FireMedic049

It's not exactly the trivial thing that you seem to be inferring. I don't have a specific term to throw out there, but here's an example to help you understand the argument. Let's say that everyone who belongs to a fire department is titled "firefighter" regardless of what role they perform or don't perform. Using that same logic, everybody who works for a hospital can be titled "doctor" regardless of what role they perform or don't perform. We don't do this because titles do matter. The titles doctor, nurse, ER tech, janitor, aide, etc. help the patients and staff distinguish between the different roles and what they each contribute to the overall operation. So, if you are sick and in need of a doctor, you wouldn't want a "doctor" (aka janitor) to treat you. If you polled the average citizen on what a "firefighter" is and what their expectations for them are, it won't be that they just drive or just help outside if that person's house was on fire and a loved one was trapped inside. Therefore, using the title "firefighter" for all members is misleading in the same fashion that "doctor" doesn't mean the person who pushes the broom down the hallways of the hospital.

Yes and No. In large departments, there may be positions dedicated to doing things like fire inspections, fire prevention and fire investigations. However, there likely aren't that many of those positions out there and there has to be a vacancy. In smaller departments, like mine for instance, inspections and prevention are something that everybody participates in and investigations are handled by the County Fire Marshals. In some departments, the position of driver rotates among the company members. In others, it is an assigned position and the permanently assigned person drives when they work, but they are expected to be able to do the rest of the job if they are not performing driver related tasks on scene like pumping or operating the aerial. In small departments like mine, off-duty personnel are called in when we have working fires. When that happens, the driver jobs are already covered and we need people to fight the fire. So, typically when you can no longer do the whole job, retirement is the only option.

The smaller hose tube at the bottom gets used pretty frequently. It's commonplace to use it to connect directly to a hydrant. The larger hose tubes for drafting probably don't get used much at all. It is my understanding that they and the current engine design are primarily for alternate water supply usage in the event that the hydrant system is unusable, like what happened on 9/11 in lower Manhattan.

Sure, but when you're riding around in hot weather and your AC isn't working because your employer hasn't gotten it fixed, it won't seem like a very good option.

We have an HP75 Quint from E-one that's coming up on the 13 year mark and still going strong. We've had a few issues hear and there. Some big, some small, but overall we've been pretty happy with it. Some issues were with non E-one components and I think there's a decent possibility that some of the other issues we've had could have more to do with our shoddy maintenance program rather than because E-one built it. We're at a point where we should be working on its replacement and move it to reserve status, but that's not happening yet (for a few reasons). I think we'd definitely consider them when it comes time to replace it (whenever that is). That wasn't the case when it came time to replace our KME pumpers 5 years ago. They were/are junk (ours specifically, not necessarily KME in general) and they weren't even considered.

Let us also not forget the efforts and sacrifices of our brothers/sisters in blue and in EMS on that day along with that of the crew and passengers on Flight 93 that prevented further tragedy.

I think to a large extent, the "problem" with quints has a lot to do with the way we view them, design them and what we expect of them. Oftentimes, when this debate comes up, the knock on the quint is this "jack of all trades, master of none" argument. Essentially, quints are bad because you can't do everything or carry everything that you could with individual apparatus. There doesn't seem to be the understanding that all quints are not equal nor are they used the same. For example, my department has been running a quint (75' RM) for almost 13 years now. It runs primarily as an engine since we only have 2 units staffed and on-duty. Overall, it doesn't have as much hose on it as our engines, but it has enough of what we need. Other than being bigger, it works very well as an engine for us. There's no doubt that we can't carry the full compliment of truck tools and ladders that you'd find on a FDNY truck, or Chicago or LA, but that's ok since we don't need all of those things. People seem to think that if it can't do everything, then it's no good. However, that's not a big deal if it can do what you need it to do 95+% of the time and do it good enough. I read an article a number of years ago regarding a city's switch to a TQC deployment strategy. It was written by a member of that department and from the way the article was written, it was pretty clear that he was not a fan of that switch. Anyway, he listed several examples as why this switch was a problem, but IMO, all of them were department created. There were issues with how the supply line deployed thru hose chutes - now this was before the sidestacker hosebed, but that's a design issue. Having to send a 2nd unit to a vehicle fire on an interstate for more water. The quint they sent was a Tower quint with a 300 gallon water tank - that's an issue of not sending the right resources. The department also used ARVs for medical responses and one time a company was responding to a fire from a medical call and was given an assignment that their "mini-pumper" couldn't handle. If I recall correctly they were to pump a FDC of some sorts, but they had a small 500gpm pump, so of course the task had to be reassigned - that's an issue of not adequately designing your ARV for the way it will be used.

