Baltimore Modifies Emergency Response

[Truck4 48]

Lights, siren to become optional

Fire Department rating its responses

By Jessica Anderson | Sun Reporter

July 1, 2008

This August, Baltimore City residents might notice fewer sirens from firetrucks speeding to emergencies.

Baltimore Fire Chief James S. Clack said the city Fire Department will launch a multitiered response system to save the city money spent sending unnecessary equipment on nonemergency calls and to increase the safety of emergency responders and other drivers on the road.

http://www.baltimoresun.com/news/local/bal...0,3646235.story

[Monty 35]

Kudos to Baltimore.

Some places (arguably too few) have been doing this for years - http://forums.firehouse.com/showthread.php?t=30266

It would be nice if we could get agreement of what plain English is for the old Westchester 10-20 code - and what it means! I do hear some more 'modern' departments doing non-emergency responses - maybe it will catch on.

Here's another old discussion http://forums.firehouse.com/archive/index.php/t-37546.html where we seem to trail common sense IMHO

[RPM3311 3]

Thats a horrible idea, its not uncommon for some one to say "my house is on fire" and hang up the phone just for a food on the stove call, or some one to say my neighbor fell outside although they fell because they went into cardiac arrest, it seems that this will get very confusing and will actually put more people at risk.

[Guest]

Its an interesting idea, similar to the EMD practices around here of having Alpha through Delta responses for medical calls. I think its just too hard to do with fire calls, people never seem to give enough or correct information, so they may say that the dumpster is on fire, so the protocol is a "cold" response, when really its a 15-yd dumpster against a row of condos. It'll be interesting to see how it pans out.

[INIT915 1,119]

Thats a horrible idea, its not uncommon for some one to say "my house is on fire" and hang up the phone just for a food on the stove call, or some one to say my neighbor fell outside although they fell because they went into cardiac arrest, it seems that this will get very confusing and will actually put more people at risk.

I'm sorry, but I must disagree. While no system is perfect, if clear guidelines are outlined and uniformly followed, this policy could be a good move on Baltimore's part.

In the two examples you give, the first would be treated as a "hot" call anyway, as initial information suggestes a structure fire. And in the second exmaple, medical calls without enough information woul be routed as "hot".

I've never understood why FD treats AFA's as high priority calls, calling for L&S responses, while (almost all) PD responds to Burglar alarms without lights or sirens. I do realize a few PD's respond L&S, but that doesn't make sense either.

[lad12derff 283]

I've never understood why FD treats AFA's as high priority calls, calling for L&S responses, while (almost all) PD responds to Burglar alarms without lights or sirens. I do realize a few PD's respond L&S, but that doesn't make sense either.

Thats a great statement I never thought of it that way.

[Oswegowind 17]

I see this as a progressive move by people who are using their brains. The surprise to many is that this is far too uncommon this day and age. No one should be responding to open hydrants, water leaks, stuck elevators etc with lights and sirens. Only true emergencies or calls of an unknown nature should be handled with priority. If the calltaker is able to get enough good information, than a downgrade of the priority if recognized is appropriate! Reduce liability during responses and increase safety all around.

[Guest]

I've never understood why FD treats AFA's as high priority calls, calling for L&S responses, while (almost all) PD responds to Burglar alarms without lights or sirens. I do realize a few PD's respond L&S, but that doesn't make sense either.

All AFA'S in the Town of Union Vale are code 1 responses (no L&S), it has been like this for two years now and we have had no problems with it, it keeps the public safe and most importantly the personnel responding in the equipment.

[Bnechis 3,961]

I've never understood why FD treats AFA's as high priority calls, calling for L&S responses, while (almost all) PD responds to Burglar alarms without lights or sirens. I do realize a few PD's respond L&S, but that doesn't make sense either.

2 reasons; 1) the majority of burglar alarms are false or in error, 2) the ones that are not they want to sneak up to catch the perp.

About 2 years ago we looked at are statistics for AFA and found that over 25 years we did about 19,000 alarms less than 10 were working fires (I dont remember the number that were minor fires...like food on the stove) the extra 2 minutes on the minor ones would have made very little difference.

During the same time we discovered more than 10 working fires by driving up the street (coming back from calls, out doing BI, training, food shopping, etc.) and noticing the flames shooting out of a window......

