Richard Marinucci

Some estimates are that 97 percent of the 200 largest cities in America use the fire service to provide EMS. One would be hard-pressed to find many organizations that don't have some role in the delivery of medical care. The result of this has been the fire service's significant transformation in many different ways. Obviously, responses have increased, and the public's expectations have changed. Customer service and bedside manner are very important, and dealing directly with other people is something that all fire-based EMS personnel must do. Think about it. When responding to a fire, most firefighters don't ever have to deal with the public. Yet for an EMS call, there is personal contact every time. Personalities and relationships with the citizens have become more important.

The Fire Service and Other Industries

Prior to EMS, the fire service really had no connection to other professions in the way that EMS aligns itself with others in the medical profession. Obviously there is a direct tie-in to emergency rooms, but there is much more to it than that. Depending on the level of service, whether as a medical first responder or paramedics who transport patients, there is a certain level of performance expected. Further, licensure, not just certification, along with continuing education is required. Alignment with the medical profession mandates the types of requirements to continue involvement not previously seen in the fire service.

There is much the fire service can learn from others in the health care industry. It behooves organizations to look at the broad picture and view various perspectives and options for improving the service. There are clear examples of how this can work by enhancing services. For example, paramedics have always used three-lead EKG technology. Hospital and office settings used much more sophisticated 12-lead devices. Eventually many EMS providers transitioned to the EKG that offers more diagnostic information.

Relationships

Organizations and individuals need to pay attention to medical advances that may someday reach the fire service for field use. One way to do this is to establish relationships with medical professionals and facilities. Build these relationships through regular contacts and by demonstrating a sincere interest in quality care. They can be with professionals in emergency rooms, operating rooms, critical care units, and perhaps outpatient clinics. Fire service organizations can press the issue by extending an invite to other health care professionals to ride along to see how they deliver medicine outside controlled environments. Mutual understanding and respect goes a long way and only improves through interaction.

Marketing

Another area to consider when looking for trends and ideas is marketing. There is so much to learn from others in the profession regarding service delivery. You can listen to advertisements on the radio or television and get a good idea of what professional marketers deem important, relevant, and the real selling points. If you listen, you will hear them tout their professional staff, their commitment to quality service, their use of the latest technology, and the speed with which you will likely receive service. They will use cases, without revealing names or compromising identities, to demonstrate positive outcomes. Occasionally, a patient will act as a spokesperson. These particulars must be effecti

By Alan M. Petrillo

Manufacturers say that customizing ambulances for customer needs has become so commonplace that it is almost expected in some measure for every vehicle they build.

Staying Within Reach

David Cole, vice president of sales and marketing for Horton Emergency Vehicles, says that custom manufacturing an ambulance is driven chiefly by customer experience and needs. "We've been making high-quality ambulances for 47 years and custom engineering them in a safe and reliable manner," Cole says. "Our focus has been on safety, so we offer a crash barrier design with a side entry door near the front of the module that moves equipment inside the box closer to the patient. It also allows the medics to stay seated and belted but still be able to reach equipment from a safe position."

1 Horton Emergency Vehicles built a custom ambulance on an International 4300 chassis for the Ocean City (MD) Fire Department that includes the Horton Occupant Protection System, a crash barrier safety configuration, a heated cabinet at the head of the bench, and rear- and side-view cameras. (Photo courtesy of Horton Emergency Vehicles.)

Horton has put a standard safety system in place for its ambulances, Cole points out. "In terms of occupant protection, we have a series of three-point seat belts, extra padding and cushioning material in various head and other strike zones, and tubular structure air bags and air curtains to provide a safer environment in the back of the ambulance," he says. "This is standard on all our ambulances, providing the design meets the requirements for installing the occupant protection system. Our goal is to build the most custom ambulance possible that still meets the design and has safety in mind."

Randy Barr, sales manager for American Emergency Vehicles (AEV), says his company has been designing the interiors of ambulances so the medics can easily reach equipment and cabinets and still stay buckled in their seats. "In the past year, we've seen a strong demand for customization in the backs of ambulances," he says, "and we have been meeting those requests."

2 The University Heights (OH) Fire Department had Horton Emergency Vehicles customize its ambulance with a bench-side crash barrier, a five-point sliding attendant seat, a dual-position CPR seat, dual electrical control panels, and a slide-out oxygen bottle bracket mount. (Photo courtesy of Horton Emergency Vehicles.)

Chassis Platforms

Barr notes that AEV "has seen a huge increase in the use of Ford

Richard Marinucci

Those that make the right purchases and keep the vehicles on the road can provide better services to their communities. There are many ways to gain insight into fleet management, but one of the most beneficial is to visit with those who manufacture, sell, and maintain apparatus. This is not to discount other research methods but more to emphasize the value in learning from those who are most knowledgeable and often most passionate.

