35 Comments Add your own

• 1. Jerry  |  June 29th, 2008 at 7:23 am

  I agree, but would add that we need to stop running $200,000 fire engines to every ambulance call. It’s a waste of fuel and expensive equipment. Instead, let’s use smaller vehicles equipped to assist if needed like Suburban’s or the like. Use a four man crew in the vehicle and trim the waste.

• 2. Chuck Sweeny  |  July 7th, 2008 at 12:18 am

  I agree. It would seem that we could outfit Suburbans, Yukons, and the like, as rescue vehicles for use instead of fire wagons.

• 3. Chris  |  July 7th, 2008 at 12:08 pm

  Thank you for pointing out to a largely unaware public that most “Fire Departments” that provide EMS (Emergency Medical Services) are indeed ambulance services that occasionally experience the need to put water on a fire. Roughly, 80% of calls responded to by all fire departments in our part of the country are strictly EMS only, with an additional 10% relying on a paramedic as well, such as car accidents and other rescues requiring medical treatment. Thanks to modern building methods, fires are way down from the levels experienced in the 70’s.

  As a long-time Paramedic, and firefighter, I have devoted my life to providing the best quality patient care on both the local and Federal levels. I have worked in many areas of this country and internationally. I hold licensure in both Illinois and Iowa as a Paramedic (EMT-P) and I also maintain my National Registry as an EMT-P (NREMT-P). In addition to my EMS credentials, I also have certification as an Illinois Firefighter II and am in the process of obtaining my FF III. I have many other hours of training with the requisite certifications and have been in the field since the late 90’s.

  As a paramedic who cares about patient care and the continued advancement of my chosen profession, I am vehemently against urban fire-based EMS in this country. No other fact has held the profession back and dashed the ideals upon which modern ambulance service was founded upon more so than the greedy fire departments that use EMS as a club with cash-strapped city councils to justify firefighter jobs. I would charge that this practice has cost lives and increased morbidity on an incalculably large scale in this country and is a crime perpetrated by the International Association of Firefighters.

  I have found that the public is largely unaware of what EMS does. People still refer to “Ambulance Drivers” and expect that an ambulance simply exists to drive them quickly to a hospital. In fact, just yesterday a lady told me of her idea to put retired Taxi Drivers into ambulances for efficiency. This is not the case in modern EMS. Today’s ambulance is designed, equipped, and staffed to bring the first hour of Emergency Room care out to the Patient. Today’s Paramedic has years of training, experience, and specialization in acute emergency critical care. With around 45 different emergency medications, ventilation and intubation equipment, emergency surgical equipment, electrical cardiac diagnostic equipment, and a direct line to almost any medical specialty, today’s ambulances are better called Mobile Intensive Care Units, and are actually designated by the State Department of Public Health in that manner.

  The public wouldn’t want their Doctor to be mandated to also be their Auto Mechanic, nor should they expect that their firefighter be mandated to be their Paramedic. What’s next, a combination Librarian/Sanitation Engineer? The psychomotor, ethical reasoning, and critical thinking skills for the Paramedic and the Firefighter could not be more different. Why then are the positions so intertwined in the minds of the public? When I went through my paramedic education ten years ago there were twenty of us. Out of that twenty, two of us actually wanted to be a paramedic and take care of patients. The rest were only there because they either wanted to be a firefighter or they were told by their fire department that they had to become a paramedic in order to keep their jobs. Can you imagine that someone who wants only to be a firefighter will make a good health care professional? Do you think that that person will go the extra mile for their patients? Do you think that they will be innovative in advancing new treatment modalities and in obtaining the requisite education needed to keep themselves abreast with the latest research?

  I’ll tell you, they will not and they do not. In this country, the lowest performing ambulance services in this country are the largest cities with Fire-Based EMS. According to the “200 City Survey” conducted by the Journal of Emergency Medical Services, the highest measured quality comes from cities with 3rd service, hospital based, or private EMS services. If you were to look at these cities with the non-fire based ambulances, such as Kansas City, MO., Phoenix, AZ., or Pinnellas County, FL., and compare them with the ambulance service provided in Rockford or Chicago, you would be outraged. We should be outraged. The public should be aware that they are being cheated by the Firefighters’ union who treat their lives as fodder in their battle to keep firefighter jobs.

  I propose that the Rockford Fire Department drops their provision of ambulance service entirely. They may respond as a first-responder service with EMT-Basic fire engines and use ambulances from a designated Ambulance Only agency. The Paramedics who are on the fire department who actually enjoy and are proficient at lifesaving emergency medical treatment may transfer over at their pay scale. This would allow for expert paramedics to focus on what they are best at, and expert firefighters to focus on what they’re best at. While you’ll never see it this plan, I would suggest that you spend ride time with the paramedics in Rockford (RFD) and the Paramedics in Belvidere (OSF Lifeline) just to see if you see a difference. You will, and it will be startling.

  Thank you for providing some information on the ambulance service in Rockford, which in my opinion is years behind where it should be. I encourage the paper to investigate and dig deep to find that there is a crime being perpetrated upon the citizens of Rockford by the very fire department they depend so much on. Some resources would be the Journal of Emergency Medical Services (www.JEMS.com), EMS Magazine, and online at www.EMSvillage.com. Do a Google search on “Fire-Based EMS” and you will find quite the impassioned debate.

  Some specific threads to read:

  http://www.emsvillage.com/forums/messageview.cfm?catid=45&threadid=6448

  http://www.emsvillage.com/forums/messageview.cfm?catid=36&threadid=6392

• 4. Shaun Smith  |  July 8th, 2008 at 3:16 am

  Jerry has the best comment on here i agree with what he said 100%

• 5. John Biltmore  |  July 8th, 2008 at 3:03 pm

  Chuckles, Chris has thrown down a challenge. Are you or the Register Star up to it? Why not investigate the costs of running a fire-based EMS? Or are you just about the quip and go?

• 6. Chuck Sweeny  |  July 10th, 2008 at 4:13 pm

  200,000 fire engine? Heck, try $600,000 fire engine. That’s more like the real cost.

• 7. Chris  |  July 10th, 2008 at 5:50 pm

  It depends, actually the costs vary from about $300,000 for a regular engine company to about $750,000 for a ladder. Seems like they could purchase and staff roughly 3 $100,000 ambulances for less than a new ladder or quint.

  Or outsource it for much less cost and much better quality…

• 8. GW  |  July 13th, 2008 at 10:54 am

  After reading Chris’ statements regarding the Fire Service and Ems service I felt the need to offer another opinion. The argument that the Fire Service and EMS have nothing in common and need to be separated could not be farther from the truth. With nearly every Fire or Rescue related incident that any Fire Service responds to, comes the inherent potential for injury to citizens and rescuers. Whether it is a fire, Haz-Mat incident, water rescue, structural collapse, motor vehicle accident, storm related hazards or a terrorist incident.
  The fire service offers the dedicated person the opportunity to train for numerous levels of preparedness and they all hold EMS at their core, whether it is as a First Responder or as a Paramedic. To have a first in company trained at the highest level of EMS skills many times means the difference between life and death. I could not and would not want to see Fire-Rescue personnel have to wait to extricate a patient from any life treathing situation before they were offered the highest level of medical care available. For example, a patient trapped in a vehicle during a extrication is given intensive medical care by the same personnel charged with extricating them. If the Fire and EMS service were separate that same patient may not receive the same level of care due until After being extricated due to the inability of the EMS provider to enter what is very dangerous area without the same personnel protection equipment and State Certified training the fire /rescue service already has. Granted that the majority of a fire service calls for service is based on the medical needs of the citizens, but there is also the very real need to have that service tied to the fire service because it is not just fire…it is Fire/Rescue. Again whether it be a man-made or natural disaster, which to most people any call for Fire/ Ems is a disaster, to be able to immediately put a highly trained Fire/Rescue personnel next to the victim and offer aid, treatment and mitigation of the problem is a service beyond reproach. In regards to your views of the Rockford Fire Department it appears as if you have an axe to grind with them. All paramedic are held to the same standards. A private ambulance offers the same equipment and the same level of EMS care. Chris offers that the RKFD Fire Dept is short changing the citizens when in reality they offer the same service with personnel that have been cross trained to handle not only the medical needs of the patient but also the ability to offer skills and knowledge not offered to the personnel who are strictly EMS based. I don’t mean to discount the service that EMS providers offer but I also don’t believe the argument Chris offers has any merit. A cross trained individual is not made more ignorant in one field due to their knowledge of another. The citizens of Rockford deserve the best services available and that includes having Paramedics on First Responding fire apparatus. The ability to put a Paramedic in the home of a person in need of EMS service before the Ambulance arrives is a service that has saved people’s lives in the past and will save people’s lives in the future, Guaranteed. Chris states that he is a trained and licensed Paramedic, the same as Rockford has. He claims Fire service and EMS should not be intermingled yet he states he is trained to a FireFighter II level and working on his FireFighter III. That statement seems a little contradictory. All RKFD fire personnel are trained to a FFII level during their first 6mos on the job. FFIII is required prior to any other specialized training such as Haz-Mat, Vehicle Extrication, Homeland Security based Technical Rescue, Dive Teams and etc. I am sure Chris is a dedicated, professional and competent Paramedic, but so are the Paramedics from RKFD fire, only with more diverse and specialized training.

• 9. Chris  |  July 14th, 2008 at 2:04 pm

  Finally, some public debate! Excellent. Oh, and I’m sorry if this goes a little long…

  First of all, perhaps I do owe an apology to the RFD personnel that I could have offended with my previous post. My intent here isn’t to individualize my beef with Fire Based EMS to the departmental or personal level. There are dedicated cross-specialty providers who provide excellent care in both disciplines. My point is to highlight the deficiencies within the system, not the individual. If I painted with too broad of a brush at first, I am sorry. However, it is long overdue for a spirited and logical debate on this subject to be held in the public arena and not just within the industry. I say to the public that this is an issue that affects not just your wallet, but the health and safety of your loved ones and yourself. I implore everyone to form an educated opinion on this, because it’s just too important not to.

