Hat tip to one of my readers who sent me to Contra Costa Times Columnist Tom Barnidge piece today. Kudos go out to Mr. Barnidge for putting out a piece on “Why Calling for an ambulance means you’ll also get a fire truck”. This is a timely piece considering the Board of Supervisors spent roughly 85% of their last fire board meeting discussing EMS services as opposed to fire services.
This topic is actually not new, its something that myself and many others have been preaching long before Measure S and Measure Q entered the debate. In fact, the county even put out document last August on the very topic Mr. Barnidge covered today.
Here is a copy of that letter I posted last August. The big take away from the document is that ambulances cannot duplicate fire first responses or activities.
Here is a portion of the document and how vital fire service is overall to the County EMS
Fire first‐responders provide emergency treatment on scene until care can be transferred to the ambulance crew, continue to assist in patient care when needed both on the scene and, in some cases, en route to the hospital. Importantly, fire first responders provide scene management, safety oversight, and rescue services (e.g., extricating patients from motor vehicle accidents). When patients require transport by helicopter (most often critical trauma patients), fire responders are required to manage the landing site. Fire personnel have all hazard capabilities not easily duplicated or replaced by other personnel.
The document also states
Fire first responders typically arrive 2‐5 minutes before an ambulance, but, depending on the location of the call and the location of the responding units, that interval can be 10 minutes or more. While a few minutes difference in response times do not affect the outcome for most patients, in certain critical cases – cardiac arrest, breathing difficulty, profuse bleeding – minutes, or even seconds, can make a difference in saving a life or avoiding serious complications.
Moving onto what Mr. Barnidge wrote today, he is spot on as he explains the services expected when a person in need calls 9-1-1. A fire truck with three firefighters, a two-person AMR unit, and Looky Lou’s (meaning neighbors looking on).
Barnidge writes:
Of all the proposed solutions to cut Contra Costa Fire District staffing costs, the most frequent is to eliminate medical response. Critics say leave it to AMR, the company the county contracts with.
Um … it’s not that simple.
Firefighter staffing needs are dictated by the manpower required to fight a major fire — often units from several stations at once. Medical calls are a bonus, not the reason firefighters are on the clock. Besides, medical calls often require more than two sets of hands.
“If you respond to a cardiac arrest,” said AMR General Manager Leslie Mueller, “it takes a large number of people to handle it.”
She explained that one person applies the airway (forced breathing apparatus), while another administers CPR, a third reads the heart monitor and a fourth hooks up an intravenous drip. When a victim needs more treatment en route to the hospital, a firefighter climbs into the ambulance to help the AMR paramedic while his partner drives.
Later in the article, Barnidge explains why fire trucks arrive to medicals. I think his examples could have been more hard hitting, but he makes a nice point.
Another question is why firefighters arrive in fire trucks. It’s the same reason police wear guns while directing traffic — so they’re prepared for other developments.
“If we go on a medical call, and it’s under control, and there’s a fire,” Vince Wells said, “we don’t have to drive back to the fire station to get another vehicle.”
The truth is, engines go on medical calls because you never know what the surroundings are on a medical call. For example, what if a door is locked, firefighters need the ax to get in. What if it’s a car accident, engines have the tools to open up a car. There are hundreds of scenarios why engines arrive to medical calls, but anti-tax folks and penny pincher focus on slam dunk incidents where engines are typically dismissed fairly quickly.
Another point is the fact even if you change a service model to reduce medical calls, you are essentially paying firefighters to sit in stations to play poker or watch TV. You might as well use them since you are paying them.
Again, kudos to Tom Barnidge for a solid piece.
