4 ms·

"Today in the US, if you call 911 about an emergency medical condition, they will often send a fire engine along with an ambulance [...]" This is SOP (Standard

by Arjuna 13y ago

"Today in the US, if you call 911 about an emergency medical condition, they will often send a fire engine along with an ambulance [...]" This is SOP (Standard Operating Procedure). 1. Imagine a scenario where an ambulance arrives as a first responder, and the EMTs [1] find that they cannot gain access to the emergency scene, because the home or other structure is locked or otherwise blocked. In this case, a firetruck would need to be dispatched, because it deploys with the correct equipment (e.g., Halligan bar [2], Denver tool [3], etc.) and personnel trained to handle such a situation. Also, ambulances are typically deployed with only two personnel, and that may not be enough in situations where items need to be moved or cleared to gain clear access to the emergency scene. 2. Most firefighters are cross-trained as EMTs. If they are local to the emergency scene, then they may be the first responders, while an ambulance is en-route. 3. Incoming 911 calls can often be confusing, with callers under extreme stress, experiencing situations that they have never faced in their lives. Imagine a situation where a caller is so distraught, overwhelmed, or focused on a life-saving effort, that they cannot articulate that they need firefighting support, in addition to an ambulance. The bottom line: in an emergency situation, it is better to have more help on-hand than too little. [1] https://en.wikipedia.org/wiki/Emergency_medical_technician https://en.wikipedia.org/wiki/Emergency_medical_technician [2] https://en.wikipedia.org/wiki/Halligan_bar https://en.wikipedia.org/wiki/Halligan_bar [3] https://en.wikipedia.org/wiki/Denver_tool https://en.wikipedia.org/wiki/Denver_tool

