Fire Dept responds to medical calls

Another incident (two actually, both basically the same) from some time back: For a while my 90+ mother still lived at home, the only other person living there was my eldest brother, nearly 70 at the time. My mother was a heavy woman, nearing 200 pounds, and my brother was rather frail and had had back trouble for many years.

Two times my mother fell. Not down the stairs or anything bad, just tripped on a rug once and purely lost her balance the other time and ended up sprawled on the floor. No real damage either time, no broken bones or whacked heads or anything worse than a few bruises. The thing is, between her weight and bad arthritis in her knees and ankles there was simply no way for her to get back up off the floor with only my brother’s help.

Both times he called 911, both times the fire engine arrived first. According to protocol all they were supposed to do until the ambulance arrived (given there was no fire or other immediately urgent care needed) was provide reassurance or fetch a blanket if she was cold, things like that. Once the med people cleared her, the fire department guys got her safely back on her feet and then back into a chair in less than a minute.

My brother thanked them all, apologizing over and over for calling them out for what didn’t seem like what a fire department should have to do, but they shrugged it off. One guy said assisting with elderly and/or overweight people who’d fallen made up at least 50% of all the times he’d ever been called out in his career. Nobody seemed the least bothered or upset.

So, yes, it seems a waste of gas and a hundred thousand dollar fire engine and (I think it was) four guy’s time, but on the other hand: 1) they were already being paid to sit around and wait for something to do and 2) how else could that problem have been dealt with? Was my brother supposed to leave my mother lying there, and run up and down the street hunting for a handful of strong fit but untrained guys to lend a hand? Put the call out to relatives to come help, from at a minimum of 200 miles away?

It may seem weird, but I guess the system mostly works.

Here, in my County, to be a Firefighter, you must also be an EMT. If you want to be an EMT for the County, you must also be a Firefighter. So, you are dual-hatted. So, in practice, Firefighters show up to medical calls, and EMTs are priming the pumps and hauling lines to put out your house fire. Specific skills are employed based on the particulars of the response.

I know half of the Fire Department.

I wanted to point this out - in NYC, many firefighters ( and police officers ) have some level of first responder medical training and it is not at all uncommon for fire companies with trained personnel to be sent to certain medical calls such as respiratory and cardiac arrests , choking and others. One of the reasons for this is speed - NYC has over 200 fire stations and something like 40 EMS stations. Much of the time a fire truck will get there first which is what you want in a life-threatening situation - they can start CPR, perform the Heimlich maneuver, etc. A response by a fire truck is less useful when an ambulance is being called because a person has fallen down the stairs and may have injured their leg.

There’s a side benefit of visibility. Most of the time I (and probably most people) see a fire truck, it’s on the road. It must be doing something important! That helps with public opinion which counts for something.

Just today I had to wait exiting the parking lot where I’d been shopping to let two fire engines, a battalion chief SUV, an ambulance, and a cop car pass by. Following along in their wake, about a quarter mile back, I saw another engine coming from the other direction. It made a left turn at a minor intersection before the parade I was following got there, the small vehicles turned down the same street, and the two engines I was following stopped on the main road they and I were using.

The two crews were climbing out of their engines when I went by but were not making any motions about hooking up a hydrant or laying hose and there was no smoke in any event. I don’t know how far the equipment went down the minor street – I didn’t want to be rubbernecking passing through the area. Another half mile and a second cop car went by, code 3.

This is common. If the person needs CPR than starting it early is helpful. I think fire crews can get people out of locked cars and do basic things like vitals, control traffic, scene assessment. Perhaps some have some basic medical skills too. I knew a police officer who claimed the fire department were almost always there first, and he thought financial reasons were involved - but I do not know if this is true.

Besides the lift assist, traffic control or whatever. The fire department really knows how to knock down doors to get in. I’m sure much better than the police.

In Québec, it’s quite usual for the firefighters (“first responders”) to arrive on the scene way before the ambulance does. They have EMT training and equipment to at least stabilise the patient in most cases.

On the question of moving a large pump truck for a EMS call: a friend of mine trained to be a firefighter, did his internships and all, but now works in a different field. When he was interning, he said it was standard protocol for the on-duty team to use the pump truck to go shopping at the supermarket (for the station’s meals), so that if a fire or EMS call came in they wouldn’t have to rush back to the station in a Corolla and then get the truck ready. He said they often had to explain this to the public at the supermarket. I’m not saying I agree, but it’s the justification that they used.

This is all very location dependent.

We have 100% volunteer fire. No one mans the station 24 hours a day. They get sent only to fire calls. Most of the time they arrive in time to save the foundation.