It appears that luck works better than an AFA.......Why get hurt, killed or hurt someone else going to an AFA, when 99% or more are not real emergencies?

[EJS1810 7]

St Louis FD has been using modified response criteria for about 10 years. They call it "On the Quiet" response. It was implimented in responce to a large number of accidents with apparatus. I remember the same "what if?" questions back then. When I served as Chief in 2001 I put the same policy in place for my department.

This is from a 2001 NIOSH LODD Report http://www.cdc.gov/niosh/fire/reports/face200039.html

Recommendation #4: Fire departments should consider utilizing quiet dispatch until it is determined that life is in danger, persons are injured, or there is a working fire.5

The St. Louis Fire Department (SLFD) has implemented the quiet dispatch (responding with no lights or sirens) for the following incidents: automatic alarms, sprinkler alarms, natural gas leaks, wires down, calls for manpower, flush jobs, lockouts, carbon monoxide detector alarms, rubbish, weeds, and dumpster fires(Bold added for emphisis-EJS). If a call is dispatched as a quiet response and Central Dispatch receives additional information indicating that life is in danger, persons are injured, or there is a working fire, dispatch will upgrade the call to "urgent" and the responding apparatus’ lights and sirens will be activated. Since SLFD has implemented the silent alarm policy for non-emergency response, the department has reduced the number of intersection vehicle crashes greatly.

[losromero 13]

Does 60 Control have the capability of a tiered response for a local department?

[Oswegowind 17]

Everyone has the capability, just getting procedure in place and an understanding that even buffs have to use their brains and be safe is the problem and most likely why it wouldn't ever be implemented in Westchester County!

Personally, I practiced this in my former career as an EMT. I also tried to inform others as to how unsafe lights and sirens could in fact be and how over used they are! One of my biggest pet peeves is FDNY EMS using the flashing box lights during transport of patients, I find this completely ludicrous and feel it only compounds the public to misunderstand its use further!

[JBE 328]

It's a great idea until response times go up, and then the bean counters will be complaining about that. I know, I know, it's not about response time to fires, but someone will complain. Probably a member of the public who will scream to the nearest TV camera that the firemen took too long to get to her poor kid stuck in an elevator, blah blah blah. You guys get my point.

Of course, you also have the people with the "Playbook" as we refer to it in the office. I'm locked out with a pot cooking on the stove, I got 5 kids(always a favorite of mine, like that's gonna make the guys get there faster), etc. Those who own the playbook also end up being the first ones in front of that TV camera. Call me jaded, but I don't see a win-win situation here. Accidents happen and unfortunately, people die. Respond safely.

[CAM502 6]

Gee I thought that even with lights and sirens on we still yeild at red lights???

Oh and they said "The firefighters, who suffered minor injuries, were responding to a call, which turned out to be a pot burning on a stove." So my guess would be it was a reported stove fire. Stove fires don't get a priority response??

Edited July 2, 2008 by CAM502

[Guest]

Vestal has started to move this way as of month or 2 ago all wire down calls and CO2 NO Symtems r NON Emergency

Everything else is emergency untill comand says so

[Bnechis 3,961]

St Louis FD has been using modified response criteria for about 10 years. They call it "On the Quiet" response. It was implimented in responce to a large number of accidents with apparatus.

Interesting that everyone points to St. Loius, but does anyone know whats behind it?

15 years ago (or so) SLFD implimented the total quint concept and radically cut down on the number of companies. This resulted in longer responses. They had a push on to maintain the response time (Dont know if it was formal or not). THen the number of vehicle accidents when wy up, they then decided to do on the quite and "on the quite" calls are not "counted" in response time stats.

The St. Louis Fire Department (SLFD) has implemented the quiet dispatch (responding with no lights or sirens) for the following incidents: automatic alarms, sprinkler alarms, natural gas leaks, wires down, calls for manpower, flush jobs, lockouts, carbon monoxide detector alarms, rubbish, weeds, and dumpster fires. If a call is dispatched as a quiet response and Central Dispatch receives additional information indicating that life is in danger, persons are injured, or there is a working fire, dispatch will upgrade the call to "urgent" and the responding apparatus’ lights and sirens will be activated.

automatic alarms, Strongly Agree

sprinkler alarms, Agree

natural gas leaks, outside agree, inside...consider the Scarsdale incident (1 more minute and a 1/2 doz. people would have been killed)

wires down, Agree

calls for manpower, Agree (for what?)

flush jobs, Agree

lockouts, Agree

carbon monoxide detector alarms, no symptoms agree, with disagree

rubbish, weeds, and Agree as long as no exposures

dumpster fires. Agree as long as no exposures

Another way to consider slowing things down if unsure if its an emergency or not is continue the 1st engine in emergecny mode and all others go 10-20 (normal nonemergency driving). If its real, you'll get there fast and can step up everyone else, will only delay the 2nd due by a minute but reduces the risks.

