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Dual Duty: October 2011

Summer holidays present a great opportunity to recharge, reflect and catch up on long-awaited vacation opportunities. No phones, no pagers, no emergencies . . . paradise. While rolling down one of southern Alberta’s highways this summer, pulling my camping trailer, I got to thinking about the next topic of this column. However, there was a more pressing issue in my head as I drove. You see, the firemedic in my soul kept on the alert as we passed through small Alberta towns. I began wondering about the level of care, the fire response and the EMS system. I wondered what might occur if an emergency were to happen during my travels and I hoped that the emergency process would be co-ordinated and efficient. Sometimes knowledge can be your worst enemy; however, in this case, the enemy is injury or death.

In this column, we will investigate means to advance fire/EMS relations, look at tips to improve your department’s medical strength and review the latest activities in services that answer medical calls for help.

Jack Stout, known for developing many EMS systems, states, “Just as a reliable ALS transport system is no substitute for a reliable first-responder program, a reliable first-responder program is no substitute for a reliable ALS transport service. A first-class pre-hospital care system must have both.” This statement clearly describes the importance of ensuring and co-ordinating efficient and appropriate patient care. Does your department’s response to medical emergencies meet satisfactory criteria?

It’s difficult to grasp the many delivery models of emergency care in these days of sweeping health-care reform. One way to handle these changes is through partnerships with our co-responders. For example, a local fire department is dispatched to a medical call but the closest ambulance is unavailable. This leaves the fire crew to “attend” to the patient until transport is available. Is your department truly ready to handle this situation? Are both responders operating within the same protocols? Are these responders communicating and co-operating en route and during this call? Obstacles such as poor interactions, personnel resistance and labour beliefs can cause a scene to backfire. We have all seen how a call can deteriorate when egos and turf wars prevail. Strong partnerships are the only way to ensure great patient care.

Firefighters are the largest group of providers of pre-hospital emergency care in North America. We train on the latest fire equipment and study the latest firefighting techniques. As “all-hazards” responders, we continually educate ourselves about how to handle the next call. Do we include EMS skill advancement in these drills? Does your leadership support and expect equal emphasis on both fire and EMS training? The definition of a firefighter covers all of the tasks of today’s fire service, including EMS. The measure defines a firefighter as one who responds to any emergency where life, property or the environment is at risk. If the fire service asks the bravest men and women to meet all these challenges, its leadership needs to have the same vision and commitment. If you’re a fire-service leader, you know that leadership comes with responsibility. With few exceptions, you can’t ignore or give less dedication to what’s often the largest source of calls.

Developing a partnership, regardless of your system, is integral to saving lives. Success with a department’s EMS care can be measured by patient outcomes. If patient outcomes and care are improved, the value to the community is enhanced. As I often mention in this column, serving the community is the goal. There are many ways a department can improve its dedication to care for the community, including:

• adding injury prevention when discussing fire safety
• ensuring staff study EMS trends and protocols
• ending any turf wars and maintaining partnerships
• identifying areas of community outreach
• providing CPR classes and blood-pressure clinics
• regularly following up after calls with co-responders
• regularly training with co-responders
• involving media to show teamwork and partnership
• including your department in EMS research projects
• training crews on medical legislation and regulation
• incorporating medical directors into the fire-station lifestyle, including participating in ride-alongs and wearing uniforms
• communicating improvements in care delivery
• providing access to online medical control
• insisting on simultaneous dispatch for emergencies
• monitoring pending legislation and trends
• educating the public on the value of fire-based EMS
• decalling your apparatuses using medical symbols

Departments that respond to any and all calls for help face a difficult challenge of co-ordinating fire and EMS but reap many benefits. For departments that are the sole responders to fires, imagine the opportunity to widen your care for the community by connecting with EMS. Excellence in patient care is the least we can do for our patients. Therefore, make it a main concern before your next run. Create a station atmosphere that is savvy to EMS, ensure your equipment is modern and your protocols are studied. Regardless of your response model, make the patient your top priority and it will pay dividends to your department’s reputation. After all, don’t we all deserve the best in medical care?

Until next time . . . 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