Lawrence,MA firefighters halt medical responses due to budget woes

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Lawrence,MA firefighters halt medical responses due to budget woes

Budget crunch forces change in procedures

By Jill Harmacinski

jharmacinski@eagletribune.com

LAWRENCE — They've delivered babies, re-started hearts and patched up the young and old alike.

But due to budget cuts, city firefighters have stopped responding to most medical aid calls indefinitely.

The ranks of the fire department are so low now, crews must focus on their primary responsibility — fighting fires, he said.

FULL ARTICLE: http://www.eagletribune.com/archivesearch/..._251021746.html

[firefighter36 52]

What a shame. I have been to Lawrence, and it is an old mill town with a HUGE fire load. I was able to see a church fire from where I was staying, and the brothers from LFD were there for most of the next day still mopping up an investigating. These guys are great at their job, and it is a big loss to the community to not have them on medical calls. Lawrence is also a very poor city, with a lot of drugs, homelessness, and crime.

In previous posts, we have all hit on how essential it is for us to be responding to medical calls in some form, not to justify call volume, but because seconds count, and we can be on scene delivering life-saving care quickly. What does everyone think of such a cut? I am eager to hear what people have to say. Does anyone know the extent of the cuts? Was it companies or just staffing reduced per rig?

[Goose 188]

I'm not sure anyone can make an accurate determination because the article dose not offer much in the way of data. The only thing we know is that fire calls dwarf in comparison to CFR runs, but thats no surprise.

If PD is already responding to these runs and/or if EMS can keep the response times low, i don't see the problem not having the fire department. I really never saw it essential to have an engine respond to EMS calls anyhow, but i'm probably in the minority.

Edited September 10, 2009 by Goose

[Guest alsfirefighter]

I'm not sure anyone can make an accurate determination because the article dose not offer much in the way of data. The only thing we know is that fire calls dwarf in comparison to CFR runs, but thats no surprise.

If PD is already responding to these runs and/or if EMS can keep the response times low, i don't see the problem not having the fire department. I really never saw it essential to have an engine respond to EMS calls anyhow, but i'm probably in the minority.

in the minority...nah not at all goose...lol. It is essential when the wait times for ambulances are horrendous or are coming from a distance. I also have seen where having even 1 body on an apparatus is a big plus when the crew on the ambulance can barely even carry their primary bag or are considered elderly. Fact remains that tiered response systems have better cardiac arrest survival rates and door to door times then those who don't do it or even worse don't do it correctly.

I am never in favor of reduction in services in any manner. On a side note the actual calls that we do where "seconds count" are far and few in between including "life saving care," particularly at the CFR level. The biggest impact is simply having someone there starting solid basic care and the calming influence of having a person whom they are looking for in their time of need. EMS is one of the best PR's the fire service can have. You're on a fire call we are all just a bunch of whatevers roaming around in funny looking clothes and all look the same. EMS face to face care and service. I've never understood with some FD's who deliver high volume, high quality medical care that the thought of even cutting back on medical service could even be contemplated. Once you do it..you do it and have to do it correctly. Particularly when you have some that have call volume ratios of 6 and 7:1 of EMS to fire runs. Resource management fluctuates all the time, and some in the fire service need to get a grip on what that means.

[NJMedic 96]

A few days ago on the "Secret List" there was some commentary about the chief that slept thru a job in Chicago. The spokesman for the CFD said that there was no significant issue because two chiefs were assigned to the alarm. Goldfeder's comment included the following...

While it is clear that tough economic times have effected most of North America's fire service, there also seems to be an impression, in some communities that they can do "without" some "parts" of their fire department. But - - - WHICH parts?

WHICH roles?

WHICH tasks?

WHICH stations and most critically: WHICH people?

What part of the FD is NOT needed?

In this case Lawrence decided that providing EMS was something they didn't need to do. For years the fire service has argued that EMS should be part of the fire department, that the fire department is best suited to provide EMS. The Lawrence FD was no different. For years Lawrence Fire responded to EMS incidents. Now the FIre Chief had to decide what the CORE mission of his fire department and he gave up EMS.

Doesn't matter the EMS incidents run 20 to 1 over fire incidents or that fact the while most people will never have a fire in their house many more will need EMS to respond.

While not having a engine company available for a house fire is it any better that the same engine company is not going to be available for the 45 year old with an MI or the child having a seizure?

