I understand that both fire/rescue and ambulances are dispatched when a medical emergency is called in to reduce response time. However, when an ambulance and a fire/resuce truck are both within a minute or two of the scene, why send both? Okay, maybe one will get stuck in traffic. Then why is it that when both arrive at the scene, the fire/rescue truck stays until the ambulance departs with a patient? If the fire/rescue EMTs arrive and see that the paramedics from the ambulance have everything under control and there’s no fire, why do they stick around? Why not go back to the station right away in case another emergency arises? Does anyone know why the more poorly equipped fire-fighters need to stay on scene? I’ve seen this on several occasions living in a neighborhood with many elderly residents.
I live in a rural area but I imagine that urban areas have some of the same problems. As a former EMT, we always welcomed any assistance we could muster. It’s hard enough to try and devote your attention to the patient(s) and their care without having to worry about everything else potentially going on around you, traffic, worried family members/friends, help loading patients or whatever else may come up.
Also, the firefighters are the guys with the Jaws of Life and the toolbox and the axes and the boltcutters, in case the paramedics discover that someone needs to be cut loose or dug out, or that a door needs to be taken off its hinges or knocked down.
Firefighters don’t only put out fires. 
…that’s why they’re known as “Fire and Rescue”.
yeah yeah silly Goose.
However, when they discover those tools aren’t needed, they still remain - that was my question. You’re unlikely to need the jaws of life when grandma is having an asthma attack in a 4th floor walkup. I think bare’s post provides a reasonable answer. They stay on scene in the event that things go from bad to worse. Plus, I’m sure it’s nice to get out of the station every now and then and run the red lights. 
1st Rule of EMS: For every floor above the 2nd, add 75lbs per floor per patient. Or, only big people live on the 4th floor.
In the case of grandma having an asthma attack in the 4th floor walkup, grandma’s getting herself carried downstairs in a stair chair. Carrying someone 1 floor can be a task, 4 floors is a downright nightmare. More manpower for that is a great thing.
Also, a normal ambulance (around here, at least) is staffed with 2 EMTs. For a paramedic (the highest level of EMTness) to work to his/her full capacity, there have to be 2 medics there. Thats both people on the truck, so someone else has to drive. Thus, the engine company comes in handy…have a firefighter drive (there are some requirements for that, I won’t bore you with them). If its a cardiac arrest, toss 2 more of the firefighters in the back of the rescue to do CPR while the medics do their thing. If the fire department and the EMTs get along (which they sometimes don’t), having the engine company on scene is a big help.
Many times, if the rescue has things under control, they’ll send the engine back. But, like you said, we just like to play with the red lights and make lots of noise
If part of the squad doesn’t appear needed, they’ll inform the dispatcher of that fact, and then wait around. That way, they’re on the scene if the paramedics do need help, but they can also be sent on any other calls that come up. They don’t need to start every run from the station.
Often, they aren’t needed. However, hanging around an emergency is more interesting than hanging around the station. If they went back there, they’d have to polish truck chrome or something like that.
Another point: some places, a response team is set at a certain number of members by law. I don’t know why, really. I just know that here in Seattle, we recently had a reshuffle of all the stations because the state decided that every run needed 5 people on it. That meant that there always would be two trucks, so they had to put even numbers of vehicles in each station. This resulted in the closure of a couple of stations, since they didn’t have the equipment and personnel to staff them all (when it had worked fine before that rule, IMHO).
Yet another reason comes to mind after reading the other responses and I know there will be lots of agreement from the others… How many times a week are you dispatched to an incident called in by a passerby or a cell call only to find as first responder an unholy mess that no one anticipated. The stories alone would make a neat thread if one of you were inclined to start one.
[self hijack]
Funny you should mention that bare. On my way home the other night on a major interstate highway, I caught a glimpse of a 3-car wreck ahead. About a hundred feet before the accident were several ducklings peering out of the underbrush at the curious sight ahead. When they started wandering into traffic, I called the state police from my mobile phone to warn them that the ducklings were about to cause an even bigger headache and perhaps they might want to send that trooper back down the road a bit to shoo the critters away. Thinking I had done my good deed for the day, I travelled on my merry way only to hear on the radio about a second multi-vehicle accident in the same place on the other side of the highway. What a mess! Oops!
[/self hijack]
Originally posted by Saltire:
Its not just a state law, its federal. Under the OSHA respirator regulations (Title 29 CFR,1910.134), there is a concept called “Two-in/Two-out.” This rule says (roughly) that fire departments cannot begin interior firefighting activities unless there are 2 firefighters to enter (since you have to work with a buddy), and 2 more firefighters, equally trained and equipped, standing by outside to rescue them if something goes wrong. In addition to this, you also have to have someone to run the pump on the engine (2+2+1=5). In addition to these 5 firefighters, you also have to have an incident commander (guy in charge) and a safety officer. In most cases, at the beginning of an incident, this is a district chief (or battalion/division chief, depending on where you’re from) acting in both roles at once.
