Minimum Level Of EMS Training For Firefighters?

[x635 4,066]

For a fire department that is not a medical first responder and does not provide fire-based EMS services, what should the minimal level of training be?

[JM15 386]

first aid and CPR

[firedude 985]

first aid and CPR

and AED! All apparatus should have proper EMS gear as well, even if they don't run ems. If I had my way, I'd add CPR, First Aid and AED training to the FF1 curriculum, among other stuff.

Edited January 15, 2012 by firedude

[INIT915 1,119]

For a fire department that is not a medical first responder and does not provide fire-based EMS services, what should the minimal level of training be?

I'd still suggest that they be trained to the EMT-Basic level if for no other reason then the likelihood of injuries to their associates. Whether it be fireground, during training, or whatever the environment, having the extra knowledge could prove beneficial.

[Bnechis 3,961]

For a fire department that is not a medical first responder and does not provide fire-based EMS services, what should the minimal level of training be?

I'd still suggest that they be trained to the EMT-Basic level if for no other reason then the likelihood of injuries to their associates. Whether it be fireground, during training, or whatever the environment, having the extra knowledge could prove beneficial.

I agree with the EMT (or at least 1st responder) as a minimum for protecting each other, but even if you do not respond on EMS calls, what about MVA's or other rescue calls. When I have been inside the car with patients during extrications their is a major difference between rescuers who have EMS training and those who do not. Those who do not often are so busy playing with the "jaws" that they pay no attention to how it is affecting the PATIENT, and thats the only reason you are cutting the car up.

[Alwaysinheat 26]

I would have to disagree with FF's having EMT certification! I'm a FF/former EMT as I agree that we should be well trained, the basic training should be CFR w/ AED. This is sufficient for FF's to begin treatment on scene on one of us or a civilian prior to the arrival or transport by EMS to the hospital. As discussed in another tread the IC should have an ambulance on scene for all working fires

[Goose 188]

I don't think anyone is going to argue that more training is a bad thing. However, i think that often times department culture is going to really dictate the reality on the ground. Some fire departments have long been an essential part of the EMS system and as a result either the department or apparatus bosses have cultured their people to become good practitioners - i think this is a great thing. On the other hand, certifications and the best equipment is worthless as some departments and their members have a holier than thou attitude or simply look down upon EMS. I've had engines refuse to assist EMS on aided cases and engines drive right past me when called to assist my partner and i working an arrest.

So yeah, good training and equipment are great but they really won't make any meaningful impact on patient care if the right culture is not well established. Just my take for the little it's worth.

Edited January 16, 2012 by Goose

[Guest alsfirefighter]

I'm going to go in a different direction then I normall do on this topic, being I for a long time believed that EMT-B should be the minimum. But as time has marched on I've started changing some of my thoughts on it and would like to use some comments already made on the thread to put my thoughts and maybe spark some discussion. Before that I would like to say that I belive that the FF 1 curriculum should require CPR with AED (pretty much standard today) for certification. Many states already have this and I in fact had to have it to get my FF 1 in Virigina and had to have an active card to complete FF 2. For the state certification...not national cert (Virginia gives you national cert just for the course, testing and evaluation. No extra testing like NY, which you then have to have CPR w/ first aid).

1. CPR w/ first aid and AED: Great, sounds nice, gives you basics for cardiac arrest and some boo boos. But what happens when it gets beyond a simple minor injury and the person is alive? The addage a little bit of information can be dangerous applies here and I've seen it far to often with civilians, firefighters and police officers.

2. CFR: I've never been a fan of this curriculum. Again, the little bit of knowledge, but the more I look at it, its not a bad basis for those who aren't tasked with providing EMS on a regular basis. It gives an inbetween of first aid training and EMT.I will comment on it in the next item, but I do not feel this should be the level of training for agencies that deliver BLSFR as a regular service.

3. EMTB: To me this should be the gold standard. While not in favor of the curriculum, it gives a decent amount of information for those to make decisions based on symptoms present. Set the expectation and people will rise to the occassion. This to me is the MINIMUM any agency that is delivering any form of EMS response should be at. My opinion but CFR is not the level to be a standard street provider on a consistant basis.

[Bnechis 3,961]

About 13 years ago I visited Morton-in-Marsh, the British Fire Service College. I was shown the training for firefighters and asked if they had medical training. I was told that it was included in the basic ff training. I asked what level was the training and they told me they didnt have a level it was just basic medical training. THen they pulled out the current Brady EMT text and said everyone had to complete that cirriculum. When done they are called firefighters (not firefighter/emt) and it was just part of what they did.