davidw 13y ago
Good points. Interesting anecdotal data: here in Italy you have to call the fire department to get a fire truck out, whereas they're part of the standard package described above in the US. Fires aren't that common here because of construction materials, so while you see plenty of ambulances and police cars whizzing around, fire trucks are a far rarer sight than in the US.
- nwombosi 13y ago
  I think the same goes for most of Western Europe. You rarely see fire trucks, but police cars and ambulances are common.
- yardie 13y ago
  In France, well Paris, it is quite common to see fire trucks. Like the US they are the first responders to most medical emergencies. And since the city is very old the buildings are mix of material, my previous apartment had plaster walls with mud and hay as fill material. And the wiring looked like it existed during WWII. Since being here, I've observed fires are quite common amongst the disaffected youth who enjoy burning cars and motos when they are bored.
stefantalpalaru 13y ago
How about a HazMat team? Imagine a scenario where the EMTs cannot gain access to the emergency scene because there are toxic substances in their way. You can't rely on the incoming 911 calls to decide on a case by case basis so you might as well send a HazMat team alongside the ambulance and firetruck for each and every call. And what about an anti-terrorist unit? Imagine a scenario where...
- earbitscom 13y ago
  If those were as common as fires and doors being deadbolted closed with child 911 callers, we might do it. You act as if the scenarios outlined by the parent are as rare as biohazard emergencies.
  - stefantalpalaru 13y ago
    >as common as fires and doors being deadbolted closed with child 911 callers Are there any statistics on the number of cases on which a firetruck was really needed?
    - dubcanada 13y ago
      Fire trucks do more then put out fires by the way. People seem to forget that a lot. They also have car tools, ladders, and other stuff.
      - throwawayyyyyy 13y ago
        a fire truck costs $250000. for the truck. If you don't need a 150 foot ladder and 1000 gallons of water, then a tool-truck like many contractors have would probably do for much less cost.
- discardorama 13y ago
  In San Francisco, people have been trying to get stats on how many times the fire trucks are sent on medical emergencies ("unresponsive man on the sidewalk"). The SFFD has resisted all attempts at such inquiry. I often see big fire trucks responding for homeless people, and it seems like such a waste. But their union is too powerful.
nostromo 13y ago
Check out this chart: http://marginalrevolution.com/wp-content/uploads/2012/07/What-Firefighters-Do.png http://marginalrevolution.com/wp-content/uploads/2012/07/Wha... There may even be a happy middle-ground with regards to firefighters. In eastern King County, they don't send out a firetruck and three firefighters for non-lethal medical emergencies anymore -- they just send a single firefighter in an SUV.
- Cthulhu_ 13y ago
  SUV? Over here (Netherlands) they send them in tiny cars (http://www.mijnalbum.nl/GroteFoto-SMYHWONA.jpg http://www.mijnalbum.nl/GroteFoto-SMYHWONA.jpg for example, but I've seen even smaller, two-person city cars with a flashlight bolted on). If it's just to carry a person with some essential first responder tools (fire extinguisher, medkit, axe / tools), you don't need anything big. Of course, in the US, distances are much larger than over here.
dnm 13y ago
I needed an ambulance in a state park and they sent a fire truck too. When I asked the EMT from the ambulance why the firetruck, she responded "they're our toolbox."
dizzystar 13y ago
I thought the reason the red fire ambulance needed to be around was because regular EMTs aren't allowed to administer oxygen do to its high flammability, which important in many emergencies. This according to one EMT that I know. In general, the EMTs you see carrying out an elderly woman are people with a few months of training. When people are getting stabbed, shot, or on the brink of life, you sort of need people with better training. https://www.cpc.mednet.ucla.edu/node/27 https://www.cpc.mednet.ucla.edu/node/27
Cthulhu_ 13y ago
And yet I can imagine this is something that could be optimized; why not cross-train the three emergency respondent department members into jack-of-all-trades that can deal with 80% of cases? Or put members of the three departments into a single vehicle equipped to deal with most cases? They could travel swifly to the site and deal with most cases, and call in back-up (like a fully equipped ambulance, fire-truck, or paramilitary SWAT-team in an armored hum-vee) if the situation needs it. I'm not an expert, but that would reduce overhead and cross-department communication needs. Of course, the risk is that if the one vehicle has an accident in itself, there's no others that can fall in right then.
- snuxoll 13y ago
  > And yet I can imagine this is something that could be optimized; why not cross-train the three emergency respondent department members into jack-of-all-trades that can deal with 80% of cases? Because we need firefighters anyway, and EMT's in ambulances are often volunteers or paid substantially lower than a fireman in most areas of the country. Bear in mind, you're also talking about putting additional equipment in what is already a jam-packed ambulance, if you end up needing to dispatch another vehicle it might as well be a fire-truck (you never know when someone forgot to say "my house is on fire" when they called in because their wife isn't breathing after dragging her out of the house).
- mabhatter 13y ago
  Firemen and EMTS DON'T WANT to be cops! That's why "public safety" movements fail. They don't want to be forced to issue citations for petty drug laws while trying to save people from health or fire emergencies. It's not an uncommon situation for somebody with petty illegal activity to start shooting at firemen trying to stop their house being on fire because they think firemen might arrest them. Regular fireman just want to take care of safety.. They don't want to put on jackboots and arrest people. Of course the Feds want as many police as possible because of the laws militarizing them and actually disincentive separete rate fire protection with rigged grant processes.
- dragonwriter 13y ago
  > And yet I can imagine this is something that could be optimized; why not cross-train the three emergency respondent department members into jack-of-all-trades that can deal with 80% of cases? Because that's very expensive (increasing initial and ongoing costs for training and equipping every first-response unit), and in the many cases where more than the minimal response is known to be necessary from the first call, and in cases where those departments aren't acting as first responders, it doesn't save anything. > I'm not an expert, but that would reduce overhead and cross-department communication needs. No, training and equipping EMTs to be adequate-for-most-cases firefighters and cops, firefighters to be adequate-for-most-cases cops and EMTs, and cops to be adequate-for-most-cases EMTs and firefighters would not reduce overhead. Quite the opposite.

by Arjuna 13y ago

davidw 13y ago

Good points. Interesting anecdotal data: here in Italy you have to call the fire department to get a fire truck out, whereas they're part of the standard package described above in the US. Fires aren't that common here because of construction materials, so while you see plenty of ambulances and police cars whizzing around, fire trucks are a far rarer sight than in the US.

nwombosi 13y ago
I think the same goes for most of Western Europe. You rarely see fire trucks, but police cars and ambulances are common.
yardie 13y ago
In France, well Paris, it is quite common to see fire trucks. Like the US they are the first responders to most medical emergencies. And since the city is very old the buildings are mix of material, my previous apartment had plaster walls with mud and hay as fill material. And the wiring looked like it existed during WWII. Since being here, I've observed fires are quite common amongst the disaffected youth who enjoy burning cars and motos when they are bored.

stefantalpalaru 13y ago

How about a HazMat team? Imagine a scenario where the EMTs cannot gain access to the emergency scene because there are toxic substances in their way. You can't rely on the incoming 911 calls to decide on a case by case basis so you might as well send a HazMat team alongside the ambulance and firetruck for each and every call. And what about an anti-terrorist unit? Imagine a scenario where...