  I agree with GW, the previous poster, on a few points, but of course, differ with him on others. I think that it needs to be said again that this is not a direct assault on the Rockford Fire Department, as I have good friends and close colleagues on the department and have myriad working experiences with them, both good and bad. Rather, my contention lies within the system that allows the IAFF (Yup, union bashing) to have created a system that allows any control of a medical operation to be held by an unrelated industry solely for financial gain.

  GW offers some points that have amounted to little more than rhetoric designed to confuse the public that, upon examination hold nothing more than semi-emotional sway. EMS stands for the Emergency *Medical* Services, which, by definition, denotes a medical specialty. As I have stated, today’s modern Paramedic Ambulance is intended to replicate the first hour or so of emergency room care and can stabilize the more critical patients that fall ill or are injured before a doctor completes the continuum of care. It is not, nor should it be, a ride to the hospital. A paramedic is nothing less than a highly specialized patient care provider who is an expert in acute intensive care. It is just like the fact that an RN who works in the cardiac step-down unit of a hospital has a vastly different specialization than an RN who works in the Neonatal ICU. While the licensure card may say RN, there’s a level of experience and knowledge requisite to both positions that can only be attained by constant and consistent immersive dedication to their respective specialty. Ask the family of a neonate if they would prefer that a gerontologist work on their baby. Even though they both have an “MD or DO” behind their name, the specialty just isn’t there. I say that the patients who call the ambulance deserve a dedicated professional whose main focus is their care.

  You stated in your post that “With nearly every Fire or Rescue related incident that any Fire Service responds to, comes the inherent potential for injury to citizens and rescuers. Whether it is a fire, Haz-Mat incident, water rescue, structural collapse, motor vehicle accident, storm related hazards or a terrorist incident. The fire service offers the dedicated person the opportunity to train for numerous levels of preparedness and they all hold EMS at their core, whether it is as a First Responder or as a Paramedic.” Then why would it not make more sense for a dedicated EMS specialty agency to overtake a fire department? Wouldn’t millions of dollars and hundreds of lives be saved if EMS providers who may not have the dedication to fire that a fire department has take over the Fire Department and run the occasional house fire? Even if every house burns down, and every extinguishment tactic is strictly a defensive operation, wouldn’t it be more economical in the long run? (Actually it is if you run the numbers. Multiply the average appraised value of every building that has burned in Rockford over the last year by the number of fires responded to and then compare that with the salaries of the fire department personnel). While I know that the last is a very inflammatory statement that even I would take umbrage to as a 10year fire service veteran, it may be true in a strictly dispassionate economic sense. Is it more important that a dumpster fire be extinguished than an elderly lady get smooth transport for a bowel obstruction? A few fire departments seem to think so. I believe that it came out in USA today when they attempted a semi in-depth analysis of a major city fire department’s run statistics that the engine crews consistently responded more rapidly to so-called “nuisance” fire-related calls than they did to EMS calls (Although I cannot find the link to the story). I question that department’s dedication to EMS as much as I question the dedication of the people in my paramedic class ten years ago who were simply in the class to attain the licensure so they could get a job on a fire department.

  ”To have a first in company trained at the highest level of EMS skills many times means the difference between life and death. I could not and would not want to see Fire-Rescue personnel have to wait to extricate a patient from any life treathing situation before they were offered the highest level of medical care available. For example, a patient trapped in a vehicle during a extrication is given intensive medical care by the same personnel charged with extricating them. If the Fire and EMS service were separate that same patient may not receive the same level of care due until After being extricated due to the inability of the EMS provider to enter what is very dangerous area without the same personnel protection equipment and State Certified training the fire /rescue service already has.”

  Unfortunately, the above statement is an IAFF talking point that has been hashed and rehashed too many times and there are too many holes in that logic to point out in this limited space. The simple examples needed to refute these statements pertain again to the medical model. In the ER when a major, multisystem trauma comes in a team of professionals with complimentary specialties is brought in to care for the patient. From the ER physician and Trauma Surgeon to the nurses, respiratory therapists, and radiation techs; each subspecialty of medicine has a vital role to play in the health and wellness of the patient and the team. I darn sure don’t believe that the trauma surgeon should know how to operate the CAT scan machine as much as I believe that every paramedic should be a specialist in the use of the Jaws of Life in regards to hybrid vehicles with multiple airbags. EMS and Fire have different psychomotor skill sets, different ethical reasoning, and different intellect requirements. The person running the tools should be an expert in just that.. running the tools. The Paramedic, who is the highest level of care, should focus on the patient’s needs in full. Besides, “BLS before ALS”. (Basic Life Support before Advanced Life Support)I can count on one hand the times that I’ve performed ALS skills in a crumpled patient compartment. In those first moments, the life is saved by good Basic Life Support with expert Advanced Life Support coming later in the continuum of care. With good BLS engines and motivated fire personnel focusing on what they are supposed to do best, you’ll never see a situation where “I could not and would not want to see Fire-Rescue personnel have to wait to extricate a patient from any life treathing situation before they were offered the highest level of medical care available.” It just doesn’t happen. FDNY treats all trauma calls at the BLS level. In rural areas, and very early on in my career I worked about as rural as you can get, BLS is all that is available. National standards as determined by the NAEMT state that an ambulance should arrive on scene within 8min 90% of the time and that is reinforced in the contracts that major cities have with their ambulance providers. In Rockford, you should almost never have to wait more than 8 minutes for an ambulance. *Should* almost never…

  As to your statement that EMS personnel should not enter the hazardous patient compartment, that’s not a very valid point either. While a 3rd service EMS provider should not enter an IDLH (Immediately Dangerous to Life and Health) environment that is the interior attack of a house fire, no firefighter/paramedic performs ALS care in their either. There are rare examples of paramedic companies that cannot buy their own extrication suits, goggles, gloves, and a hard hat, and be familiarized with the extrication scene. Besides, most teams that compete at TERC (Competitive Auto Extrication) wear NOMEX jump suits, not structural firefighting gear. In my career I’ve worked at ambulance/rescue departments that performed their own rescues. Is that the way of the future? No, but neither is the FD having control of a medical system. What’s next, urgent care clinics at the fire stations? Actually it’s a good idea… but it’d never be staffed by firefighters.

  In addition regarding the above statement, the only reason that the fire truck beats the ambulance is because the system is imbalanced and resources are improperly spread. Now, this is not an attack on RFD specifically, but I’ll use this example in the hope that you can enlighten me on why this is. According to the RFD web site:

  “The Rockford Fire Department is under the direction of Fire Chief D. William Robertson, who heads a staff of more than 270 uniformed and administrative personnel. Additionally, there are 61 employees associated directly with the 911 Telecommunications Center. The Rockford Fire Department provides firefighting, emergency medical service, hazardous materials mitigation, extrication, and technical rescue services to the 150,000 city residents. Annually, the department responds to nearly 19,000 emergency incidents and maintains an ISO Class 2 rating. The city is protected by eight engine companies, three quint companies, two ladder companies, and five ALS ambulances housed at fire stations strategically located throughout Rockford.”

  Ok, here is what substantiates my above statement. There are 8 engines, 3 quints, and 2 ladders. Not taking into account the reason for the specialized areal apparatus, and assuming 4 person crews, that’s 13 companies staffed with 4 personnel each for a total of 52 people on duty at a time. Add to that two District Chiefs to cover the city and that’s 54. The website states that there are 5 ALS ambulances in the city, and they are staffed with 2 personnel each. That’s 10 people. So, if the website states that you run 19000 “emergency incidents” and national statistics agree that roughly 80% of all calls to a “fire department” are medical in nature, that’s 18% of your on-duty staff being devoted to running 80% of your calls. It doesn’t make sense. In Belvidere (and I do not work for Lifeline nor BFD), their ambulance is dedicated to running 100% of their calls with 100% of their resources. In Davenport, IA (Comparable in population to Rockford) Medic EMS runs 100% of their calls with 100% of their resources. So does Kansas City, so do a number of other progressive cities. You may say that my statement is false because your engines respond to EMS calls in their first-due area. I say that there should be more ambulances and specialty medical personnel so that the fire engines wouldn’t have to.

  “I don’t mean to discount the service that EMS providers offer but I also don’t believe the argument Chris offers has any merit. A cross trained individual is not made more ignorant in one field due to their knowledge of another. The citizens of Rockford deserve the best services available and that includes having Paramedics on First Responding fire apparatus.” Again, look at the research. The old adage, “Jack of all trades, master of none” does apply. Having a paramedic on every fire engine makes it so the chances of an individual paramedic getting the chance to perform a skill enough times to maintain expertise are slim. The research is out there, do a google search on “Paramedic skill degradation with oversaturation” and read it for yourself. An Anesthesiologist performs hundreds of tubes before he or she is considered competent. How many have I had this year? How many have the RFD paramedics had this year? Even I’ll admit that to that standard, not enough. Fire units should have competent BLS care backed up by experienced specialized ALS Paramedics.

  Now let me state again, this is not an attack on RFD. It’s an attack on the mindset that EMS belongs under the realm of the Fire Department. Rescue? Probably. EMS? Nope. The citizens of Rockford deserve to have the benefit of an impassioned, yet logical debate about such a desperately important issue. The citizens of our nation deserve it too. Heck, maybe I’m wrong and Fire based EMS is the best when it comes to the current minimum standards.. but that doesn’t refute my point that there should be much higher standards that the fire departments could never match. EMS is a medical subspecialty better suited to the realm of academia than IFSI. (The Illinois Fire Service Institute),

  “I am sure Chris is a dedicated, professional and competent Paramedic”. I am in complete agreement. “but so are the Paramedics from RKFD fire”. I agree that most of you are. “only with more diverse and specialized training”. I beg to differ. While there are a lot of people out there with great training and skills. My resume will hold its own against industry standards without any trouble. I’d go on, but this isn’t a “measuring” contest. It’s a debate where logic and reasoning should stand devoid of rhetoric or personal attack.