[meat441 43]

I've been reading this thread carefully and i don't think people are realizing the LIABILITY issue's which could involve personnel and department's who provide first responder care.

Questions?

1. At what level of training is the proper equipment levels to be carried on all apparatus? If at the EMT level then the equipment should be as much as a BASIC LIFE SUPPORT UNIT, excluding a streatcher. What good is an EMT arriving at a scene without the supplies needed to properly care for a patient, I.E. all proper size of BP cuffs. O B kit's suction unit's with the proper size cath's. Assorted Cervical collars. Splints. Airway management. Splints. Traction splints, it's a long time to hold traction waiting for that transport vehicle? Oxygen unit's, with ALL the right type's and sizes for patient's.

The list goes on for PROPER PATIENT CARE.

2. Who will provide the money for replacement of the equipment used? REALITY. MY previous work agency WILL NOT hand over replacement supplies to other agencies who provide care at MVA's or other patient care situations prior to EMS arrival and without minimal training.

3. Patient care reports? Legal document's of care provided by First Responder's prior to EMS arrival? I HAVE and WILL continue to document on my patient care report's the agency and personnel involved with care prior to my arrival. In this day and age of camera phones i need to protect MY livelyhood by proper care being delivered. Going to court or giving depositions is becoming old, trying to answer why this or that was done for this patient. I have seen it time and time again C collars placed backwards or upside down on patients and need to correct these mistakes. But it is also documented. If i go to court again, then so will you. This is my profession. For those who have been in front of a judge, jury and especially attorney's, IT'S NO FUN. EMS is frequently involved, not that EMS personnel are being sued but you are part of the process for money mittigation.

Just a few examples. Keep Safe.

[helicopper 1,050]

I've been reading this thread carefully and i don't think people are realizing the LIABILITY issue's which could involve personnel and department's who provide first responder care.

Questions?

1. At what level of training is the proper equipment levels to be carried on all apparatus? If at the EMT level then the equipment should be as much as a BASIC LIFE SUPPORT UNIT, excluding a streatcher. What good is an EMT arriving at a scene without the supplies needed to properly care for a patient, I.E. all proper size of BP cuffs. O B kit's suction unit's with the proper size cath's. Assorted Cervical collars. Splints. Airway management. Splints. Traction splints, it's a long time to hold traction waiting for that transport vehicle? Oxygen unit's, with ALL the right type's and sizes for patient's.

The list goes on for PROPER PATIENT CARE.

2. Who will provide the money for replacement of the equipment used? REALITY. MY previous work agency WILL NOT hand over replacement supplies to other agencies who provide care at MVA's or other patient care situations prior to EMS arrival and without minimal training.

3. Patient care reports? Legal document's of care provided by First Responder's prior to EMS arrival? I HAVE and WILL continue to document on my patient care report's the agency and personnel involved with care prior to my arrival. In this day and age of camera phones i need to protect MY livelyhood by proper care being delivered. Going to court or giving depositions is becoming old, trying to answer why this or that was done for this patient. I have seen it time and time again C collars placed backwards or upside down on patients and need to correct these mistakes. But it is also documented. If i go to court again, then so will you. This is my profession. For those who have been in front of a judge, jury and especially attorney's, IT'S NO FUN. EMS is frequently involved, not that EMS personnel are being sued but you are part of the process for money mittigation.

Just a few examples. Keep Safe.

Interesting perspective but the focus of this thread is not on agency's providing EMS services but on the one's that do NOT. So this isn't about a BLSFR FD, it's about a fire-only FD that just pulled up first at the scene of a motor vehicle accident with injuries, fire with someone jumping out a third floor window, or God forbid a FF drops during the call or at training.

A reasonably complete set of equipment/supplies should be on all apparatus but I would stop short of traction splints and things like that for an FD (or PD) that doesn't do EMS. I would counter that traction isn't going to be initiated until someone decides to apply the traction splint so it should be there before grabbing some poor soul's leg and hanging onto it. In nearly 25 years of doing EMS I can count on one hand (alright maybe two) the number of times I used a traction splint but that's a different story.

The goal is to be able to provide immediate meaningful treatment to somebody until EMS arrives. For that the cost of replacement equipment is negligible and if the FD won't commit to that token expense there are bigger problems. There are also problems in an EMS agency that won't give the FD/PD an O2 mask or bandage supplies but that's for a different discussion.

Patient care reports get written by the EMS agencies involved. If the FD is not operating as an EMS provider, this isn't an issue. Of course the EMS agency should document what was done and by whom but that really has no bearing on an FD training its personnel to be able to operate effectively within their scope as FF's. I too have been deposed and testified in many proceedings about EMS operations but that has very little to do with this topic.

