMS calls after midnight and see if you don't have to change the battery in that little pager by morning time.

How many calls did your Ambulance run last year? Mine ran 4000. Thats over 10 calls a day. And that is for one Ambulance, not 3 or 4 coming out of one Station. Sorry, I didn't join the Fire Service to cart people to the Hospital at 3AM for a broken finger. .

the one i work for ran about 1000, the one i was volunteering for ran about 4000...but that service has 7 ambuls and a medic unit. a good number of the ems services around here are either private services or if they are with in the fire department that are a seperate entity.


Too bad it's true. Maybe not in your corner of the world, but down here...they will pull a Firetruck off of a Box Assignment to get an Ambulance out. Do you see a problem with that? Pulling a Firetruck off of a Fire Call to get a BLS Unit out for a minor Medical Emergency?

yes i do see a problem w/ that. the next due ambul would be dispatched in our place. most of the time to get our engine out the door we have to split the ambul crew if there is someone to take the engine. members usually respond to the scene, wich isn't always the best thing cuz now there are more vehicles in the way and risk for another accident.

Congrats...I got a news flash for you....MOST FIREFIGHTERS ARE EMTS OR MEDICS! I had my EMT-A before I had Firefighter I. So whats your point?

i know pleanty that aren't...

i know where we are from things are run differently...you have your opinions and i have mine.

[Fghtng5thFemale]

EMS is the cancer eating away at the most noble profession on earth. ~ Jake Rixner

If you're posting on TWD you don't know who he is, spend more time in a few books or fire service publications rather that F'ing off on the computer.

I not only know who he is, but I've met him, bullshitted with him before, and bought Kentland tee-shirts off him. Rixner has forgotten more fires then you'll ever hope to see and he is one of the most laid back, easy going guys I have ever met.

That aside, you are forgetting one important fact. The whole reason everyone is on this accident is because of patients. So yes, EMS should play a very important role and make vital decisions during the call. Bottomline, the person who techs the call and takes care of that patient is ultimately responsible for whatever happens to that patient. It falls back on that person, not the firefighters who cut the guy/girl out of the car. Having a medically trained person inside the vehicle with the patient is also very important. Not only can that provider begin the intial assessment and keep the patient calm, but they have the patient's point of view and can point out possible problems or better ideas for a faster, safer patient extrication.

I agree that there are a lot of bullshit ambulance calls out there, I've been on many myself. I've also been on calls where someone's worst nightmare is coming true. It's a part of the deal. You have to take the good with the bad, but if you become so jaded that to you every ambulance call is a waste of time then you don't belong in an ambulance to begin with. It's not for everyone. So people love it and some hate it. To each his own. But realise that everyone has different opinions about it and that yours isn't the only correct one.

[SIXand17]

I’m sure the same holds true for you (since you’re a mere 24 years old) and most everyone else that uses/abuses TWD.

On to your spiel about EMS. You can read my post 1,000 more times and you won’t see anything in it that you referenced. No where did I say that their (EMS) role was unimportant or that their decision-making ability should be limited. Any good or even able-minded Incident Commander is going to take the information provided to them and put it into action. You’re the technician in the car and you tell me that you need an additional Medic or a Med-evac or whatever, it’s going to happen - guaranteed. I’ve never ever seen an argument on an incident scene between an IC and someone doing patient care because the IC didn’t fulfill their request or second-guessed the level of care that was being provided. You’ll also notice in my post that I didn’t mention that the IC must be a Fire Officer or someone from the fire side of the business.

As for my “opinion” on Incident Command – read through the NFA ICS Manual and see if it’s opinion or fact. You’ll be hard pressed to find any of the four faux “Commands” that I referenced – and if you don’t have a copy, I’ll send you one and you can read the opening line from:
Module 1: Introduction and Overview

At any emergency, small or large, involving fire department response, one person must be in command; assessing the situation and available resources, determining an appropriate incident action plan, monitoring the plan’s effectiveness, and continually modifying the plan to meet the realities of the situation.

