Chief Concerns Richard Marinucci
Fire-based emergency medical service (EMS) has proven itself to be very beneficial to the communities that elect this delivery option.
The advantages are many: quick response time, the ability to dispatch adequate numbers of people, and support for operations such as those needed for extrications. The match up with fire has been good for everyone and continues to provide value-added service to the jurisdiction. It adds to quality of life and has proven to save lives, shorten hospital stays, and decrease the time needed for rehab after an injury or illness. But there are some current challenges to agencies providing the service and potential emerging issues. It is time for individual departments and the fire service as a whole to look at what they are providing and how they will address these challenges.
There is no doubt fire departments and firefighters are capable of delivering quality service. The track record of success is outstanding and beyond question. The issue facing the fire service is how this will continue. EMS in many organizations is being strained. This is from increased run load, abuse of the system, continuing educational requirements (time required to maintain licensure), and firefighter burnout. There are other factors to consider, but these may be the most significant. It is important to analyze each and assess the current status of the organization to ascertain whether any action should begin to address the concerns.
It is appropriate to determine what is a reasonable number of responses that a unit can make during an average shift. There are going to be times when that number will increase but, in general, there should be a normal response expectation. Realistically, what is that number in your organization? Factors to consider are the obvious: staffing and the number of “other” responses, including fires. There is a need for training and other ancillary duties such as apparatus and equipment maintenance and house duties. In volunteer or on-call organizations that provide EMS in a more traditional way of responding from home or work (as opposed to scheduled shifts), what is a reasonable expectation? How often can you expect people to disrupt their personal lives to respond to calls? When a break point is reached, individuals and organizations suffer. Those with an option may elect to move on, while those with no choice may develop unhealthy attitudes or habits.
The term “frequent flyer” has been used to describe individuals who make multiple calls to the fire service for medical reasons, often minor in nature and not necessitating an emergency response. Some may consider this insensitive and maybe even not politically correct. You can call it whatever you want, but the bottom line is that this is an issue that needs to be addressed if it is occurring in your department. The individuals who make these calls obviously need something but maybe not emergency response vehicles with licensed paramedics. There must be a better way to