One has to tread carefully when presenting information that can be interpreted as critical of "civil servants," be they policemen, public school teachers, or, as in this case, firemen. With that in mind, I'll note at the start that the embedded graph is deceptive, because the vertical scale has been truncated. The trend certainly is valid, but the implied amplitude has been exaggerated. Now, on to the text, excerpted from Marginal Revolution, via The Dish:
Taxpayers are unlikely to support budget increases for fire departments if they see firemen lolling about the firehouse. So cities have created new, highly visible jobs for their firemen. The Wall Street Journal reported recently, “In Los Angeles, Chicago and Miami, for example, 90% of the emergency calls to firehouses are to accompany ambulances to the scene of auto accidents and other medical emergencies. Elsewhere, to keep their employees busy, fire departments have expanded into neighborhood beautification, gang intervention, substitute-teaching and other downtime pursuits.” In the Illinois township where I live, the fire department drives its trucks to accompany all medical emergency vehicles, then directs traffic around the ambulance—a task which, however valuable, seemingly does not require a hook-and-ladder.I can vouch for the type of incident described, because at the senior living complex where my mother previously resided, both an ambulance and a fire truck responded to all non-fire emergencies. I never understood the justification for this duplication.
Moreover, most of the time the call is not for a fire but for a minor medical problem. In many cities, both fire trucks and ambulances respond to the same calls. The paramedics do a great job but it is hard to believe that this is an efficient way to deliver medical care and transportation.
See this link for a more detailed discussion.
When we had to have an ambulance respond to my place of work for a client, a fire truck was dispatched as well. I asked one of the firefighters why they had been dispatched as well & he said that (in our town) the a fire truck comes as well in case the medical issue requires both paramedics to attend to it. If that is the case, one of the firefighters will hop in the front of the ambulance and drive it to the ER while both paramedics are providing care.
ReplyDeleteIt seems like overkill to do this every time but I'm guessing they do it every time so that the dispatchers don't have to try to guess whether or not the fire truck assistance is needed, simply based on the information provided by a (likely) distraught caller.
Why would an org with a name like the National Fire Protection Association release such a crummy graph?
ReplyDeleteI'd certainly be wary after reading the author's final sentence:
Delete"Sounds obvious, but it’s hard to negotiate with heroes especially when they are unionized with strong featherbedding contracts."
Probably for the same reason that organizations like the National Organization for Marriage is trying to restrict marriage: deceptive naming seems to work.
DeleteI suspect the "data" (numbers) came from that source, but the graph was created by someone else. Just my guess.
ReplyDeletePersonally, I would rather have them well-rested when they are needed, but there is so much stupidity about civil service coming from the right-wing these days that I understand how this could come to be. Another factor might be that the equipment for ripping open a car when the doors are jammed is usually in the fire truck, not the paramedic vehicle?
ReplyDeleteTaxpayers are unlikely to support budget increases for fire departments if they see firemen lolling about the firehouse.
ReplyDeleteThat is sort of like saying that cops are 'lolling around the neighborhood' if they're just cruising around the block on patrol while they wait for a call, or something to happen.
In many suburban fire departments firefighters are now cross-trained as paramedics. When the fire department arrives at a medical emergency the "firefighters" are paramedics who have the same advanced life support (ALS) equipment as the ambulance. They have the ability to transmit 12 lead ECGs to the ER or to recognize a stroke patient and transport to the closest Stroke Center or to diagnose a STEMI. The medics on the fire equipment have medications to treat 'heart attacks', diabetic emergencies, seizures, asthmatics, allergic reactions, heroine overdoses and the like...
ReplyDeleteTrue, for most fire departments the "fire calls" have dropped over the years but the medical calls have increased greatly. When an ambulance transports a patient it can be out of town or out of service for extended periods of time - time that an asthmatic or heart attack victim does not have. The next ambulance may at best be coming from a nearby town/suburb. Many communities have seen this issue and have taken a service that is already in place (fire department) and adapted it to meet the needs of its citizens. The fire stations are usually strategically located to provide the fastest possible response in the event of a fire. Now they are there to provide the fastest possible ALS care in the event of a medical emergency.