I disagree. All fire trucks should carry water............... in easily deployable 16-20 ounce plastic bottles.

Now, I'll qualify those answers with the following: 1) Is it important that as a fire department, we are consistent with our response to a dwelling fire? Is it important that we always send 2 engines and 1 truck or is ok to do that sometimes and just send a mini-pumper sometimes or just 1 engine and 1 truck? Setting aside the "every fire is different" aspect, can we expect a consistent outcome, if we aren't consistent with how we respond to the same type of incident? 2) Is it important that the individual companies in the same department respond in the same manor (SOPs), operate in the expected manor, use the same concise terminology and format? 3) Dispatchers will always exhibit their own "style" in their dispatching. However, that must be done with compliance to their dispatching SOPs as consistently as possible. Would it be ok for a dispatcher to use 10-codes because it's their "style" when the SOPs clearly state they are not to be used and there are no locally adopted 10-code definitions? If the SOP says the dispatch format is tones, address, complaint, company due, is a big deal if a dispatcher occasionally announces calls as tones, complaint, address, company due? I would say no, because nobody will be exactly consistent 100% of the time and the variation is minor. Does every dispatch have to be given as a monotone oration like tones, 123 Main Street, Building Fire, Company 5 respond? I would say no, the dispatcher can throw in a little style as long as they stick to the basic format and convey the required information in a timely fashion, like - tones, At 123 Main Street in Anytown for a report of a dwelling fire, Company 5 is due to respond.

Depending on how the RIT is staffed, it may not be the band aid that you think it is. If the RIT component is being staffed by a single company with only a handful of people, then I can agree with your concern. However, I know that some departments, probably based on the research that has been done on the use of RIT, are staffing their RIT at a task force level. So, if you have multiple companies making up the RIT component, then having a couple guys throw some ladders shouldn't be a significant detraction from the ability to respond to a RIT activation.

We respond from 2 stations. We used to have 4 a couple decades ago, but lost some as the manpower decreased. Truthfully, losing the stations themselves isn't that big of a deal from the standpoint that as a small city, we can pretty much reach the entire city within 4 minutes drive time from one of the stations. At minimum staffing, we are split 3/2 manning an engine and a quint with 2 each, plus the duty officer in his own ride. With 6, we split 4/2. For our situation, it's more operationally beneficial to do this vs splitting 3/3. That side of town typically has more 1st due fires than the other, plus it puts another FF on the quint for out of town truck calls. If the engine runs a mutual aid call, the duty officer can always grab the 3rd guy off the quint to take with him to give us 4 for the call. With 7, we split 4/3. Our fires tend to be in the areas between the 2 stations so in most cases, by the time the first unit arrives and stretches the first line to the door, the second unit is there to fill out the 2in/2out. The main area we need to work on is getting faster and more aggressive with our callback. We primarily fill out our working fire response with our off-duty guys, but the duty officer has to request it. Since we live there, it's pretty much a wash compared to the response times of the mutual aid VFDs to get people on scene. Unfortunately, our leadership tends to be too conservative with the request and in some cases to proud to ask for help it seems. RIT is an additional request and we're hit or miss on that. For some reason, we just can't get to the point where we automatically do a full callback with mutual aid RIT when a working fire is confirmed. Well, the fact that our fire chief is in no way a leader on anything fire department related definitely has something to do with it.

