Firefighters Could Gain New Role Under Proposed Bill

So…. If you are not a firefighter/EMT you would become a second class citizen in EMS.

That's how it is now, in some places. Even with regulation.

I agree with you. A medic should be a medic in the eyes of the law. You could have easily made your point in a professional manner without the sarcasm and negativity toward other public safety professionals. The average firefighter/medic takes both aspects of the job seriously and can render patient care just as well as you can.

There are plenty of folks in your private/third service/EMS only agencies that have bad attitudes and poor performance, just like every other job. I could sit here and recount a hundred times that my crew and I have had to deal with incompetent private EMTs who seemed to disappear anytime a patient needed to be carried, but that doesn't mean that you would do the same. Maybe you should stick to blogging about guns, Sumdood, and foreign made trucks. Whining about firefighters just demonstrates your jealousy and ignorance.

Ah, the wi-fi must be working well at your ambulance status point. I agree with your point, albeit not your delivery, and you call me a troll. All while smiling about the possibility of someone losing their job.

As far as the blogging myself, I don't have time. Between training for hazmat, paramedicine, firefighting, vehicle extrication, my military reserve responsibilities, and family, my plate is full. Especially since my dept is about to lay off a bunch of guys due to all those “lazy union workers” losing their jobs and not paying taxes anymore.

I used to come by just to read some of your humorous thoughts about the job, like the sumdood series, usually while the wife was watching Twilight again. Since your more recent posts seem to run to conspiracy theories and self promotion, I'll save you the effort of banning me and stay away on my own. Nothing worth wasting my time on here anyway.

AD –

Call your state representative and state senator in Louisiana, not your Congressman. This is Louisiana state legislation.

Divemedic,

You and topv hit the right notes. It appears that this law would be a terrible mistake for the citizens of Louisiana. For those in the fire service that support the law…it'll all be ducks and bunnies until the first investigative TV report comes out after some on-scene screw up with no accountability.

As for the argument between fire-based and non-fire based? Like Kelly, I know a lot of fire-based medics who are excellent at their job (at least the medical side…how does one judge an individual's skills on suppression; send them to a burning house alone? I've had the pleasure of seeing some pretty strong Fire/EMS agencies…though the non-EMS neighboring departments often snicker and call them basement-flooders.To the suppression-only folks apparently they're not as good at the fire stuff as they are on medicals.

Overall, I'm not a supporter of fire-based EMS. My reasons are quite simple:
1) Money. Many cities in my area are looking at EMS as the goose with the golden eggs; since aid to local government has been cut repeatedly. I got news…the EMS money boom went away years ago. If fire departments really wanted to make some ching off EMS, they should've started in the 70s and 80s. The staffing models most FDs seem to use mean that EMS will have a substantial start-up cost (we don't have ALS first response here…no medical need for such a thing) to train and equip. I suspect any return on investment to be heading out toward infinity…since EMS now must accept assignment from Medicare. Most FD staffing models simply mean another method of smoke and mirrors to the public when the chief asks the city to raise property taxes…again. “Look, EMS made almost a million dollars last year, but it's not enough (never mind that EMS costs were over a million…they lost money). Divemedic…in your case, adding transport probably made sense…sounds like you were already running medics on the trucks. If you're going to spend money to provide ALS, you might as well recoup some of the costs through transport, I suppose. Though my first question when the system was created would've been, “why spend money on fire-paramedics when the ambulance already has paramedics?”

2) Structure. It may not always be the case, but I see the fire service acting very much in a “team” fashion…almost like football. Not a bad way to fight fires, do hazmat, etc. For the chest pain patient? I'm not so sure that mindset/structure works as well as my partner and I (mostly me if I'm the one attending) quietly calling the shots and doing the job. Just an observation.

3) The need for buy-in from the staff (and the resultant difficulty). There are too many Fire Departments that forget that EMS is their primary job nowadays. IMHO, if they're going to do EMS, they need to suck it up and understand that playing with the big equipment is something for special occasions. Those of us working in straight-up EMS…it's what we do. It's what we signed on for (just like many firefighters signed on to fight fires). In short, it requires a huge culture change in any fire department wishing to go into EMS. Not all are up to the task.