Any Incident Commander is only as good as his/her training, experience, leadership abilities, and the ability to apply the information that he/she is provided to ensure a positive outcome at any scene.

[Blondiemed2004]

Can someone please explain how EMS is the cancer of the fire service?

[SouthsideLadderMan]

Let me try this in a non-biased way.

Fire Based Emergency Medical Service places a strain on Fire Suppression Duties. In places where Firefighters are required to cross-staff EMS units, Morale is usually low (Unless they are getting some kind of OT or Bonus for doing it.)

The terrible practice of downstaffing Fire Apparatus to staff EMS units is killing Fire Departments across the Country, career and Volunteer alike. EMS is the wicked step-child of Local Government and usually is dumped on the Fire Department after years of mismanagement and burnout by third-service agencies (FDNY EMS is a perfect example of the EMS being dumped on the Fire Service.)

I am not familar with how Career Firefighters feel about Ambulance Duty, I guess I can at least say, hey...they are being paid for it. However I am sure Firefighters in DC, Baltimore and other cities are discouraged when they are sitting on the scene of the ump-teenth EMS call of the night, listening to surrounding companies run Fires in their area while waiting for the Loads on the Ambulance to clear the Hospital and Respond on the Priority 3 EMS call for the Tummy Ache. The Practice of sending Fire Apparatus on low-priority EMS calls just to "get someone there" is complete and utter BULLSHIT.

In the Volunteer side of the spectrum, people normally do not join expecting EMS duty. I have seen an Ambulance take a strong Volunteer Fire Station and turn it into a 90% career house in a matter of two years (Kentland does have a Second Station, and it used to be STRONG!)

Another aspect in the VFD that makes EMS SUCK is when you have a crew of Live-in Firefighters. These guys are usually the life-blood of the VFD. I hate to reference them again, but call and ask Kentland Station 33 what they would do without their live-ins. When you have 5 EMS people that participate maybe once a week, the people who have to run EMS the rest of the time are the Firefighters. It takes a toll when you have non-participant EMS people. It is not fair to the people who want to join and NOT do EMS that an EMS only person has the Opportunity NOT to ride Fire Apparatus, but the Firefighters are forced to do both.

I could go on and on about this topic. And luckily, I am not a Chief in my department, or the Company up the street would be running two EMS units after I put ours out of service.

[BigGreasy]

Actually Southside you got it right. just the other day siting detailed to the damn gut bucket and wouldnt you know my company had not one but two fires. The medics in the city run non stop is an understatement try 22 medics trying to cover well over 100,000 calls. I have actually been called for a person having a nightmare. yes in a given day iw ill save a life but having to deal with 10 or more disrespectful pts. between well think it speaks for itself. As long i wish to be a ff in the city i dont have a choice i have to ride the crappy medic in a fill role which is every other trick just about. Earlier in the year we had a unit go out to stand by on a sick on the street. A box came out in that units first due and kids died in the fire lord only knows the impact it would have had if that unit would have been able to respond.

[SouthsideLadderMan]

EMS is the CANCER of the Fire Service. I say again, EMS is the CANCER of the Fire Service.


Now all you Cross-training and Fire Based EMS proponents write that on the chalkboard 3000 Times. :D

BigGreasy,

I know B-More Medics earn their paycheck and then some....I know I couldn't be on a S--tbox that much. I don't care what the salary is.

[Fghtng5thFemale]

Don't get all lofty and superior over me because I'm a "mere 24". My age has nothing to do with this issue. I don't care how old you are or how young I am to you. I wasn't excluding myself from that comment. It was a general statement and it probably holds true to 90% of the Watch Desk population. If not more...

And don't flatter yourself thinking I was only referring to your post and yours alone. There are a lot of posts and varying opinions on here last time I checked. My post was generally directed at everyone and not just you.

[Fghtng5thFemale]

You provide some very good knowledge and I wasn't arguing with what you said, just how you present things. 90% of the fights on here are started because of the way people present what they say on here and how it is taken.

Age doesn't equal knowledge and neither does education.