There is an opportunity for those with apparatus responsibilities to attend a unique event that can only help when buying or setting up maintenance of vehicles, and it is the 27th Annual Fire Department Safety Officers Association Apparatus Specification and Safety Symposium. This conference is held in conjunction with the Fire Apparatus Manufacturers' Association (FAMA) and brings together practitioners, manufacturers, suppliers, technicians, and fire professionals in a format that provides valuable insight and information to everyone in attendance. The Symposium is scheduled for January 18-20, 2015, in Buena Vista, Florida, just outside of Orlando. More specific information can be found at www.fdsoa.org.

The upcoming symposium promises to be an outstanding event, and Fire Apparatus & Emergency Equipment is a partner in delivering this critical information to the attendees. An informed consumer is more likely to be successful than one who doesn't possess enough information. Learning from those with specific knowledge about the various components of apparatus in workshops and having the opportunity to "pick their brains" in a one-on-one setting is not only a great opportunity to stay current, but it can also prevent costly mistakes. What you learn during the formal sessions or informal networking between the workshops could make a big difference relative to your apparatus needs.

Every department needs apparatus that is cost-effective to purchase and maintain. It is not just about the price but also reliability. Fire trucks that are not on the road cannot help citizens. There is no doubt that price is a major consideration, but reliability has to be a significant factor. In the government world, where "low bid" is the norm regarding purchasing, departments must be as prepared as possible to acquire the best apparatus that provide reliability and confidence within the financial constraints of the community. Knowledge, even relatively minor bits of information, leads to better decision making. Trucks that are purchased and stay in service with the right routine maintenance should be everyone's goal.

The program and visits with vendors are what make this event unique and beneficial. Gordon Graham will lead off the symposium with his perspective on risk management relative to issues affecting apparatus. He is one of the most widely known and respected presenters in the public safety arena. Those who have heard him speak leave with tools that will help throughout their careers.

The remainder of the program includes speakers from the fire service and vendor companies who have a wealth of knowledge on the topics they will present. Attendees will have the chance to hear about virtually every aspect of fire apparatus. Included will be presentations on components, maintenance, standards, and specification writing. Attendees will also get to attend a session on the political side of apparatus purchasing and maintenance.

Throughout the conference, opportunities will exist to spend quality time during breaks to talk directly to vendors and manufacturers' representatives regarding their products. Those who know do not underestimate the value of these interactions. It is here where attendees not

By David Hartman

Population growth and changes in what fire departments are now required to do have prompted many jurisdictions to start planning for new fire stations. My involvement in building the Fontaine Fire Station and Training Center in Charlottesville, Virginia, as well as being a speaker at the 2014 F.I.E.R.O Fire Station Design Symposium has led many people to ask me for advice on building fire stations. As the owner's representative (OR) for this project, I logged more than 7,000 hours. The Fontaine Fire Station and Training Center opened in February 2014 and continues to garner national attention and awards. More importantly, it has positively transformed its community and the Charlottesville Fire Department (CFD) and serves as a learning opportunity nationally.

1 Charlottesville (VA) Fire Department (CFD) Engine Company 10 is ready for response in its new home. All utility support comes from overhead for all vehicles. (Photos by Joe Rice.)

Background

The Fontaine Fire Station and Training Center opened in 2014. It was the first fire station built in Charlottesville, Virginia, in 53 years. Charlottesville is 10.3 square miles with a residential population of 44,349. The city is home to the University of Virginia, many startup national businesses, and the Miller Center on Public Policy. The department's headquarters opened in 1959, and a second smaller fire station opened in 1961. In 1993, the CFD opened up a temporary fire station to respond to growth. This temporary station was a 700-gross-square-foot (gsf) mobile home supporting three firefighters and housing one engine company. The need for building a new station was evident as early as 2001. In addition to population growth, the CFD's mission has evolved from a fire department built to primarily respond to fires into today's public safety agency that I refer to as an "all-hazards first response and mitigation organization."

2 This overhead view shows the front side of the station. From left to right are Engine 10, Engine 1 visiting, Tower 10, and HazMat 1 with its trailer.

In addition to responding to fires, many of today's fire departments respond to vehicle accidents, hazmat incidents, and technical and specialized rescues; support large-scale special events; prepare for mass-causality incidents; accommodate expanded community fire education programs; lead arson investigations; perform fire and life safety code reviews; perform building inspections; accommodate Bureau of Alcohol, Tobacco, Firearms, and Explosives accelerant detection canine units; become basic life support (BLS) and advanced life support (ALS) nontransport first responders or BLS and ALS transport providers; provide for massive amounts of documentation for Insurance Services Office (ISO) and accreditation; make facilities handicap-accessible for everyone; respond to