Monday, December 8, 2008
Ambulance staffing solution: Go driver only and have the patient sit in the front seat. MD officials want to know why you must have two.
In Frederick County, Maryland, the leadership of the Fire and Rescue Services Division had to spend part of last Tuesday morning telling a Board of County Commissioners meeting why it wouldn't be prudent to change state law requiring a minimum staffing of two people on basic life support units.
Director Gene Mellin and Bureau Chief Doug Brown had to first explain to County Manager Ronald Hart when a station in the combined system finds itself with a driver only who is an EMT, the unit will often respond to a nearby emergency. It has to do so, not as an ambulance, but as a special unit. Staffing is usually added at the scene and the unit is upgraded, or the special unit provides care until a fully staffed BLS unit arrives.
Chief Brown explained the reason the unit can't respond as an ambulance is it would not meet the minimum staffing requirements set up by the Maryland Institute for Emergency Medical Services Systems (MIEMSS). Ronald Hart wanted to know how to go about changing the state regulations.
That was followed by Commissioner Kai J. Hagen who thought there were occasions that it might be okay to not only respond to the scene driver only, but to transport to the hospital with the same staffing and have the patient sit in the front seat.
Hagen said, "I could see somebody who had a certain injury, or bleeding, or they are just concerned about potential internal trauma, but they seem fine. Or a snake bite. Do you always have to, absolutely no matter what, have a second person in the vehicle?"
Chief Brown did most of the talking on this topic. Brown nicely explained he didn't see a reason to try and change state regulations on staffing. The chief also said, beside the need to have an EMT to monitor the patient's condition, it was important to have the driver concentrate on the task of driving.
You can watch the conversation here. This part of the hearing begins about 1:22. The exchange over BLS staffing starts around 1:29.
However, the chiefs are doing their department a disservice by using a metric ton of fire department lingo in their presentation. Admittedly, I fall into the same trap myself sometimes when talking to non-fire folks. We need to learn to communicate our needs to the public in plain, everyday, English.
Frederick DFRS is about to be spread so thin when these new stations open in a month, it's not even funny. Stay tuned because I am sure it is going to get more interesting.
You can't make good a report to an accurate narrative if you're the only one.
Just move on, this guy is a wacko!
Not to be out done a Shelby County commison member wanted to know why they had to pay for fire protection, "What did the home owners do before there was a fire department".
It is incumbent upon us to contact the newly elected officials, and to regularly report to the entrenched ones, in order to help them understand the services provided to the community. Point out significant incidents as examples- both locally & regionally. Explain to them about the good & bad in your department, the costs, and the implications of both improved and reduced service levels.
It is the same type of ongoing, preventative efforts we perform to ensure public safety, like checking hydrants, performing fire code inspections, and teaching fire safety to school children. The work is never ending due to human nature, fire, medical emergencies, bad luck, and the newest crop of politicians who don't understand the cost-benefit analysis involved with providing public safety services to the citizens.
ltfd Seattle FD
Frankly, I find this extended discussion (and all the ridicule, and attacks) to be somewhat out of line, and certainly not productive - at least insofar as one simple question was misinterpreted, taken out of context, and assumed to be more and different than it was.
I certainly wasn't suggesting anything, or advocating for anything. I asked one basic question, out of curiosity, which was whether or not it was ABSOLUTELY necessary, legally and otherwise, in ANY and ALL circumstances, for there to be a second person on hand in order to consider ANY sort of transportation, for ANY reason.
That was nothing more than that: A quick and basic question, in the flow of a broader conversation. Not a comment about policy or, in any way, a recommendation. It doesn't speak well of some others (mostly anonymous, at that) to see the sort of responses posted here (and elsewhere, as well, I suppose).
In the first two years of my first term as a commissioner, I have learned a great deal about the fire and rescue services in the county. I have read a great deal, spoken with a lot of people (and met with anyone who asked), gone on ride-alongs, attended meetings and dinners (career and volunteer-hosted), etc.
Overall, I would say that I have been very supportive of the career staff, while also trying to be supportive of the many volunteers in the county, too. And, throughout, recognizing and trying to understand and address the challenges and stresses inherent in a situation where the county is growing and things have been (and still are) changing rapidly.
If you review my voting history over the last two budgets, for instance, I think you will see that I've been at least as supportive as any of the five commissioners in trying to address and meet the needs of our expanding personnel (which is just one part of the broader equation, of course.)
If one simple comment or question negates all of that, one has to wonder.
kai
With regard to the comments about alcohol in county parks (and the anticipated increased in emergencies, etc.):
The county commissioners did have a public hearing. That was in addition to a number of public meetings at which the issue was discussed, before and after the hearing.
The change does not allow the consumption of alcohol throughout the parks.
Rather, it is enabling legislation that allows the commissioners (with assistance and advice from the Division of Park and Rec., and the Park and Rec. Commission) to allow alcohol, for certain people or groups who register and pay a modest fee, in a FEW specific park facilities.
That would, for instance, allow champaigne at a wedding reception at the Browning Building, or beer or wine at a family reunion that reserves a certain large picnic shelter, etc.
This is consistent with (but at least as restrictive as) a majority of counties in the state.
Sorry to sidetrack the conversation, but, as with the assumptions and assertions about the one comment that started all this, facts should matter.
Too many Chiefs and not enough Indians and this is on both sides of the fence. A county “EMS Battalion Chief” that responds and takes non EMS sectors on working incidents and a volunteer chief that seems to be everywhere, but is he really the chief of his department? Depends on which hat is being worn that day.
For some reason we are stuck in the 80's. Flush the toilet, career and volunteer, and get rid of what is stinking up the system.
On the other side of the fence we have volunteer "Chiefs" that do not meet the previous training standard and no one to enforce the current standard. How about the Chief that lit himself on fire burning brush, is he qualified?
Add in a dose of people that think a class gives you experience and we are doomed to fail.
Political immaturity is posing the question in a public forum where every word is measured, analyzed, dissected, etc. Comm. Hagen needs to observe how Obamma picks and chooses his words - and gives great though to the questions he asks in public.
Watch again Neary was there! It looked like he chose to make sure the LT's were kept in the seat. Apparently the BOCC doesn't know how young of a department they have in the field. Like any other meeting I think he only had 5 minutes to rebut their hour of micromanaging.
Just my 2 cents,
DDE
you hit a nerve! 84 percent of all calls in frederick county are made by career ff/emt/pm--PERIOD.Yes they keep some money for doing very little. some will set in the station and watch the ambulance fail because the next call could be for the fire engine.If the county vol. fireman assoc had 3000 members as it claims , who ride this would be different. Remove the 2700 bingo workers,pancake flippers and whiners and that is close to how many vollys make calls--300. Now for your statement of waiting to go on calls unitl the folks come from home THIS IS TRUE!!! names and station numbers can be furnished. You can have 3 certified ff/officer on the unit and you must wait 3 minutes before you can go help someone who may be trapped in a fire or in a auto accident.outside thinking is needed--sent help
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