Wear And Tear On Apparatus From EMS Calls

[sympathomedic 383]

Barry, ya lost me on the second paragraph. "They do not put medics on the ambulances." Do you mean the ambulances do not have medics on the crew, or the medics on the larger fire apparatus do not ride in on the ambulances?

[Bnechis 3,961]

For those who think that they have to go to the apparatus if they are out to "swap", that's not the concept I'm reffering to. Use two guys from the company (this only applies to a properly staffed FD) to run a truck like this, that runs concurently with the apparatus when needed. This apparatus could also be supplemental during storrms, and other needs.

That would mean "properly" staffed is 6. Since once you lose 1/2 of your 4 man crew, the engine is either out of service or understaffed.

When you consider the costs of an Engine, like tires and other components that will need replacement several times duiring it's life, there's savings right there.

Our Mechanic says most of those items like tires need replacement based more on time than milage. Even in a busy system how many miles are we talking about.

It also keeps the Engine in service more. The Engine also should be busy enough tending to fire calls.

The engine is not in service more if 1/2 the crew is not with it. If the engine is busy enough tending fires, then you need 2 units with proper staffing, one for fires and one for EMS. And if thats the case, why run a mini attack for EMS calls....get an ambulance and be able to transport.

[Bnechis 3,961]

Barry, ya lost me on the second paragraph. "They do not put medics on the ambulances." Do you mean the ambulances do not have medics on the crew, or the medics on the larger fire apparatus do not ride in on the ambulances?

PFD's ambulances are all BLS and they run ALS Engines and Ladder companies.

[wraftery 1,275]

If you have followed Brunacini for any length of time, you would have probably found that he appears all over the country with theories, advice, etc. and when you read about incidents that have occurred in Phoenix over the years seem to contradict what he has been saying in his speaking engagements. I kinda think he should spend more time in Phoenix.

[sympathomedic 383]

Over use of EMS is something you hear talked about a lot. I think I saw that in last 35 years, fires are down 30% and EMS use is up 247% We do spend a lot of public outreach on fire prevention, and maybe it worked- the fire numbers are down for all kinds of reasons. Maybe if we did some illness/injury prevention we could do the same with EMS. A difference is that a building does not ever have to ever burn down, but every person will eventually get sick/injured and die and probably create at least one EMS run when they do.

Getting any agency to spend money to DECREASE demand for what they provide, and therefore shrink their importance/profile/budget/staffing/fiefdom is something so smart and efficient that I doubt you will ever see it in America, sad to say.

I figure I got into this to take care of the sick and injured. If that's you, call me and I'll help. Even if you are the quite healthy and minimally sick or hurt. I knew the deal when I started. If all I did was 24/7 constant shootings, jumpers, frothing pulmonary edemas, cardiac arrests etc one right after another I would probably have to quit.

[Guest alsfirefighter]

I know a lot of departments have to justify apparatus replacement, and if it's not used often then it becomes an issue in some cases. I'm sure in most departments that run EMS first response, the Engine responds to more EMS calls then fire, putting uneccesary wear and tear on $400,000 pieces of apparatus, plus fuel costs.

I'm seeing two concepts that are becoming popular.

The first is the FD responding only to 911 calls that are not in a medical facility (doctors office, nursing home, etc) where there are verified trained medical personel. And prioritizing calls. In a lot of cases here, EMS arrives or beats the FD to the scene, and most of the time they are not needed.

The other is the Squad concept. I know it's a different term wherever you go, but for this sentence I'm going with Squads. It's becoming increasingly popular here.

Many departments are running light rescues, brush trucks, or even outfitted pickup trucks or SUV's. They respond to EMS calls, minor accidents, fluid spills, etc. Usually staffed by dedicated personel that will supplement the company they are with, or will contain two members from the company who will meet up with the Engine or Truck when needed. They are also used for general purposes, like going to the supermarket, etc. And they can be used to shuttle personel and equipment to difficult to access areas, or to fire scenes where only manpower is needed, and the apparatus can stay in it's home district.

This keeps the fire apparatus available for fires, as well as reduces wear and tear and fuel usage. The replacement cost for a Squad is much less then an engine, and so is fuel usage.

Just some thoughts and things to consider.

