Why Do Fire Engines Go On Medical Calls?

I was at the Dream Cruise on Woodward last week and had an opportunity to see some other fire departments at work.   We saw one EMS run that included both an ambulance and a fire engine following.  Now I don’t know what the call was so I don’t know what was needed.  But I do know a bit about this sort of thing in general.  It is a question that comes up frequently.  A-2

Back awhile ago,  we frequently sent an engine on the same calls with an ambulance because we didn’t have detailed enough information about the call to know exactly what was  needed to treat the patient or take the needed action.  There are 2 people on the ambulance–most of the time it is two paramedics but it could be one medic and one EMT (Emergency Medical Technician–it is a state licensing category).  And there are another 1 or 2 on the engine.  As of June of this year, we began using Emergency Medical Dispatching (EMD) which is a dispatching strategy using flip cards or software to question callers about the nature of the medical emergency in such a detailed way that we can classify a call’s emergency status.  Our dispatch staff had to go through significant training to operate under the system.  (It is carefully monitored so we also have frequent quality reviews to make sure we are doing it correctly.)  So now we know what is likely to be happening at the call so we can more accurately send the right apparatus and personnel.  For certain types of calls that indicate high likelihood of a life threatening event–like trouble breathing or chest pain–we know that we need all hands on deck because if it is likely to be a CPR call which will require lots of on scene personnel to do all the tasks it takes.  Others receive a lower classification if call is determined to be a lower priority.  Some are even answered without lights and sirens.  It is very dangerous for the motoring public and for us to drive lights and sirens anywhere–so we minimize the times we do it.

Our police and fire operate on two different radio talk groups and don’t usually listen to each other since both radio groups tend to be pretty busy and “step” on each other’s transmissions.  The dispatch listens to and dispatches on both groups.  With EMD when dispatchers find that a medical call is classified by the software or on the flip cards as a life threatening emergency, the police are also dispatched because they can get there more quickly and we don’t have to send another apparatus with more firefighters.  They can locate the patient and begin some forms of treatment (like CPR or automatic defibrillator).  When the patient is transported, they go back on patrol.  We get a quicker, more effective response with both groups working more efficiently together.  Previously, police didn’t respond for the most part because it was a waste of time to send one or more officers along with 2 fire apparatus to every medical call, “just in case.”  It is just more efficient for both groups.

By limiting the number responding to any one call, we stay ready for the next call.  Now that we are providing advanced medical care ourselves, without the public/private partnership, sometimes you’ll see only the fire engine on a medical call.  That means that the 2 ambulances are busy on other calls so we’ve sent EMTs or paramedics, they are just on another type of apparatus.  They can treat you-they just can’t transport you.  As soon as an ambulance frees up, you will be on the way to the hospital.

It is a closely coordinated system and we monitor it closely.  We have found that it works efficiently for both police and fire.

Detroit Police pass up tech upgrade | The Detroit News | detroitnews.com

CLEMIS is the most valuable tool we have as crime fighters. It is disappointing that the DPD doesn’t feel it has the resources to join our consortium. Although it will cost them in the beginning what they will save will make it up to them very quickly.  As a mid sized agency in Oakland County, we simply couldn’t afford to purchase and support the suite of CLEMIS products available to us including computer aided dispatch, records management, electronic crash reporting, electronic tickets, Bluecheck finger print devices, property management, digital fingerprinting, digital mugshots, video arraignment and others. We have purchasing power we wouldn’t have as individual agencies when it comes to buying mobile computers, digital fingerprint machines, crime mapping and analysis and other things. And that isn’t even discussing what we get from the sharing of information allowing us to engage in crime analysis outside our borders.  And an additional positive is that the programs are designed and modified by our own police to fit our needs.  Our user groups determine what the programs will look like and will do. 

Detroit Police pass up tech upgrade | The Detroit News | detroitnews.com

via Detroit Police pass up tech upgrade | The Detroit News | detroitnews.com.

I think they are missing an opportunity here…..

Being Prepared

Earlier today I had an opportunity to be an observer at the very first Oakland County Tactical Training Consortium’s small squad tactics practice exercise held at the CREST center.  This was the culmination of a year’s worth of training–700 officers in total –in Mobile Field Force tactics which is essentially readiness for a violent civil disorder event.  There are all kinds of situations that can cause an event that would require the team:  people “celebrating” a sports victory, political protesters, economic protestors, labor disputes, all sorts of things.  Here in Auburn Hills we have trained in this type of preparedness for more than 10 years.  I am a believer in being ready for any reasonable potentiality and civil disorder is one of those things that is low-frequency/high risk, which means that it doesn’t happen very often but when it does, there is a very high price for failure–for the community and the agency.  So to deal with the fact that we are not faced with these events very often, we must train and train.  The beauty of this kind of  cooperative effort is that when our people train together they can react together.  This type of event is very likely to need a large force of people to contain, in today’s exercise there were 50 officers and command officers involved. No single agency can produce a large enough force to get the job done–we have to work together.

