Fire Departments Best-Equipped to Handle 911 Emergency Response

Released at the IAFF Dominick F. Barbera EMS Conference in Houston, Texas, in June, the 13-page report – written and prepared by top EMS physicians – outlines the time-critical role fire-based EMS provides, and stresses the need to educate policymakers about the importance of fire-based EMS.

“As the federal, state and local governments consider their strategic plans for an “all hazards” emergency response system, EMS should be included in those considerations and decision makers should recognize that the U.S. fire service is the most ideal prehospital 9-1-1 emergency response agency,” said researchers, who included Franklin D. Pratt, M.D., FACEP, medical director for the Los Angeles County Fire Department; Steven Katz, M.D., FACEP, EMT-P, associate medical director for Palm Beach (Fla.) County Fire Rescue; Paul E. Pope, M.D., MPH, professor of medicine, surgery, public health and chair, emergency medicine, at the University of Texas Southwestern Medical Center and the Parkland Health and Hospital System; and David Persse, M.D., EMT-P, FACEP, physician director, Houston Fire Department Emergency Medical Services.

“The men and women of the IAFF are answering the calls for natural and man-made disasters, auto accidents, swift water and high angle rescues and hazardous materials and WMD incidents, but all of those calls combined do not equal the call volume in virtually every jurisdiction for medical emergencies,” said IAFF General President Harold Schaitberger in his keynote to delegates. “EMS is literally 'under fire' in most major cities, and that's what we've worked hard to achieve: a multi-role, all hazards approach to emergency response.”
The whitepaper is intended to help organizations as they continue efforts to educate local, state and federal officials about the role of fire-based EMS.

According to the white paper, the fire service can be configured many was to deliver prehospital 9-1-1 emergency medical care such as the following general configurations:

• Fire service-based system using cross-trained/multi-role firefighters. Firefighters are all-hazards responders, prepared to handle any situation that may arise at a scene including patient care and transport.
• Fire-service based system using employees who are not cross-trained as fire suppression personnel. Single-role EMS-trained responders accompanying firefighter first responders on 9-1-1 emergency medical calls.
• Combined system using the fire department for emergency response and a private and “third-service” (police, fire, EMS) provider for transportation support. Single-role emergency medical technicians and paramedics accompany firefighters first responders to emergency scenes to provide patient transport in a private or third-service ambulance.

“While there are pros and cons to the various system approaches, the emergency medicine EM literature indicates that the most likely time to create error in medical care is when care is transferred from one provider to another in a relatively short encounter time,” said researchers. “Such circumstances require that the fire service regularly exercise the leadership needed to ensure that integration of the parts of the prehospital emergency care system are coordinated well, with maximum benefit to the patient and minimum risk to the community.”