Why Do Fire Engines Go On Medical Calls?

I was at the Dream Cruise on Woodward last week and had an opportunity to see some other fire departments at work.   We saw one EMS run that included both an ambulance and a fire engine following.  Now I don’t know what the call was so I don’t know what was needed.  But I do know a bit about this sort of thing in general.  It is a question that comes up frequently.  A-2

Back awhile ago,  we frequently sent an engine on the same calls with an ambulance because we didn’t have detailed enough information about the call to know exactly what was  needed to treat the patient or take the needed action.  There are 2 people on the ambulance–most of the time it is two paramedics but it could be one medic and one EMT (Emergency Medical Technician–it is a state licensing category).  And there are another 1 or 2 on the engine.  As of June of this year, we began using Emergency Medical Dispatching (EMD) which is a dispatching strategy using flip cards or software to question callers about the nature of the medical emergency in such a detailed way that we can classify a call’s emergency status.  Our dispatch staff had to go through significant training to operate under the system.  (It is carefully monitored so we also have frequent quality reviews to make sure we are doing it correctly.)  So now we know what is likely to be happening at the call so we can more accurately send the right apparatus and personnel.  For certain types of calls that indicate high likelihood of a life threatening event–like trouble breathing or chest pain–we know that we need all hands on deck because if it is likely to be a CPR call which will require lots of on scene personnel to do all the tasks it takes.  Others receive a lower classification if call is determined to be a lower priority.  Some are even answered without lights and sirens.  It is very dangerous for the motoring public and for us to drive lights and sirens anywhere–so we minimize the times we do it.

Our police and fire operate on two different radio talk groups and don’t usually listen to each other since both radio groups tend to be pretty busy and “step” on each other’s transmissions.  The dispatch listens to and dispatches on both groups.  With EMD when dispatchers find that a medical call is classified by the software or on the flip cards as a life threatening emergency, the police are also dispatched because they can get there more quickly and we don’t have to send another apparatus with more firefighters.  They can locate the patient and begin some forms of treatment (like CPR or automatic defibrillator).  When the patient is transported, they go back on patrol.  We get a quicker, more effective response with both groups working more efficiently together.  Previously, police didn’t respond for the most part because it was a waste of time to send one or more officers along with 2 fire apparatus to every medical call, “just in case.”  It is just more efficient for both groups.

By limiting the number responding to any one call, we stay ready for the next call.  Now that we are providing advanced medical care ourselves, without the public/private partnership, sometimes you’ll see only the fire engine on a medical call.  That means that the 2 ambulances are busy on other calls so we’ve sent EMTs or paramedics, they are just on another type of apparatus.  They can treat you-they just can’t transport you.  As soon as an ambulance frees up, you will be on the way to the hospital.

It is a closely coordinated system and we monitor it closely.  We have found that it works efficiently for both police and fire.

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I'm the Chief of Police for the Auburn Hills Police Department.