  Please, please, keep this going and invite others to the debate.

• 10. five hundred seventy four  |  July 15th, 2008 at 1:08 pm

  Chris it is nice that you opened this dialogue. Between you and GW you have brought up some excellent arguments, but please allow me to add my two cents on the role of the cross trained firefighter / paramedic. I am making this post under a name that will be fairly easy to figure out who I am, and I will identify myself as a firefighter / paramedic for the city of Rockford right now, therefore, I am not blogging the anonymity that others have.
  Chris I have experienced EMS in a variety of different EMS settings. I have worked for a private EMS only company in a rural setting, hospital based EMS, and finally a dual response cross-trained personnel system. Allow me to tell you the biggest, most simple differences. One is time, and the second is help.
  Allow me address the time situation first. In EMS time is everything. I have experienced in Winnebago county, as well as other rural areas, single ambulance responses to 911 calls. I am sure that you have lived the 10+ minute response time, followed by a 10+ minute transport time. In the city of Rockford, every 911 emergency medical call has a paramedic staffed fire apparatus and ambulance dispatched. If you have any knowledge of the Rockford Fire Department you know that the ambulances are busy, very busy, and getting busier. The fire apparatus, generally, arrives minutes prior to the ambulance and the apparatus has paramedics on the fire truck. Ask a resuscitated cardiac arrest victim that has received treatment by a paramedic on a fire truck if they like the idea of the ALS fire apparatus. Ask an anaphylactic shock patient that has received treatment by a paramedic on a fire truck if they like the idea of the ALS fire apparatus. Ask a diabetic that has received IV glucose by a paramedic on a fire truck if they like the idea of the ALS fire apparatus. I think you get the point. These are things that the fire department paramedics do EVERYDAY. Just based on geography you have to concede that fire trucks respond faster than ambulances, FIRE TRUCKS ARE CLOSER !!!!
  The second point I would like you to consider is the number of responders on a scene. In my days as a private ambulance paramedic, for the most part, it was my partner and I. I can really say that the patient receives better care when there are more paramedics and firefighters on the scene. Let’s not forget that EMS is now a “team work driven field”. As well, you know the wear and tear on the body that being a paramedic takes. In Rockford, I don’t have to lift the cot, the patient, call all of the equipment on EVERY call, there is always someone to help you. To me, that is priceless. It keeps my back healthy, it keeps my legs fresh, and it makes for safer patient transport.
  Everyone knows that in urban EMS there is a moderate level of ambulance abuse, but that really has more to do with the national health care crisis than how the city of Rockford responds to calls for service. Spend some of your time and beautiful writing ability writing letters to your senators and congressmen and help offer ideas to help that situation. We can only respond to the calls and transport people where they want to go when they want to go.
  Finally, in your initial post you really did take cheap shots at the personnel on the fire department. I hope that you don’t really think that you are better then the people that I work with, because its not true. If I was a betting man, I would wager that you have tried to or will try to get on the fire department someday. Good luck!

• 11. Chris  |  July 15th, 2008 at 5:27 pm

  574, thank you. I was wondering when someone else would pick up on the thread. I love a good debate and I’d like to have the public get a chance to view the discussion. As I’m sure you’ve seen if you’ve taken the chance to peruse the industry message boards and publications, this is a highly charged issue within the industries that we are both purporting to represent. I believe that the public in general, not just in Rockford, will benefit from taking the discussion outside of the inner circle, and from my point of view, making the IAFF and the IAFC defend their rhetorical talking points. I made mention of Rockford Fire because this is the Rockford Register Star, not because I have a personal axe to grind. And Good Sir, you’ve lost your hypothetical bet… I’ve never attempted entry into your department nor do I have intentions on doing so… less because of local circumstances and more because I have no love for the politics of your national union and do not wish to become a member. With that being said, I do not want this to become an issue of union vs. non-union labor as that discussion is best handled elsewhere. Besides, I’d have to take a cut in pay.

  If I may, I’d also like to qualify my viewpoint on this issue. I am passionate about EMS. I believe that the public deserves the highest quality of care at the times that they need us. I look at it as an honor and privilege that I get to go out every day and serve my fellow man. In my ten years as an EMS professional in both paid and volunteer roles I have not experienced the burn out that I’ve seen my peers succumb to. I love EMS and find that it compliments the other aspects of my life nicely. In working for the busiest of cities to the most rural areas, whether in rank-and-file, middle management, or Director positions I have never lost the love I have for the profession of EMS. I believe that our profession is a critical service to our nation that is integral to the psyche of our citizens. Think about it, in the 30 years or so that we’ve been around as a coherent entity, our profession has gone from untrained “Ambulance Drivers” rocketing around in hearses to professional providers offering truly Curbside Critical Care. The public doesn’t think much about us until the unthinkable happens, but when it does, it is our duty to be there for them.

  It is also our duty as EMS professionals to be there for the public and solve the issues that are affecting our level of service to them; and Fire Based EMS in urban areas is one of those factors that limit our profession in the sole name of maintaining union firefighting positions (and the IAFF’s political power) at the expense of the lives of the public.

  With that said, in your post, you stated:

  ”The fire apparatus, generally, arrives minutes prior to the ambulance and the apparatus has paramedics on the fire truck. Ask a resuscitated cardiac arrest victim that has received treatment by a paramedic on a fire truck if they like the idea of the ALS fire apparatus. Ask an anaphylactic shock patient that has received treatment by a paramedic on a fire truck if they like the idea of the ALS fire apparatus. Ask a diabetic that has received IV glucose by a paramedic on a fire truck if they like the idea of the ALS fire apparatus. I think you get the point. These are things that the fire department paramedics do EVERYDAY. Just based on geography you have to concede that fire trucks respond faster than ambulances, FIRE TRUCKS ARE CLOSER !!!!”

  These, as I stated to GW in my previous points, are emotion-based talking points that are invariably put forth by every proponent of Fire Based EMS that enters into this discussion. Of course they grab the attention of the uninformed because they’re emotional daggers that personalize what needn’t be personalized. Medicine is both an art and a science. Dispassionate medical research and discussion advances the standard of care and, “saves lives”. Emotional anecdotes do not. While I am not familiar with an established body of research other than the JEMS 200 City Survey that thoroughly reviews the issue, if you take in the body of research that is available you will see that there is a pattern developing that discounts your arguments. Besides, as I have stated before: Fire trucks are only closer because your department (Oops, sorry… *ahem* Most fire departments) spend $600,000 on a quint and staff it with 4 personnel rather than spending $600,000 on 6 ambulances and staffing them with two Paramedics a piece.

  Hey!! I have an idea. Let’s deploy Quick Response Vehicles (QRVs) and more ambulances into the city and suddenly; Just based on geography you have to concede that ambulances and QRVs respond faster than fire trucks, AMBULANCES ARE CLOSER!!!!

  Maybe that was a cheap shot, but it’s deserved. Fire trucks are for putting out fires, pumping out basements, rescuing kitty cats from trees, and well, “fire truck stuff”. Ambulances and medical vehicles are for “medical stuff”. It pains me when you state the obvious fact that your city’s ambulances are being stretched and that they’re going to be stretched more and more. Of course they are… and you’re very correct to say that the national healthcare crisis plays a large role in the problem. However, deficiencies in ambulance system design and deployment on the local level does as well. So does the fact that EMS has so much unrealized potential that is being held back by the IAFF and IAFC because they’re scared to let Paramedics reach their higher potential such as providing curbside *primary* care, and curbside *preventative* care, and curbside *public health*. Look no further than the differences between the nightmare that is the so-called “National Scope of Practice” and Dr. Bledsoe’s recent essay on the “Bledsoe Scope of Practice” that was published in JEMS. The IAFF and IAFC have scraped clean any meaning in the former, and the American Ambulance Association, as usual, is powerless to stop them.

  I say that We as Paramedics need to educate ourselves on how best to serve our public and step away from the fire-based EMS model in most urban areas. It’s failing and in cities like Pittsburg, New York, and San Francisco, it has failed. While Fire Based EMS may be very appropriate in rural areas and/or smaller communities with limited population, it is not in an area that has a population base deserving of professional sole-EMS providers. Let us not bring up the differences in Quality Assurance/Quality Improvement, In-Field Medical Oversight, Protocol Advancement, or EMS training between your department and say, MEDIC EMS in Davenport, IA. How many specific positions do you have assigned to those positions? I would love to know. I’d also like to know what your percentage of in-house case review is. It’s not that I’m saying that your medics aren’t dedicated. I am close friends with many and do not wish to malign their service. However, on a strictly dispassionate professional level with the public interest in mind, I’d like to know.

  If you want to have someone to carry your equipment, have them respond in a QRV. If you want to have more people out there, staff more single-role Paramedics or EMT-Bs. If you want to save more lives, have your Paramedics focus on medicine (Like Seattle does). Remember in my first post I advocated for the fire apparatus to respond at an EMT-Basic level. Not only would it lower the cost of the medical equipment on the apparatus and lower the cost of initial firefighter training, it would also allow for immediate BLS responses and build EMT-Bs with a strong BLS foundation for when they advanced their training into being a Paramedic on an ambulance. It’d be a promotion to get on the ambulance, rather than the opposite.