First, I'm not sure how EMS calls are as you put it putting "unnecessary wear and tear" on the vehicle. I can think of several "fire" calls that could and should be considered unnecessary then running BLSFR. I've never understood this thought process. If my tax dollars are funding a $400,000 apparatus...I want it to run. I'd rather be told it was run into the ground...then the maintenance costs that often are higher if it sits. Moving things like to move to simply put it. My thoughts and considerations are this..how can engine companies in NYC run thousands of calls and they last just fine, but its an issue in lower volume departments. And if you knock out them for the use of EMS calls...it has to be common sense across the board. Meaning parades, etc. Furthermore, to me a respiratory distress, MI, syncope (add your favorite higher priority job here) is more necessary then wires down, fluid in the roadway etc. Why send multiple units to an AFA? Why not send 1 with several utilities or any other thing they've been called in posts?

IF they're not needed..that's a management issue both on scene and the department level. Its pretty simple to turn around and go home...or work out an agreement that the unit is cancelled if they are ON SCENE and its determine no additional resources are needed.

As far as using utilities etc. I'd rather keep the crew integrity intact and in many cases this could drop an engine or truck to 1 or 2 persons only and if its every roman has his own chariot..that apparatus is then out of service until they get back to the station.

[yanks4ever1320 6]

I have a question here. Someone stated early on in this thread that running an SUV would potentially create more drivers without needing pump ops or EVOC. Since it is still considered an emergency vehicle utilizing Red/White Lights and Sirens wouldn't you need EVOC?

[Guest alsfirefighter]

I believe that when a member of Mohegan VFA and MAC successfully ran for Fire Commissioner 5 years back, he did some math and determined (my memory is very suspect) that running their engines cost about $17/mile and running their SUV's was less than $5/mile, taking in many costs. Big district, lots of calls = many miles.

I also recall a quote from Allen Brunacini who was the Chief of the Phoenix FD and a highly respected national leader and speaker in the fire service. He said "Using a class A pumper to answer EMS calls is like using a cement truck to deliver a pizza."

So when every roman has its own chariot in Mohegan and they are out in the SUV and they are running their normal call volume and an additional fire call drops...what do they do? Go in the SUV? Why not run to low priority fire calls with them then? Did they stop spending $17 a mile to go to parades?

I can also quote where he talks about the importance of crew integrity, customer service etc.

[PFDRes47cue 653]

Getting any agency to spend money to DECREASE demand for what they provide, and therefore shrink their importance/profile/budget/staffing/fiefdom is something so smart and efficient that I doubt you will ever see it in America, sad to say.

This makes sense but it is seen in America. As you said, FD's spend money on fire prevention which is one factor to why the numbers of fires is way down, thus decreasing demand for what the FD provides. I wish there was some way to get people to have family members or friends drive themselves to the ER for the non-emergency bul***** that we all deal with frequently. It is frustrating (for a few moments) to walk up to a patient complaining of ankle pain, to find that the person has sprained ankle and several calm and collected family members or friends standing around who are very capable of driving to the ER. Or people who have had general malaise for hours and are sick of vomiting and are sitting in bed with a calm and collected spouse or family member who is very capable of driving to the ER.. Seems to me that an education program should be put in place teaches people that when you have symptoms for hours or days on end, it is not so much of an emergency that an ambulance is better than a minivan for getting you to the ER.

EDIT - spelling.

Edited February 4, 2012 by PFDRes47cue

[Guest alsfirefighter]

No offense..but seriously I have to laugh at some of these posts as I thumb through them.

1. Most EMS systems when they got away from funeral homes, tow truck companies and orderlies from hospitals were done by Fire Departments.

2. I understand this...occasionally I save a life. Every day when I walk into the firehouse....I improve multiple peoples lives through our EMS program. Why...because not everything is life threatening. Some of the process I can revert, slow or halt are in the long run. But I bring relief. Be it physical or mental. And sometimes the mental is more important.

3. EMS is direct face to face contact with people. They see a face you introduce yourself and your department. Not a bunch of people in black with the department name on the back looking like they're tearing up a place.

4. We've identified more hazards or things of concern through EMS calls then any other means. Simply put for every fire call, we run 5 to 7 EMS calls depending on the volume for the given year. I'm getting in buildings that we would not otherwise.

5. If I'm paying taxes for salaries...I don't care what you think, what you think your role is. I want service. So to me...my thought is where I work..should give service.

6. If you're having the nosebleed an felt you needed assistance because it wasn't stopping...you wouldn't care what the deal it. By the way..once the bus gets there you can be inservice as equal care is there for turnover. But yet we take a engine out of service waiting on a utility company. But lets not do it for someone who needs help. And yes..relax...there are those that abuse the system. Educate them. And in the end...I don't let it aggravate me more then a few minutes. Runs equals staffing and job security. Simply put. Don't like it...opt for another service or profession.