[LostOnScene]

Fire Based Emergency Medical Service places a strain on Fire Suppression Duties. In places where Firefighters are required to cross-staff EMS units, Morale is usually low (Unless they are getting some kind of OT or Bonus for doing it.)

let me put it to you this way...EMS pays for itself...fire doesn't.

i don't need OT or a bonus to go out on my stations ambul...i do have minimal fire training but i'd rather be on the ambul.

In the Volunteer side of the spectrum, people normally do not join expecting EMS duty. I have seen an Ambulance take a strong Volunteer Fire Station and turn it into a 90% career house in a matter of two years (Kentland does have a Second Station, and it used to be STRONG!)

my station is fire and ems...as i said before all members are either emts or medics. 95% of the members are employees of the ems side. ...thats now our station survives...on the income from the ems...


again as i said before things are different here than they are where you are...our fire station would probably be shut down if it weren't for the ambuls.

[Blondiemed2004]

Cry me a fucking river.....

Your sitting here bitching and moaning about "ems is the cancer of the fire service". NO, its whiny ass bitches like you that are the cancer of the fire service. I missed a fire b/c i had to go help a fellow human being, sniff sniff. I agree that ems does run ALOT of BS calls but that is a dispatching problem with where ever you come from. And fire side runs alot of BS as well. As for patients disrespecting you, so far you attitude explains that. I think you have lost your compassion for the job and need to find a new career.

I will agree with LostonScene, that EMS pays for itself and helps the fire side in vollie combo systems.

As for fire based ems placing a strain on fire suppression......hmmm, OK. I don't know what kind of system you all are affiliated with but it sounds like you have staffing problems. If you have problems like that then administration is to blame not ems or fire.

I guarentee that most of us involved in this thread are cross-trained and have a personal preference of which side, ems/fire, that we enjoy more. But a comment like that insults your fellow peers that may enjoy ems more.

[SouthsideLadderMan]

Wow, your comments really made me change my mind about EMS. A medic calling me a whiny Bitch. That's funny.

You stay on your Ambulance and I will stay on my Firetruck. You can take your Cross-training and put it where you pee. Because I will stand by my statement that "EMS IS THE CANCER OF THE FIRE SERVICE!"

[SIXand17]

Not trying to be lofty or superior, but you quoted me then directly referenced me in your statement: “Rixner has forgotten more fires then you'll ever hope to see….” This doesn’t constitute a general statement where I’m from or where I went to school. It was a direct poke at me and now you’re backpedaling on it.

I’m sorry if you (personally) didn’t like my presentation about/on an issue that you disagree with. I’m not going to sugar coat or present in a manner that is more appealing to those persons (notice I didn’t say “you” which would be addressing you) with thin skin. Thanks for the comment about posting very good knowledge, though.

I’ll leave you with this since you speak of knowledge:

knowl•edge
n.
1. The state or fact of knowing.
2. Familiarity, awareness, or understanding gained through experience or study.
3. The sum or range of what has been perceived, discovered, or learned.
4. Learning; erudition: teachers of great knowledge.
5. Specific information about something.
6. Carnal knowledge.

Most of them reference some form of experience or study/learning…where age and education would apply.

[LostOnScene]

Wow, your comments really made me change my mind about EMS. A medic calling me a whiny Bitch. That's funny.

You stay on your Ambulance and I will stay on my Firetruck. You can take your Cross-training and put it where you pee. Because I will stand by my statement that "EMS IS THE CANCER OF THE FIRE SERVICE!"


hey, jackass...i don't think anyone was trying to change your mind. you are entitled to your own opinion, maybe we are tryin to get you to see the other side...

and FYI...there are fire stations out there that will pull their EMT off their ambul while they are on scene to go fight fire...i could bitch about that but i won't cuz that is how the station functions. thats their business...

[SouthsideLadderMan]

hey, jackass...i don't think anyone was trying to change your mind. you are entitled to your own opinion, maybe we are tryin to get you to see the other side...

