4 ms·

Our community has three large fire trucks, and one is sent out for every 911 call, even though the vast majority of calls are for medical emergencies, not somet

Our community has three large fire trucks, and one is sent out for every 911 call, even though the vast majority of calls are for medical emergencies, not something requiring a fire truck (which always arrives quickly, but a subsequent ambulance on call is what inevitably hauls a patient to the hospital). I've never understood why the fire department doesn't acquire and dispatch small vehicles for all those medical calls instead of a giant fire truck. Seems like that would help hold down costs.

dominick-cc 1y ago
I assumed it's so it gets used, otherwise it would just sit there and might not work when needed
brudgers 1y ago
The fire truck goes because it has a paramedic. It needs a paramedic because fire fighters often need paramedics. So if the small vehicle has a paramedic, you still need one for the big truck. And if you have another vehicle, you need a bigger apparatus bay at the station and more beds and more staff times three shifts. Finally, when the 911 call comes in there is not time to triage. The system is optimized for response time because people might die.
JeremyMorgan 1y ago
Valid question, and I hear it all the time. Most of the time it's due to preparedness and staffing. By having those 4 people on a fully equipped engine, if something big (structure fire, vehicle extrication, rescue) happens, they can jump in and go with a vehicle full of tools. (provided the ambulance crew can take over). Otherwise if they're in a car, they'd have to drive back through traffic to the station, move their gear to the new vehicle, and drive back to the scene. It can cost valuable time. Fire engines carry a surprisingly large amount of tools and equipment for a variety of purposes. That being said, many larger departments are trying out "cars" (usually an SUV) with two people and a med bag to go to medical calls. While the engine/truck and crew stay at the station. This is fairly expensive with the new vehicle, equipment and extra staffing. However it is being done now with success in urban areas.
- insane_dreamer 1y ago
  but the ambulance crew already has a paramedic, so why do they also need one from the fire department?
  - _moof 1y ago
    Because the fire department can usually get there faster. The goal is to get medical help there as quickly as possible.
    - ViewTrick1002 1y ago
      What do you optimize for? Person on scene? Time to hospital for patient? Time to arrival of a fully equipped ambulance to deal with emergencies? Risk and time from dealing with a complex handover of the patient from fire truck crew care to ambulance care? For me it seems like in the vast majority of cases optimizing for getting a fire truck on scene fast is the wrong solution. Waiting a few extra minutes for the ambulance would improve outcomes. And it is of course possible to differentiate on calls. A life or death situation like a cardiac arrest or someone bleeding out would select from all available units. Including the fire department, ambulances and police. But those are a tiny sliver of 911 calls.
      - M95D 1y ago
        Vote up from me, but even this isn't optimal. As opposed to fire trucks, ambulance vans can be parked almost anywhere in the city waiting for calls. They don't need to wait at their base station. They get faster to a call location than a fire truck.
        lotsofpulp 1y ago
        In 99% of US jurisdictions, you cannot even develop land in a way that prevents an enormous firetruck from driving all around the property. Which means less density, more wasted space for road, further cementing a car-centric life.
coryrc 1y ago
> Seems like that would help hold down costs. That's not a goal.
Glawen 1y ago
Most rigs in Europe (I'm in France) are Sprinter type van like an ambulance, which is the one which gets mostly called. The other Sprinter are with tools, and or two big ladder trucks for the real fires which rarely happen. To me they seems to have tuned their rigs to what they need most In rural area prone to forest fire, they have big all terrain trucks with water tank (useless in cities)
deleted 1y ago
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os2warpman 1y ago
> I've never understood why the fire department doesn't acquire and dispatch small vehicles for all those medical calls instead of a giant fire truck. Staffing. Almost every call requires more than two people and ambulances are typically only staffed with two people. If there is a second call (fire, rescue, or anything that requires the larger apparatus) while the fire engine is out assisting the EMS crew and the crew has taken a smaller vehicle, they have to drive back to the station, get on the engine, and then respond to the second call. This is not uncommon-- for my department I'd say it's routine. In smaller volunteer departments like mine, there aren't enough people to go around. In larger paid career departments, the cost of the extra personnel needed to staff smaller vehicles very quickly exceeds the cost of the wear and tear on the larger apparatus. You have to account for more than just their salaries, but also insurance, training costs, any equipment issued, and retirement contributions. There's also the matter of equipment. Larger apparatus carry tools and equipment that smaller vehicles can't or don't. Many jurisdictions do have a mix of resources where EMS crews can get the additional resources they need on a call without an engine or truck responding, and it does work for the most part. Most jurisdictions can't afford that. It seems common in Europe to not send fire apparatus, but I'm willing to bet they deal with many fewer bariatric patients so most calls don't need six guys.