  In closing this post, I’m not taking cheap shots at the Rockford Fire Department. While any department has its failings, I know you guys and I’ve worked closely with you. This is a tightly-knit little EMS community we’ve got here in Winnebago County and as individuals; the darn-near-most of you have earned my respect. The disrespect, however, goes two ways. Condescension of those of us in the profession who do not kowtow to the “big boys” doesn’t fly here. My father told me that Respect is earned every day. It doesn’t stay around if you don’t earn it every day. Your rank-and-file aren’t the problem here. The system, and benign neglect may very well be.

• 12. five hundred seventy four  |  July 15th, 2008 at 7:46 pm

  Chris let me start by saying that in reference your post about the “fire department stuff”, if you really think that the fire department “pumps out basements and saves kittens from trees” I wonder why you are wasting your time pursing a FFIII certification. I hope that have a lieutenant or some sort of a firefighter supervisor that discusses that with you and helps you improve your attitude toward the fire service, because that is WAY OFF BASE.

  But, say for a minute I agree with you. Lets separate every portion of the fire department into its own separate specialty. We will separate the ambulances from the fire trucks and buy more ambulances, we will of course, hire more fire fighters to replace those that went the ambulance. We will need at least eight new stations for to house a hazardous materials department, a trench rescue department, a collapse rescue department, a dive call department, a high angle rescue department, an automobile extrication department, a confined space department, and of course, the lift the uninjured fall victim department. Obviously, each new station needs equipment, staff, apparatus, and training. Each new department will need to create a training division and have command staff. By my count, THAT IS A LOT OF PUBLIC MONEY!!!!

  OR

  We can keep doing things the way we have been because it works for us. Don’t misunderstand me and think that things can’t be improved. When ever public money is being spent at the rate that we (Rockford Fire and all fire departments) spend it, you have to be accountable and try to improve and that is what we do daily. Instead of spending all of that money on different departments, why not use the same person to fill in a couple of those spots and really maximize the use of public money. That’s being responsible.

  and that is it for tonight because the all-star game is on in HI-DEF !!!!

• 13. Chris  |  July 16th, 2008 at 8:44 am

  Actually, in some cases, there are fire departments that pump out basements and save kittens from trees. It’s called “Community Service”. I understand that you weren’t familiar with it, but there’s really a big ol’ world out there beyond Rockford where some strange things happen. Maybe you could check out a book at your local library.

  Perhaps it is mean-spirited to make the above statement, and then to continue on with this train of thought, but it’s early and I was up late for the all-star game too. Had to watch it in a hotel because I’m out of town on business right now, and I didn’t make it past the 10th. So it’s an early morning.

  Follow closely here folks; this is a little thing that I like to call “Math”. The department, on their web site states that they run approx 19000 calls per year. As stated above in the original blog posting, the department unofficially runs 80% medical calls. That leaves 3800 annual “Fire” calls. So 15200 annual calls are medical only. While I would argue that 90% of the calls to the “Fire” department are medical in nature when you consider the mostly medical calls like traffic accidents, I will not for the point of this paragraph. So if you have 8 engines, 2 Quints, and 1 ladder, that’s 11 Fire units. You could take that 3800 annual “fire” calls divided by 11 units which would equal 345 calls per unit per year. Now, please correct me if I’m mistaken, but your assignment for anything from an activated fire alarm (AFA) to a house fire (and rightly so) is 2 engines, a ladder/quint, an ambulance, and a chief. So these will skew the numbers a bit, but if we assume that 50% of the 3800 annual “Fire” calls are AFAs and Structure Fires that leaves only 1900 annual calls that are multi-company responses and then 1900 more that are so-called “Nuisance” runs like dumpster and brush fires that only require a single company response. I don’t have the numbers without some digging, but I’m sure that an insurance company out there has a report on the number of traffic accidents in the city. So we could get those numbers as well… but let’s not. Let’s just be generous with our assumptions and round high for the sake of egos and say that for each company, in one 24 hour period, would run just around 2.5 calls per day if the FD stopped responding to EMS calls.

  Wouldn’t that give you all the time you needed to pump out a few basements? And please, won’t someone please think of the kittens?

  Let us now further your logic a bit from your paragraph where you wanted to agree with me. I see your point and I realize that people can multi-task but let’s swing the pendulum the opposite direction to point it your way. So you think that separating all of the differing roles that the fire department plays wouldn’t make sense… because as you stated and I agreed above, there’s a whole lot of things to do and you can multi-task. However, since you only run about 2.5 fire calls per day, wouldn’t there be a lot more time for training? Heck, if the fire department has taken over something completely medical, wouldn’t it make more sense for them to take over things that are related to their job in some way? I mean, you guys are great with ventilation and building construction… so couldn’t you take over some code enforcement functions? Every Big Red Truck you’ve got has a pump on it, so shouldn’t you create some synergy with the water department and help them out? Hey! I have an idea about water reclamation too!

  See my point?

  My friend, if you’re willing to think about the idea and defend your position then you, personally are not the problem. You’re also probably willing to be part of a solution. The fire service is proud to be 150 years of tradition unimpeded by progress. The old mindsets need to be changed. It’s not wrong to challenge the status quo. I’m darn proud to be a firefighter and I treat the job with the respect and seriousness that it deserves. I do everything to the best of my abilities every time I have to do it. I’m sure you do as well. I’m not knocking your dedication to your tasks, nor the credit that the RFD deserves for the good it does for the community. I’m just saying that there are issues that need to be called out into the open and discussed. EMS and the lack of real devotion to it by Urban Fire Based EMS needs to be challenged and fixed. I want to see those 15,200 people that are afflicted by medical emergencies serious enough that they feel they need help from EMS to have people respond that take their concerns seriously enough to care about the system, not just throw 5 overrun ambulances at it and get annoyed by the extra time.

  Yea, I said it. If you’ve got 5 ambulances running 15200 calls per year that’s 3040 calls per year per ambulance. Hmmm, 912 calls per year for the fire guys (assuming 2.5 calls per day) and 3040 calls per year for the ambulance guys. What does your department truly care about? Maybe I should ask what your death rate is for structure fires, which I assume is an almost non-existent number because you guys do an heckova job fighting fires. I’d also ask what your survival-to-neurologically-intact-discharge is for cardiac arrests? What? You don’t even track it? How many cardiac arrests do you run per day? Wow…

  Remember, public discourse is good. Challenging the status quo is good. If the current situation is adequate, then it can be defended against legitimate debate because the public deserves to know why it is or is not adequate. My feeling is that we can do better.

  Looking forward to your next.

• 14. GW  |  July 16th, 2008 at 10:01 am

  My postings are not necessarily a debate on the benefits of Fire based EMS but more are a clarification of misinformation. You can pull statistics and opinions from multiple sources to suit an argument. If I felt the need or desire to run comparables I would…but I don’t.
  Chris states:
  “so couldn’t you take over some code enforcement functions?”
  As far as RKFD Fire goes we do code enforcement, unsafe structures are inspected, capacity checks are done, plan reviews, pre-plans and living condition inspections are done on a daily basis…again you state opnion as fact.
  “ Every Big Red Truck you’ve got has a pump on it, so shouldn’t you create some synergy with the water department and help them out?”
  On a yearly basis hydrants are tested thru-out the city by the Fire Dept, not only for flow rate but for general maintenance. We are currently in the process of testing such hydrants using GPS to pinpoint the locations for the purpose of computer mapping in the fire apparatus. Again… opinion as fact.
  Chris, while you claim to be an advocate of non-fire based EMS; you again contradict yourself by stating that, “Remember in my first post I advocated for the fire apparatus to respond at an EMT-Basic level. Not only would it lower the cost of the medical equipment on the apparatus and lower the cost of initial firefighter training, it would also allow for immediate BLS responses and build EMT-Bs with a strong BLS foundation for when they advanced their training into being a Paramedic on an ambulance. It’d be a promotion to get on the ambulance, rather than the opposite.”
  I personally do not view my ambulance career as a demotion and I know that my colleagues and peers do not view it as such either. I do acknowledge the fact that to run a BLS Fire company would save money on medical equipment but it would cost a patient in distress the advanced medical care they need. In other words it would cost lives! Put a price on that. Label it as emotional rhetoric but it’s the plain and simple truth…people will Die due to a delay in medical treatment that had been in place in the past. Explain that to the family members.{ I’m so sorry Mrs. Smith that your husband has passed, but as a BLS engine company we are no longer allowed to carry or administer medication that may have saved his life.}
  I do agree with you that respect is earned every day but it’s also given at the initial meeting until lost by the inconsiderate or disrespectful actions of others…and then it has to be earned all over again. I feel you’ve disrespected not only RKFD fire but any Fire/ EMS personnel that have had the opportunity to read this blog. Your argument would carry more weight if not for the personal attacks against the Professionals of RKFD Fire as a whole. You present your opinions as facts and insult others while contradicting yourself. Another example of inaccuracy is your reference to IFSI (Illinois Fire Service Institute) as having control of the EMS aspect of the fire service, when in fact all EMS control is handled at a regional level, regardless of whether it is fire service based or strictly EMS…we very well may practice under the same Dr’s license as do you. IFSI handles fire related educational programs and the State Fire Marshal handles certification and testing of the Firefighter/Paramedics who strive to continue a fire related educational career that will continue as long as their Fire/EMS careers will last if so chosen.
  Someone once told me “this career is what you make of it”…pretty open ended I know. It’s also pretty accurate in that, like all careers, some individuals are content doing exactly what their job description spells out. I am in no way slighting anyone who doesn’t continue their education …to many other factors come into play… family, past times, etc. My point is that, again, to be proficient in one field does not make you more ignorant in another. Fire based EMS is truly the “jack of all trades” and it is possible to be master of them all. You state opinion as fact and in my eyes that short changes us all.
  National Paramedic Institute(NPI), International Association of Fire Fighter( IAFF)and the California Professional Firefighters just formed a partnership to allow for online training for Paramedic recertification and other firefighter, EMT and paramedic training needs at a discount. Hopefully this will be offered soon to all fifty states but as you can see the IAFF embraces the EMS fields as strongly as the fire service aspect. Associations such as the IAFF allow for assistance in continuing the knowledge base of its members and also offer some protection from the attempted bureaucratic roadblocks a separate and possible private service would provide. It has been charged that “The public should be aware that they are being cheated by the Firefighters’ union who treat their lives as fodder in their battle to keep firefighter jobs.” That statement, in my opinion, couldn’t be farther from the truth.
  I’m sure fire services from Stillman Valley, Byron, Rockford, NORTH PARK, HARLEM-ROSCOE and countless others all hold EMS as a true need and service for their community. Service such as OSF LIFELINE and others are also staffed by dedicated and professional people. To say a Firefighter cannot focus as strongly on fire related subjects as they can on EMS related subjects is comparable to saying a mechanic can only work on one make and model of cars..or a carpenter can only build a ranch style house vs. a two-story. All services have their own methods to weed out the few who may not be right for the job, whether it be for lack of knowledge, lack of interest or bad judgment. But to state, as fact, that only a dedicated Ambulance service is capable of providing top notch care, based solely on the fact that they focus on nothing else is misleading and border line unethical.
  Again, EMS control is handled at a regional level, regardless of whether it is fire service based or strictly EMS…we very well may practice under the same Dr’s license as do you.