[Remember585 815]

Our Department's SOG is fairly similar.

Code 1 = Emergency Response / Code 2 = Non-Emergency Response

Code 2 is for CO-No, Elevators jammed, fluid spills, lockouts, relocates, fires w/ no exposures or hazards to life, police assists and public assistance calls.

Code 1 is for CO-Yes, MVAs w/ injuries, fires, rescues, etc.

For an AFA, the 1st Due goes Code 1, all others Code 2. Most of the time we get an update saying it is workers or burnt food, and the Chief will knock it down to just one unit, Code 2 for the paperwork.

[JohnnyOV 2]

My feeling is if you don't drive like an idiot going lights and sirens, then you have no worries...stop at the intersections, look, and then go. I could have sworn that it was a little law called due regard.

If you have this great number of vehicle crashes, instead of looking around the problem, why not go back and review the departments policy on driver training, the personal driver's training and then modify it to better standards then what you had before.

[weaselff 6]

I've never understood why FD treats AFA's as high priority calls, calling for L&S responses, while (almost all) PD responds to Burglar alarms without lights or sirens. I do realize a few PD's respond L&S, but that doesn't make sense either.

I used to think this way until I had an AFA turn into a 10-75

[weaselff 6]

Personally, I practiced this in my former career as an EMT. I also tried to inform others as to how unsafe lights and sirens could in fact be and how over used they are! One of my biggest pet peeves is FDNY EMS using the flashing box lights during transport of patients, I find this completely ludicrous and feel it only compounds the public to misunderstand its use further!

I worked for FDNY EMS from 2005-07 and never heard of this, maybe this was personal prefernece of the EMT's you encountered?

[Monty 35]

Our Department's SOG is fairly similar.

Code 1 = Emergency Response / Code 2 = Non-Emergency Response

Code 2 is for CO-No, Elevators jammed, fluid spills, lockouts, relocates, fires w/ no exposures or hazards to life, police assists and public assistance calls.

Code 1 is for CO-Yes, MVAs w/ injuries, fires, rescues, etc.

For an AFA, the 1st Due goes Code 1, all others Code 2. Most of the time we get an update saying it is workers or burnt food, and the Chief will knock it down to just one unit, Code 2 for the paperwork.

Interesting to see that most of those that see this kind of thing as a bad thing are the younger guys (at least accoridng to their profiles)

I think what Croton is doing here is great and I hope others follow suit.

Interestingly, last night I heard Batallion 17 tell everyone to respond non-emergency (don't know if it was a relay from the IC - or if Batt 17 was the IC) - I think it was an EMS extraction from a hiking trail.

[191SH 4]

I see this as a progressive move by people who are using their brains. The surprise to many is that this is far too uncommon this day and age. No one should be responding to open hydrants, water leaks, stuck elevators etc with lights and sirens. Only true emergencies or calls of an unknown nature should be handled with priority. If the calltaker is able to get enough good information, than a downgrade of the priority if recognized is appropriate! Reduce liability during responses and increase safety all around.

i agree 10000 %

[INIT915 1,119]

I used to think this way until I had an AFA turn into a 10-75

And, unfortunately, no system is 100% perfect, so this scenario could happen.

However, considered the odds of that AFA that was legitimate versus all the MVA's and close calls that occur when responding to these alarms.

I think the benefits outweigh the costs.

Besides, hasn't it been discussed here (on EMT-Bravo) a thousand times, how much time does L&S cut off your response? Seriously?

[antiquefirelt 994]

I used to think this way until I had an AFA turn into a 10-75

I would hope that once in awhile the AFA does report an actual fire, or we've been forcing a lot of people to waste their money.

Our Dept. has been running this way (tiered responses) for many years. It really started for us with EMS runs and is evolving into more and more fire runs. Currently our fire runs are almost exactly as Bnechis's agree/disagree column.