dominick-cc 1y ago

I assumed it's so it gets used, otherwise it would just sit there and might not work when needed

brudgers 1y ago

The fire truck goes because it has a paramedic. It needs a paramedic because fire fighters often need paramedics. So if the small vehicle has a paramedic, you still need one for the big truck. And if you have another vehicle, you need a bigger apparatus bay at the station and more beds and more staff times three shifts. Finally, when the 911 call comes in there is not time to triage. The system is optimized for response time because people might die.

JeremyMorgan 1y ago

Valid question, and I hear it all the time. Most of the time it's due to preparedness and staffing. By having those 4 people on a fully equipped engine, if something big (structure fire, vehicle extrication, rescue) happens, they can jump in and go with a vehicle full of tools. (provided the ambulance crew can take over). Otherwise if they're in a car, they'd have to drive back through traffic to the station, move their gear to the new vehicle, and drive back to the scene. It can cost valuable time. Fire engines carry a surprisingly large amount of tools and equipment for a variety of purposes. That being said, many larger departments are trying out "cars" (usually an SUV) with two people and a med bag to go to medical calls. While the engine/truck and crew stay at the station. This is fairly expensive with the new vehicle, equipment and extra staffing. However it is being done now with success in urban areas.

insane_dreamer 1y ago
but the ambulance crew already has a paramedic, so why do they also need one from the fire department?
- _moof 1y ago
  Because the fire department can usually get there faster. The goal is to get medical help there as quickly as possible.
  - ViewTrick1002 1y ago
    What do you optimize for? Person on scene? Time to hospital for patient? Time to arrival of a fully equipped ambulance to deal with emergencies? Risk and time from dealing with a complex handover of the patient from fire truck crew care to ambulance care? For me it seems like in the vast majority of cases optimizing for getting a fire truck on scene fast is the wrong solution. Waiting a few extra minutes for the ambulance would improve outcomes. And it is of course possible to differentiate on calls. A life or death situation like a cardiac arrest or someone bleeding out would select from all available units. Including the fire department, ambulances and police. But those are a tiny sliver of 911 calls.
    - M95D 1y ago
      Vote up from me, but even this isn't optimal. As opposed to fire trucks, ambulance vans can be parked almost anywhere in the city waiting for calls. They don't need to wait at their base station. They get faster to a call location than a fire truck.
      - lotsofpulp 1y ago
        In 99% of US jurisdictions, you cannot even develop land in a way that prevents an enormous firetruck from driving all around the property. Which means less density, more wasted space for road, further cementing a car-centric life.

coryrc 1y ago

> Seems like that would help hold down costs. That's not a goal.

Glawen 1y ago

Most rigs in Europe (I'm in France) are Sprinter type van like an ambulance, which is the one which gets mostly called. The other Sprinter are with tools, and or two big ladder trucks for the real fires which rarely happen. To me they seems to have tuned their rigs to what they need most In rural area prone to forest fire, they have big all terrain trucks with water tank (useless in cities)

deleted 1y ago

[deleted]

os2warpman 1y ago

> I've never understood why the fire department doesn't acquire and dispatch small vehicles for all those medical calls instead of a giant fire truck. Staffing. Almost every call requires more than two people and ambulances are typically only staffed with two people. If there is a second call (fire, rescue, or anything that requires the larger apparatus) while the fire engine is out assisting the EMS crew and the crew has taken a smaller vehicle, they have to drive back to the station, get on the engine, and then respond to the second call. This is not uncommon-- for my department I'd say it's routine. In smaller volunteer departments like mine, there aren't enough people to go around. In larger paid career departments, the cost of the extra personnel needed to staff smaller vehicles very quickly exceeds the cost of the wear and tear on the larger apparatus. You have to account for more than just their salaries, but also insurance, training costs, any equipment issued, and retirement contributions. There's also the matter of equipment. Larger apparatus carry tools and equipment that smaller vehicles can't or don't. Many jurisdictions do have a mix of resources where EMS crews can get the additional resources they need on a call without an engine or truck responding, and it does work for the most part. Most jurisdictions can't afford that. It seems common in Europe to not send fire apparatus, but I'm willing to bet they deal with many fewer bariatric patients so most calls don't need six guys.