But the kicker is this statement "A three-tiered response normally pulls police, fire and an ambulance crew to a medical aid call. Without firefighters, only police and a Patriot ambulance crew will go to the majority of calls now. Paramedics from Lawrence General Hospital are also available to respond to life-threatening calls.

"When someone has a medical emergency, they will still get a response," Takvorian said.

Firefighters will still respond to car accidents, including crashes where a victim is trapped and a Jaws of Life extrication tool is needed.

"Absolutely," Takvorian said.

And Patriot Ambulance has assigned another ambulance crew to the city to help fill the void, Mayor Michael Sullivan said."They stepped right up to the place," Sullivan said of the ambulance service.

So essentially the FD gave up EMS, which sends the message that the FD responding to EMS runs wasn't REALLY needed.

Of course the media and the public might ask "Well, if its not REALLY needed, and other agencies (PD and Patriot Ambulance) are going to address our needs why do we have to pay taxes to have the FD respond to EMS runs in the first place?"

I'm sure the lose of over 2,700 runs to the FD is not to going to add anything to the arguement to maintain staffing.

I'm not saying its right its the stuff the public and the media eat up.

[efdcapt115 1,511]

And Patriot Ambulance has assigned another ambulance crew to the city to help fill the void, Mayor Michael Sullivan said."They stepped right up to the place," Sullivan said of the ambulance service.

So essentially the FD gave up EMS, which sends the message that the FD responding to EMS runs wasn't REALLY needed.

Sure "Patriot Ambulance" is going to "help fill the void". The void could also be showing in Patriots' bottom line, and adding runs for the ambulance company means more $$ for them yes?

I'm sorry, this is an absolute shame for the LFD, and the City itself. They must be in some tough economic times to pull such a drastic step.

In my experience, I can't tell you how many times one of the members in our crew, ended up in the back of our VAC; performing CPR, setting up lines, and providing support services to VAC. It's a great system that works everywhere in the United Sates, the three tiered response for med calls. When I was working, our VAC could always COUNT on our crew to provide every and all need they might have had; extra sets of hands on the ride to the hospital was/is common practice. We used to (still do I imagine) get the fly car for the Medic back to the VAC, saving him/her possible life saving time. And what about the carries? The 300 pounders down the flights of stairs?

You know, the reasoning behind three tiered also has a lot to do with P.D. and their multiple responsibilities. You think a tour commander over at PD would want to pull a sector car out of service for that officer to ride in the bus, to help provide patient care, on a regular basis like FD does all the time? The logic was, yes PD gets in first most times, and FD support to EMS frees up those first in PD to the hundred other things they have on their plate every day.

The logic behind the three tier system is so apparent it is a national model pretty much, and Lawrence citizens will suffer losses because of this policy change. In a way it's kind of a tax increase; for emergency medical response. There must have been many times an FD patient RMA'ed, and now that RMA might turn into a $300 bill from Patriot.

I can understand a City having $$ problems in this economy; but really how much are they going to save by eliminating EMS runs for FD companies? On EMS supplies? On diesel fuel? On a little stipend the firefighter makes for becoming an EMT? Great, just have the members sit there instead and read the newspaper or do some more training.

It makes no sense, PD is going to have extra burdens by the move, FD is going to now become under utilized, and the EMS provider (no disrespect to for profit EMS companies in all honesty, I have many friends in the field, and many of them started at our VAC and went on to become awesome Paramedics for Empress and the like) ends up with a higher bottom line from another unit assigned.

Wait until the first heart attack victim dies who lives across the street from a Lawrence firehouse. Then the public will BLAME THE FIRE DEPARTMENT. "Buncha bums sitting right across the street playing checkers." Can't you just hear it?

The Chief in Austin, Texas made an adjustment to their "response policy". It's not too late for the Lawrence Chief to step up and do the right thing; make an adjustment to the running code, call priority, maybe pull FD from some types of EMS runs, but to sweep the whole system under the rug, is too drastic. A compromise can and should be made to this policy asap.

And this quote from the Chief tells me he wants to do the right thing; "These were the calls that represent most of our runs ... This is where the department needs to get back to in the future. We should play a larger role," Takvorian said.

But I have to question the statement about the "special rescue vehicles" the dept. purchased for the mounting EMS runs. Why is he talking about tying up pumpers at EMS runs when they have these vehicles?