I do see the other side. From the window of the Fire Truck. And BTW, I am preparing for my 4th EMT recert...do you think that qualifies me to discuss EMS? I've forgotten more about EMS than you have probably seen.

there are fire stations out there that will pull their EMT off their ambul while they are on scene to go fight fire

If that EMS unit isn't committed, whats the problem? This is the FIRE DEPARTMENT. We put out Fires...

[LostOnScene]

I do see the other side. From the window of the Fire Truck. And BTW, I am preparing for my 4th EMT recert...do you think that qualifies me to discuss EMS? I've forgotten more about EMS than you have probably seen.


wow isn't that great...4th recert...i don't care how long you have been in ems. if you dislike ems so much...why keep your EMT?


If that EMS unit isn't committed, whats the problem? This is the FIRE DEPARTMENT. We put out Fires...

i believe i said on scene...that would tell me that they are committed to the fire scene?

[Emtmom]

This thread makes me glad I live where the fire department and ambulance are seperate departments. We thank our FF's for being our first responders and for being volunteers with us. Quite frankly if we didn't have FF's who are also EMT's, and LIKE doing it, we wouldn't have enough people to have an ambulance assoc.. First and foremost for them is the fire dept., those of us who are not FFs are reminded at monthly meetings that when there is a fire WE are to respond for the ambulance so the FF's can be used where they are needed most. We also have FF's who obviously prefer the ambulance even when there is a structure fire they respond with the ambulance.
Working together is what's important. Some of us know how important our FF's are, and thankfully some FF's know how important we EMT's are too.

As for the question at the begining of the thread.....here, the fire department is in charge of all calls. We work with them, and we get our patient when the officer in charge is sure it's safe.

[SouthsideLadderMan]

if you dislike ems so much...why keep your EMT?

Because the Department says I have to in order to remain an Officer.


that would tell me that they are committed to the fire scene?

If they are committed on a Fire Scene and the Fire Apparatus is short, what is the priority? To put the Fire out or sit there with their EMS bag with thier thumbs up their asses? Tell me what you would do....I am willing to bet your thumb will smell bad afterward... :rolleyes:

Some of us know how important our FF's are, and thankfully some FF's know how important we EMT's are too.

I know how important you are, I just don't want to have to do your job when you are not around.

[Emtmom]

Because the Department says I have to in order to remain an Officer.

If they are committed on a Fire Scene and the Fire Apparatus is short, what is the priority? To put the Fire out or sit there with their EMS bag with thier thumbs up their asses? Tell me what you would do....I am willing to bet your thumb will smell bad afterward... :rolleyes:

I know how important you are, I just don't want to have to do your job when you are not around.
It's too bad some departments are forced to run EMS. If you don't want to do EMS you shouldn't be forced to.
I agree with you, putting the fire out is the #1 priority. There are times when you do what you have to do at the time.
LostOnScene, when and IF there is an injury, believe me when I tell you, there is NO problem getting one of the FF/EMT's to jump in and help that patient. We were at a lumber yard fire, there were 2 of us on the ambulance. One was a FF also, he got pulled to help, a FF from another department went down from smoke inhalation. He was brought to the ambulance by one of our FF/EMT's, who cared for him while I drove to the hospital.
Think about being an EMT, do you do everything in the field the way you were taught in class? There are times when you have to bend to get the right results.

[SouthsideLadderMan]

You wanna know some even more jacked up stuff?

EMS Only Members are allowed to get "Stand-by" Credit for a Fire Call when they are in the Station! This means that when the year is done, if an EMS person hangs out enough, they can get "Top Runner" in the Fire Category without EVER TOUCHING A FIRETRUCK!

Firefighters cannot get "stand-by" credit for EMS Calls.

EMS People have a Choice of being "EMS Only" and never have to set foot on a Firetruck.