Yanks...in NYS EVOC is not a requirement unless the AHJ requires it. So simply put..unless its policy..no you do not need EVOC.

[PFDRes47cue 653]

I believe that when a member of Mohegan VFA and MAC successfully ran for Fire Commissioner 5 years back, he did some math and determined (my memory is very suspect) that running their engines cost about $17/mile and running their SUV's was less than $5/mile, taking in many costs. Big district, lots of calls = many miles.

I also recall a quote from Allen Brunacini who was the Chief of the Phoenix FD and a highly respected national leader and speaker in the fire service. He said "Using a class A pumper to answer EMS calls is like using a cement truck to deliver a pizza."

Nothing against the Chief being quoted but I have never been a huge fan of this analogy, simply because when it boils down to being used for its "proper use," a class A pumper is only being optimally used when pumping. Using a class A pumper to tend to a fluid spill in a parking lot is like using a cement truck to deliver a pizza.

I have a question here. Someone stated early on in this thread that running an SUV would potentially create more drivers without needing pump ops or EVOC. Since it is still considered an emergency vehicle utilizing Red/White Lights and Sirens wouldn't you need EVOC?

In the post you are referring to, I put the "?" after EVOC because I was not positive if this was a state or department requirement. Come to think about it, I should have been definitive with my definition since ambulances have red/white lights and sirens and do not require EVOC.

[SECTMB 612]

Let's blame the lawyers. And remember that most legislators are lawyers.

In the 'old' days, pre 911, a person called the local police to report an odor or smoke. They sent a patrol car to check it out. Now with 911 the FD is dispatched to every single call, every single automatic alarm. Why? liability. My house burned down because you 'checked it out' before you sent the firetruck. The patient died because you checked it out first and we lost time in our golden hour. How many 'steam from the shower set of the alarm' calls to you hear? In a week?

Also, before we became a nation of milquetoasts you took yourself to the hospital for most anything short of a traumatic amputation. Now you call 911 for a hangnail. I monitor the scanner while working from home and I hear the dispatches. An engine and a rescue responding to a fall down drunk, etc. etc. It used to be the cops would pick him up and take him to get help. No more. And this in districts where, if a fire call were to come in, mutual aid would be required because their on duty manpower and apparatus are tending to a drunk, etc.

Volusia County is trying to cope with their issues. They're trying to find a balance between call volumes, staffing and money. What works or doesn't work for them may have no bearing on another district as each district has its own unique characteristics. Don't fault them for trying and I haven't heard a definitive plan as to how they plan to deploy these rigs.

The public isn't demanding more and more services, the legislators over the years, to curry favor with the electorate created the nanny state and the public is taking advantage of it. I don't remember the exact date, but personal responsibility disappeared, I think, about 20 years ago or so.

Unfortunately the public has no more money to contribute to support the system as it is today. Catch 22.

[antiquefirelt 994]

I also recall a quote from Allen Brunacini who was the Chief of the Phoenix FD and a highly respected national leader and speaker in the fire service. He said "Using a class A pumper to answer EMS calls is like using a cement truck to deliver a pizza."

But then running the same engine to let Mrs. Smith's dog out to potty or to take her groceries in to ensure they didn't spoil in the sun made sense? Bruno has/had a lot of ideas, some good others, well...

I must say I agree with ALS's comments as my Fire/EMS department shares may of his views. As a smaller agency we cannot support a proper staff for just the Fire call volume, the runs vs. money just wouldn't work with the public, even in good times. Many years ago, as was noted the FD took over EMS from the local funeral home. It was a logical extension at the time, as they had paid personnel waiting in the station to respond to emergencies and in the beginning CPR and first aid was about it. Over the years the Fire and EMS calls grew, then the fire calls stopped growing and receded while EMS continues to rise. There was a time when our job was a Fire/EMS dept. now it's and EMS/Fire department by volume anyway.

The issue with low volume FD's is that we still need the same expensive equipment for just one first alarm, yet can't justify staffing to man this equipment. Personnel-wise we need more EMS licenses to keep up with the volume and supervisors to maintain a hierarchy, paperwork, QA, training etc. The direct correlation between people assisted and the taxes required is far easier to show. Much as it pains many of us, our FD really is more in the EMS business, while maintaining quality trained and equipped firefighters. Could our city do away with the career FD, have a FT EMS department and a VFD? Not without losing services such as inspections, fire Prevention, haz-mat, tech rescue and a degradation in firefighting quality. Oh and where would the medics come from? In our area 75%+ medics are firefighters who don't want to do EMS only, EMS only medics are few and far between.