Okay they lost two stations and a number of firefighter positions. Obviously the City is in dire straights. But why not designate just one on these "rescue vehicles" for EMS runs? With 58 working fires this year, it doesn't sound like the City is burning down. What's the major concern about call overlap? With three engines in service, you run a rescue for EMS with an engine company o.o.s. A working fire comes in, the FD activates the third engine and automatically EMS runs for FD are diverted. The odds of this occuring are quite low with the number of working fires on the books for the year.

Finally, if the City is in the red, why aren't they thinking about making FD the primary EMS agency? Then they could turn FD service into a money maker for the City, and maybe rehire those poor lads who got laid-off.

I wish the brothers up there the best; and hope they can remember that famous quote from FLSTP "this too shall pass."

~Just IMHO, thanks.

Edited September 10, 2009 by efdcapt115

[Tanker 10eng 140]

I am confused, is it the City who has cut them from responding or the fire chief ?

[Guest alsfirefighter]

I feel for them and the community. I can only speak from my experiences and areas I'm familiar with but I have seen similar arguments trying to be made in other areas and I still just don't buy it. Since when is it the FD's job to sit around and wait for a fire to occur? The PD doesn't keep an officer free waiting for a bank robbery. They don't cut back on service and quality of life calls all because a violent crime may occur. Why is it so often you see stories or listen to points being made that they can't have the apparatus tied up? The apparatus? To me the staffing is the most important. I can always find apparatus...god knows that with mutual aid...but I can't stretch people. If you are really that worried about the apparatus why not leave a member on scene and have the apparatus roll with the remaining personnel? How often is having an additional engine on scene that is second or 3rd due the difference between success and failure of an operation? Again reduction in service simply by cutting back...oh how so difficult...think outside the box and find a way to make it work. I'd be making the argument of how important it is, not that I can simply cut back. How about taking an overall look at the system and reevaluate response modalities for alarms. What about using EMD to maximize your personnel to medical calls where extra resources are a plus or needed during high volume times. EMS is not a throw away service for many FD's. It is THE most used service for those who do it. NJ medic used a statement that I have for several years when dealing with this kinda mentality. Which is more important...a 55 year old with radiating chest pain, no ambulance currently available, or having a 2nd engine responding to a fire alarm to a facility with a 99.999999% false alarm rate? Or even worse...someone lying on the floor not breathing? Your answer will depend on what type of system you have run in or are used to. What level of EMS training you have or if you even have any. Non-EMS trained managers tend to have a lower view of EMS in FD systems.

Cutting services is not the answer!

[Goose 188]

I am confused, is it the City who has cut them from responding or the fire chief ?

They chief is announcing the cut but he was faced with budget constraints from the mayor, so they killed off EMS response in an effort to save dollars.

[Guest alsfirefighter]

They chief is announcing the cut but he was faced with budget constraints from the mayor, so they killed off EMS response in an effort to save dollars.

Did he? How is cutting EMS saving dollars? Because I still haven't seen where. Again the following discussion I am intending as being directed towards thinking as a manager of a XYZ FD with similar issues as the one in the article as it is not right to argue against a chief of another department.

All I see is that staffing is lower and the perceived need for a fire apparatus instead of it being held up a medical call where they did 2,700 EMS runs last year and some 108 fires of some sort in a building. I would ask this question if I was fighting for a way to keep some additional staffing and service...how many of those 108 fires was operations compromised because of a medical call. If so how was it compromised and if there was an issue was it identified by someone responding with the responsibility for handling such issues.

At least I'm not seeing the ridiculous old "wear and tear" argument I've seen some try to throw out there. Medical calls are causing maintenance issues with apparatus...riiiiight. So with that train of thought we shouldn't go to AFA's either....or how about parades?

[Goose 188]

ALS, I don't know the answers to your questions nor was I attempting to answer them. Just trying to clarify the announcement for a poster who was confused. I can only imagine that the mayor either requested cuts or said this is the budget work with. As chief I can only assume that he and whatever group he works with are the ones who chose to cut EMS response. How that saves money, I have no idea.

[16fire5 693]

No offense to any law enforcement officers but in the places I have worked and now work the PD does not provide the same quality of first response service as the fire department. Also having the PD respond to EMS calls does not always mean that they will administer care. The citizens of Lawrence will suffer and the EMS workers will work harder without the assistance of firefighters on scene.