Firefighters must be "Fire/EMS" members and have to ride EMS as well if no EMT's are around.

emtmom, thanks for the back-up I guess...I guess I should take back all that nasty stuff I said in the other thread.... :D

[Emtmom]

You wanna know some even more jacked up stuff?
EMS Only Members are allowed to get "Stand-by" Credit for a Fire Call when they are in the Station! This means that when the year is done, if an EMS person hangs out enough, they can get "Top Runner" in the Fire Category without EVER TOUCHING A FIRETRUCK!
Firefighters cannot get "stand-by" credit for EMS Calls.
EMS People have a Choice of being "EMS Only" and never have to set foot on a Firetruck.
Firefighters must be "Fire/EMS" members and have to ride EMS as well if no EMT's are around.
emtmom, thanks for the back-up I guess...I guess I should take back all that nasty stuff I said in the other thread.... :D
Damn, no wonder you're pissed off. If you are going to force FF's to become EMT's then the EMT's should be forced to become FF's. It's so unfair to give credit for a call to one group and not the other. Hell if you are all techs. then you should get the credit for being there for EMS standbys too.
Now I know how lucky we are here. My hubby hates the EMT stuff, let his cert go, because he wants to be a FF, not an EMT. Me, I wanted to be a FF too, but, I'm afraid of heights and I can NOT stand to have anything on my face. (put an oxygen mask on me and I feel like you're suffocating me.) SO, not exaclty the kind of person you want on the department. I did however take my Haz mat Operational level class with one of the fire departments here in town. The night of the lumber yard fire the chief taught me to check the seal and change a scot bottle, so I can still help.
No appologies are needed. There were just things on the other thread that pissed me off, and my temper got the better of me. Most of the time, I'm level headed, can laugh at the posts and walk away.

[LostOnScene]

If they are committed on a Fire Scene and the Fire Apparatus is short, what is the priority? To put the Fire out or sit there with their EMS bag with thier thumbs up their asses? Tell me what you would do....I am willing to bet your thumb will smell bad afterward... :rolleyes:


yea it prolly would smell cuz i don't do the fire thing...even though i am listed as a FF at my station...haven't figured that out yet...

[Fghtng5thFemale]

knowl•edge
n.
1. The state or fact of knowing.
2. Familiarity, awareness, or understanding gained through experience or study.
3. The sum or range of what has been perceived, discovered, or learned.
4. Learning; erudition: teachers of great knowledge.
5. Specific information about something.
6. Carnal knowledge.

Most of them reference some form of experience or study/learning…where age and education would apply.

I think intelligence was the actual word I was thinking of at the time. Thanks for the definition of knowledge, but I was already aware of it's meaning. You seem very much like a by the book kinda guy. Therefore I understand why you think education always equals knowledge or intelligence. There are lots of people in this world with degrees and a decent amount of time put into their degrees who don't know jack. Having a college degree does not make someone better then others who don't and quite possibly not any smarter either.

[BigGreasy]

There is no way some of you guys are in a real urban setting where you run your ass off. We have medics quit regularly due to two things too busy from volly or district they came from and two disrespectfull pts. who call for plain bs. So i guess every medic in the city brought the disrespect on them selves then blondie. Some of you should be blessed you get to do the job the way it is suppose to be but others of us in busy urban areas get the short ugly end of the stick. Some of that is due to statements some of you made like EMS pays for itself well yes and no, see joe blow in the ghetto calling the medic for bs has no money therefore will never ever pay a dime for the hundreds of calls generated by himself, but the department stances is maybe they might get money ems pays for itself and all so go out take all the bs take all the disrespect we dont care if they acctually shit on you take the run so we get the money which if they are lucky happens 50% of the time. Sad part if i tell the guy it is not an emergency or he might consider other means of treatment ie put a bandaid on the paper cut he has and he complains i lose atleast a days pay. LOL so i guess the medics do pay on bs calls too.

[BigGreasy]

LOL see this shit is so stupid i logged in here to comment on the initial thread and have yet too. Look some of us love fire and helping people that way, some love ems and helping people that way some love both ways and those who do both wish they didnt and could do mainly one or the other. Called differences and it is what makes us individuals. So with that said i can finally comment on the initial thread. Ems should take initial IC if first on scene of rescue, when fire gets there IC is past to them so that ems can fully concentrate on pt care which is the priority for them, fire side will handle IC directing rescue efforts since that is the reason they are there and direct additional support to ems as requested by ems. In my jurisdiction a battalion chief is IC on rescues and everyone i have been on he is all ways a pest to ems constantly asking what they need that is the way it should always be.