4) Role: Pure and simple. EMS is not a fire role, any more than it's a police role (and we have some police EMS agencies here too). To me, the easy way to look at it is this: EMS is like the Coast Guard of public safety. We work in similar environments (just as the CG operates in similar environments as the military). If we're fortunate, we even have similar benefits (pay…not so much). We wear uniforms, yada yada. Like the CG, in “the big one”, we find ourselves under a unified command with public safety (BTDT). However, on a day to day basis, we get our marching orders not from city hall (or the Pentagon), but from the local hospital (or medical director). EMS is the limited (and delegated) practice of medicine in the public safety environment. While there are similarities, EMS and Fire (and Police) are different disciplines, and should be treated as such.

As for your comments about the privates and other non-FD EMS agencies. Every department (Police, Fire, EMS….public and private) have their share of duds (or underperformers). The issue with the Louisiana legislation is that it would remove oversight from the underperformers in the Fire service. If we wish to excise the duds from our agencies, we need to have proper EMS oversight for EMS providers. Otherwise, the risk is that the only remaining duds will be in the fire service.

From an EMT/FF perspective in AZ…if you're going to try and tackle one, you should be able to handle the other! The FF aspect of being “Billy Bad Asses” is not going to do what needs to be done..i've watched it! You (we) are no better than an EMT or MEDIC! If you roll up on a scene regardless of being EMS or FF….you do what you were trained to do…SAVE LIVES!!

While the concept is just plain wrong, I have to agree with a lot of the people who ask how this will change anything. That is already the way that things work in bad FD/EMS systems.

This is what would change:

A non firefighter EMT who is arrested for child porn – this person will be treated like any other health professional, RN, MD etc. by its board of peers. The EMS board does not make a set of rules for firefighters and non firefighters.

A firefighter EMT – Nothing will happen because there will not be a method to revoke, suspend or discipline this persons certification.

What is best for our (fire based and non fire based) profession.

While i agree that people may be treated diffrently on the basis of who employees them – they should all be held to the same level of accountability.

This bill – if approved – will make non fire EMS professionals second class citizens in our own profession.

The funny thing, or not so funny thing, is that the chair of the board is a firefighter. Its hard to say your being treated unfairly when the chair of the board is one of your own.

When I started in the Fire department in 1963, the only training we had in first aid was the American Red Cross advanced training. Our ambulance service was provided by the local funeral director. (Talk about job security.) As our town grew, there was a real need for a more professional approach to the EMS problem. Thus our local hospitals and se-rounding fire departments(8) started an EMT program for ALL FD members, officers included, even some chiefs attended. Upon completion of the EMT program, 6 members of each department started taking paramedic training, in selected fire stations and at the hospitals for our clinical time. Upon completion of the paramedic program, we would have trauma nurses, and even doctors ride along with our ambulances from time to time. We now have 3 full time ALS ambulances, 1 in every station, along with one reserve unit, and every front line engine is also equipped with the latest cardiac care equipment. So now our department has over 60 state certified paramedics, that rotate between, Ambulance, Truck, engine and squad. Thus the engine, can provide the necessary care ( if the primary ambulance is on another call) until another ambulance arrives on the scene. Plus all member are also are state certified FF, and some also have specialties in HAZMAT, High Rise rescue, Under water Rescue and recovery, Arson, ETC. Our paramedics can op out of the program, IF there are enough medics in the department, and that is at 75% but it stands today at close to 90%. All of the fire departments in our area work this way, All FF are paramedic trained, along with the normal FF duties. Private ambulances provide hospital to hospital transport, and other related duties, but the greater % of our EMS and ALS calls are provided by the FD. Today our department run's about 5,500 fire and EMS calls.

I work in 2 different combination departments and I can't agree more with the fact that your certifications should control your level of liability, on the other hand as a fire fighter I feel that when the med unit arrives on scene it is time for some of the fire fighters to step back at let the med unit attend to “their patient” because ultimately that is their patient. Understandingly the med unit personal, depending on the trauma, may need additional personal to continue with patient care, but the firefighters also have a role to carry out on scenes besides patient care which are become overlooked all to often.

I feel they should actually have higher standards for fire/medics, as medics they have a DUTY to act in regards to patient care, but when they get complete with patient care shouldn't they have that same DUTY to act on securing that vehicle that they extricated the victim out of. I have heard to many times about overturned vehicles catching fire when the wrecker uprights it. Well where are the firefighters when this happens? In a lot of departments they have already gone back to their TV shows or station duties. In our department there is to be a “Safety Line”, 1 1/2 charged and manned hose line on the ground for ALL motor vehicle accidents until the scene has been completely secured and all vehicles involved are removed from the scene. I travel a lot and have worked many scenes with many departments and have yet to see a department that takes scene safety to this extreme, why? Standards like that need to be to be held and not just in SOP's/SOG's.