  The need for a $600,000.00 quint still exists for the fire protection expected from the citizens. It would not be possible to purchase and man “6 ambulances” without incurring that as an additional cost above and beyond the cost of the quint. As far as the statement of “most teams that compete at TERC (Competitive Auto Extrication) wear NOMEX jump suits”. Pretty sure NOMEX suits don’t meet NFPA standards. Wearing them in competition where most fluids have been drained from the vehicles and is done in a somewhat controlled setting is very much different that a MVC extrication with fluids present and an uncontrolled setting.

  Feel free to correct me if I’m wrong but it appears as if your argument is based on one article. “While I am not familiar with an established body of research other than the JEMS 200 City Survey that thoroughly reviews the issue”
  Opinions have been presented as facts. Facts have been misrepresented. Colleagues have been maligned. Blanket accusations of ineptness and indifference have been cast on a system built by a Chief heralded by the City recently as running a Dept. second to none. An international union who consistently outperforms all others in fund raising for Jerry’s Kids is charged with crimes of “cost(ing) lives and increased morbidity on an incalculably large scale in this country”. All for what? Is it emotional rhetoric? There better be some emotion in there. Is it grandstanding? With a claim of respect for “darn-near-most of you”. Could be. Don’t know …and don’t care for Chris’ blathering anymore.

• 15. Chris  |  July 16th, 2008 at 10:09 am

  Just came by to post a link to some interesting reading material. I’ll answer the other charges when I get the time.

  http://www.jems.com/news_and_articles/columns/Bledsoe/Should_EMS_Be_a_Part_of_Public_Safety.html

• 16. GW  |  July 16th, 2008 at 3:14 pm

  Chris, just noticed I missed this “talking point “….
  ”I’d also ask what your survival-to-neurologically-intact-discharge is for cardiac arrests? What? You don’t even track it? How many cardiac arrests do you run per day?.” …
  Of course its tracked, I don’t have those numbers in front of me but I would like to mention that approx 3 yrs ago Rockford and Byron Fire were requested to take part in a area pilot program of Continuous Chest Compressions (CCC ) . CCC is an aggressive variation of CPR, its been used quite often and quite succesfully by RKFD Fire Ambulance crews and first-in crews. Our survival rating improved significantly from the national average. I’m sure you heard of the program. You’re Dept. probably adopted this protocol after Rkfd and Byron had verified its progressive nature in both the urban and rural settings. For additional details Dr Underwood at SWA would be a good contact. So again you present opinion as facts. Chris you need to understand that your sarcasm degrades your creditability, your statement that we as a region embrace “status quo” without offering irrefutable facts strengthens the appearance you do not know what you are talking about. Offer facts based on this region and the EMS system in place here. You mention the volume of calls RKFD Fire runs, are you inferring that they are all BLS runs? How many runs does your Dept run? Chances are the paramedics on the RKFD Fire ambulance and first in company have more runs under their belt in a year than you as a professional . Yes, many being cardiac in nature. The sheer numbers of calls the RKFD Fire dept runs each year gives its Paramedics extensive experience in a short period of time. I do not understand how you can state that a branch devoted strictly to EMS would be better than what is already in place…. which is a branch of RKFD devoted strickly to EMS. Are you looking for cost savings? I don’t think you’ll see it. Better service or response time. I can’t see it getting better than it already is. To place a Paramedic with their equipment and support next to the patient within 4-5 mins is the goal, correct? No wait, I believe your goal was 8 mins wasn’t it. I guess my point is you are intent on showing that RKFD Paramedics are not experienced enough even though they run a high yearly volume of runs. With medical runs and continuing educations (CU’s) comes experience…..I guess my point is where are you going with this? You cannot have it both ways. Drop the attitude, offer facts rather than opinions and you may redeem yourself in the eyes of your colleauges reading this.

• 17. seasoned  |  July 18th, 2008 at 8:50 am

  Chris, 3 questions! Does your Chief at Harlem Roscoe know how you feel about Fire Dept based EMS? Do the people that you have solicited for your Stateline Paramedics business know your public relations skills and the inability you will now have in getting any type of mutual aid? Are the Paramedics you work with at the Fire Based EMS aware you think their abilities are not even worth the paper the state sent them for their Paramedic licensure? I will let you know who I am when I see you.

• 18. Chris  |  July 18th, 2008 at 9:41 am

  Rumor on the street, Chris, is that you volunteer for Harlem Roscoe FIRE Dept and you work for FEMA. If so, you have totally contradicted yourself throughout this entire blog. You are volunteering for a FIRE dept that also runs and assists on medical calls. I guess if I was a citizen in the Roscoe area, according to you, I should be nervous of the care I would be given by the fire personell in that area because they aren’t as highly trained in the medical field, right?
  You say you’re ‘passionate’ about EMS, yet, if the rumors are true, you don’t even work for an ambulance complany. Your credentials that you so graciously paraded at the beginning of this blog, are no different than the paramedics on RFD, yet, they’re on the street everyday putting them to the test.
  Just because one procedure works in one city doesn’t mean it will also work in another. If that was the case, every fire and ambulance service in the nation would run the exact same way. But I thank you for telling everyone the qualifications you have tell everyone else how to run their depatments.

• 19. Deputy Chief 794  |  July 18th, 2008 at 1:40 pm

  After reading such “jibberish” I want all the non fire and EMS related citizens, not only in the City of Rockford, but in Northern Illinois to understand that fire based EMS is a must. Either Paid or Volunteer, our EMS and Fire departments around the nation are professional and are highly trained to provide the highest level of care outside and emergency room.
  If you guys are old enough, we firefighters took over EMS for the police departments and funeral homes. I am not bashing either the police or funeral homes, we all know they have very important aspects of their jobs as well as we do. But to sit and say fire related EMS is wrong and Volunteer EMS is wrong is just off the wall.
  Volunteer or Professional paid, we are all taught the same information and we are all asked to fulfull our time to certify on an ambulance. I guess what I am trying to say is both paid and volunteer services offer great service weather its fire, EMS, rescue and extrication.
  We are all professionals in our field. Being professionals, we must act as professionals and stop the bickering. Shame on both of you, if you both are truely fire and EMS providers, for lowering yourselves to this kind of behavior.
  Yes, both paid and volunteer departments have their standard operational procedures to follow, but why are you guys or gals wasting you time. Do what is right and put more constructive and or positive productivity within your profession.
  As a 24 year vet of the fire service, I must say we have all came a long way. Dont sit and bash eachother when all of us, as professionals, in the fire service should be proud of what we do. I have only two words, “Brotherhood” & “Sisterhood” Live by it!!!!

• 20. Chris  |  July 18th, 2008 at 2:10 pm

  Well Gentlemen, you seem to have found out who I am. You also seem to have discovered and trotted out all of the entities that I work for and own right here in the public forum. You’ve tried to attack my character, my dedication, and my honesty.

  I will state now that my opinions are my own and are not those of anyone that I work for or am affiliated with. I’m confident in my own beliefs, but I don’t purport to speak for anyone other than me.

  Honestly, I’m not all that bothered by it. It’s no secret that I’m an opinionated and outspoken. Anyone who knows me well will tell you that. I take pride that I actually form opinions and am capable of defending them. I think for a living here, guys. It’s not a crime to dissent from the majority and I’ll say that it just makes the group stronger. We live in a democracy. I don’t work on an ambulance every day these days because in Rockford there’s just easier ways to support a family. The fact that I found more money elsewhere in the emergency field doesn’t mean that I’m not a dedicated Paramedic.

  I’m sure that right now you’re letting everyone know what a horrible guy you think I am. I’m sure that this page is going to get a lot of views. And maybe, since the medics in Rockford are close-knit enough that you were able to find out right who I am and probably find people who know me, maybe those other medics will post. Maybe we’ll actually get everyone in an open discussion. Maybe we will. Maybe I’ll be proven wrong, discredited, and drug through the mud. Maybe you will be. Maybe this is just the discussion that we’ve all needed to have in this region for as long as I’ve been here.

  Trust me; I’m not alone in my opinions. Perhaps I am the minority here, but now Gentlemen, you’re hopefully going to get a frank discussion. I enjoy eloquently stating my beliefs without resorting to personal attacks, apparently not everyone else does. I used this as a chance to get a public discussion going about EMS that we’ve needed to have. We need to have EMS brought to the forefront and have more people pay attention to it. That’s what I wanted. This is what we’ve got.

