US Medical Capabilities

[OscarTango]

@Gatts2

What medical capabilities do your guys on the engines have? Versus houses that run a dedicated ambulance?

The EMT title is a bit ambiguous and I know "paramedic" doesn't mean the same in the states as it does here.

Edited June 10, 2018 by Carl
Split to form a new "On Topic" thread.

[Gatts2]

All suppression apparatus carry EMS equipment that will allow for treatment up to Maryland ALS (Advanced life support) protocols. (EMT-Paramedic)

Our protocols come from our medical director. These differ from state to state. There is no national standard. 

From roughly 1998 - 2007 the BCFD required everyone joining the FD to gain their ALS licensure. After 2007 only BLS EMT- Basic (Basic life support). So it really depends on who you have riding on the wagon that particular day as to what level you can operate.

As far as dispatch goes they don’t differentiate between the two. 

[Luminoki]

When responding to an EMS call, how often will you get there before an ambulance ( if there isnt one at that firehouse already) Do you find yourselves waiting some time for back up from paramedics?

[Gatts2]

The majority of times we’ll arrive on scene before the medic does. Even if you have one that runs out of you’re firehouse the chances of them being in station when you get a run is small. 

Really the only times you see the medics in you’re firehouse are at shift change.

Wait times on EMS units vary depending on how busy the city is. Normally around 5/10 minutes. The longest I’ve been on scene for without a medic is around 1hr.  

[ChalkAndSheez]

I'm a Paramedic in the UK. The UK ambulance service is cripplingly busy, it operates on a knife edge on the brink of failure 24/7. To this day, my personal record for the oldest call I've attended was just over 11 hours old by the time I knocked on the front door.

In my own personal opinion, the fire service and ambulance service merging together here would be a disaster, because the ambulance service will grab and take advantage of any resource they can get, often abusing it. The prime example being RAF responders, or voluntary 'Community First Responders' (CFR). Slowly increasing their code-set of things they can attend, then making them wait hours for backup because they've already stopped the clock as far as targets are concerned. Expecting the CFR groups to raise their own funds to buy equipment etc, even though they're doing the ambulance service a favour.

Much as you say you only see your medics at shift change because they're out all day, the same will happen with the Fire service here if it started responding to medical calls full time. There's far too many calls and not enough resources, and the call volume increases by about 6% every year (this is the trend over the last 20 years, and shows no signs of slowing down. It's actually speeding up). The service where I was working before joining FRS was receiving approximately 5000 calls a day, I would imagine that's higher now.

I think I recall a few instances across the country during the Co-Responding trial for FRS where they ended up conveying the patient in the appliance due to such a long wait for backup. I'll try not to say much more as I don't want to scare people!

[Gatts2]

Co-Responding is definitely resource heavy. I’ll try & give a little perspective.

Baltimore City: 92 square miles, Population: 620,000

Supression: 35 Engine companies,           17 Trucks & 1 Rescue 

(These units co-respond)

EMS: 21 24hrs ALS units, 3 24hr BLS units.

12 BLS & 1 ALS, 0900-2100 Peak units. 

Even with the above we are regularly run out of EMS units.