For All You EMS Types…

I should have asked this before I wrote my snarky comment, but does “dual role” refer to the same people running EMS calls on the ambulance and running fire calls on the engine, or does it refer to two different groups both working for the Fire Department?

I should have asked this before I wrote my snarky comment, but does “dual role” refer to the same people running EMS calls on the ambulance and running fire calls on the engine, or does it refer to two different groups both working for the Fire Department?

I tried, but failed to resist, commenting here. I think you asked the wrong question AD. The question should be, what does the fire service need to do to become respected by EMS? The notion that EMS providers have to prove that they can multi task or master multiple skill is absurd. It’s what we do every day. As a third service provider for almost 30 years, my experience is that the fire service only wants EMT involvement when they see run volume dropping. Other than that, they aren’t interested. Nor, generally do they do a good job. Mr. Fixit talks about the west coast leading the way in paramedicine. Indeed, they were the among the first, but they are hardly among the best. There is a difference between training paramedics and teaching paramedics. The best systems in the country teach their medics, they don’t train them. California medics in particular are famous for being trained, not taught. Which is why their skill set is limited and seems to be getting more so as time progresses. Capo comments on successful FD/EMS mergers, but doesn’t name any. San Francisco, New York City, Louisville, Winnipeg are all mergers which have either failed or been pulled back. DC and Philadelphia FD EMS systems are frequently in the news, and not for innovative or excellent care. When Al Whitehead talks about fire EMS, he talks about jobs, run volume, higher salaries. He doesn’t talk about better patient care. The reason would seem to be that the fire service cares about run volume, not quality of care. Good fire/EMS systems are like the pot of gold at the end of the rainbow. Everyone has heard the story, but no one has actually seen one. Gary

I tried, but failed to resist, commenting here. I think you asked the wrong question AD. The question should be, what does the fire service need to do to become respected by EMS? The notion that EMS providers have to prove that they can multi task or master multiple skill is absurd. It’s what we do every day. As a third service provider for almost 30 years, my experience is that the fire service only wants EMT involvement when they see run volume dropping. Other than that, they aren’t interested. Nor, generally do they do a good job. Mr. Fixit talks about the west coast leading the way in paramedicine. Indeed, they were the among the first, but they are hardly among the best. There is a difference between training paramedics and teaching paramedics. The best systems in the country teach their medics, they don’t train them. California medics in particular are famous for being trained, not taught. Which is why their skill set is limited and seems to be getting more so as time progresses. Capo comments on successful FD/EMS mergers, but doesn’t name any. San Francisco, New York City, Louisville, Winnipeg are all mergers which have either failed or been pulled back. DC and Philadelphia FD EMS systems are frequently in the news, and not for innovative or excellent care. When Al Whitehead talks about fire EMS, he talks about jobs, run volume, higher salaries. He doesn’t talk about better patient care. The reason would seem to be that the fire service cares about run volume, not quality of care. Good fire/EMS systems are like the pot of gold at the end of the rainbow. Everyone has heard the story, but no one has actually seen one. Gary

Good Stuff. This disfunctional family that we live in could use some counseling…

Good Stuff. This disfunctional family that we live in could use some counseling…

“I should have asked this before I wrote my snarky comment, but does “dual role” refer to the same people running EMS calls on the ambulance and running fire calls on the engine, or does it refer to two different groups both working for the Fire Department?”It refers to any department that requires all of their medics to be cross trained as firefighters, and to a lesser extent, requiring all firefighters to be trained to some level of EMT -even if they’d rather never render any patient care.

“I should have asked this before I wrote my snarky comment, but does “dual role” refer to the same people running EMS calls on the ambulance and running fire calls on the engine, or does it refer to two different groups both working for the Fire Department?”It refers to any department that requires all of their medics to be cross trained as firefighters, and to a lesser extent, requiring all firefighters to be trained to some level of EMT -even if they’d rather never render any patient care.

Where I am, cross training (in this context you are refering to) means everyone at the basic rank of firefighter is both fire and paramedic certified. EMT-basic is not an option.To be really honest, around where I work in DFW, being a fireman is a defacto comment that you are also a paramedic.Cross training around here often means fire and police training such as a public safety department like DFW Airport or Highland Park.Fixit

Where I am, cross training (in this context you are refering to) means everyone at the basic rank of firefighter is both fire and paramedic certified. EMT-basic is not an option.To be really honest, around where I work in DFW, being a fireman is a defacto comment that you are also a paramedic.Cross training around here often means fire and police training such as a public safety department like DFW Airport or Highland Park.Fixit

Why would anyone want every fire fighter to be a paramedic?Where is the benefit?Our problem is that there are far too many medics not too few.

