This is a similar news report sent out a couple of days ago about the Orange County (CA) Grand Jury report.
There is an interesting debate about the ‘expense’ of using of fire engines for medical first response (MFR). Fire engines are staffed with firefighters typically based on a fire response deployment model (assembly of personnel for fighting a fire, etc.), which is why they typically have 3 to 4 firefighters on board). In many departments, most of their response volume is EMS responses, with relatively few actual fires. Some feel that using resources that are already on-duty and staffed for a fire response for MFR is very cost effective. In essence, if the engine stopped going on medical calls, would you still retain those personnel for fire calls? If yes, then the cost of the MFR is marginal. Yes, the engine is expensive, but most fire engines are often replaced because they become outdated, not because they wear out due to things like high mileage.
Additionally, very few EMS calls are for time-life-sensitive emergencies, and therefore may not require an immediate MFR. Life-threatening calls (cardiac arrest, severe trauma, severe difficulty breathing) represent only about 10% of EMS calls in most communities. Perhaps it may be better to keep MFR resources available for the true life-threatening calls, as opposed to having them respond to call in which they will likely not have an impact on the patient’s outcome? If a MFR unit is tied up on a non-life threatening call, they may not be available to respond to the cardiac arrest that comes in 3 blocks away.
Perhaps reserving MFR resources for the calls they are truly needed for would reduce wear and tear on the engines (and the streets), reduce firefighter fatigue, and help assure the MFR resources are available for the calls they will make a difference on?
And, as we know from numerous studies, HOT vehicle operations put providers, and the public, at significant risk of injury and death, and should only be used in cases where that mode of operation may make a difference in the patient’s outcome.
Stop Sending Fire Trucks on Medical Calls, OC Grand Jury Report concludes
BY JESSE LA TOUR
MAY 31, 2022
A recently released Orange County Grand Jury report entitled “Where’s the Fire? Stop Sending Fire Trucks to Medical Calls” questions this widespread practice.
In Orange County, nearly 80% of all 911 calls to fire departments are for medical services. The report highlights potential problems with the deployment model of the Orange County Fire Authority (OCFA), which Fullerton is considering joining, as well as other city fire departments.
“Sending a 36,000 to 60,000-pound fire engine or aerial ladder truck down residential streets for strictly medical calls is not only dangerous and costly, but it also results in unnecessary wear and tear on our streets,” the report said.
The Grand Jury’s findings include:
- Despite use of a tiered dispatch system, Orange County Fire Authority deployment of resources for medical responses are the same for nearly all calls, resulting in unnecessary wear and tear on expensive fire-fighting equipment and public infrastructure.
- Ambulances or smaller squad vehicles are often the most appropriate response to medical calls and do not compromise the quality of medical care
- Over-deployment of firefighters for medical calls contributes to the current climate of firefighter fatigue.
- Code 3 response (lights and sirens) is over utilized by OCFA, unnecessarily putting the responders and public at risk.
The Grand Jury’s recommendations Include:
- All Orange County fire agencies utilize criteria-based dispatch protocols and send a single unit response [ambulance] to those incidents triaged as non-life threatening.
- OCFA should station a paramedic squad vehicle, which is more nimble and less costly to operate, in place of a second engine in stations with high volumes of medical calls.
The Grand Jury’s investigation “also revealed a breakdown in communication and trust between Orange County Emergency Medical Service (OCEMS) and Orange County Fire Chiefs, which includes Fire Chiefs of the Orange County Fire Authority (OCFA) and various city fire departments.”
The report commended the city of Placentia’s recent changes to their emergency medical response protocols after leaving OCFA, which have resulted in improved medical call response times.
To read the full report visit http://www.ocgrandjury.org.