[thefrmn78]

I whole heartedly agree with Lontal, Paramedic 35, and BigGreasy. I think, no matter what the situation on the MVA, Fire should have IC. As for SSLM, I agree with some of your points too. Although I am part of a VFD, in my county it is usually us that have to provide for the EMS. I am not saying EMS in whole does a bad job, but the majority of the time we are answering first responder call because our rescue squad cannot get out. Although in my time here I have not experienced that, it has happened. As for saying they are the cancer, that may be a little too extreme.

[Blondiemed2004]

Big Greasy,

I agree with your last two posts. I WAS trying to say that some of us prefer one side to the other more. As thefireman said the cancer comment was extreme and hurtful to those of us that may prefer the ems side more. The bottom line is we are all in this together. I know what is like to not sleep on a 24 hour shift. It sucks ass and you get frustrated at those who abuse our help (especially over and over again). But when we don't get the respect from our patients then it doesn't help to have your coworkers saying something like that to you. My anger of it got the best of me and I appreciate someone commenting who is level headed.

[BigGreasy]

Well actually i must agree with you after alot of though it is more the politcis in my department and the politics of the city that make me feel the way i do so in a corrected statement. The politics of my area either deparment or government are a cancer to the service as a whole. Because of some of the policies from one or the other we have lost alot of firefighters and Medics who i looked up too and i considered heros and rolemodels. The wisdom and experience they held will never be able to be recovered and that is a sad shame and a black eye.

[Truck123]

If the EMS OIC prefers to get the patient out a certain way, what is wrong with the EMS OIC telling the Rescue OIC how he/she prefers to have the patient extricated? While fire/rescue crews most of the time have much more knowledge on an extrication, the EMSOIC's responsibility is still the patient, and if the EMS OIC want's the patient extricated a certain way, then 9 times out of 10, there should be a reason for this? Fire-Rescue & EMS should work together on whatever is best for the patient's overall condition.

Maybe I am with a fortunate company that works fire & EMS, therefore we are always on the same page and working together? I have never ran anywhere other than Clairton, so I can not say that this is always the case outside of our jurisdiction.

[hog]

the biggest problem i see at an accident is cribbing

[regs1]

Hog:

I have a semantics problem with your answer, to me cribbing is constructed by stacking wood a certain way to stabilize something [car, building], in you case I believe you trying to state something else, please restate your answer.

MVA the best answer is each department SOPs, who in charge, if you have a BFC on scene he is, everyone should funnel info to him, and why something should be done a certain way, rescue has their SOP in extraction, yes they sometime will not follow what the EMS wish’s but that what a BFC is there for.

Overall, Fire should be in charge, but EMS should have a profound say in patient care.

[DrGreenbaumberg]

Esu.......

[hog]

Hog:

I have a semantics problem with your answer, to me cribbing is constructed by stacking wood a certain way to stabilize something [car, building], in you case I believe you trying to state something else, please restate your answer..
ok the vehicle has to be stabilized.....that is the biggest problem i see at a MVA..............paid and volly

[EMT/FF99]

Ems & Fire need to have joint command while on an accident scene, if they do not work together all the time (such as same station).

[TheRaisin]

Oh hell, I can't stand when you have a MVA with heavy entrapment and EMS is always getting in your way and want to have friggin hour discussions with you. They are incharge of patient care, they need to stay out of our way until we get the patient accessable and ready to be removed from the car and go in there bus. Stay out of our way or we'll go home.