Non-emergency:

Outside fire with no exposures (bark mulch, dumpster)

CO alarms with no symptoms/victims

stuck elevator

spilled fuels-minor

water salvage ops

any medical where life or limb is not threatened

wires down

arcing electrical (outside)

odor of smoke with nothing visible from occupants (may be upgraded by C.O.)

The rest for the most part are Code 3 (emergency responses) We're trying to eliminate more of these, and AFA's and sprinkler bells are the big controversy. I think many points here show the relative infrequency of a working fire, yet we know the increased risk driving emergency can have. In our first due, the lights and sirens will save us maybe 60 sec. at most, so we have little issue going quiet.

As for response times, our reporting system allows us to enter the type of response and does not calculate the response time for those reported as "non priority". Doing this we can show that anything we respond to with lights and sirens has a annual average of 4 min. 30 seconds, with 3 second margin between the last 3 or 4 years. Oh, and this is total time from the 911 operator picking up the phone to out first arriving unit (no POVs).

A lot of this depends on your trust of the dispatch info. If you have a decent dispatcher who elicits good info, you should have little problems. In my time on the career job, I can think of only once we were burned by this policy. We had a report of a man with a laceration on his finger from a power tool. A 5 block run, with very little traffic and the crew went non-emergency to find the guy had stuck his hand in a snowblower and lost two fingers, and his family was pissed we didn't show up lights and sirens! Of course it would have sped our response time by all of 15-30 seconds, which would not have changed the fact that you cannot reattach hamburger.

Edited July 2, 2008 by antiquefirelt

[firemoose827 324]

I am all for lights and sirens when used correctly, and when they are used in conjunction with due regard and defensive driving. Accidents happen because of the driver getting caught in tunnel vision and becoming complacent by responding to X amount of calls per shift. Lights and sirens dont cause accidents....DRIVERS cause accidents.

The first due unit should go L&S and provide a report for all other units. I have been told by the dispatcher before that we are responding to an "Omega" response, meaning lift assist only, to find the person in full cardiac arrest MANY times. I have lost faith in that form of dispatch and will always respond L&S until I confirm there is no threat to life or limb. Same goes for fire calls, have the first unit respond L&S, the rest should go without all the time unless the unit on scene is reporting life hazzard and resources are needed to effect the rescue.

My only question with some of the above opinions is for the request for manpower. If that request for manpower is for a structural fire, or wildland fire where weather is a factor and rehab of firefighters is crucial, shouldnt that manpower need to get there as soon as reasonably and safely possible? When the manpower is responding from across the county and response time is already high, L&S should be requested to get that help there in a reasonable time frame to keep the scene running smooth and safe. I KNOW....You should be calling for the manpower as early as you can so it gets there BEFORE you need it, but I thought I would ask the question anyway.

[JBJ1202 27]

I worked for FDNY EMS from 2005-07 and never heard of this, maybe this was personal prefernece of the EMT's you encountered?

i believe what he is referring to is how in the older buses you have two switches for the lights, some old timers just throw on the box lights for job and go with traffic.. i dont get it, but they cant do it in the new buses because its only one switch now. i cant believe some of our buses are still in service... those '97s are the worst...

[weaselff 6]

i believe what he is referring to is how in the older buses you have two switches for the lights, some old timers just throw on the box lights for job and go with traffic.. i dont get it, but they cant do it in the new buses because its only one switch now. i cant believe some of our buses are still in service... those '97s are the worst...

Off topic slightly but its a disgrace the kind of buses you guys are rolling around in. When I started there were 1 or 2 of those red white and blue buses floating around BK. I think they were like 92's or something and were left over from HHC.

[firebuff08 29]

In my lifetime I have been an emergency responder for over 20 years (paid and volunteer), a 911 dispatcher for 15 plus years and President of a large Volunteer Ambulance Corps who had to deal with crashes involving ambulances. There is absolutely no doubt in my mind that Lights and Sirens are way over used. The problem with the use of Lights and Sirens is not only the tunnel vision effect and the adrenaline effect on the emergency vehicle operator but the effect or lack of effect lights and sirens have on other motorists. How many pull to the right and stop? Some will stop in the middle of a travel lane. Some will not pull over but slow down. At intersections I see drivers all the time trying to beat an emergency vehicle through an intersection.

