Fire Fighter vs. Paramedics

[Sandles2Sidearm]

I was wondering what you all thought about this argument. I have heard that firemen should work only fire and EMS should handle Emergency Medicine.

What do you all think?

[JimSpoor]

I've said this before but I like the sound of my own typing....

I believe that with the amount of knowledge and practical skills necessary today one can be a Great EMT-P or a Great Firefighter, but not both. Good, competent, professional, yes. Great? No.

This being said, more and more agencies are looking to combine services. Being the cynic I say that is because the number of fire calls are going down and the number of EMS runs are increasing.

[Sandles2Sidearm]

...EMS is combined with Law Enforcement. Keeping it pure is good, but having a "medical side to fire" i.e. NYFD paramedics is a good compromise. Where I live Medics are Firemen and the trend is moving towards all Firemen having the EMT-P certification.

LA City only hires people with EMT-P or with the assumption that those people will acquire their EMT-P after their probationary period.

ps
I too like the sound of my own typing, it is sporadically unrythmic...and full of errors

[Firewoman203]

In the county I live in most of the FD's are volly. We also have First Responder Agencies in each community that are also vollys. A few of the departments in my county have people who are cross trained due to low numbers of responders.

I started as a FF and then became and EMT-P. I have seen where it can have benefits on a large scene where there are a limited number of responders. You can utilize the extra FF's there to take on patient care.

The one full time fire dept in the county madates that all FF's have at least an EMT-B certification. That way they can assist the Ambulance. I have not heard to many complaints from them about it. Of course their fire duties come first.

If the FF's fire duties come first and their EMT duties 2nd I don't see a problem. I don't think FF's really need to be at a level of an EMT-P unless they are transporting.

[nyfo]

I do not agree with FF's performing patient care of any sort nor do I agree with FF's performing extrication (which is patient care). FF's should fight fires and EMT's should be involved in patient care.

A lot of dept's run FD on MVA's which is a good idea...if the car is on fire! But not to sit there and hold up traffic while they stand and observe. They should do what they do best and that is fight fires. You wouldn't send an EMT into a buring building to go save injured people because it's a fire scene so why send FF's into an EMS scene w/o a fire? I guess they have to put those tax dollars to work some how....:devil:

[FireKila23]

Fire fighters are extremely useful in situations involving patient care. Suppose you have in accident with multiple aided, and there are a limited number of techs (EMTs), you mean to tell me that fire fighters shouldn't even be administering any form of patient care? I've been in many situations when I've had to help out the techs cause there weren't any around...besides its not like we're performing open heart surgery or anything...we'd simply just stabilize and assist with the stretcher etc. Everything is obviously done under the direction of the technician in charge which I don't see a problem with. Also, when responding to MVAs, isn't it necessary to have the FD...like when the radiator bursts or the car begins leaking oil...you need to put some speedy dry on all that junk to contain it. And if there is a need for a vehicle extrication, at least in my town, fire fighters are trained in using the hurst tools and what not so they are definitely essential in those types of emergencies. just my .02...

[Chuck29216]

Being a fire fighter and an EMT-B myself I don't see a problem with fire fighters being crossed trained. I feel that having an EMT at the ready can help save a life. I do agree that being both a fire fighter and an EMT can cause problems but it's nothing that can't be taken care of. Yes, you coud probably be a better fire fighter or EMT if you focus on just one field but when we are in the buiness to save people's lives it could be a good idea to have the extra hands to help out when needed. :burnt:

[Sandles2Sidearm]

...to see some of the opinions discussed in this forum. In the county I live in, EMT-P's are only with the Fire Service. All ALS care is ran through the FD, with one exception Mercy Air Ambulance.

All Fire Fighters are EMT-B and the trend as said before, is make all new Fire Fighters Para-Medics.

My department runs 7 BLS rescue vehicles and all Operators are atleast EMT-B. We have a few Medics, but they are limited to BLS level treatment.

We run into the conflict of Medical Aid vs. Rescue quite often, as a matter of fact, we present the dilema as a practical during the training process.

Do you stay with the victim who has a compound ulna fx., or do you make the rescue (if they see it in the first place) I would say, 60% of trainees fail this evolution.

[nyfo]

Would you send an EMS Rescue truck to "cut up" a working struture fire? No. Would you send a Fire Rescue truck to cut up a pin? No. (at least you shouldn't IMHO).

BUT after reading FireKila's post I must add that my opinions and views are tainted by my experiences with the FD I must work with.

I have no problem with having other agencies "scratch my back" but what some 'multi taskers' need to realize is that there are priorities in emergency services...and that is the job most important to you is the one your on. I don't care how many working structure fires or working codes are going on, the job your on is priority.

Also, I have no problems with EMS that is run by FD's (such as FDNY) because that EMS Division does EMS. It doesn't matter what your patch or pay check (if you get on) says.

Most importantly, I would like to point out that it depends on the dept. What every works for you, right? Because what works, it well, what works!:p

[K9 Police]

I thought I would mention that I have worked for a department where their Police Officers were also Paramedics. Therefore, they would be sent to ALL police, fire, and medic calls. They would keep their police and paramedic stuff (usually 2-3 bags) in the back seat. After arriving at a call, usually an EMT-B would bring the bus to the location for the officer-medic. It was definetly an interesting combo, but it seemed like they did more medic stuff than actual police work. Although, the response time to a code was extremely faster in a squad than a bus.

K9

[JimSpoor]

Paul,

The recent changes in Medicare reimbursement have impacted all EMS transport agencies, mostly in a negative fashion. A major problem that remains is reimbursement for first-response/non-transport agencies. Medicare will not pay two providers for the out-of-hospital treatment of the same patient. This can lead to many problems. Perhaps the largest is when the first response agency is providing ALS care and personnel while a BLS agency is providing the ambulance service. ALS intercepts is also a major sticking point in most jurisdictions.

This situation, along with having to justify annual budgets is the driving force behind many fire services looking to start or increase EMS service. I realize that fire depts have been doing EMS since before there was EMS and many do it very well. The nature of EMS has changed. I hesitate to use the term but ...the business of providing pre-hospital medical care has evolved. As paramedicine has become a profession the way things get done has inevitably changed.

To clarify a statement I made earlier, I was referring strictly to firefigther/paramedics. I believe that having firefighters (and police officers) trained to at least the frst responder/AED level, if not the EMT-B is a very good thing.

[Sandles2Sidearm]

the only exception however, is tactical situations, it is better to have a BLS Police officer in a tactical situation than it is to have a well prepared EMT putting on a vest...

just .02 more