[hog]

Oh hell, I can't stand when you have a MVA with heavy entrapment and EMS is always getting in your way and want to have friggin hour discussions with you. They are incharge of patient care, they need to stay out of our way until we get the patient accessable and ready to be removed from the car and go in there bus. Stay out of our way or we'll go home.
hmmmmmmmmmmm that is a bad way of thinking in my opinion

[Emtmom]

Oh hell, I can't stand when you have a MVA with heavy entrapment and EMS is always getting in your way and want to have friggin hour discussions with you. They are incharge of patient care, they need to stay out of our way until we get the patient accessable and ready to be removed from the car and go in there bus. Stay out of our way or we'll go home.If you have this kind of problem with your ems provider you need to have a meeting and discuss what's expected of them on scene. We luckily work VERY well with our fire departments here. We are allowed access to the patient as soon as we arrive, provided it is safe for us. The FIRE OFFICER is ALWAYS in charge of any scene in which the fire department is called out to. Even if they are called for medical calls, our departments are first responders, so we get them for strictly medical calls too. You MUST go through the officer in charge to get whatever you need, ie....medic, another ambulance, more help. Working together is the only way it all works! Our ambulance is equiped with a full set of bunker gear, in case one of us is needed inside a car during extrication.

[blstxi]

Just because it's a tradition doesn't mean it's a good one. The on-going, archaic chest thumping between either fire vs rescue and/or paid vs volley has become about as logical and useful an argument as north vs south and "i'm in charge" vs "i'm in charge."
As far as who's in charge of an MVA it shouldn't matter unless your personnel are so caught up in the above arguments and/or are so limited in the amount of their training/experience as to not have an understanding of both fire and rescue practices. For those of either side that have such a problem with being "forced" to work with, cover for, or act in place of their counterparts, either discuss it within your agency administration, handle it among the street crews, or quit. Do what needs to be done on scene using whatever resources from either fire or rescue as needed. Train together as needed before and after. And, whatever you do, get over yourself if you think you and your "side" are better than the other.

[mohican]

We solve that by the virtue of our department being fire/ems, and everybody is familiar, if not expert, in what it takes to extricate

If it's a mva with enough components to become an MCI, Ohio solves that by putting the Fire Chief in charge of MCIs per ORC

people talk about "rapid" removal, but in my time, I don't think I've seen an example where it was necessary or viable. Of course, there will be those times, but I haven't seen it. It's still valuable to train on it, but I don't think it happens that often.

[Rescue23]

Lucky for me I happen to be both a FF/EMT usually on an MVA I assume an EMT role our Fire Department is connected with our Ambulance so we roll together!
The Chief usually assumes IC but ultimatly the EMT in charge of patient care directs FFs to cut or not to cut. The FF doesn't always understand that patients have a priority if you have more than one patient who gets cut out first (The most injured)
For instance we had an accident on our main road here and two cars and a tractor trailor was involved the tractor trailor left the scene of the accident prior to our arrival on scene. The two cars hit head on and then the tractor trailer ran over the driver side of the one car. Upon my arrival on scene the car run over the driver was DOA and in the other car 4 patients two walking around and the driver (mom) was in pain in lower body but talking and breathing well. My patient was 14 trapped behind his mom and not breathing. My patient was cut out first 16 minute extrication and was driven to the LZ and flown to trauma center mom 32 minute extrication also flown to trauma center both lived cause we cut the right person at the right time.

[Rackin A Round]

Okay here is my thoughts on this thing: I really dont know what is the problem with EMS providers. I am one, but some of them get a huge hard on for getting to an MVA before fire...personally, if I happen to end up on the gut box, I want people there with the proper PPE to stabilize the vehicle(s), control leaks and cut the power so that when I am getting my patient out, the airbag wont go off and hit me in the face....let fire get there, assume command, take care of hazards and let me assume command over the patients and patients only! Just my personal practice

[popeyefireman]

Here are my thoughts

1. Joint command is a big no no. Its ok to assign Operations officers, Ems Control, etc. But overall there needs to be 1 person in charge making the decisions. No leading by comittee.

2. Most of the EMS providers in my locality are without turnout gear wich puts them out of the game until the patient can be extricated.