Many of the comments I have read on this thread from those who don't get it and still want to respond lights and sirens to every call, are very similar to those that have been heard in community after community over the last 30 or so years when it was proposed to remove False Alarm Boxes from street corners. In every community, a close examination of alarms from street boxes for multi year periods, showed that there NEVER was a working fire reported via a Street Alarm Box that wasn't also reported via landline phone and or cell phone. 99.999 percent of all call from street alarm boxes in each community, for many years prior to their removal were FALSE and yet the fire departments continued to respond lights and sirens with a full assignment because they always did it that way.

Never mind firefighter safety, public safety demands that the response be in relation to the seriousness of the event. I know of fire department in my area of CT that will respond to the same automatic fire alarm -- three times in an hour - with four pieces of apparatus with lights and sirens. That is insane. In this day and age where working fires are few and far between, there are not too many calls that warrant lights and sirens unless the purpose is to provide the apparatus operator with a woodie!

As for the argument about caller not giving enough information....it is not the responsibility of the caller to "give enough information" .. it is the responsibility of a well trained 911 dispatcher to elicit enough information to determine the classification of the call... 99 percent of the time, that is not a problem. Of course in Westchester (where I lived for 20 years) I know there are still villages where a police officer answers the phones and feels he or she has done their job if they simply find out "fire" and "address", the heck with kind of fire, size of fire, exposures, call back number, caller's name, etc, etc.

[antiquefirelt 994]

Lights and sirens don't cause accidents....DRIVERS cause accidents.

But we can only control/train our own drivers. Many civilians make irrational moves when they finally see and/or hear an emergency apparatus approaching them. Minimizing these responses will reduce the risk.

Same goes for fire calls, have the first unit respond L&S, the rest should go without all the time unless the unit on scene is reporting life hazard and resources are needed to effect the rescue.

We tried this with negative results. When responding from the same station civilian traffic was very confused when only the lead apparatus used their lights and sirens and the others did not. Many drivers pulled over regardless, while others tried to pass the one pulling over. This would happen block after block when the lead engine was nearly out of sight, but it seemed drivers who pulled over for the first engine were waiting for more apparatus. I could see this concept and would implement it in a multi-station environment where only the closest apparatus used L&S.

My only question with some of the above opinions is for the request for manpower.

We always respond L&S to the scene of mutual aid calls unless otherwise instructed by the IC, and we never respond L&S for station coverage regardless of the receiving communities policies. Further we have instructed our mutual aid companies that they are not to use L&S to cover our station or they'll be taken off the alarm card.

As was noted by another, it's usually the kids or wannabe heroes that balk the quiet response policies. As you mature and/or attain rank and responsibility your realize which risks are acceptable.

[firemoose827 324]

But we can only control/train our own drivers. Many civilians make irrational moves when they finally see and/or hear an emergency apparatus approaching them. Minimizing these responses will reduce the risk.

We tried this with negative results. When responding from the same station civilian traffic was very confused when only the lead apparatus used their lights and sirens and the others did not. Many drivers pulled over regardless, while others tried to pass the one pulling over. This would happen block after block when the lead engine was nearly out of sight, but it seemed drivers who pulled over for the first engine were waiting for more apparatus. I could see this concept and would implement it in a multi-station environment where only the closest apparatus used L&S.

We always respond L&S to the scene of mutual aid calls unless otherwise instructed by the IC, and we never respond L&S for station coverage regardless of the receiving communities policies. Further we have instructed our mutual aid companies that they are not to use L&S to cover our station or they'll be taken off the alarm card.

As was noted by another, it's usually the kids or wannabe heroes that balk the quiet response policies. As you mature and/or attain rank and responsibility your realize which risks are acceptable.

Points taken, and thanks for the reply.

I guess this is one of those "Agree to dis-agree" points that we all too aften have here!! LOL

Its different for each response area...those of you with large traffic problems and drivers who are immune to the L&S will have these issues. People like me with large response areas but less frequent call volume have less trouble getting people to move for us. That, and we have an aggressive Fire Prevention campaign all year round with open houses, informational meetings with parents and teachers, and public announcements in papers and radio stressing the importance of the local emergency services and allowing them the right of way when they see the Red/Blue/Green lights approaching. Smaller communities understand that it could be their loved ones involved, or their house burning, so they generally move for us.