This rule does not preclude firefighters from initiating a rescue when it is reasonable that someone is still inside (the actual language isn’t “reasonable”, but it sounds like “don’t do it if you’re not pretty damn sure someones still inside”).
I’m not personally familar how Seattle FD operates, but sending 5 firefighters at the same time, from the same station, almost assures that you’re going to have your required 5 firefighters there at the same time. Otherwise, you’ve got 2 or 3 guys standing in the front yard with a hose in their hand fighting the fire from outside. Thats a bad way to go about doing things. Most fire departments had to increase their response to incidents to meet this standard. Others increased staffing-per-truck to increase it (5 firefighters per piece is the most efficient, but its also frowned upon by city hall). Still others didn’t do anything. Thats just fine, but if/when something bad happens, they’ll end up paying for it in the end.
I was taught that the first Rule was: All bleeding eventually stops. 
But amen to yours. Yup aunt ethel had an asthma attack again, the sad part is that alot of these people are regulars too. So you know every second of the way you are going to have to carry a 450lb person down 3 flights of stairs. [insert back spasm here] Oh and of course the gurney wont make one of the corners either.
Where I work it gets even more hetic
if there is a medical call that requires a full emergent response, you are going to get 3 emergency vehicles at your door…resulting in atleast 9 responders being present at the scene. Here is why
The fire department responds with both the engine and a rescue for all “Delta” (IE, really sick people) calls. This is because they need to have enough hands to run the entire call themselves. The fire department is also responsible for having a unit on scene in less than 6 minutes.
However, the fire department in my city does not transport. That duty falls to a privately run ambulance company. That unit has two people on board. This unit often arrives at the same time, or shortly after the responding fire fighters. This unit is supposed to arrive with in 10 minutes to provide transport.
This equates to a lot of people, but here is the goal
- have first responders on scene within 5-6 minutes
- to have ALS care on scene within 5-6 minutes
- to hvae ALS level transport on scene within 10 minutes
This frees up the responding firefighters to stay in their district instead of transporting patients…
Beside, I’d rather tell people to go back home than to keep calling for more help
I am a Fire Captain and Paramedic 24 years experience total.
My department (75 members0 has SOP’s (Standard Operating Procedures that direct almost everything that you do.
We respond a rescue (2 man crew) and engine (2 man crew) to every rescue call except simple assaults. We need the additional manpower to set up IV’s, Hook up ECG. and record the vitals and other pertinent history. Then when you move the pt it usually takes three people to lift them to ensure that no one injures their back.
If the Pt is considered a “TRAUMA ALERT” then three people are required to rinde to the hospital with the pt. I hope this answers your question.
In many modern Fire-Rescue departments the personnel are cross-trained as firefighters and EMT/Paramedics. The rescue trucks and engines belong to the same department and are quartered in the same stations. In my dept. it’s not uncommon to see an experienced Paramedic driving the engine, with 2-3 medics riding rescue.
I usually ride the engine, and yes, we do tend to hang around certain scenes. It helps to have a lot of trained guys around in case the situation suddenly heads south.
Hey, drachillix, why do you think you have the Reeves, man??? I LOVE that thing. Easier to handle on stairs and tight areas, nice thick leather handles- the firefighters love em. Also handy for immobilizing a patient who is a danger to themselves or your crew. Stair chair, sure if they are able to sit- but then you’re stuck with two people carrying the 425 lb. patient down four flights. At least you have a few firefighters there to share the flights
Where I learned it, Rule # 1 is- Safety of your Crew FIRST. Everything flows from that Rule.
As for the firefighters responding, the O.P.? Keep this in mind- the posters here have already made it clear that more hands are better. Everyone responding, be they fire or EMS or a mix thereof are WEARING radios, in addition to the mounted units in the vehicles. Better to have extra people on scene that you don’t need than not enough. If a fire call hits and there is a truck with you and you’ve got the medical call under control, they can be toned out from the street as easily as their bay. Sometimes ya get lucky that way, and are on the right side of town to boot.
I ride with both a volly corps, and a paid company. The volly ( volunteer ) corps sends one EMT and one driver minimum. We can request fire dispatch at our discretion. For MVA’s and certain other calls, it’s protocol and they’re dispatched regardless. If we need ALS, we call in and ask for it- protocols also provide for simultaneous dispatch for the usual ALS situations. We transport with an ALS Paramedic on our bus.
With the paid company, it’s one EMT and one Paramedic per ambulance. Dispatch will send multiple crews when needed, such as CPR, MVA with multiple casualties, etc.
Ride Safe, love this thread
Cartooniverse, NYS EMT