earbitscom 13y ago
If those were as common as fires and doors being deadbolted closed with child 911 callers, we might do it. You act as if the scenarios outlined by the parent are as rare as biohazard emergencies.
- stefantalpalaru 13y ago
  >as common as fires and doors being deadbolted closed with child 911 callers Are there any statistics on the number of cases on which a firetruck was really needed?
  - dubcanada 13y ago
    Fire trucks do more then put out fires by the way. People seem to forget that a lot. They also have car tools, ladders, and other stuff.
    - throwawayyyyyy 13y ago
      a fire truck costs $250000. for the truck. If you don't need a 150 foot ladder and 1000 gallons of water, then a tool-truck like many contractors have would probably do for much less cost.
discardorama 13y ago
In San Francisco, people have been trying to get stats on how many times the fire trucks are sent on medical emergencies ("unresponsive man on the sidewalk"). The SFFD has resisted all attempts at such inquiry. I often see big fire trucks responding for homeless people, and it seems like such a waste. But their union is too powerful.

nostromo 13y ago

Check out this chart: http://marginalrevolution.com/wp-content/uploads/2012/07/What-Firefighters-Do.png http://marginalrevolution.com/wp-content/uploads/2012/07/Wha... There may even be a happy middle-ground with regards to firefighters. In eastern King County, they don't send out a firetruck and three firefighters for non-lethal medical emergencies anymore -- they just send a single firefighter in an SUV.

Cthulhu_ 13y ago
SUV? Over here (Netherlands) they send them in tiny cars (http://www.mijnalbum.nl/GroteFoto-SMYHWONA.jpg http://www.mijnalbum.nl/GroteFoto-SMYHWONA.jpg for example, but I've seen even smaller, two-person city cars with a flashlight bolted on). If it's just to carry a person with some essential first responder tools (fire extinguisher, medkit, axe / tools), you don't need anything big. Of course, in the US, distances are much larger than over here.

dnm 13y ago

I needed an ambulance in a state park and they sent a fire truck too. When I asked the EMT from the ambulance why the firetruck, she responded "they're our toolbox."

dizzystar 13y ago

I thought the reason the red fire ambulance needed to be around was because regular EMTs aren't allowed to administer oxygen do to its high flammability, which important in many emergencies. This according to one EMT that I know. In general, the EMTs you see carrying out an elderly woman are people with a few months of training. When people are getting stabbed, shot, or on the brink of life, you sort of need people with better training. https://www.cpc.mednet.ucla.edu/node/27 https://www.cpc.mednet.ucla.edu/node/27

Cthulhu_ 13y ago

And yet I can imagine this is something that could be optimized; why not cross-train the three emergency respondent department members into jack-of-all-trades that can deal with 80% of cases? Or put members of the three departments into a single vehicle equipped to deal with most cases? They could travel swifly to the site and deal with most cases, and call in back-up (like a fully equipped ambulance, fire-truck, or paramilitary SWAT-team in an armored hum-vee) if the situation needs it. I'm not an expert, but that would reduce overhead and cross-department communication needs. Of course, the risk is that if the one vehicle has an accident in itself, there's no others that can fall in right then.

snuxoll 13y ago
> And yet I can imagine this is something that could be optimized; why not cross-train the three emergency respondent department members into jack-of-all-trades that can deal with 80% of cases? Because we need firefighters anyway, and EMT's in ambulances are often volunteers or paid substantially lower than a fireman in most areas of the country. Bear in mind, you're also talking about putting additional equipment in what is already a jam-packed ambulance, if you end up needing to dispatch another vehicle it might as well be a fire-truck (you never know when someone forgot to say "my house is on fire" when they called in because their wife isn't breathing after dragging her out of the house).
mabhatter 13y ago
Firemen and EMTS DON'T WANT to be cops! That's why "public safety" movements fail. They don't want to be forced to issue citations for petty drug laws while trying to save people from health or fire emergencies. It's not an uncommon situation for somebody with petty illegal activity to start shooting at firemen trying to stop their house being on fire because they think firemen might arrest them. Regular fireman just want to take care of safety.. They don't want to put on jackboots and arrest people. Of course the Feds want as many police as possible because of the laws militarizing them and actually disincentive separete rate fire protection with rigged grant processes.
dragonwriter 13y ago
> And yet I can imagine this is something that could be optimized; why not cross-train the three emergency respondent department members into jack-of-all-trades that can deal with 80% of cases? Because that's very expensive (increasing initial and ongoing costs for training and equipping every first-response unit), and in the many cases where more than the minimal response is known to be necessary from the first call, and in cases where those departments aren't acting as first responders, it doesn't save anything. > I'm not an expert, but that would reduce overhead and cross-department communication needs. No, training and equipping EMTs to be adequate-for-most-cases firefighters and cops, firefighters to be adequate-for-most-cases cops and EMTs, and cops to be adequate-for-most-cases EMTs and firefighters would not reduce overhead. Quite the opposite.