By Frank R. Myers
At my former department, the majority of the firefighters working in the emergency response division were paramedic-certified. Our department had a major restructuring around 1994 since better building codes and fire prevention practices were resulting in fewer structural fires. Some fire suppression units were taken out of service permanently and replaced with basic life support (BLS) and advanced life support (ALS) transport units. Eventually, these BLS units (two crew members) were reassigned as ALS units (three crew members). We ended up with practically two ALS transport units per station—which traditionally had only one—in addition to the suppression units. Our department was by no means alone in this transition; departments across the country began adding ALS and BLS units since a majority of alarms were medical.
A few of our stations were single-company stations and had only one ALS transport unit assigned after the restructuring. Therefore, the decision was made to make the pumper an ALS unit (nontransport). This proved to be a good idea. It required a few changes to the inventory, like adding ALS/medicine, intubation, and pediatric cases as well as exchanging automatic external defibrillators (AEDs) with electro cardiogramd (ECGs).
Why not make the switch? The paramedics were already on the fire truck. They had the knowledge, skills and abilities; all they needed were the tools. The State of Florida required that two members of these crews had to be medics. Rank aside, if paramedic intervention was needed, they ran the scene and treatment.
At these single-company stations (one pumper, one ALS transport), if the ALS transport unit was out on an alarm, the ALS pumper at that station would be dispatched if it was in its first-alarm territory or no other ALS units were available. Simultaneously, another ALS transport unit from another station/territory was dispatched. The pumper would get to the scene prior to the ALS transport unit arriving. The ALS pumper crew would initiate treatment and, in most circumstances, would have the patient stabilized and ready for transport. All the arriving transport unit had to do was place the patient in the truck, continue monitoring, and get to the hospital.
Every transport unit dispatched with the ALS pumper greatly appreciated the fact that they did not have to do all the initial tasks that normally took a lot of time—things such as reviewing patient history, medications, insurance info, demographics, events leading up to calling 911, etc. In the long run, we were providing better initial treatment and service to our citizens.
Plus, all they had to do was a short transport report rather than the full patient/treatment report. The ALS pumper officer would complete that portion of the report. Since we had better training from most of our personnel, why not use it? Those days were the best years of my career, combining driving and medics all at the same time—the best of both worlds. I miss those times. None of it would have been possible without the support of all crew members.
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