Why would anyone want every fire fighter to be a paramedic?Where is the benefit?Our problem is that there are far too many medics not too few.

Rogue Medic, you are absolutely right. Systems with fewer medics have medics with better skills. Systems with too many medics mean that the high value skills are few and far between. That means that skill competence is harder to come by. Gary

Rogue Medic, you are absolutely right. Systems with fewer medics have medics with better skills. Systems with too many medics mean that the high value skills are few and far between. That means that skill competence is harder to come by. Gary

I loved the article. The truth hurts.

I loved the article. The truth hurts.

Greetings…long time lurker, first time commenter.Trust me when I say, I’m not meaning to pick nits here. The main bit of my experience comes from a dept in a suburban (almost metro) fire dept where there are medic/FF. Granted, most medic/FF who preferred the EMS side were allowed to serve out their career on the ambulance only, with minimal experience on the fire trucks. Sadly, these were the exception and not the rule. The majority of the medics I rode with were medics (and later, EMT-I’s) simply for the faster promotion track that those in ALS in that dept got. A FF/medic (NOTE: not a medic/FF) has a greater chance of making capt in a shorter period to time than his FF/EMT brethren. Many FF see ALS (since most FF in the area are required to be at least EMT’s for the first response issue) as simply a means to greater pay and faster promotion.Capo, I’d like to respond to this comment (again, not meaning to pick nits)<>Fire personnel (in other than the Metros) already pretty much know and have accepted that the job includes EMS. The fire only jobs are far and few between. People that want to specialize in EMS have many other avenues to do only EMS…they can work in a medical facility as you do as an example.<>In my area, a FF/EMT or FF/medic can make anywhere from $45k/yr and up, depending on OT and some other considerations. That equates to about $21/hr. A thrid party, private ambulance service EMT-B makes about $7.50/hr (no counting shift differential) and a medic makes about $13/hr. Hospital based EMS workers (which in the great state of MD must be paramedic level unless you take a CNA class) make slightly more. So while EMS workers who don’t wish to train as firefighters DO have other options, those options are usually not economically feasible. That said, this is in my state and area only (DC metro area) as I have researched, experienced, and learned about. Mileage may vary in different parts of the country. Good discussion! Thanks for the opportunity. I look forward to more in the same vein.

In my area, a FF/EMT or FF/medic can make anywhere from $45k/yr and up, depending on OT and some other considerations. That equates to about $21/hr. A thrid party, private ambulance service EMT-B makes about $7.50/hr (no counting shift differential) and a medic makes about $13/hr. Hospital based EMS workers (which in the great state of MD must be paramedic level unless you take a CNA class) make slightly more. So while EMS workers who don’t wish to train as firefighters DO have other options, those options are usually not economically feasible. That said, this is in my state and area only (DC metro area) as I have researched, experienced, and learned about. Mileage may vary in different parts of the country. Good discussion! Thanks for the opportunity. I look forward to more in the same vein.

Good entry man. Sadly, you inspired me to make my own little smudges in the dirt and throw a post up on mine, so I decided to try and figure out a way to shamelessly pimp my blog out to ya.Oh wait. Here it is.

Good entry man. Sadly, you inspired me to make my own little smudges in the dirt and throw a post up on mine, so I decided to try and figure out a way to shamelessly pimp my blog out to ya.Oh wait. Here it is.

Holy crap. I got an honorable mention on the excellence in ems thingie. They must’ve had…what, three submissions?Uh, wait, I mean some guy, named Chance, who is not me, did something. He and I are not the same guy.For reals.-MM

Holy crap. I got an honorable mention on the excellence in ems thingie. They must’ve had…what, three submissions?Uh, wait, I mean some guy, named Chance, who is not me, did something. He and I are not the same guy.For reals.-MM

Hey AD… I just read your Top Ten Signs It’s EMS week.. it was fantastic!!!!

Hey AD… I just read your Top Ten Signs It’s EMS week.. it was fantastic!!!!

<>chaos culprit said… Hey AD… I just read your Top Ten Signs It’s EMS week.. it was fantastic!!!!<>What?! Where? A little linky, please?