This morning we woke to lights flashing. A fire department ambulance had been called for the lady 2 doors down, who had been ill for some time. Also in the residential street - engine idling and lights flashing - was a big “hook and ladder” firetruck.
I’ve seen this before, that FD ambulances almost always seem to be accompanied by firetrucks. Anyone know why?
My wife thought it had something to do with the truck being able to generate power if needed, tho I don’t know what would need such power generation.
In my experience, emergency calls for medical assistance might have a fire truck closer at hand than an ambulance. Since most firefighters are experienced in medical assistance, they got there first.
Where we are the paramedics and the fire trucks are both dispatched out of the same station. So samclem’s experience wouldn’t apply around here.
I live in a mid-rise condo full of elderly. I’m on the board of our condo and as such get notified of these events as they’re happening. Our building has plenty of experience with this scenario.
The fire truck shows up to provide more manpower and more equipment. If the door needs to be broken down, or they need to move some cars to get access to the problem all those goons & gear & horsepower come in handy. They also do mild crowd control for the Lookie Lous. Although they’ll be quick to call for law enforcement if the crowd gets unruly or too big for some reason.
Our local department usually sends a pumper truck, not a ladder truck. But I suspect that’s more a matter of what vehicles happen to be stationed at our nearest stations.
There are three reasons to have a fire truck response to an emergency medical situation. The first is that there is much more demand on ambulances than fire service, and therefore if an ambulance is not available or nearby fire crews can provide basic first responder support, or assist the ambulance crew in the case of a more severe case with higher workload than an ambulance crew of two can support. (Most fire crews are trained to Medical First Responder certification, and in many cities crews are trained Emergency Medical Technician-Basic.) The second is that extraction or egress support may be needed in the case that the injured party is inside of a locked or damaged building or car; ambulance EMTs are generally not equipped or trained for extraction operations. The third is that an emergency situation may often be more significant than the first impression given to the dispatcher; for instance, a natural/propane gas leak or CO[SUB]2[/SUB] buildup may cause one person to pass out, followed by multiple people passing out or fire, hence the need for additional support. Fire crews can also perform traffic and crowd control if there is no immediate police response. Basically, too much support is far better than not enough, and fire crews are typically not occupied with fighting fires, so it makes sense to have them support medical first responders.
It should be noted that prior to the 1960s, ambulance services were generally either run through the municipal police department (hence why you see references to a “police surgeon” in old detective novels) or a separate municipal service, were run by the hospital, or were private contractors (often the local funeral home) and were often as not staffed by either an emergency room intern or no one at all except for a driver and non-medically trained assistant, and many seriously injured patients died en route before they could receive initial diagnosis or care, especially cardiac and traumatic injuries that were potentially survivable. After WWII and the Korean War, the value of emergency first response in the reduction of traumatic life-threatening injuries was evidence, and the utility of dedicated emergency medical response became evident, though it wasn’t until the 1970s that ambulances staffed by paramedics with advanced EMT training were common, following both requirements of the National Traffic and Motor Vehicle Safety Act and subsequent legislation, and popular portrayal of such services in television (Rescue 8, Emergency!, and CHiPs). Prior to this, fire and medical services were dispatched separately, with the latter often lagging the former and much later on scene, substantially delaying medical response.
I wonder if its kind of an ego thing or just wanting to keep crews on their toes. A kind of “we want to be there too so they dont get all the credit” type of thing. Heck maybe they are all just bored since our area gets very few actual fires.
Seriously.
I remember once I had my kids at a public pool and this kid (about age 10) who was with a day care group, accidentally fell off the side of the diving board, clunking his head good as he went down and over into the water. Luckily the lifeguard was right there and pulled him out fast. He was bleeding and partially knocked out but they quickly had him on a stretcher and were rendering aid.
Well then you’d think the world had come to an end. Not only an ambulance showed up but 2 firetrucks, a couple of police cars, and the head guys from the city parks department (who were in charge of the pool) in their vehicles. Probably 20 people or more all around this kid and the pool area and I’d swear most were just trying to look important. Heck at most all the kid needed was to be taken to an ER (which was less than a mile away).
In Houston, not every fire station had ambulances. Around 1987 they started dispatching pumpers along with ambulances for more serious type calls, specifically heart attacks, strokes, gsw’s, or the “person not breathing” type calls. Studies found that (at the time) pumpers had a 3 to 5 minute response time while ambulances had about a 7-10 minute response time. At that time the “save rate” increased considerably. That practice continues.
Stranger is partially right in his response. There is every combination & permutation of EMS out there:
[ul]
[li]FD-based, [/li][li]PD-based, [/li][li]Separate, hospital-based EMS, [/li][li]Separate BLS (Basic Life Support) EMS with hospital-based paramedics providing ALS (Advanced Life Support) care on appropriate calls. [/li][li]Separate BLS EMS, [/li][li]Separate ALS EMS[/li][/ul]
There are even more dispatch protocols, frequently based upon the nature or location of the call but sometimes based on unit availability or other factors.
FD is most often dispatched with EMS when EMS is FD-based. If the closest EMS isn’t available or their station is further than FD, fire apparatus is frequently dispatched as many/most firefighters are also First Responders or EMTs. By getting there first, they can start medical treatment before the ambulance arrives. This is the primary reason to dispatch FD along with EMS.
Again it varies with jurisdiction & company but in PA ambulances are required to carry basic forced entry/extrication tools for licensure. To make entry into a house we (EMS) can handle this w/o the need for FD. Everywhere I’ve run, PD comes out to almost every non-institution (ie. nursing home) call. On the one or two times it was necessary, they made entry for us.