  So go ahead, let everyone you see know about this little discussion we’ve had. Hopefully everyone who comes and reads this will post their thoughts. If you think that I’m an awful, horrible human being after reading this, please let me know. If you would like to join in and contribute your ideas, please do that too.

  So, I ask everyone that reads this: Even though I believe that Winnebago County is blessed with very good EMS, and I’m sure that you might too.. Do you think that we can improve? What would you like to see to make it better? Is it worth it to try? Am I the scum of the earth that the other two guys seem to say that I am?

  Oh, and gentlemen. I’m no longer anonymous. Howsabout you?

• 21. GSW (formally known as GW)  |  July 18th, 2008 at 3:41 pm

  It very well may be time for a discussion on the direction of EMS in this, and other, areas. Read some of my above posts and see if this region doesn’t already have some exceptional services in place. Focus on making it better…not throwing your colleague under the bus. Now, Chris, if you can read your own writings without bias you will see the arrogance and insulting nature of your words. You may enjoy debating and you probably feel you come out on top quite often…but I feel it may be because people are offended and put off by your style, there for it is easier to walk away than to beat their head against the wall. Again just my opinion…I may be wrong.
  Now some may say I’m not “work(ing) harmoniously” with Chris when actually I view this more as constructive criticism. (reference paragraph 13 of below link)
  “I enjoy eloquently stating my beliefs without resorting to personal attacks, apparently not everyone else does.”
  Not sure if I agree with you about your style of writing…..
  As far as the anonymity aspect, some could figure out who we are with little effort. You didn’t offer your identity voluntarily, why should anyone else?
  In closing, I don’t mean any harm or disrespect to Chris. I simply couldn’t stand by and watch as “one of our own” attempted to discredit and insult competent, ethical and dedicated professionals. And again, for what… personnel gain? Ego feed? …Don’t know ….but I do care. “Trd”

  http://www.naemt.org/aboutEMSAndCareers/ems_code_of_ethics.htm

• 22. ER  |  July 18th, 2008 at 9:40 pm

  Chris,

  You speak very highly of yourself as a paramedic and otherwise. Why haven’t you menitioned the fact that you were fired from the very ambulance service you worked for. Because it discredits you. Therefore, as a Firefighter and Paramedic, debating with you is not worth my time.

• 23. Chris  |  July 19th, 2008 at 10:33 am

  Ladies and Gentlemen,

  Wow, lots of venom is being spewn forth in my direction. However, I finally got a conversation going about Rock River Valley EMS. Constructive criticism and outright flaming accepted. Perhaps my tone in the first few posts was tougher than it should have been. If you know me, you know that I care more about EMS than almost anything else. Sure, I’ve hit a stumbling block or two in my career, but there aren’t many people in the field who haven’t. I’ve worked with a lot of you for quite some time here, we’ve talked about the issues that I’ve brought up, and the fact that we all think that EMS in general should be taking steps forward.

  For the citizens who read this, you’ve been blessed with some of the most hardworking, caring, and dedicated EMS professionals around. The state of EMS in the area is good. My intentions here were to start a conversation to make it better and to hopefully bring back the innovation and spirit that was in place that first attracted me to the area to ply my trade all those years ago. I sought to strengthen, not break down.

  And folks, you’re right. My first postings were too harsh for that purpose. I’ll apologize for that. Never have I sought to offend anyone. As I’ve stated, I wanted to start the conversation, to bring forth issues that could be collaboratively worked on and improved. I did this probably a little too publicly, but that was because I believe that we can only improve our collective service level by bringing the issues we face to the public discussion. If we can raise our voice and educate the public more so to what we do, perhaps we can find the solutions to the challenges that we face. I wanted collaborative involvement of EMS professionals actively talking about issues. I intended for the spotlight to be shown on EMS in general.

  Say about me what you may, but don’t you agree that we should all actively participate and not be afraid to have our voices heard? I think that it’s time for the people actively participating in the Greater Rockford area EMS to have a forum to talk. I used my strong convictions to attract interest, and my intentions were misinterpreted as evil… when they weren’t.

  So here’s what I’m going to do. I’m still going to have my strong convictions. I’m still going to be vocal about what I believe in, and I’m still going to work as hard as ever to improve upon our collective successes… and they are successes.

  The next part of this is entitled, what I believe we can do in Rock River Valley EMS. We can emulate national Best Practices, we can improve our educational opportunities, we can increase our pay scales, and we can do what’s most important: Strive to give our patients the best possible care… like we always have.

  And the best way to do that is to start talking.

• 24. Dani Havens  |  July 19th, 2008 at 12:09 pm

  I just wanted to say that Rockford Fire saved my life 7 years ago when I was shot twice in the abdomen. The Medics did a damn good job considering I am alive today. I am also Paramedic/FFII certified and have been trying to get on Rockford Fire for 8 years now. I work for a private ambulance company and was on a volunteer fire department for a few years. It’s important for fire and EMS to be intertwined. I can do a good job in both aspects. Many of our calls require both specialties. Why wouldn’t you want someone who is cross-trained?

  Hiding who you are and bitching about who works where and who got fired for what gets you nowhere.

• 25. Chris  |  July 19th, 2008 at 2:49 pm

  http://www.emsnetwork.org/artman2/publish/article_28849.shtml

  Don’t have to listen to me on this one.

• 26. Dani Havens  |  July 19th, 2008 at 9:06 pm

  GET OVER YOURSELF!!!!!!

• 27. Dani Havens  |  July 19th, 2008 at 9:13 pm

  Wait let me rephrase that…BLAH, BLAH, BLAH, BLAH BLAH… talking on a blog is not going to change anything. What makes you think that a debate on an online blog is really going to get anyone’s attention? Come on Mr. Kaiser, time to put foot in mouth.

• 28. jo  |  July 20th, 2008 at 3:19 am

  Last time i checked, professionalism didnt include bitching.

  Last time i checked, doing things to better your service didnt include bitching either, come up with some new material, make some constructive suggestions and people may listen.

  Dani has a point, blogging wont change anything, leading by example will, setting a high standard will, and acting with integrrity will. This will not only help people listen to you, but will also achieve your goal of improving your service.

• 29. Rob Lanious  |  July 20th, 2008 at 11:12 pm

  If Fire based ambulance services are doing more ambulance calls, then why doesn’t Fire then fall under EMS?
  Why do firefighters feel threatened and resort to personal attacks against anyone who disagrees with them. Fire based EMS is common in third world countries and only some industrialized countries though it is losing popularity in those countries. Most industrialized countries use a public health model instead of a public safety model for EMS and this is perhaps where EMS needs to be.

• 30. mike  |  July 21st, 2008 at 1:59 pm

  Interestingly enough, those services out there who are the most respected and have the best numbers for whatever arbitrary benchmark is being used (like cardiac arrest ROSC) are non-fire based third service providers. Places like King County Medic One in Seattle, BostonEMS and others are strictly EMS. They consistently have the best services and providers and offer the best treatment for the people they serve. This then leads me to ask why people aren’t modeling themselves more on programs and services that have success rates far greater than any other services out there? If you want to succeed, wouldn’t it make sense to model yourselves on proven and demonstrated success?

  Further, there was a USAToday series back in 2005 that debunked the myth that ALS engines were a good thing. They aren’t a good thing and can prove to be a detriment to the people they’re trying to serve. This just furthers the question of why fire is so demanding on running EMS.

  I don’t think you’ll see anyone arguing to make FDs obsolete. (I’d go so far as to argue that in many areas FDs are making themselves obsolete through code development and enforcement, effective prevention programs and effective public outreach. That’s another discussion for another day.) However, the public safety function of the FD does not mesh with the public health function of EMS. They are two completely different mind sets and require a different approach to different problems. As such, the role of EMS as a function of the FD should be made obsolete as they are two different jobs with little in common aside from occasionally working on the same scene together.

  I also don’t think you’ll see many people out there argue that there aren’t some good prehospital providers employed by FDs. What I do think you’ll see is ineffective and general mismanagement for a variety of reasons, some good some bad, by FDs with regards to their EMS programs. Unit deployment as discussed above is a big one.

  This isn’t about us. This isn’t about medics and FFs. This isn’t about us versus them. This is about the public we’re supposed to be serving. It’s about the patients we’re supposed to be treating. The best services out there are not fire based and provide for their communities far better than any fire based service can. Model yourself on what the most successful programs do and you can’t fail. Insist on the status quo and the only people who lose are members of your community.

• 31. JAF  |  July 22nd, 2008 at 9:06 am

  Well I have just come across this article and must say that I am blown away. This debate has been going on for years and there are valid arguments for both sides. After reading this I must ask, Where is the Professionalism? Let me start off by stating that I am for fire-based EMS. I enjoy the cross training and feel it is very important to understand both Fire and EMS if both services are going to run together. Even though I am for fire-based EMS I will say that there is plenty of room for improvement and will add that Chris has brought up many valid points to the table. Rockford runs 5 ambulances for a population of approx 150,000 is it really crazy to suggest adding more ambulances to better provide for the community? The Fire Service as grown a lot with the increase of need of EMS and I believe that if the Fire Department is going to run EMS then they need to continuously improve their services to feed the need of the community. A good way to improve their services is by focusing the majority of their attention and monetary support to EMS, most of all call volumes are EMS related. If you looked through the links Chris offered you will see that we need to keep on top of our skills. There is a huge difference in the success rate of procedures given by paramedics who are fire-based than to those who are non-fire based. Now I don’t think that we should do away with Fire-based EMS but it is obvious that we need to have more sufficient practice (training), so our skills do not diminish (you know they do). We all know that lack of experience and skills can pose a danger to ourselves and others. How many of us actually get to put our skills to use as often as we should? A little extra focus on EMS training wouldn’t hurt, if anything, we would all become more proficient in our skill set and save more lives. That is the goal isn’t it?