With regard to the proper application of a cervical collar, were they applied by certified personnel or well intentioned responders without medical training? That would have a lot of significance to this discussion.

Proper patient care isn't in dispute here. Quite the contrary, the whole point is what level of training should be required of an FF?

Good points, thanks for highlighting these issues.

[Ga-Lin 86]

Since this topic originally asked about training for FF's not responsible for providing medical care for the public, lets start there. First, I believe all emergency providers, which include LEO's should be trained in CPR & the use of an AED. It's a few hours of training & the payoff in saving a life is immeasurable. An AED should be at every fire call/response, whether a trash fire or an all hands-5 alarmer like we had in Cornwall yesterday. I'm not sure if cardiac arrest is the #1 killer of FF's on the fireground but I do know its at the top. It should be immediately available as the trucks arrive and not waited for until the IC calls for an ambulance standby. As we've seen recently in MV, cardiac arrest can happen to any of us, at any time, anywhere, that's why its know as sudden death.

Secondly, I would limit training to life threatening injuries only, specificity bleeding control. Other training is academic, if you're not responsible for moving someone from point A to point B, other than removing them from a unsafe area in which case care is postponed, why do it. If you are not tasked with providing such care you probably don't have the proper equipment such as splints, C-collars, KED's, backboards etc. While I agree with Barry's post, on why are we cutting up the car, I think this 1.)attitude & 2)Cervical immobilization(as opposed to cervical stabilization, applying C-collar, KED /long board) could be addressed in an extraction class.

Thirdly, if the dept. is responsible for public care it also is divided into care at scene only &/or transport. If its care at scene only, CFR should be enough. As ALSFF, I also have some issues with the current curriculum, but at the moment, its all we have. It provides enough background for initial treatment of emergencies encountered when responding to care for the general public which, hopefully, FF's don't have such as asthma, OD's etc. If you're transporting, EMT level. The problem that I both have & see with requiring CFR &/or EMT is not so much the initial training (at least with CFR anyway) its the upkeep both in the actual cert. & with maintaining proficiency.

Finally, I see alot of dept requiring FF's to also be either EMT's or Paramedics. My opinion is that its both a mistake & asking alot. I'm not a FF, but as a lifelong career EMS person, I can tell you I'm constantly reading, going to Conferences & keeping up with what's new in addition with being active in both the field & teaching in the classroom. I am under no illusion that firefighting is any different. With new hybrids, electric autos, hazmat & other firematic stuff there are not many who can keep up & do both well. Leadership is, either through outside civil pressure (town, district etc) or internal reasons trying to expand in order to pump up their response numbers in order to justify their budgets or prevent layoffs, attempting to make people a Jack of all trades yet they are masters of none. This is especially dangerous in a volunteer system where members are not also working FF's, EMT's or medics but regular 9-5ers. Additionally, there is, what I call the emergency providers mindset. When asked who you are or what you do, how do you answer FF, EMT, medic. That's your mindset, as you see yourself, that's where your effort will go to maintain proficiency. If asked most FF, if honest, (paid more than Volunteer I think) will resist becoming involved in providing EMS. Now here's the question, do we, as civilian members of our individual communities want someone who doesn't see themselves as or doesn't want to be providing EMS caring for us or our loved ones.

In my community we have separate VFD & VAC yet there are some who are both. While this might look good when looked at by both organization individually the emergency SYSTEM, as a whole, is weak when we are essentially counting one member (& two different jobs) twice. That's my opinion.

Edited January 16, 2012 by Ga-Lin

[Guest alsfirefighter]

I've been reading this thread carefully and i don't think people are realizing the LIABILITY issue's which could involve personnel and department's who provide first responder care.

Questions?

1. At what level of training is the proper equipment levels to be carried on all apparatus? If at the EMT level then the equipment should be as much as a BASIC LIFE SUPPORT UNIT, excluding a streatcher. What good is an EMT arriving at a scene without the supplies needed to properly care for a patient, I.E. all proper size of BP cuffs. O B kit's suction unit's with the proper size cath's. Assorted Cervical collars. Splints. Airway management. Splints. Traction splints, it's a long time to hold traction waiting for that transport vehicle? Oxygen unit's, with ALL the right type's and sizes for patient's.

The list goes on for PROPER PATIENT CARE.

2. Who will provide the money for replacement of the equipment used? REALITY. MY previous work agency WILL NOT hand over replacement supplies to other agencies who provide care at MVA's or other patient care situations prior to EMS arrival and without minimal training.

