Many people haven’t thought of what to expect when they dial 911. If they have, they may figure that a call for help means that someone will show up relatively quickly and deal with their problem. If someone were to ask you why you would call 911 you would list a handful of situations. At the top of that list would likely be a medical emergency, fire, burglar and the like. But do you give much thought to who shows up or how they get there and who decided that is the best way to respond to your emergency call? In these challenging economic times, we are all looking for ways to save money, reduce waste, and eliminate duplications in services, but is sending a fire engine with three specially trained professionals a duplication of service?
When you call 911 in Contra Costa County, your 911 call is routed to the Fire District for emergency medical calls. Every Fire District dispatcher is certified in emergency medical dispatch (EMD) and trained to ask a series of questions to determine the best response.
Why send a fire engine? The Fire District is the primary medical first responder in most communities due to short response times, a skilled workforce, and the ability to bring time-sensitive, life-saving interventions to a patient quickly. Think of a fire engine as a multi-use platform for fires, rescue, and emergency medical service (EMS) calls where three trained professionals are always ready and available for the next emergency call, whatever it is. The apparatus are big and expensive but very versatile. They are like a giant tool box filled with the tools that can save your life.
The current EMS delivery model in our county includes a priority dispatch of the closest paramedic fire engine with a typical response time of 4-6 minutes. A simultaneous dispatch of a private paramedic ambulance with a required (by contract) response time of no more than 11 minutes and 45 seconds occurs. The Emergency Medical Dispatcher will give pre-arrival instructions to the 911 caller, if applicable. The engine will arrive to evaluate the situation and begin patient treatment. The ambulance will arrive and, depending on the situation, either assist fire paramedics already at the scene or take over patient care prior to transport to the appropriate hospital. Regardless of who arrives first, the fire and ambulance crews work together to provide you with patient care.
Recent advances in emergency medicine have contributed to increases in patient survival rates. Our county has a survival rate of 35.5% for witnessed cardiac arrests with a shockable heart rhythm. That percentage is astounding compared to the national average of 20.5%. The combined efforts of the County EMS Authority, our Fire District, AMR ambulance, and the hospital system continue to make a difference!
While the primary mission of the fire service has changed dramatically in the past fifty years, fires still occur with regular frequency in our county. In our Fire District, we still experience a significant level of fire activity, both structural and wildland. The geographical coverage afforded by fire station locations and the number of fire engines within our Fire District allows us the capability to address both fire and emergency medical response.
Our County has an integrated EMS team. The County EMS Authority, who has the ultimate responsibility for the delivery of these services, has worked diligently to provide the highest level of EMS care possible. Working together, the emergency medical dispatch, fire engines with advanced life support paramedics, transport ambulances, and emergency rooms do not provide a duplication of service but rather an organized systematic approach to medical emergencies in our county. The initial response, detection, and treatment of critical trauma, stroke and heart attack provide our residents with the best chance for survival. Current survival rates for sudden cardiac arrest are at the highest in the county’s history and every responder in the system makes significant contributions to that success.
The Contra Costa County Fire Protection District provides 28 staffed fire companies with three personnel – at least one of those personnel on each fire apparatus is a paramedic. Our fire apparatus provide all the necessary tools, equipment, supplies, drugs, and medications to provide advanced life support emergency medical care.