As for the original topic, our Fire/EMS dept. cannot justify taking personnel off the fire apparatus to provide back-up, via a non-fire vehicle, to the EMS crews. This would take first due units off the road, understaffed as they are to start. For many of us smaller departments it's a juggling act to put the best personnel where the citizens need them most. That means today my FF/medic might ride the bus, the engine or drive the tower depending on who's on what call. One thing we do preach is that we respond to each emergency as best we can, not withholding anything "just in case" another call might occur (and they do). This doesn't mean we don't keep fire trucks on the road or ensure an ambulance is readily available, but we have to be a little more creative and utilize recalls and OT more.

[Reliance 29]

I see alot of departments are sending Aerial Platforms & TDA's on medical calls. What is the justification there. In the sense that a lot of fire departments in the US of A are closing fire houses and staions because of budget cuts.

Can they not use a half ton utility or Explorer type vehicle for those type calls to save on fuel to stop the closing of buildings and cutting staff.

[Guest alsfirefighter]

I see alot of departments are sending Aerial Platforms & TDA's on medical calls. What is the justification there. In the sense that a lot of fire departments in the US of A are closing fire houses and staions because of budget cuts.

Can they not use a half ton utility or Explorer type vehicle for those type calls to save on fuel to stop the closing of buildings and cutting staff.

Why do they use garbage trucks to plow streets when they have snow plows? Why an aerial? Depends on the agency. For many its because no other units available. If you really think that fuel costs are why they are shutting down stations and cutting staffing...your sadly mistaken. Runs save jobs in most cases. Not even that is working right now. Sure..."they" can use a SUV or half ton utility...but then what? Depending on staffing your dropping one of 2 guys and again to some that means no staffing at the aerial.

You buy apparatus to respond to calls....its an investment and again...is the person with chest pain or SOB more or less as important then the AFA, outside gas..blah blah blah. To me...yes it is. They are paying for SERVICE.

What business are we in anyway? I thought it was public safety.

[Guest alsfirefighter]

Let's blame the lawyers. And remember that most legislators are lawyers.

In the 'old' days, pre 911, a person called the local police to report an odor or smoke. They sent a patrol car to check it out. Now with 911 the FD is dispatched to every single call, every single automatic alarm. Why? liability. My house burned down because you 'checked it out' before you sent the firetruck. The patient died because you checked it out first and we lost time in our golden hour. How many 'steam from the shower set of the alarm' calls to you hear? In a week?

Really? So with that thinking why doesn't the PD call my station to check out the panic alarm at the deli a 1/2 block down the street? The reason why the FD is dispatched is because if an alarm activates it did its job and activated for a reason. I mean by all means...never mind a fire doubles in size every minute its allowed to free burn. I don't refer to things that are really common sense and clearly defined responsibility of a particular agency anything but what it should be. So sometimes..liability is the correct driving force for those who try to cut corners and not do what should be done. I bet its a lot cheaper sending persons trained to deal with activations and fire then it is to pay the lawsuit because I police officer came to the door and didn't do what I know should be done.

How many steam from a shower calls to I hear in a week? Sometimes none but then again only radio I listen to is when I'm at work. Then again I really don't care what the reason is...I am the fire department. They are the police department and have their own issues to deal with.

[Guest alsfirefighter]

And oh..am I so waiting for the one normal comment that comes up about FD's having dual role providers. And yes I'm going to put that one to bed as well.

[ny10570 745]

Yeah, but what about FDs having dual role providers?

[Reliance 29]

Why do they use garbage trucks to plow streets when they have snow plows? Why an aerial? Depends on the agency. For many its because no other units available. If you really think that fuel costs are why they are shutting down stations and cutting staffing...your sadly mistaken. Runs save jobs in most cases. Not even that is working right now. Sure..."they" can use a SUV or half ton utility...but then what? Depending on staffing your dropping one of 2 guys and again to some that means no staffing at the aerial.

You buy apparatus to respond to calls....its an investment and again...is the person with chest pain or SOB more or less as important then the AFA, outside gas..blah blah blah. To me...yes it is. They are paying for SERVICE.

What business are we in anyway? I thought it was public safety.

I agree with you to a certain extent. But what if that pumper or TDA was on a medical run and then a call for a high rise came in. How would you handle it and what would the insurance company say.

[antiquefirelt 994]

I agree with you to a certain extent. But what if that pumper or TDA was on a medical run and then a call for a high rise came in. How would you handle it and what would the insurance company say.

At some point no FD or EMS service has the resources to cover every eventuality. Some are far better poised to handle multiple incidents, others not so well.