  In the beginning, I asked, where is the professionalism? While reading through this blog I was truly sickened by the lack of brotherhood portrayed through the writings. If you read through it entirely you will notice that both Chris and GSW had a very good debate going on. Maybe one that needs to be had in your area. They are two of the three people who posted valuable, interesting contributions regarding the issue. I don’t believe Chris posted anything personally offending towards anyone as stated in his previous postings, he merely used his local Metro fire/based Service as an example. If you would look behind the bickering you may notice that he is speaking about the system and the lack of experience some people have not specific personnel. GSW offered some very good information too but it seems he took it personally, which led others to misinterpret the material and caused the anger of those who posted the other comments. As far as I am concerned, not that my opinion really matters, this debate is a well known, nationalized, public debate and both Chris and GSW have every right to speak on it without anyone discrediting their Professionalism and Love for what they do. It seems that Chris had some great ideas and a wide array of EMS experience, maybe instead of his colleagues teaming up, beating him up and supporting closed mindedness. They could help him pull the knife out of his back that they so deeply penetrated and listen. It is unfortunate that so many of you offered to give names and throw a fellow paramedic under the bus because his opinion differs from yours. For those of you who so readily came forward with his personal information, you didn’t offer anything of value to the discussion, nor did you state your opinions on the topic. That is not only unprofessional, but childish. Tattling is not going to help anyone get anywhere. On that note, my suggestion is this, let’s all get to know and understand the debate for it is important. That knowledge can help us all bring the EMS system to the advanced level it needs to be for our community, whether we are for Fire-based EMS or not. Improvement is necessary for top-level care. (not that we don’t offer a high level of care but we can learn more and provide at higher levels). Like Mike said, it’s not what is right for us; it’s what is right for the community.

• 32. Rob lanious  |  July 23rd, 2008 at 12:59 am

  Bravo. It is good to see a fire based medic debate without making personal attacks that lack maturity. Thanks.
  I still have to disagree with you. You are making a point that fire needs to do alot to improve their service, but this should not be if fire would focus on public safety instead of trying to delve in the medical profession. This would give more resourses and energy to protect the public in the areas they specialize in such as fire suppression, prevention, rescue, haz mat and other public safety issues. It should not be involved in medicine any more than the police should. Do many fire departments provide good EMS? You bet! Are there shabby private services doing a horrible job at patient care. Of course. This does not take way from the basic premise that EMS is a medical profession and needs to fall under public health. I just think fire should focus their energies on what they were designed to do. Ambulance services in the US started with hospital based ambulances in the 1860s, and it is in health care where EMS should stay. Not the police, not the fire department, not the funeral homes.

• 33. Chris  |  July 23rd, 2008 at 10:26 am

  Hopefully some of you out there have taken the time to read what is above all of this and understand the debate. Make sure to read the supporting articles that were included by both sides with research to support our points.

  Here’s some more things to compare and contrast:

  http://nasemso.org/documents/FINALEMSSept2006_PMS314.pdf

  - This is the National Scope of Practice model for EMS as released in 9/06 by a number of stakeholders in EMS with heavy involvement from the fire service (look at the credits). It’s 26 pages of information, but the charts in the latter part of the document are the most interesting. It’s a great read for everyone who is interested in where EMS is going and is a publicly available document.

  http://www.jems.com/news_and_articles/columns/Bledsoe/Bledsoes_EMS_Scope_of_Practice_Model.html

  - This is the “Bledsoe Scope of Practice” model written by Dr. Bryan Bledsoe, a well-known, well-written Emergency Physician who advocates nationally for EMS. He has stirred up a lot of controversy with his recent series of articles in EMS magazine entitled “Making Hamburger out of Sacred Cows”. It shows his disagreement with the above “National Scope of Practice” model and offers an alternative viewpoint.

  http://www.emsresponder.com/print/Emergency–Medical-Services/Making-Hamburger-of-Sacred-Cows–/1$2506

  - This is an interview that Dr. Bledsoe had on the series of articles. There is a section stating his disagreements with both the “Public Utility Model” of EMS (Where a jurisdiction grants franchise rights to a private service for exclusive EMS service, like a cable company) and the Urban Fire Based model of EMS.

  http://www.emsresponder.com/print/Emergency–Medical-Services/EMS-Mythology/1$2023

  - This is his popular series on “EMS Mythology”

  As you can see, I like Dr. Bledsoe’s writings, but there are other resources out there. The best research available for EMS can be found by taking the time to do your homework. EMS is something we all should strive to improve every way we can.

  May I ask you all where you think we should be heading?

• 34. WFCP  |  July 25th, 2008 at 11:22 am

  My comments are much broader and serve to truly educate someone who reads these postings for the purpose of understanding if the system is truly broken. In fact, it is not the Fire-based EMS system that is broken but rather it has saved in so many ways. This is not a debate in support or against unions either. Many fine, dedicated, and well educated responders in this area and across the country are represented by a union, and for every one of them there are even more qualified and competent first responders that have no representation except for the patch that they wear on their sleeve. Whether you have the title of EMT-Basic, EMT-Paramedic, firefighter/paramedic, or the all encompassing title of simply “firefighter”, which really stands to mean fire suppression specialist/paramedic/technical rescuer/hazardous materials technician/water rescue diver/airport crash specialist/public educator/code enforcer/and overall the first line of preparedness against another terrorist attack, please rest assured that an institution did not give these titles to you…the public did.

  The fact is if you attempted to extract any one of these specialties from the rest something would be lost from the other. They build off each other and support one another. The firefighter throughout history always claimed to be a “jack of all trades” and it never claimed to be a “master” of any. The firefighter is not arrogant enough to think he or she could be a “master” at any one of the rescuer disciplines because he or she is smart enough to know that emergency management is fluid, always changing, and the firefighter is always in transition along with it. The firefighter does not attempt to be a “master” because he or she knows that no two fires are the same, no two heart attacks are the same, no two auto accidents are the same, and no two positive or negative outcomes of any kind are the same. The firefighter doesn’t know it but he or she is really only a master of their own perception of themselves because they realize their own individual limitations and rely on team members to problem solve. That is the true foundation of our business and why the tax payers always win with the firefighter acting as the paramedic acting as the rescue specialist acting in the best interest for their neighbor.

  If you truly want to rob from the public go and tell them that they now have to fund an EMS department through tax dollars. Don’t think for a second that you wouldn’t still have to support a fire suppression service as well. Fires are down across the country in commercial structures due to better construction and fire protection features. But the fire service continues to fight aggressively in residential homes because we still find our highest causalities in one and two family dwellings. The fact that today there were no fire fatalities is not a point that can be argued. Tomorrow there may be one or an entire family or 3000 Americans. So until a sprinkler system is built into every newly constructed home or retrofitted into the existing ones across the country at the expense of the home buyer, I don’t think anyone is getting away from funding and properly staffing a fire department. Because no one wants to step outside and watch their neighbors home go up in flames. Or imagine yourself standing on the front lawn seeing one of your own loved ones trapped in the upstairs bedroom waiting for the down sized and under staffed fire trucks to arrive. And therein lays the greatest benefit to the taxpaying citizen that called for help. When they call for today’s crossed trained firefighter/paramedic they are truly getting the greatest bang for their buck. Firefighter/Paramedics respond in a constant state of readiness 24 hours a day, 365 days a year to small and large emergencies. It is of no matter if today the firefighter/paramedic responds to three fire related calls, 9 medical related calls, one auto accident, and one shooting during their 24 hour tour of duty. It is a matter that in every one of these cases the firefighter/paramedics are responding with the hidden potential that the very call they are going to may be exactly as it was describe upon dispatch, or something of a completely different nature. However, rest assured that the cross trained firefighter/paramedic does not care if the call is a fire, an auto accident, a heart attack, or a cut finger. He or she will mitigate and treat any situation found upon their arrival. That is what they are trained to do and that is what the public taxpaying citizen expects from them.

  Furthermore, local firefighter unions, state firefighter associations, and the International Association of Firefighters are not out there in USA land making the argument that the fire service needs EMS to stay alive. They make the argument that the public receives far superior fire protection, medical care, and emergency response from rescuers that are supported by tax dollars. This is because the tax paid firefighter/paramedic knows where their paycheck comes from and is loyal to the citizens that make those funds available. Private services and hospital based EMS cannot offer that level of blanket loyalty to any community. In fact these two entities would not even be interested in offering pre-hospital medical treatment to the public if the potential to make money was not there. This is not a reflection that the people who work for private ambulance companies or hospital based EMS services are greedy. There are certainly people who are simply passionate about providing pre-hospital medical care and only want to perform to that level. Agencies that only offer medical care and transport do a great job but their limitation to the public is in their job description. And because private forms of EMS are not tax based driven, they halve to charge in order to operate their budget to cover overhead cost, pay wages and benefits to the employee, and simply make a profit. If private agencies could find the nest egg that would allow them to fund an Emergency Medical Service along with related emergency response mitigation they would be selling themselves as a multipurpose agency for hire.

  The charge has been that the fire service uses EMS as job justification. This suggests that fire departments have shifted their responsibilities to overcome a deficit. Not true what so ever. Public demand shifted because we are growing in human numbers and the fire service was already in place to answer the call. A true crime would have been to overlook that fact and attempt to build a completely new infrastructure that only addresses one public need. In many cases it is a city by city model that depicted where EMS responsibilities would be placed. Some very large cities, such as Boston and New York City (which in 1996 shifted EMS under FDNY making it the largest Fire-based EMS department in the country), started out by building two separate infrastructures; one that supported fire suppression and one that supported medical treatment. But in most cases the fire department was already in place and it made sense to use this group to meet the needs of the public. Is there room for improvement? Of course there is, but it is by no means broken.