Lastly I have found that how stupid you are depends on what part of the world you are standing in at the particulare time you say something. What I mean by that is somehting that works in DC may not work in Rural Virginia and what works in VA may not work in FDNY. So try and look past your nose for experience and dont get "localized" (when you think the way your locality does it is the only way).

Stay Safe out there
Robby Owens

[mercerneedshelp]

Just to add some more thoughts. First of all, all of you out there who keep saying EMT and fire should share command I don’t know where you’re coming from but, in most towns (not all) they don’t get along as well as you guys make them sound like they do. Two I agree with rescue 23 highest ranking fire officer should have command and the EMT who is inside doing pt contact/care should direct how they want to extricate the pt and the Fire should do so. But overall I believe the fire should stay in command since more things such as stretching a line, cutting battery cables, looking for hazards (power lines) and such will be over looked.

[Retired Guy]

Agree Fire should have command. FD is more used to a formal Chain of Command. Not to mention all of the stuff that happens on scene that the EMT isn't involved with. Once the patient(s) is on my cot/in the box then I am in charge of his/her care. Just remember I may be in the car holding C-spine when you cut the roof off!

Stay Safe,

Paul

[SmokeEater77]

After reading some of these posts, and looking back at the many different depts I have worked with and the varied systems we have in place today I think this is a good thread for people to see how others view things in their own areas.
IMHO, Fire should always be responsible for the scene, EMS when run by a private company is mainly concerned with what they can bill. If they aren't transporting patients, they aren't making money. Most times Fire will arrive first, and leave last. I know there are time when many meds/rescues/busses what ever you use in your local arrive first, but how many times does a medic unit ever stay once fire leaves? Its very rare. How many medics are versed in the other hazards associated with an accident scene?

Imho its the Fire officer who is in charge of the overall scene, safety of responders, safety of patients, etc. The Medic is responsible for patient care, if the medic is also the IC then where does he/she sacrifice his attention? To scene safety? to responder safety? or to patient care? Its extremely difficult to treat a serious trauma patient, and control a fire scene. If you can do it, you should come try working with us, cause you would have to be omniscient and omnipotent, or at the very least able to clone yourself.

In answer to the poll at the beginning of the thread, when does EMS take over? EMS never takes over, however, EMS is always responsible for PT care. But how many private Ambulances train their crews for extrication? how many carry turnout gear? or even extrication suits, helmets, goggles and gloves? I dont know how many times I have seen medics in the vehicle in just their duty uniform and wanting fire to cut or begin extrication. When I was in EMT school we used to have a saying, "Paramedics save lives, EMTs save Paramedics".

Even when I worked in a dept where there was a medic unit at almost every station, and both engine co and medics were dispatched at the same time, the Engine company still maintained Command, even on strictly medical calls. The Paramedic might have been responsible for PT care, but the IC was responsible for the safety of the crew.

[heretothere]

I have read and seen everyone thoughts on this. Almost everyone agrees that the FD should have command when it comes to cutting the car and the scene. Well I have worked from Texas to PA for EMS and FD. And in all cases not one time has either the FD or EMS not had tunnel vision. It may be wanting the spot light in the paper or the glory on this web site. Either way in the end it is all about doing what is right for the pt and going home safe. Though be it the FD thinks that everyone should be in full PPE because they are on scene, but in EMS protocol set by the states it gives EMS the choice. And when it comes to EMS yes most of the time we do get tunnel vision and only worried about the pt. But to many times I have see the FD put spreaders where it would hurt the pt or not hold c-spine or be a worse danger to the pt than a help. And to all the people out there that want to rip this post apart I now work for a company we carry all PPE and Tools for MVA so if FD doesn't show up we can do what needs done. But I would rather have the FD there so they can do what needs done and I can worry about my PT. When it comes down to it the Fire CHief should be command but not making EMS decisions and should let EMS do the job they are there to do. And from time to time that will call for EMS to get in the car and no not always in PPE. To close I would just like to say let work together and quit acting like we know it all I have been in this for over 10 years and still learn new things all the time.