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Dual Duty: April 2012

As if being a paramedic firefighter for two departments doesn’t keep me busy enough, I always make time to practise my hobby – flight simulation. Although I do this while keeping my feet planted on the ground in front of a computer, it does provide a good intellectual challenge as I attempt to land an airliner in near-zero visibility using only instruments.

It has always amazed me that the aviation industry is able to carry millions of passengers over great distances and prides itself on incredibly low incident rates. As a matter of fact, 2011 was the safest year in history to fly. Interestingly, these statistics are comparable all over the world. So how does aviation achieve this impressive data? If aviation can achieve success, then why can’t emergency services? Is it partnership? Is it teamwork? Is it mutual respect?

On a recent trip to Amsterdam, I visited the flight deck of a hefty KLM airbus. I watched crew members use the incident command system as they handled multiple situations, checklists and communications. It didn’t take me long to determine how similar the aviation business is to the fire/EMS industry.

As we cruised at 30,000 feet over the Atlantic Ocean, I asked the captain how pilots are able to handle the flood of information, co-ordinate with so many players, and be prepared for the unknown. The captain explained it perfectly. In a distinct, authoritative pilot voice, he said that when aviators enter the flight deck, all egos are dropped, selfishness does not exist, and every decision made is for the safety and comfort of passengers.

He continued to explain that on any route to any destination, worldwide, everyone follows this concept, best described as co-operative partnerships aimed at excellence.

Shared goals, shared knowledge and mutual respect are the strengths that have helped the aviation industry achieve its high performance levels and command admiration from the public. The captain also revealed that finger-pointing and fear of punishment only harms progress. As a matter of fact, crews are encouraged to share and discuss errors, for the betterment of all.

You are probably questioning what airplanes and fire trucks have in common. Simply put, there is a lot to learn from the success of others. In our world, most emergencies require some mix of fire and emergency medical care. Just as passengers are the main concern for airlines, our focus must remain on the public we serve. A new approach to teamwork may be just what we need.

We are all familiar with the tension in central Canada between EMS and fire services. Duelling websites, turf protection and down-calling has reached a disturbing level. Some communities continue to divide fire and EMS, believing they have no correlation. It appears that serving the patient has taken a back seat on emergency calls. In late 2011, most Canadian media outlets quoted a report that determined that firefighters are non-beneficial at the majority of medical calls. What benchmark is being used to measure this? Simply tracking cardiac-arrest save rates does not provide the whole picture.

We must remember that patient satisfaction and community assistance is our ultimate goal. As all-hazards responders, we must recognize that a unified, collective effort to mitigating incidents is by far the superior way to meet that goal.

Building partnerships and initiating a co-operative response is necessary to reach the goal of public satisfaction. Through the eyes those in crisis, we must remember that the people who call simply want skilled help to arrive quickly and that it doesn’t matter whether it arrives on a fire truck or in an ambulance.

Integrated fire and EMS services that do not separate these roles have proven very successful; many studies have verified that the public satisfaction with combined fire and EMS services is extremely high.

Communities in Alberta, such as Lethbridge, Strathcona County and Red Deer, have many years of fire/EMS experience and understand the principles of co-operative response and building partnerships. The system was put to the test in 2009 when the province of Alberta assumed responsibility for EMS. Integrated services stepped up and built partnerships with government health officials. By working collectively, both sides realized a co-ordinated approach to emergency calls was preferable.

Today, many Alberta communities benefit from contracts with health officials to continue this dual-role fire/EMS system. Leaders from Alberta Health Services watch as their benchmarks are met through consistently good practices. The ability to send any combination of apparatuses to mitigate a situation is clearly the strength of these departments. If a paramedic on a ladder truck is closest to the emergency, then it is simultaneously dispatched without question.

Thinking outside the box may be just what is needed in these challenging times. Emergency services, in general, need to step back and realize the strengths of all parties involved. The aviation world is unbeaten in its quest for passenger safety because it sticks to the principle of doing whatever it takes to achieve excellence. Let’s work together to solve our internal issues. Remember that welcoming co-operative response and building partnerships will position fire/EMS to soar into success.

Until next time, buckle up and be safe.

Lee Sagert is a career paramedic/firefighter with the City of Lethbridge in Alberta 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. He resides in Coaldale, Alta., and enjoys photography and spending time with family. Contact him at leesagert@shaw.ca