Unless there is reason to suspect it (air quality alarm {CO detector} or multiple people passed out) FD typically doesn’t take there “sniffer” equipment in. Similarly with an auto accident, the FD may be used for scene safety, is it’s better to an an oncoming car hit a fire truck than first responders; however, a fire engine is typically not the rescue truck with the specialized equipment like the “jaws of life”
With one exception of a car with the front wheels over the edge of a quarry (& that was a rescue, so FD was dispatched for that part of it), I have never used or remember hearing about a ladder used on an EMS call. BTW, pulling someone with smoke inhalation out of a burning building is considered a fire call with EMS supporting FD so not germaine to this question.
You have got to be fucking kidding with this response. The posts above address to the question in a way that that lays out in detail the reasons that additional support and capability is desired in a notional medical response, backed up by citing actual fire department webpages and professional expertise on the topic. You throw out some contempuous and borderline obloqical speculation pulled directly out of your ass. Are you under the impression that you have somehow provided any kind of value whatsoever?
Don’t dismiss it so readily. Sending out full size pumper/ladder trucks is not standard operating procedure in most of the world. There really does seem to be a bit of a “boys and their toys” mentality with fire equipment, and as others have said, they have little else to do. Fully 2/3 of fire department calls are for medical emergencies and only single-digit percentages are for fires, according to the NFPA.
The thing is, these calls could just as easily be answered with smaller more mobile pickup trucks or vans. Sending out full-size equipment on medical calls is actually a self-fulfilling hazard in that we need wide smooth high-speed roads to get our fire trucks to all the car crashes and other incidents caused by our wide smooth high-speed roads. Fire marshals consider accessibility for their biggest trucks to be sacrosanct, which leads to neighborhood design that’s more dangerous for everyone, motorist, cyclist, pedestrian, and resident alike.
I recently read a book, “A Thousand Naked Strangers” about an EMT in the bad old days of Atlanta, and the book mentions using fire trucks for getting through high traffic areas, since the fast moving truck the size of a small house with a siren multiple times louder than the ambulance’s can make a huge difference in response time at certain times of the day. Probably not pertinent to the OP, and an anecdote from over 20 years ago, but I found that interesting.
As a supervisor in a 9-1-1 center I do have cause to send of fire units on medical calls on occasion. It is not SOP that the fire service goes to all (or even most) calls in out jurisdiction.
The top reason the fire service is sent is assistance lifting a patient. That can include carrying a patient up or down stairs and the like. Others have already touched on this point.
But the other major form of assistance the fire service provides is providing a driver who is already familiar with driving an emergency response vehicle running lights and sirens. Most ambulances are staffed with only two crew members. For calls involving CPR, major trauma, childbirth in progress, or similarly major events our EMS crews want to have both ambulance crew members in the back working on the patient. So either they wait for another ambulance arrives on scene and we tie up two ambulances for the duration of the call or just have a firefighter drive the ambulance.
I don’t know about the fire dept webpages and other cites you provided, but I can report what our local fire chief told a group of homeowners about 10 years ago. He said that the reasons for sending out fire trucks to non-fire calls are two: a) there are more fire stations than ambulance stations and the trucks get to the emergency faster, and b) it brings out the trucks more frequently and keeps up the public awareness of the importance of the fire department when tax voting time rolls around. He said the latter was an increasing common reason in many areas of the country as the numbers of fires have dropped over the last several decades.
It made perfect sense to the audience who all are in favor of a strong well-funded fire department. (around here our fire departments are funded via a property tax which has to be renewed by the voters every 10 years.)
purplehearingaid’s link pretty much explains it. by me, the “fire truck” which gets sent out isn’t an actual pumper or ladder truck, but a “Paramedic Engine.” The people in the ambulance are usually only certified “EMT-Basic,” with a limited number of procedures they can do on-site. The Paramedic Engine is usually staffed with people certified to do more procedures on-site. in the past my dad had a string of severe insulin shock incidents while his Drs. were constantly screwing with his insulin regimen. a few necessitated a 911 call, and all times both the Paramedic Engine and an ambulance arrived. the people in the paramedic engine were equipped to insert IVs and the like, and the ambulance was there in case the on-site procedures didn’t work.
I think there is some truth to this, at least in some instances. You ever witness a medical emergency in a hospital? A couple dozen nurses, doctors, respiratory therapists, nurse managers, hospital administrators, security personnel, and gift shop clerks come out of the woodwork. Sure, some are essential, but they keep showing up and lollygagging even after the situation is clearly in hand.
One of the problems with providing a generic answer to the question is that policies and the reasons for them vary greatly from one jurisdiction to another (for example, how well firefighters are trained and equipped for specific kinds of medical emergencies, the response times of ambulances vs. fire trucks, etc.).
One thing I will note from my perspective where I live is that it’s essentially impossible to call an ambulance without an accompanying fire truck – believe me, I’ve tried, when it wasn’t a true emergency but the person was not ambulatory enough to make it to hospital on their own. It can’t be done. A screaming fire truck always arrives.
I had a chat about this once with a paramedic, who undoubtedly had his own axe to grind, but what became clear is that a turf war has been brewing between paramedics’ and firefighters’ unions and it seems that it’s been going on for years. Part of the basis for it is that actual fire calls as a percentage of firefighter response calls have been drastically dropping off over the decades, and today the vast majority are medical calls, at least around here.
So while I have no doubt that there were, and no doubt continue to be, good and valid reasons for firefighter response to medical calls, in many cases there may also be self-interested strategic reasons being promoted by the respective unions which is basically a battle for budgets.
.jpg)
“Lookie Lou?”
op. cit.