BLS is contracted to a private company. They are required to maintain a certain number of units in town. We used to have 100% volunteer first aid squads but manning became more and more difficult.

ALS is dispatched through a central network covering multiple towns.

Police are sent to every medical call. We usually get there first. We have oxygen and defibrillators and a full aid kit.

Fire may be called out for a lift assist if a bariatic unit isn’t available from central dispatch.

My wife had a medical thing (it turned out not to be an emergency, just extremely and deceptively bloody) and we called 911. The fire department arrived first, probably about five minutes before the EMTs. This was in Montreal.

And, when I was a teenager in the '70s, long before 911, I was taking various lifesaving and lifeguarding courses and our instructors told us to dial 0 and ask for the fire dept as they had a mandate to arrive within three minutes. This was in Ottawa, Ontario.

Typical pumpers cost about half a million, and a well-equipped ladder truck can easily cost over a million. Even a run-of-the-mill city bus costs half a million dollars.

I believe the best answer is that fire trucks usually can get to the emergency faster and golden minutes are important. A fire chief told me a couple of years ago that fires in America are becoming less and less frequent. The US is actually approaching western Europe. Imagine that. In order to keep the public engaged (and paying taxes for fire departments), responding to medical emergencies keep the department in the public eye. That is important since they have to be available even for rare events. Besides, it is part of the continual push down the chain of medical care. Routine medicine that used to be provided by doctors are now provided by PAs. Care that used to be in dedicated facilities are now provided at home. EMTs are now diagnosing and treating some medical conditions without sending the patient to a doctor. Emergency care that used to be provided by EMTs are being provided by fire department personnel. There are already apps for the next step in this evolution.

At least around here, they are the only ones allowed to knock down doors to assist. The police can’t unless they have probable cause about a crime. The fire department can enter a building to check on the health of someone. So wellness checks require the fire department.

In most of metro Vancouver, if you call 911 with a medical emergency, it is likely both an ambulance and a fire truck will be dispatched. One reason for this is fire stations are much more widely dispersed than ambulance stations and fire trucks, with people with some emergency training, often arrive several minutes before the ambulance. Since the ambulance stations are more centralized, they also cover a larger area, which means they could be at the far end of their jurisdiction and more likely to be stuck in traffic, than the fire trucks.

Where is around here? Because legally police can absolutely kick in a door if there are exigent circumstances. The police get called to do welfare checks because the fire department does not have the ability to investigate where someone is. If the police show up and find reason to believe someone is in immediate need they do have the legal right to go in. I have both kicked in doors to assist people immediately and I have asked for fire to be dispatched because the need was not as immediate and they have better equipment.

This is what I have been told by neighbors who called the police to conduct a welfare check on a missing neighbor (the news wasn’t good). The police showed up promptly but when no-one came to the door, they called the fire department. The told the neighbors that they couldn’t enter the home unless there was suspicion of a crime. They may have been simplifying it for the concerned neighbors, but that is what they said. That said, the one time I ever called the police for a wellness check, the police entered the home themselves (this was more than 15 years ago), but even then the local sheriff would not enter the home until an state police officer showed up to assist. Next time I can I will ask the sheriff office what the current policy is.

In my area (Topeka, Kansas), the firefighters are mostly all EMTs (you have to be EMT-certified or currently enrolled to be hired). The fire department does not have any ambulances or specialized paramedic units; that’s all provided by a private company under contract to the county. The contract divides the county into zones, and the ambulance company is required to arrive at a call within a certain time period (9 to 15 minutes, depending on zone) or pay a penalty. (They tend to show up on time about 85% of the time.) There are no fixed ambulance stations, other than the central garage, so when not on call you’ll find them hanging out at various convenience stores or other parking lots.

Meanwhile, the fire department works from twelve fire stations around town and averages around four and a half minutes response time. They are dispatched to all 911 medical calls.

I was a volunteer fire fighter and EMT, in my county, in Virginia fire and rescue were colocated and different days I was assigned to fire, or rescue. Usually, an engine company was dispatched with an ambulance to help with manpower, traffic control, carrying a stretcher down a flight of stairs, etc.

I live in another place where ambulances are much slower than fire trucks to arrive at an emergency. The fire trucks always have trained EMT staff so it’s fine if they arrive first.

In fact just now our local ambulance company announced that they have zero available ambulances in the whole county. They are all already in use. So it’s a good thing fire trucks get sent to emergencies.

That’s overkill and sounds like padding stats. The ammount of medical calls that require an engine company have to be well under 5%. We call out fire for assistance a dozen times a year. Maybe. And we can easily have a dozen medical calls a day.