Police vs the Protesters

The training and equipment were purchased by federal grant dollars–your tax dollars at work.  Our goal in this type of event is to prevent or limit injury to people or property using the least amount of force necessary.  That is much more likely to happen, in my opinion, if the officers are well-trained and well-disciplined in this type of highly emotional and challenging situation.    The goal is always to get the people to disperse without further action.   If you study this type of event you’ll find a whole range of instances where they went good and not so good–examples are the G8 Summits held around the world. One in Seattle about 10 years ago went disastrously wrong and others have been done very successfully. 

We are part of the leadership of the group through Deputy Director Jim Manning who is the group’s secretary and Deputy Director Thom Hardesty and Lt. Cas Miarka who volunteered to be the command officers for the exercise; Officers Bryan Eftink and Matt Halligan who are instructors and were participants today.

I heard the group’s leader, Chief Gary Mayer from Troy talk to the team about how he hoped that this training would never be used–but that he was glad we were ready if called upon. 

I couldn’t agree more.

Fire Department Technical Rescue

In my new position as Emergency Services Director I am learning as much about the specifics of fire operations as I can.  Because it is so very interesting, I thought you might want to read more about it.  So here is the first in my series of blogs about the FD and how they do their work in a modern fire department.  My first installment is TECHNICAL RESCUE.

I knew a little bit about Technical Rescue but not as much as I wanted to know so I spent some time the other evening talking with one of the members of our Technical Rescue team, Firefighter Gary Chapman, about what he does as a member of the team.  Other members are Firefighter Tony Randolph and Firefighter Mike McNamara. 

Firefighters Mike McNamara, Tony Randolph and Gary Chapman

Technical Rescue can be divided into several subcategories:

  • confined space rescue – these rescues can occur in steam tunnels or sewer pipes, places that are small and tight
  • high angle and low angle rope  rescue – this type of rescue might be out of a multi story building or down into a ravine; rescuing a person from a TV tower or water tower is another kind of example.
  • structural collapse –  Our team was on the list to be called into Joplin, MO after their terrible tornadoes with many collapsed buildings. 
  • trench rescue – often these are workers down in the ground who become trapped when the sides of trench they are working in collapses on top of them.  This team can go down as far as 22 feet to rescue a person given their training and equipment.

All firefighters have some training in rescue. There is an “awareness” level where they learn what it is and when to recognize the need for specialized skills.  “Operations” is the second level.  These folks can assist with some aspects.  “Technician” is the level that firefighters reach to be the ones actually doing the work — they are the ones doing the building repel or down in a collapsed structure cutting their way to the victims of a building collapse.  To be a technician level each of these specialties requires some serious training time: 

  • confined space – 40 hours
  • high angle and low angle rope rescues – 80 hours
  • structural collapse – 80 hours
  • trench rescue – 80 hours

Plus they train monthly to maintain these important skills.  Here is a video that gives an example of what technical rescuers do:  1991 New York Rescue  It is an example of a real life high angle rope rescue. 

You’ll be pleased to know that this is an area of shared services here in Oakland County that has been in operation long before anyone at the state government suggested that local governments ought to share – about 20 years.  Auburn Hills is part of a county team and they are part of a state team that delivers skilled personnel and equipment where needed.  Our team has about 32 personnel total for our east side of Oakland County made up of about 6 or 7 departments.  There is a west side team as well and one made up of the purely career departments (ours is a combination of career and paid on call) along Woodward Ave.  and then Southfield has its own.  When there is a need for  rescue team members are alerted by a page and 16 respond immediately.  The other 16 are on stand by in case they are needed to relieve the first team after 12 hours.  The team is also part of a larger in state response and could be called out for a situation anywhere in the state and even at the national level as a result of compacts between the states that direct trained personnel into critical incidents as quickly as possible when a large-scale event is in progress or when an event has exhausted the resources of the local area.

The team trains 4-8 hrs per month in scenario based training and twice a year they do a longer training that includes all 4 disciplines in one day.  They are looking for a multi story building to repel from as one of their next exercises. 

Here is a look at our Special Response Unit vehicle.  It has a command post in the front area of the truck and is loaded with stuff in each compartment.  There are ropes, extra air bottles, a decontamination set up for a hazardous materials incident, material to dam and soak up a hazardous material spill and many, many other pieces of equipment.

This slideshow requires JavaScript.

I’ve been on scenes where people are trapped and frequently are injured and need help.  These firefighters do a challenging and sometimes dangerous job when they enter into these technical rescues.  I know they train so diligently and carefully maintain their equipment and training because they sincerely want to help people. 

I hope you never need to meet them on the job…..