EMS Is Not a Distraction from Our Job, It Is Our Job

Multiple LAFD ambulances at scene
Photo courtesy of Rick McClure

By Matthew J. Sulentic

Over the past several years I have attended many firefighting conferences across the country. A common theme I have found in these conferences is encouraging firefighters who are passionate about being students of firefighting to ignore unmotivated firefighters who insult them for their passion. Yet in the very next breath some presenters insult firefighters who are passionate about being students of EMS. EMS calls are the majority of our job, and that is not changing anytime soon.

At one popular, firefighting conference I attended, I was surprised by the attitude that conference organizers, presenters, and attendees held towards the EMS aspect of their job. During the conference, there was a raffle for different items and the money raised would go towards a chosen charity. Most of the items being raffled were firefighting in nature, but a few of them were of the EMS persuasion. When pulling a ticket to determine the winner of one of the EMS items, a conference organizer stated: “I can’t believe there are any tickets at all in the jars for the EMS items!” This comment, stated as he was picking the winning ticket, made the walk to the front of the auditorium extremely awkward for the winner as he claimed his prize. I felt bad for him.

At this same conference, a company officer who was presenting a class told the attendees that there are two things that he does not allow at the kitchen table of his firehouse: cell phones and EMS talk. Most of the attendees laughed in approval, and a wave of anger and dismay welled up inside of me. How was such a large part of the job of a firefighter being ridiculed to the point of shaming anyone who might actually enjoy it? This attitude about EMS is hypocritical and ignorant, and it needs to change.

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According to the United States Fire Administration’s “Fire Department Overall Run Profile” for 2019, there were 28,534,400 calls for service to our nation’s fire departments. Of the almost 29 million calls, 65 percent of them were EMS and rescue in nature. Only four percent of all reported runs were fire related. Keep in mind that the national percentage of EMS calls is brought down to some degree because there are still some fire departments in the U.S. that do not respond to EMS calls at all. Of my department’s calls, 69.6 percent are EMS in nature. Even in the Fire Department of New York (FDNY), the busiest fire department in the U.S. by total call volume, and a department that is not often associated with running EMS calls, between 50 and 60 percent of their total runs are EMS related (FDNewYork.com).

Whether we like it or not, EMS is a significant portion of a firefighter’s job. That reality is probably going to become greater as time goes on. Recognizing how important providing EMS care to the community is, the International Association of Firefighters (IAFF) produced a white paper in 2007 that showed how fire departments are best positioned to provide EMS over private ambulance companies. Then in 2010 the IAFF participated in a study with the National Institute of Standards and Technology (NIST) that showed how staffing fire apparatus with at least one advanced life support (ALS) provider decreases the amount of time it takes to effectively care for trauma and medical patients. Although firefighting is the most dangerous part of our job and is absolutely a high-risk, low-frequency event, EMS is the biggest part of providing service to our community.

This is not a zero-sum game. To care about EMS and want to excel at it doesn’t mean we can’t care about firefighting. To care about firefighting and wanting to be good at it doesn’t mean we can’t care about EMS. Firefighters can strive to be good at both and care about both equally. Firefighters who care deeply about EMS and daily make a tangible difference in a person’s life should be valued and encouraged, not demeaned. A firefighter who makes a concerted effort to know as much as they can about EMS should be encouraged to continue that pursuit, not discouraged, and made to feel less “cool.”

Not caring about 65 percent of your job should not be a cause of pride! The “I don’t do that nurse stuff” firefighter and the “we don’t talk about EMS at my dinner table” company or chief officer, in my opinion, are unknowingly harming the very citizens they have sworn to serve. Unless their attitudes change, they should consider finding a different profession. Don’t get me wrong—I love firefighters, company, and chief officers who are passionate about firefighting! I hope they are the ones who arrive at my house when it is on fire and I or my loved ones need to be rescued. But I also want to call those members out who object when it comes to providing EMS care.

The American fire service should desire to change this attitude, and fully embrace the importance of what our citizens need from us. We should want to provide the best service and care we possibly can and not consider EMS calls a distraction from our “real job.” We should look at EMS calls as opportunities to help get our citizen’s lives back to normal as much as is possible. They should be opportunities to show the public that we are worth their hard-earned tax dollars.

One great example of this type of attitude comes from Chief Dave McGrail of the Denver (CO) Fire Department. He says he loves automatic fire alarms, something most firefighters loathe. He loves them because we are given access to buildings so we can preplan for the eventual fire we may have to fight. EMS calls offer the opportunity for firefighters to do the same, especially in the residences that make up most of our districts. By law we can access commercial buildings while performing fire inspections. This is not the case for private residences. Unless our citizens grant us access to their personal homes, we cannot go inside to learn the layout. This is what the EMS call does! It gives us access we otherwise would not have. Let’s be as enthusiastic about EMS calls as we are about fires and use them to prepare ourselves for the fire we will one day have to fight and the victim we will one day have to save. Our citizens deserve nothing less.

So how do we start to change this attitude? It begins with fire service leaders. Company and chief officers must instill in their members a love for the entire job, not just what most would consider the fun part, but it doesn’t stop there. Senior firefighters, some of the best leaders in the fire service, should also step up to ensure we are as competent as possible at every aspect of our jobs, and that we care about all the services we provide. Lastly, fire service conference organizers must ensure that the craft of firefighting is being taught without demeaning the other 65 percent of what we do. We can and should be better, and this improvement must start today.

Don’t tell me you joined the fire service to “help people,” and then complain about having to run EMS calls. If it were not for those EMS calls, we wouldn’t have nearly the opportunity to help our citizens as we do today.

MATTHEW SULENTIC is a firefighter/paramedic for West Metro Fire Rescue in Lakewood, Colorado, where he has almost 20 years of service. He spent almost seven years on active duty as a U.S. Navy Hospital Corpsman and became a certified paramedic in April 1997. He has worked for Wake County EMS in Raleigh, North Carolina, for three years. He has an associate degree in emergency medical science from Wake Technical Community College and a bachelor’s degree in fire administration from Bowling Green State University. He is a credentialed Fire Officer through the Center for Public Safety Excellence and a credentialed Training Officer through the International Society of Fire Service Instructors.

This commentary reflects the views of the author and not necessarily the views of Fire Engineering.

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