Firefighters are also trained in HazMat, Technical Rescue (trench collapse, vertical rescue - think window washers, building collapse, confined space. These are all disciplines that require intense training and skills that must be maintained as technologies/techniques change. Continuing education for fire, EMS, technical rescue, HazMat takes place daily in many departments. I'm not even going to delve into the Public Education (which is a big reason for the drop in fires over the years - education!), Building Inspectors, Arson Investigation, Juvenile Fire Setter programs, car seat installation, CPR/First Aid programs that are all provided by your local fire department.
Firefighters wear many hats and have plenty to do to keep busy.
At the risk of sounding too "pro fire service" I don't think most people understand what their local firefighters are actually required to perform on a daily basis. Hopefully, you will never have to.
This firefighter has spent years painting at work.
ReplyDeletehttp://www.artists4kids.com/artist.php?artist_id=PENHALL
jobbie is spot on. Often, in those medical emergencies in which both firetruck and ambulance respond, a firefighter ends up driving the ambulance to the hospital so both paramedics can work on the patient in the back.
ReplyDeleteAlso, car accidents are frequent, and they can require both medical care and extrication from the car...
Google "firefighter charged with arson" (use the quotes) and be amazed how common this is.
ReplyDeleteDon't forget that the Department of Homeland Security has tasked firefighters to be their spys. On its own I'd shrug as I believe most FF would say 'not any of my business, I am here to help people' but with budgets for their services on the chopping block and DHS's new 'Assistance to Firefighters Grant Program' literally keeping stations open - I have to wonder who is brave enough to bite the hand that feeds them? [Hey, it is just one tiny little step away from personal privacy, nobody is going to notice and you get to keep your job.]
Maybe I am still just miffed...
Last night, a group of the local ff were inside enjoying a dinner of Torchy's Tacos while several groups on the patio, including ours, had to strain our voices to be heard over the idling emergency vehicle they parked in the firezone. I almost you-tubed it but the 'tread carefully' fear of a sheet-storm(of rain of course) kept my phone in my pocket. I know, first world problem.
In Ottawa when you call 911 they dispatch police, fire, and ambulance. The idea is that they all have some degree of cross-training and all are able to take control in an emergency. Those few critical minutes can make a huge difference. A firefighter or police officer can buy a heart attack victim a few more minutes if the ambulance arrives last.
ReplyDeleteI actually thought this was the way it worked everywhere.
The issue here is that it takes X number of firefighters to respond to the most severe fire you can have in a community (X varies by community). In the old days there might have been 100 serious fires per year. Now there may be just 1 serious fire per year. You still need X whether it is 1 or 100 unless you are willing to trade away something like response time - which means that you're willing to sacrifice the building that catches on fire (and anyone in it), since responding 10 minutes into a fire only has the effect of preventing it from spreading to the neighbors.
ReplyDeleteThe "public" now gets angry when told that X firefighters are being paid $50k per year to sit around doing absolutely nothing but wait for that 1 fire per year. To avoid that ill-will, departments have figured out how to serve the public in different ways.
Wow. This really is one of those conversation starter type posts. There are so many other topics that touch the main theme that I am not sure that I can cover all my thoughts well in just one reply. Hmmm. Here is to trying.
ReplyDeleteI work as paramedic in two Indiana counties and have also worked in Kentucky. I have also worked in emergency response as a park ranger in a couple other parts of the county. So, though I am by no means an expert on the subject, I am very very familiar with it.
Yes, fire prevention has really done great things over the years and there are many less fires reported. So, fire departments have really spread out to doing many other things than fighting fires. As mentioned in other comments by people, (I will not relist them here.) Responding to medical emergencies is just one of the many things that many departments do.
