Questions to Discuss with Your Fire Chief

How many response resources is the “right” amount for fire calls? For medical calls? What tells us that this is correct?

Undoubtedly, the speed of fire department services, as well as any emergency services, is rather valuable. When people dial 911, they expect fast response and reaction as the call is of the urgent matter. Some studies demonstrate that even minor delay can cause significant damage. In the case of fire, the damage may be increasing with every minute; the same regards medical response as some injuries require the treatment as fast as possible, otherwise the patient’s condition may significantly deteriorate. Even the periods of time that seem to be quite short in the non-emergency situations can be vital in the emergency ones. At the same time, in the case of minor injuries, a slight delay is not of great significance. According to Brendan Kearney, the 5-6 minute delay of ambulance dispatch does not have a negative impact on the patient’s state when the latter is not serious (“NAEMSP Dialog: Fire First Response,” 2011). Meanwhile, the same period can be vital for a patient with anaphylactic shock or someone who needs defibrillation.

The right amount of resources for a 911 call is the one, which enables to provide adequate help and service, while not wasting any resources. There is no formula of how people in the fire department should provide an adequate response to all 911 situations. According to Gary Ludwig, Deputy Fire Chief of the Memphis Fire Department, there is no principle and no definition of proper number of firefighters/paramedics in the team. Therefore, one should focus not on the amount of people but on the efficiency and adequacy of the whole team, as well as understanding, which calls are primary and which are not. There is no definite amount of people that have to respond to each 911 call as they significantly differ from one another (“NAEMSP Dialog: Fire First Response,” 2011). A major uncontrolled fire requires different response than that for the assistance in a car crash with minor injuries. Thus, the system should be rather based on the specification of types of responses than a unified definition of responses for all 911 calls.

Do we need to send a fire apparatus to calls, including all medical requests from 911?

Nowadays, fire department is able to respond not only to fire calls, but also to other 911 requests, including emergency medical services (EMS). As the number of calls in the cases of fire declined significantly, people are acquiring additional qualifications and certifications that give the possibility to assist the population in the cases that do not include 911 calls. It is important to maintain the sustainability of fire departments and keep them running. The role of the fire department in the provision of EMS is truly essential, as it is one of the entities that provide the main amount of EMS responses.

Currently, the members of the New Haven Fire Department are prepared to respond to numerous hazards except fires themselves. The list of 911 emergencies includes “medical emergency, automobile accident, hazardous materials incident or any other emergency” (“Services,” 2015). Fide department is able to provide pre-hospital medical care, and the department members are not only trained properly in order to respond to medical calls, but also have such certifications as Emergency First Responders, Emergency Medical Technicians, and Paramedics. The department members are ready to address various rescue situations, which may emerge basing on the topographical complexity of New Haven. Moreover, the department members are able to provide basic services while handling hazardous materials.

The fire department team is a well-organized structure with a short response time, which means that it is capable of providing high-quality EMS. Therefore, since 1960s the members of fire departments have been undergoing trainings in EMS that provide knowledge and understanding of adequate responses in various medical situations (“Making smart choices…,” 2010). The responsibilities of the fire departments while dealing with EMS situations are not limited to providing first medical aid. Their role is more complex, as departments have more resources than medical teams, which might help to clear the way for ambulances; get patients out of cars and other closed spaces; retrieve people from hard-to-reach areas, etc. Therefore, the complex training of the New Haven Fire Department is truly important for providing EMS.

At the same time, it is essential to understand that fire department is not a primary healthcare provider and should not be responsible for all 911 medical requests. One should remember the primary function of the fire department (which is dealing with fire-related situations). Excessive amount of responses to EMS calls may lead to the drainage of the department’s resources to other spheres and thus limit the capabilities in responding to fire. Therefore, while EMS are an important element of the fire department functioning, the 911 calls that require its response should only be related to the life-threatening situations. Fire department should have a clear protocol, to which EMS cases it should respond, basing on its capabilities.

Fire-related responses are declining significantly. When are the numbers low enough to consider consolidating or contracting with another community? Are there other alternatives to having our own fire department?

It is true that the number of fire calls is declining. At the same time, according to Making Smart Choices (2010) the number of 911 calls continues increasing. With the primary aim of serving the community, there seem to be the constant growing need for the 911 responses, although not in the case of fire. Therefore, one can assume that instead of dissolving a fire department, the community can reorganize it in order to adjust the department to different situations. The case of the New Haven Fire Department is quite a good example, as it shows how the fire department members can learn and get certified in several spheres. In fact, the department is prepared to encounter a wide variety of emergency situations, which include (but are not limited to) car accidents, dealing with hazardous materials, and emergency medical services. Statistics shows that modern fire department should be able to respond to multiple 911 situations, with the number of EMS calls constantly increasing. Therefore, even without fires, firefighters are required to handle various emergency situations in the community.

Still, if a community is willing to decrease its’ expenses on the fire department, there are several alternatives to closing it. Firstly, there is the “browning out” system, in which the costs are cut by reducing the amount of staff on each company’s engine, although studies show that this system is not efficient enough(“Making smart choices…,” 2010). Another way of reducing costs would be decreasing response to EMS calls and expenditures by limiting the number of transported EMS patients. Anyway, the community should be aware that dissolving a fire department or contracting with other community would cause the increased response times of the department, which might lead to negative consequences. Therefore, a good alternative would be the repurposing of the department by providing additional qualifications to its members. In such a way the community will still benefit from the existence of its own crew that is able to respond to a wide range of calls.