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Why does a fire truck respond to a medical call with an ambulance?

By Staff | Sep 21, 2011

It is the policy of the Sanibel Fire & Rescue District to provide the highest standard of care to sick and injured patients. The Sanibel Fire & Rescue District ensures the highest standard of care is being delivered to patients by providing the fastest response times possible. These fast response times are achieved when the closest fire apparatus and medic unit are dispatched to an emergency call. The Sanibel Fire and Rescue District currently has two fire stations on Sanibel. Station One on Palm Ridge Road also houses a medic unit from Lee County EMS.

All firefighters are certified either as an EMT or Paramedic. Each fire apparatus on Sanibel is always staffed with at least one credentialed Paramedic. This means that if a fire apparatus arrives at the scene of a medical emergency before the ambulance, trained EMT’s and Paramedics begin life saving treatment. In fact, both fire apparatus on Sanibel are appropriately equipped to treat all life threatening emergencies ranging from cardiac arrest, asthma, diabetic, allergic reactions, falls, etc.

In addition to being capable of performing advanced life support procedures when the fire crew does arrive first on the scene, it is also very important to have enough personnel available to appropriately treat critically injured or ill patients. Having the two paramedics on the county EMS unit is not enough to appropriately treat these critically injured or ill patients. It takes the additional personnel with training to correctly treat these patients. For example:

1) Two Firefighters/EMTs/Paramedics are needed to maintain the airway

2) One Firefighter/EMT/Paramedic starts an IV

3) One Firefighter/EMT/Paramedic defibrillates a cardiac arrest patient

4) One Firefighter/EMT/Paramedic is needed to administer medication

5) One Firefighter/EMT/Paramedic provides chest compressions.

As you can see from this example, it takes six trained personnel to properly treat a critically ill patient.

Many people have asked, “Why not send a fire truck to just critically injured or ill patients?” The truth is, in almost all incidents, that emergency responders do not know how critical the patient is until they get on scene. It is standard operating procedure for the Sanibel Fire & Rescue District to arrive at the scene of a medical emergency with the appropriate number of personnel to treat the patient. What may appear to be a minor illness or injury to the untrained bystander can turn out to be more serious. This serious condition requires the additional skills and staffing from firefighters assigned to the fire apparatus to properly treat the patient.

Another common question that people ask is “Why send a ladder truck or a full sized fire truck to a medical emergency, why not send a smaller rescue or pickup style truck with two fire fighters?” The answer to this question is simple: manpower. The Sanibel Fire & Rescue District operates with minimum staffing on each shift of six personnel. That is three on the ladder at station one and three on the engine at station two. If a pickup style rescue is put into service to run medical calls two fire fighters would have to be pulled off the ladder, leaving it out of service with one fire fighter left at the station unable to respond. It is totally unsafe for one fire fighter to respond alone on the ladder truck or engine to any type of call.

A rescue truck could be put into service if manpower were added. To put one rescue truck into service would require hiring a minimum of six personnel, or two per shift. This would result in a substantial increase to the budget and ultimately an increase in taxes. The most cost effective and efficient use of manpower is to simply run the crew on the fire apparatus. Here is why.

Typically, rescue units are added to stations that have high call volumes in densely populated areas to save ware and tear on the fire apparatus. Personnel at these stations also rotate off the rescue truck to avoid “burn out” which leads to excessive use of sick time. At busy stations this also keeps the fire apparatus available for a quicker response to fires. In these cases it may be necessary or cost effective to hire personnel to run rescue and medical calls on a rescue/pickup type vehicle.

Sanibel Fire & Rescue District ran a total of 1,221 calls in 2009 that is 3.3 calls per shift, not a high call volume by any standard. Of those, 736 – or 66 percent – were medical calls. These are the calls that a rescue/pickup truck would respond to. That is about two calls per shift. Sanibel Fire & Rescue District staff does not believe it is cost effective to hire six personnel and keep a rescue truck maintained for two calls per shift when a ladder or engine with full crews are in service, available, and capable of doing the same job.

Additionally, since we are unable to predict when or where the next fire call will be Sanibel Fire & Rescue District staff is also in agreement that it is not prudent to take a fire apparatus and crew out of service to run medical calls by shifting personnel to a smaller vehicle based on the call type.

In conclusion, the Sanibel Fire & Rescue District would like all citizens to know that we strive to provide the highest standard of care possible. This can only be accomplished through a coordinated effort involving the response of both a County EMS Unit and a fire apparatus to medical emergencies.