  If you truly want to address what is broken then look no further than the 911 system in this country. As a whole society we have become dependent on calling 911 for anything and everything. In the past, calling 911 truly meant your home was on fire, you were hurt in an auto accident, or you were having a heart attack. Today 911 is dialed if we can’t figure out how to relight the pilot on our furnaces or we lock ourselves out of our car. All while at the same time the 911 operators are answering the same serious “life or limb” type calls. Because there is no other system in place to answer the non-emergency calls, they fall to the fire service in many cases. The reason for this is because public trust has already been built between the people and their fire department. In the minds of many are saying as they dial 911, “the fire department has never let me down before and I’ll bet they won’t this time either”. If you truly want to fix something try developing a non-emergency agency that answers “no distress” calls and free up the Fire-based EMS departments to do what they do best, which is manage emergencies.

  Because we live in a post 9/11 world and have all seen the true nature of what an emergency looks like, the public has demanded that we as First Responders become more versatile and adaptive to respond to anything thrown our way. It just happened to be the Firefighter that picked up this call to duty from the public. It is the public masses that demanded a better response to man-made and natural disasters after events such as 9/11 and “Katrina”. And because publicly funded Fire-based EMS departments are transparent to the taxpayers and by nature a “not for profit” organization, it allows the public to trust that the Fire-based EMS department will do the job well.

  I don’t attempt to take anything away from someone who wants to dedicate themselves to a medical specialty. Just don’t suggest that this type of person can outperform a crossed trained firefighter/paramedic. That’s not really even the argument at all. No one is outperforming the other. It’s simply a fact that the crossed trained firefighter/paramedic can truly go into so many different environments where so many others can’t go. However, to suggest to the public that they would be better served by one specially trained “medically orientated” department is placing far too much confidence in that type of system. It would be impossible for a signal disciplined response group to know what to do in every situation requiring medical care. Because it is a fact and often very real that caring for patients is intertwined with some other emergency it makes perfect sense to train rescuers in the art of Basic and Advanced Emergency Medicine. If the idea is that the public would be better served by a stand-alone EMS service and a stand-alone fire department because of the specialized training involved then it only stands to reason that all types of emergencies should be separated and handled only by individuals and agencies specialized in a particular discipline. This model would appear as a metropolitan area being protected by a Fire Department, EMS Department, Police Department, Water Rescue Department, and Technical Rescue Department. But wait! The technical rescue arena is wide ranged involving Confined Space Rescue, Structural Collapse Rescue, Trench Collapse Rescue, Rope Rescue, and Vehicle/Machinery Extrication. Should there be a department for each of these specialties as well? Please realize that within each type of discipline listed we are talking about people (patients) who are all too often trapped and seriously injured requiring immediate medical care to sustain their life while the extraction from the incident is lengthy and on-going.

  To broaden the picture further the Police Departments across this country are cross training themselves as we speak. Because of our heightened awareness to terrorism they are becoming more diverse in man-made attacks involving everything from active shooters on campuses to man-made devices that destroy buildings or even blocks of cities. Should police departments be cross training themselves? They too spend the majority of their time responding to lesser violations but they are always prepared for the worst as well. If you agree with the vision of a total EMS department or an EMS driven fire department then you should be wagging your finger at the SWAT teams that are training their police officers in Tactical SWAT Medicine. That is the epitome of crossed trained personnel performing high risk tactics while delivering advanced medical care to not only patients but to their partners under fire! Bravo to them for stepping up to these challenges! Time and time again fire departments and police departments are proving that they are modular and can grow to support multiple tasks that in the end serve the public well. Both groups respond to the public when called and realize that in many cases there is a patient submerged in a realm of chaos.

  Certain individuals show their lack of experience when they suggest that Advanced Life Support care is rarely initiated in the “hot” danger zones. True, two firefighters dragging a victim out of a burning house do not stop midway and begin ALS care on the victim. They turn them over to firefighter/paramedics on the scene who start that type of care within seconds (by the way, while those two paramedics awaited the victim they helped to throw a ladder to the second floor window, flake out the hose in the front yard, and helped the engine hook to the hydrant because they were cross-trained in these tactics which helps to save time). This is the only scenario that I can think of where the conditions around are changing too rapidly for that type of care to begin in that type of environment. However, there are countless cases of firefighters trained as rescuers who are trained as paramedics administering ALS care to victims who are trapped in adverse conditions. This type of crossed trained firefighter/paramedic offers the best chance of survival to the victim because this rescuer has a three pronged approach to all emergency situations. First, as a recruit firefighter it is instilled that any environment can rapidly change and it is our heightened awareness to the risks that can save us and our victims. This is continually beaten into the firefighter over his or her career by the firefighters that have gone before them. Second, teamwork is what gets the job done. Having a Fire-Based EMS Department with crossed trained personnel means that everyone is working off the same game plan. Third, we will risk a lot to save a lot, and risk nothing to save nothing. If that means that a rescuer is going to enter into a trench, a confined space, a crumpled automobile, or a collapsed building and there is a viable victim trapped for hours, that rescuer will stay with that victim giving them as much basic and advance care possible for the duration of the incident. Neither private services nor Hospital based EMS can contend with that reality.

  Overall the point is this. Obviously there is no metropolitan area that could support endless departments of emergency response groups from the city budget. The real reason that it makes good sense for EMS to fall under the Fire Department of any city is that it does save the tax payer money and uses tax funds in the most efficient manner. It is true that both fire trucks and ambulances are expensive pieces of equipment but necessary none the less. The crossed trained firefighter/paramedic cannot be blamed for the cost incurred of purchasing apparatus. But when a crossed trained responder rides out on the fire trucks or the ambulance they are ready to respond to anything saving taxpayer’s money. Let us try to focus on reducing the number of calls that every response unit must go out on by educating the public as to what a fire truck and an ambulance is really intended to be used for. Only then would we reduce fuel costs, reduce the wear and tear on our units, reduce the frequency of needing to replace apparatus, and overall reduce the health and safety risk to all first responders.

  Across the country fire stations are situated in areas to deliver quick response. Apparatus is on hand and most importantly the servants of the community are already on-duty and ready to answer the call. The fire department represents dependability to the public and an overall attitude that “no problem is too large or too small.” The fire service is to be commended for stepping up and not only meeting the challenge of EMS delivery but doing it in a way so that other services offered do not suffer. Because of its personnel on-hand and the infrastructure in place, this makes the fire department modular, meaning that it can respond in a small way (one engine, one ambulance) to individual emergencies or respond in force when demand calls for it. People cannot always describe what has happened, but they always know when something is wrong. And when they call 911 they can be assured that when a Fire-based EMS department arrives that they will be able to ascertain and mitigate the emergency while administering basic and advanced medical care within that “first” hour without hesitation.

  The argument against changing any fire department’s name to something in the realm of the “Rockford EMS / Fire-Rescue Department is a selfish one on the part of the person who doesn’t even perform the duties described above. The fire service is not attempting to hide from the public that it responds to more medical related calls then it does fire calls. Thank god that is the case because could you imagine the widespread panic if homes were bursting into flames every hour of each day. The fact that the funding of a fire department goes heavily towards fire suppression and other emergency responses is because we all have learned early on that you don’t bring a knife to a gun fight. The fire service operates off of the premise that it must be prepared that the odds will go against them at some point. These were the cases in Charleston, South Carolina in 2007 when nine firefighters were killed in a furniture store fire, in Worchester, Massachusetts in 1999 where six firefighters died in a warehouse fire, and was certainly the case when 343 firefighters died in the World Trade Centers in 2001. In each of these cases there were reports of people trapped inside, so they didn’t die for the cost of the building. The members that enter into burning structures to remove a trapped victim, cut someone out of a crashed vehicle, dig a person out of a collapsed trench, or perform CPR on a living room floor are the ones who should be allowed to call themselves what best suits them. Yes, the statistics don’t lie. Roughly 80% of all fire department responses are medical in nature. And this is what the Rockford tax payer gets based on that statistic… between my partner and me we hold sixteen years experience between us of serving on the ambulance as paramedics for the city. We hold twenty years experience between us as firefighters for the city. We have been put through the best training that can be found. We have treated thousands of patients in their homes, advanced hundreds of lengths of hose towards fires, extricated many out of vehicle wreckage, and fell into the game plan with our fellow cross trained co-workers in large disasters. This diversified experience is available to every citizen in this area that calls for help. That is the experience we as firefighter/paramedics present to the public every time we step off the fire truck no matter what the call is for.

  It has become the cross trained firefighter/paramedic that wears many hats. Not because they are made too or because any union told them too, but because the public asked them too! And they are the experts in managing emergencies in the streets, in the factories, in the trenches, in the burning or fallen buildings, and in your living room.

• 35. TMJR  |  August 1st, 2008 at 6:51 pm

  Chris is correct when he stated that ambulance drivers should be replaced with taxi drivers. This should happen when Private ambulance companies transfer patients from home to their scheduled \"appointement\" at the hospital. 80% of Private ambulance calls are for transfers only. This is what should be investigated. The enormous amount of money that the privates charge to give a \"ride\" to the hospital. Its bad enough that insurance and Dr. visits cost our elderly a lot of money. Now our elderly have to pay $600 plus dollars for a ride to a Dr. visit! Most private ambulance personnel take this job seriously, unfortunatly they do not have the experience of real calls to compare to most Fire and EMS city departments across the nation. One more small point. Most private ambulance companies send their ambualcnes all over the midwest everyday. So if you call 911, and get a private ambulance, you most likely will not get paramedics who are familular with those city streets. This will end up with a longer response time. Which in the end could cost citizens lives.

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