Given the history of fire departments and still current pressures by things such as insurance ratings, fire departments tend to still be all over the place. Check what your home insurance would be if your nearby fire department wasn’t there. This heavy saturation has helped there be a certain standard for fire department response times no matter the type of emergency.
But another topic really, but connected by so many comments is the firefighters going on medical runs. This can be for many reasons due to local protocols.
Ambulance services are by-in-large much younger and much less staffed than fire services. This causes ambulances to be spread out in a much larger geographic area and also work at a level much closer to capacity. Yes, this can cause a host of problems on its own, but the fire department adding support for medical runs can really lessen negative impacts on patients.
In the rural and small town regions, firefighters will go on every medical run. Think that the ambulance might be anywhere from 10-30 miles away, where like states above, there tends to be at least a volunteer fire department in most communities in America. A quick first responder response when the ambulance location can be that far away can make a huge difference in the outcome of the patient.
In the more developed urban communities, there is a more tiered response where dispatch tries to determine if the average ambulance response time might be too long (think 8 minutes) or that additional personnel might be needed (think auto accident, cardiac arrest, serious injury, or morbidly obese patient.) The local protocols can vary widely on exactly when the fire department goes or what vehicle they drive. But, realize that there is a chance the fire department may need to leave to go on another run immediately from that one. So, if you get a certain vehicle or certain number of firefighters, you will get a large fire truck vs. maybe a smaller response vehicle.
Two side topics that I see a lot in relation to this topic are budgets and “is that really an emergency?” 911 calls. Fire departments have had a lot of pressure to control their budgets. Medical runs can be seen as possible “income” to many of these departments. They may see it at least as increased run volume on reports which make it easier to justify budgets. This is a view that I think is more debatable because I really do think most firefighters really do want to help people, and doing medical runs is another way to do that.
ReplyDeleteThe last is the “why did the fire truck show up for a stubbed toe?” type can-of-worms question. Well, umm, that might be due to local protocols, misleading information given to dispatchers. I am not going to get into a healthcare debate. But, I do know that calls come in every day, multiple times a day in every community where the ambulance is significantly more response than the situation calls for. But, the person called 911 and the community has a duty to supply a response. If the person says the right things, or says they don’t know to the right questions, even more response may happen. This is a fact I do not have a solution to that I am going to get into here. But, it is something as a community that needs to be solved.
Ok. I’ve typed waaay too much already. Here’s the soapbox back.
I have family members involved in both services and understand that many medical emergencies require additional safety attention. Some situations may not quite be at the level that requires law enforcement but that firefighers can handle differently than medical personnel, or at least attend to while allowing paramedics to concentrate on the medical emergency. I don't know of examples, since in a small town a good EMS (who are all volunteers by the way) worker does not tell tales. I do believe that while a medical worker cannot touch an individual without their permission, a firefighter who identifies a safety concern can be more 'assertive'.
ReplyDeletePerhaps other readers will be able to elaborate on or debunk this possibility.
Funny, but whenever I see firemen lounging around the station I assume that they have polished all the brass that can be polished, and the hoses are dry, folded, and ready to roll. Why would anyone think differently? Common sense would dictate that they should be at their stations well rested and ready for as quick a response as safety and human capability allows. Not with some large vehicle clogging up the scene even more. Ambulances should have a dedicated driver who also directs traffic and provides logistical support. Cost more? Not as much as the growing police state - and we still do not pay the officers on the ground enough. I know, we need to get ready for the war over the arctic, so there's not that much money to go around.
ReplyDeleteLooking at that graph, I wonder what story the creator intended for it. I can see at least a few possibilities:
ReplyDelete1) Having more firefighters reduces the number of fires (presumably through education).
2) Decreasing numbers of fires make firefighting a more attractive job, resulting in increasing numbers of firefighters.
3) Some demon-possessed conspiracy is trying to shaft taxpayers by hiring more firefighters even though the number of fires is decreasing because the holy market is providing fire-proof buildings.