What would the public say if they knew that the EMS crew was struggling to take a cardiac patient out of the 4th floor and couldn't treat and transport at the same time, while the nearest firehouse had a staffed aerial sitting there waiting for something that might happen (with far less frequency than medical runs)? If you have two separate system that can provide quality service to their mission without relying on the other, that's great. But for a significant portion of this country anyway that's not even remotely close to the case.

Edited February 4, 2012 by antiquefirelt

[Bnechis 3,961]

Let's blame the lawyers. And remember that most legislators are lawyers.

Agreed and most legislators 1st goal is to get reelected, so they do many things that do not help us as a state or nation, but what is good for a group.

In the 'old' days, pre 911, a person called the local police to report an odor or smoke. They sent a patrol car to check it out. Now with 911 the FD is dispatched to every single call, every single automatic alarm. Why? liability. My house burned down because you 'checked it out' before you sent the firetruck. The patient died because you checked it out first and we lost time in our golden hour. How many 'steam from the shower set of the alarm' calls to you hear? In a week?

This is not completely acurate. In the communities that had a fire alarm box system, the FD got the call long before the Police dept even existed. This went on since the 1880-90's. PD's check and advise was not common till the 1950's or 60's and then it was because they answered the phone and sent a "Radio Car" out, sometimes with the FD notification but often not. Fast forward to today and Automatic Fire Alarms go from the alarm service to Fire Dispatch and PD often never knows, till we tell them.

In my experience the "check and advise" mentality occurs mostly in volunteer communities (this is not a Vol vs career thing, is an FD vs PD thing), as many PD's do not want to "bother the VFD", but does not want career FF's sleeping while they are out on the road. I've heard this issue from all sides in many communities. And sometimes liability is a driving force, but more often the depts ignor the threat and roll the dice. Its changed because of politcial pressure.

Also, before we became a nation of milquetoasts you took yourself to the hospital for most anything short of a traumatic amputation. Now you call 911 for a hangnail. I monitor the scanner while working from home and I hear the dispatches. An engine and a rescue responding to a fall down drunk, etc. etc. It used to be the cops would pick him up and take him to get help. No more. And this in districts where, if a fire call were to come in, mutual aid would be required because their on duty manpower and apparatus are tending to a drunk, etc.

You are very correct in how we have changed, but its not just the medical calls....we get called for lock ins, lock outs, no heat, no hot water, broken light....etc.....etc......etc....

PD dealing with the "drunk" has been gone in the areas I work for close to 30 years for multiple reasons:

1) Our PD was told they would be put on charges 30 years ago for transporting "patients"...because it cut into the city's billing.

2) I know of a number of cases where PD has transported to either the ambulance building ("to save time") or the ER. I have opened the PD car door in both of those cases and watched the "patient" throw up all over the back of the car (that usually is the last transport for that officer).

3) I do no of legal cases of "drunks" who died sleeping it off in the drunk tank...but they were not drunk, they were medical calls. That usually ends the practice.

The public isn't demanding more and more services, the legislators over the years, to curry favor with the electorate created the nanny state and the public is taking advantage of it. I don't remember the exact date, but personal responsibility disappeared, I think, about 20 years ago or so.

Its not the legislators who are dialing 9-1-1. We have more than doubled our calls in 25 years. Yes we have created a nanny state, but thats because we are teaching that you do not need to learn to fish, since we will keep giving you a fish.

Unfortunately the public has no more money to contribute to support the system as it is today. Catch 22.

Agreed, but they have a short enough memory, so they do not remember that the cost for not supporting us costs more.

[Guest alsfirefighter]

I agree with you to a certain extent. But what if that pumper or TDA was on a medical run and then a call for a high rise came in. How would you handle it and what would the insurance company say.

What if a bank robbery should happen? Or an active shooter scenario? Should we keep a few police officers sitting in their station for those scenarios as well?

What if the pumper or TDA was on a wires down call? Or inside odor of gas? Or AFA? And then a call for a high rise came in? The same exact thing you would do if its on a medical run. You call for another unit or make a request for mutual aid. Not to mention if on a medical call when the ambulance arrives you see if they are set and take up. In my case we will always at least have a Paramedic on scene so communication with them (or me being I rarely get out of the ALS units anymore) and 9 times out of 10 they will tell you to take the other call.

Resource Management is what it is. So again please...someone make a argument that can't be quantified from answering by me based on similar lesser priority calls. And note I don't say "fire" calls. Where I work a call is a call...being we are the FD...I guess an EMS run would also be a fire call wouldn't it.