Features Fire & EMS Hot topics
Dual Duty: July 2011

As I write this, I am helping to train eight new paramedic/firefighter recruits. The challenge is enormous because the training encompasses both fire and EMS procedures. However, the greatest challenge is breeding a culture of dual-role service to new recruits from various backgrounds. These new hires are very enthusiastic and proud of their decisions to choose careers as firemedics.

Lethbridge, Alta., Day 1
Recruits arrive at the station to find a lifestyle that does not separate paramedic and firefighter duties. It may seem unusual to these new personnel, whose backgrounds were working at stand-alone ambulance services. This becomes evident when they see a team preparing an ambulance for duty one moment and checking fire nozzles the next. This combination of service delivery shines because everyone realizes the common goal of equally supporting one another. Throughout their training, it will become engrained in their heads that serving the community is the goal, regardless of the type of emergency. The recruits will learn to change roles depending on the incident. This culture is developed as the recruits are educated simultaneously in both specialties. Over the course of their training, the recruits will learn about the similarities between the two services and the benefits of combining them, for example:

• Both disciplines incorporate and study SOGs;
• Training scenarios are designed to engage medical and fire duties;
• Scene photographs/videos are studied to emphasize the importance of teamwork;
• Seniority or merit does not restrict recruits from learning about and operating all apparatuses and equipment;
• Continuous emphasis on using all department resources to provide safe, excellent emergency care (back-up support is always available);
• A station atmosphere of teamwork, lack of egos and keenness for both EMS and the fire service is emphasized.

As the recruits progress through their training, dual duties continue for front line crews. Achieving this on a daily basis comes down to command and control. Clearly defined roles are vital to operating at any emergency. By following the incident command system, freelancing is eliminated and firemedics are able to identify with their roles more easily because they are given clear direction. Incident commanders must prepare for continually changing conditions and unexpected issues as they occur. Combined fire/EMS departments have the ability to easily adapt to these challenges by deploying more paramedic or firefighter roles if the situation requires. This flexibility eliminates obstacles that may be caused by multi-agency responses. The effectiveness of this approach pays dividends since everyone on the scene is capable of any role. Due to its long-time integration, Lethbridge is now seeing paramedics in captain roles and chiefs who have worked many years as paramedic/firefighters. The benefits include:

• The incident command system is used on all fire and EMS calls for consistency.
• Promotion of firemedics to officers allows all-around knowledge of protocols and procedures.
• Having one incident commander reduces confusion (everyone can recognize the blue command vest).
• All ambulances contain breathing apparatuses, turnout gear, hydrant wrenches and basic extrication tools.
• Engine companies are all stocked with advanced life-support medical gear.

A 2008 survey by Ipsos Reid showed 98 per cent of Lethbridge citizens rated fire and ambulance as high in both performance and importance in the community. Public support has been overwhelming in Lethbridge due to the department’s efficient and effective operations. Dependable professional service for more than 125 years has resulted in a sense of pride to the true owners of this service – the taxpayers! Citizens of Lethbridge know that a call for help will bring a team of rescue specialists that may arrive in any type of apparatus. A fleet of vehicles with matching decal packages and uniforms that do not divide roles only adds to this level of community pride. It is not uncommon to see firemedics in the hospital wearing turnout gear after a serious call or hearing a captain describe a mechanism of injury to the ER physicians. It’s what the people have come to expect here.

The ever-increasing demands on emergency services continue to challenge responders. Hazmat, biohazard, medical, technical rescue and other specialties have redefined the role of the firefighter. Closer scrutiny on safety, line-of-duty injury/death, and operational tactics has brought a clearer vision to our duties. In some communities, there may be a response to an incident that could involve several different agencies that each bring a specific specialty. Are these agencies co-operating and operating under one unified command structure? Are they following standardized, evidence-based procedures that match each other? In my opinion it all falls under the umbrella of “hazards.” An all-hazards department that is able to bring the correct response under one umbrella may be in the future.

Is it our responsibility to determine just how these services are provided? Is it professional to dispute on various delivery models when our true role is to provide lifesaving care? Maybe we need to take a step back and re-evaluate our meaning. Either way, respect for both professions is critical. Caring for the public is straightforward when these barriers are removed. Providing dual duty via integrated fire and EMS services may just be the answer.

Until next time . . . be safe.

Lee Sagert is a career paramedic/firefighter with the City of Lethbridge and a volunteer lieutenant with Coaldale Emergency Services. Lee is a former flight paramedic with S.T.A.R.S. and has trained at Oregon Health Sciences University in Portland. Contact him at leesagert@shaw.ca