“There is no room for improvisation on the fireground.”

I've heard it from many of my firefighter colleagues, and I would submit that if you ever run an EMS call that doesn't involve some level of improvisation, I'll eat my hat.

That's a significant difference in mindset right there, Firehat.

I'll readily concede that there may be fire departments out there that could do a great job with EMS… with could being the operative word.

But when your call mix is 80/20 EMS vs fire suppression, and your training, promotional pathways and budgeting is 80/20 the other way, that in my mind does not seem like a department takes EMS seriously.

EMS may indeed be a natural fit, for the fire department's needs. For EMS's needs, not so much.

And this is not an ad hominem attack on you or the fire service, but why does a discussion of EMS need involve the fire service?

You say “inextricably linked,” and that may be so in many cities.

But is that a good thing?

“There is no room for improvisation on the fireground.”

I've heard it from many of my firefighter colleagues, and I would submit that if you ever run an EMS call that doesn't involve some level of improvisation, I'll eat my hat.

That's a significant difference in mindset right there, Firehat.

I'll readily concede that there may be fire departments out there that could do a great job with EMS… with could being the operative word.

But when your call mix is 80/20 EMS vs fire suppression, and your training, promotional pathways and budgeting is 80/20 the other way, that in my mind does not seem like a department takes EMS seriously.

EMS may indeed be a natural fit, for the fire department's needs. For EMS's needs, not so much.

And this is not an ad hominem attack on you or the fire service, but why does a discussion of EMS need involve the fire service?

You say “inextricably linked,” and that may be so in many cities.

But is that a good thing?

“There is no room for improvisation on the fireground.”

I've heard it from many of my firefighter colleagues, and I would submit that if you ever run an EMS call that doesn't involve some level of improvisation, I'll eat my hat.

That's a significant difference in mindset right there, Firehat.

I'll readily concede that there may be fire departments out there that could do a great job with EMS… with could being the operative word.

But when your call mix is 80/20 EMS vs fire suppression, and your training, promotional pathways and budgeting is 80/20 the other way, that in my mind does not seem like a department takes EMS seriously.

EMS may indeed be a natural fit, for the fire department's needs. For EMS's needs, not so much.

And this is not an ad hominem attack on you or the fire service, but why does a discussion of EMS need involve the fire service?

You say “inextricably linked,” and that may be so in many cities.

But is that a good thing?

A great discussion here, CK and firehat. as someone trapped straddling the fence (by choice) I can tell you that without fire resources many communities would struggle to provide services under their current requirements. But as Rogue and AD will remind us, those numbers are based on the AHA and their belief that people are beginning the chain of survival before we arrive.

We have to make ALS calls within 8 minutes and BLS calls within 5. Backwards, yes, but only because we could never meet the 5 minute ALS standard because we built the ALS framework on top of the BLS frame.

EMS is not connected to the fire service any more than Motorcop is connected to directing traffic. Sure a traffic department would be better, but many communities can't afford people jsut to write tickets and re-direct traffic.

It comes down to how EMS landed in the fire service to begin with – A budget looking for a mission. While the Chiefs that were sat at teh table wondering how to keep their call volume up and justify all the resources scattered throughout their jurisdictions, the sirens of passing ambulances lit a bulb over their heads.
“If we go where they're going, we'll never be slow!”

It was a brilliant idea that was horribly implemented in most of he nation. Now it has morphed into an ALS Ladder Truck mentality where sending a $750,000 5 man truck for an asthma attack is justified. Take that medic and put him in a car, on a bike, or *gasp* put him in an ambulance and let's make some sense out of all this.

For now, we need each other. Fire needs the business and EMS needs the man power.

The goal of EMS 2.0, when I first envisioned my perfect system, let's us stretch man power by allowing medics to be trained to refuse an ambulance to those who truly don't need it.

A cardinal sin today, a reality tomorrow? if I have something to say about it, then yes.

Keep up the discussion guys, this is what has been missing every other time this has been tried. Keep the channels open.
HM