Fire Service EMS Needs Evaluated At Rockville Workshop Held by USFA
“The fire service can provide emergency medical service better than any other group, and it is the aim of the United States Fire Administration to get every fire department in the United States involved in this necessary service.”
With these words, Gordon Vickery, administrator, USFA, opened the national workshop for fire service EMS needs that was held at the Montgomery County Fire-Rescue Training Center, Rockville, Md., Dec. 3-5.
Vickery also drew attention to the lack of standards in training and the unwillingness of some fire chiefs to assume responsibility for the EMS. He was pleased with the makeup of the faculty that represented all parts of the country and which covered all fire department ranks from fire fighter to chief of department.
The purpose of the workshop was to define, articulate and establish priorities for fire service EMS needs. A secondary purpose was to prepare suggestions as to “how the USFA might aid or assist the American fire service in meeting these needs.”
The faculty of the workshop (see box) was selected to serve on the basis of their experience and expertise in the field of emergency medical services “as delivered by fire service agencies.” Michael F. Olsen of the USFA chaired the workshop, which was moderated by James 0. Page of the ACT’ Foundation, assisted by William Hummel, fire fighter/paramedic, Albany, N.Y.
Fire Service/EMS Needs Assessment
- System planning and design
- Recruitment and selection of EMT and paramedic personnel
- Training and certification
- Fire department administrative policies
- Fire company supervision of EMS personnel
- Staffing requirements for dual role services
- Dispatching policies and procedures
- Triage of cases by first-responders
- Medical direction, accountability, control
- Continuing education
- Paramedic and EMT attrition
- Transport protocols
- Relations with private sector ambulance personnel
- Budget and finance of EMS operations
- Qualifications for fire department EMS program managers
- System “abuse”
- Legal services and legislation
The ACT Foundation had been selected by the USFA to organize and conduct the workshop, which was intended to aid the USFA in its mission as lead agency and federal focal point for fire service RMS. In his opening remarks, Moderator Page spelled out the capabilities of the USFA to provide assistance as follows: leadership and advocacy, consultation and staff assistance, research and studies, training and education, resource documents, funding, and coordination with other agencies.
18 General Areas
The assessment of needs was developed by the workshop with these capabilities in mind. Prior to coming to the Rockville workshop, faculty members were provided with a suggested list of 18 general areas of EMS needs (see box), a list that ran from “systems planning and design” to “systems abuse.” The faculty was also asked to list any additional areas that they could think of and advised that “no topic should be considered unreasonable or farfetched.”
There were four subdivisions under each of the suggested needs for a total of 72, but the needs stretched to 105 (later condensed) when the faculty members added their own topics. These needs were all “subjected to the scrutiny and creative talents of the faculty at the national workshop.”
As an example, under system planning and design, the number one item on the agenda, the members were asked if the following represented valid fire service/EMS needs:
A directory of fire service/EMS profiles and operational systems which might be used for consultation, study and comparison,
A planning handbook for use by fire departments interested in adopting an EMS activity or service or for use by fire departments interested in changing or altering current EMS activities or services,
Consultation services to help indicate and guide the EMS planning process, and
Planning grants for exclusive use by fire departments for EMS-related planning.
National Workshop tor Fire Service/EMS Needs Faculty Members
Public Safety Director/Paramedic Coordinator
University of Connecticut Health Center
John P. Cernich
Littleton, Colo., Fire Department
Birmingham, Ala., Fire Department
Battalion Chief/EMS Coordinator
Columbus, Ohio, Fire Department
IAFF/IAFC EMT Apprenticeship Program
Bill G. Roberts
Dallas, Tex., Fire Department
St. Paul, Minn., Fire Department
Seattle, Wash., Fire Department
Miami, Fla., Fire Department
Mary Beth Michos, R.N.
Montgomery County, Md., Dept. of Fire/ Rescue Services
Phoenix, Ariz., Fire Department
Los Angeles County, Calif., Fire Department
Howard Westney, M.D.
Albany, N. Y., Regional Emergency Medical Organization
These four subdivisions were adopted almost unanimously, but the workshop members came up with seven additional topics, three of which were incorporated into the other four, which then became part of the needs under system planning and design. This latter, incidentally, became the number one priority recommendation made to the USFA.
Recruitment a high priority
Recruitment and selection of EMT and paramedic personnel also rated high on the list of priorities. Workshop members called for a “standard examination, or examination process, for use in selecting personnel,” plus “equitable economic and career incentives to encourage voluntary participation in EMS activities,” and “an educational program within fire departments to instill greater understanding of the EMS function and to decrease negative peer pressure on personnel assigned to EMS activities.”
It is interesting to note that under this category a suggestion to include a “scientifically measured and published profile of t he ideal candidate was voted not valid by the members.
“Not valid” was also the decision in a related area under “fire department administration policies.” Here the members voted down a “recommended job description of fire service EMTs and paramedics which considers the special needs of such personnel and precludes certain of the traditional maintenance functions of the fire fighter (mopping floors, etc.).
As the faculty went to work. Moderator Page established the mood by stating that “EMS is here to stay and problems abound.” He backed up this statement with some statistics: About 17,000 tire departments (involved in some form of EMS) answer some 18 million calls a year.
It would be impossible to cover all the other assessment needs weighed by the faculty in this short space, but a few stand out. Recertification,” which was thoroughly covered, is one of them. Recertification exam content and the deadlines between examinations received a lot of time and attention as did salary increases linked to recertification as an inducement.
Paramedic and EMT attrition is unquestionably a problem of many emergency systems and it too received a lot of attention. One of the items under this heading called for a study “to determine the average probable tenure of fire service personnel…..” (to allow for planning and budgeting).
Statement of philosophy
One of the most important items on the agenda was a proposed recommended statement of philosophy for the USFA which was drawn up at the conclusion of the workshop:
“The U. S. Fire Administration recognizing the American fire service tradition of, and readiness for, efficient and effective pre-hospital emergency care, strongly supports this public service as an essential part of the total fire service responsibility and pledges to the extent possible its aid, assistance and support to fire departments engaged in prehospital emergency care as part of, and in cooperation with, comprehensive emergency medical services. This support is intended to enhance the quality and availability of emergency medical services resources available from or supported by other agencies, organizations or individuals.”
All in all, we feel that this Rockville workshop was the most important ever held on EMS and one that will have a long and far-reaching effect. A full report of the workshop will be produced by the ACT Foundation within the next few months and widely distributed by the USFA.