3. Patient care reports? Legal document's of care provided by First Responder's prior to EMS arrival? I HAVE and WILL continue to document on my patient care report's the agency and personnel involved with care prior to my arrival. In this day and age of camera phones i need to protect MY livelyhood by proper care being delivered. Going to court or giving depositions is becoming old, trying to answer why this or that was done for this patient. I have seen it time and time again C collars placed backwards or upside down on patients and need to correct these mistakes. But it is also documented. If i go to court again, then so will you. This is my profession. For those who have been in front of a judge, jury and especially attorney's, IT'S NO FUN. EMS is frequently involved, not that EMS personnel are being sued but you are part of the process for money mittigation.

Just a few examples. Keep Safe.

First I would think that most do realize the liability of providing first response level care...or they wouldn't provide it and have an agency number.

Second, maintaining the basic equipment as outline in Part 800 for non transport vehicles is not all that expensive and if your previous agency won't work with replacement supplies then that's an issue between agencies. I don't know what your point is there. I've never had an issue getting something replaced in regard to disposibles that are mostly replaced at the hospital. You're also missing the bigger part that there are situations that arise where EMS personnel do not have the training nor equipment to be in areas where patient care must be administered. For example technical rescue, high rise fires where a medical emergency might be occurring in an area that things can be started where firefighters can safely be but not EMS personnel.

As far as your documentation comments. Again I'm not catching your drift. We have 2 things we use for every call for BLSFR. The first is a simple card that was made by DOH that gives basic information gathered (if time warrants based on patient needs), care delivered, etc. The BLSFR PCR is completed back at the station based on this information. If you are seeing the things you are then you need to address it through appropriate channels. It sounds like there are those practicing outside of their scope of care and is improper, dangerous and can involve I'm sure some legal matter. IF its not then you have a training issue that needs to be dealt with as no agency can provide BLSFR without written agreement of the area transporting agency. You hit the mark with documenting issues with things upon arrival, however, you also talk about protecing your livelihood by providing good care. Awesome, that is the best way to CYA, camera phone or not, our profession and customers deserve nothing less. Then you state its getting old going to court. As a person who rides in a high volume area, I mostly have dealt with criminal cases where I was subpeonaed. Its not fun, but it is what it is. And as you said not many providers are being sued. So again you make a point that has no true destination or any weight behind it. Do your job. If they sue and you get called to testify most of it tends to be what they reported etc. Not your care and either way..just be truthful. And while the documentation holds weight, as long as your honest even if you didn't write it down, you can discuss what was done.

Just like the wheel wasn't invented yesterday, neither was BLSFR.

GA-LIN, nice post. But one comment you made I've heard time and time again about being a firefighter and EMT or Paramedic and the efficiency of doing both and not being able to be good at either. Obviously I disagree with that or there would be numerous more professions where things overlap that this would be true. If it were it would also be a case against volunteer firefighters who have what they do for a living and then try to be a firefighter. There is no correlation that this even is remotely the case. As with anything it comes down to having a good comprehensive training program and time management both at work and personal discipline. For example I am a Firefighter/Paramedic, and a fire service instructor and not as much as I used to but an EMS instructor as well. I feel more then confident and adequate in both fields I perform in and I've never been told by anyone that I seem to suffer in either. Any other comments I could leave to others who work with and around me that are on here.

[MoFire390 118]

For example I am a Firefighter/Paramedic, and a fire service instructor and not as much as I used to but an EMS instructor as well. I feel more then confident and adequate in both fields I perform in and I've never been told by anyone that I seem to suffer in either. Any other comments I could leave to others who work with and around me that are on here.

ALS you by far are one of the medics that I hope when something happens to me you are working. There are a few others on that list as well. but you by far lead the top 5.

I believe that Firefighters should have atleast CPR/Firstaid/AED training. I believe it should be in the FF1 class. It should be up to the department on what level of training the member should have if he/she wants to run EMS calls. I know its difficult because of the politics. As the NY Lotto slogan goes "Hey, You never know."

[Guest alsfirefighter]

ALS you by far are one of the medics that I hope when something happens to me you are working. There are a few others on that list as well. but you by far lead the top 5.

I believe that Firefighters should have atleast CPR/Firstaid/AED training. I believe it should be in the FF1 class. It should be up to the department on what level of training the member should have if he/she wants to run EMS calls. I know its difficult because of the politics. As the NY Lotto slogan goes "Hey, You never know."

Thanks for the compliment. As I've said in the past on other threads..you are a very competent and I trust your instincts. Maybe not your stomach..lol...I think they named that shade of green your face turned after you that evening.