Engine Company EMS: Keeping the Fire in EMS Response

By Michael Morse

“We’re running so many EMS calls that we’re forgetting how to fight fires!”

When an agency founded to provide fire protection becomes involved in emergency medical services (EMS), there is a very real possibility that the original purpose of their existence can become overlooked. Fire departments that handle EMS are becoming EMS departments that respond to fires, and that is a troubling trend. The number crunchers tell us there are far more EMS calls than fires; this can lead to attempts to gut the firefighting forces, neglect firefighting equipment, and focus on EMS (the revenue producing part of the public safety equation).

This approach is disastrous and needs to be exposed. It is true that EMS calls are far more frequent than actual fires. Many departments balance their budgets on the income that EMS provides. Fires, on the other hand, need qualified, trained, and experienced people to fight them. Fires are costly events and can drain city budgets when resources to put them out are lacking.

With so many EMS calls to respond to, many fire departments are lacking experienced firefighters. Fire companies are being replaced with EMS units, and staffing is adjusted accordingly. Fire officers are assuming their roles with very little experience fighting fires despite being able to interpret a 12-lead with their eyes half open. To maintain an effective firefighting force, up-to-date and well-maintained equipment needs to be purchased, and people need to be trained, trained, and trained again. Readiness to respond must be maintained, not only to things burning but for hazardous materials, gas leaks, complicated extrications, electrical hazards, biological weapons, ice rescues and, any other conceivable emergency that happens in the area they protect.

The hours needed to become proficient at firefighting are vast, and the dollars needed to equip proficient people scarce. The tendency for our elected leaders to follow the path of least expense for public safety is well documented. The time is upon us—the dedicated firefighter—be it volunteer, call, or union to advocate for the fire side of our profession while maintaining our EMS proficiency. It is shaping up to be a difficult battle, but I believe one well worth engaging. We, as a profession, need to be excellent firefighters. We need to insist on the best equipment, proper training, and realistic compensation.

EMS will not save the fire service. The fire service will provide the EMS as part of our mission, but we cannot allow that mission to become EMS centered. There is too much risk involved when anything but dedicated firefighters operating well-maintained and modern equipment show up on an emergency scene.

The sheer number of EMS calls makes it difficult for even the most dedicated among us to commit the proper amount of time needed to stay sharp at firefighting, but that is a battle in which we all must engage. We can and do see the results of the EMS side of firefighting daily, usually one patient at a time. There is true satisfaction in helping the elderly man who has fallen, treating a cardiac arrest, bandaging the injured following highway wrecks, and reviving overdose victims. Those are battles fought and often won with limited resources, sometimes two or more fire medics, but seldom more than six personnel or with more than two pieces of apparatus. On the other hand, large-scale emergencies are handled by multiple companies, dozens of responders, an incident command structure, and potential for catastrophic loss of life and/or property. If we allow ourselves to be anything but the absolute best at what we do, we hurt not only ourselves, our company members, and the rest of the responders, but the people who need us as well.

Each and every one of us who has earned the privilege of donning turnout gear owes it to the rest to advocate for the fire part of the fire service. Be our absolute best at EMS and continue the tradition of excellence we were given by those who came before us. Theirs was a different battle, but every bit as difficult and essential as ours.

Michael Morse is a former captain with the Providence (RI) Fire Department (PFD), an author, and a popular columnist. He served on PFD’s Engine Co. 2., Engine Co. 9, and Ladder Co. 4 for 10 years prior to becoming an EMT-C on Rescue Co 1 and Captain of Rescue Co. 5.

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Engine Company EMS: Talking About What Happens at Work

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