It's somewhat of a pet peeve of mine and I don't have any definitive answer to that. Personally, once the patient is in the ambulance, unless there's a critical issue that immediately needs to be addressed - like an airway problem, I want to get moving. We're 20-30 minutes from a trauma center by ground, so I want to get moving and I'll do what I need to on the way. If we're going to fly, then I want to get moving to the LZ. If makes no sense to me in the vast majority of cases to sit on scene doing stuff and potentially have the helicopter land before you get there vs going to the LZ and then doing whatever you can get done before they arrive. Unless there are extenuating circumstances, every minute that the helicopter is on the ground and not yet with the patient is wasted time. I've ruffled a few co-worker feathers over the years telling people to get out of the ambulance so we could leave the scene.

1) agreed 2) since the pump operator may not be part of the 2 out (once committed to pumping) and the IC clearly is not, the issue is do you (and by you I mean any FD) respond with enough interior firefighters to safely operate? In that context, for us the answer would be no a fair bit of the time since our minimum staffing is 5 on-duty. We're probably at that level about 1/3 to 1/2 of the time. We're probably at 6 on-duty about 1/3 to 1/2 of the time. Some days we're at 7 or 8, but they are not very frequent. Overall, I think we have enough to operate reasonably "safely" in most situations in terms of initial operations, assuming there are no immediate life safety issue to address, but we definitely have a very dark grey area between getting started and when the cavalry arrives. Unfortunately, I'm not in a position to make that area a lighter shade of grey, but I'll keep shouting at the wind about it. 3) agreed 4) agreed, but does the ruling help your department prevent dropping down to an even lower response just by the fact the standard exists? I don't think it has any true impact at all in terms of our staffing. Our staffing parameters have been set in our contract for at least 15 years now. That is more of a factor than any external regulation. Like many departments these days, we're a fraction of the size we once were. We used to have individual shifts that were the size of what the department overall is now. When I came on, our minimum was 4 and we worked like that most of the time. Fortunately, we've been able to increase our minimum and probably work above that at least 1/2 the time.

While this may all be true, in my experiences, it is a very small percentage of patients that would truly benefit from these things vs getting to the hospital quickly in this mid-range distance from a trauma center. The paramedic in charge of caring for the patient on the ground needs to be able to distinguish between patients that could benefit from these critical care offerings and those in which would likely see no appreciable benefit from air transport and make the appropriate decision regarding mode of transport.

Yes, they are pretty strong words, but I stand by them based on my experiences. I also didn't say that was specifically the case for this incident, only that it was a possibility. I've spent a significant part of my 20+ years in EMS working in areas that are 15-30 minutes from a trauma center by ground. I've seen it first hand on many occasions. I've discussed incidents with co-workers that have seen it first hand on many occasions. In my experiences in these areas, many patients that get flown, don't get flown because it's truly faster or because they specifically require an intervention that cannot be performed by a street paramedic. Far too many times they get flown because the ground crew either lacks confidence in their own ability to treat the patient or they are poor providers that find themselves "in the weeds" anytime they get a bad patient. I've never claimed to be the best and readily admit that I'm not. I'd say that I'm confident, above average and have plenty of people that I've run calls with that would concur.

When you consider what the intent of the 2 in/2 out rule is, I would say that anybody who is counting non-interior qualified/capable personnel towards the 2 out are clearly fools. As Dinosaur points out, the rule itself appears to ignore certain best practices for handling an incident, like the need for an IC and pump operator for situations the rule would apply to for the fire service. The reality is that the rule is typically going to really only be a consideration during the initial stage of a fire response while additional units are still enroute. As someone who's department has a minimum on duty staffing of 5 and had been as low as 4, it's certainly not ideal, but it is possible for the IC to man the pump and direct incoming units until additional personnel can arrive and take over that role. Additionally, the 2 out is not going to be sufficient to perform a FF rescue in most cases. So, it begs the question, depending on the situation at hand, is it better to initiate an interior fire attack (potentially halting the fire growth) with just your 2 in / 2 out or waiting until you have sufficient personnel to staff that plus an IC, a pump operator, etc., but allowing the fire to grow and potentially be "more dangerous" when the fire attack is initiated?

Possibly for the reason I stated in the thread that spun off from this one - lack of confidence in treating a trauma patient for the duration of ground transport.