Fire Department Provided Ambulance Service

[nfd2004]

As many of us know, many fire departments, from our smallest towns to our major cities provide ambulance services to it's citizens.

It may be a small town with a group of dedicated volunteer firefighters/EMTs, to a major city with a round the clock ambulance service, including paramedic service.

If you are a part of that "fire department sponsored ambulance service", then let's hear from you.

As firefighters, is there any incentive to encourage members to man these ambulances ?
Is it the responsibility of the most junior firefighters to be assigned to these very busy units ?
Is it a separate run organization within the fire department, similar to the FDNY ?

Here in Connecticut, most of the "Larger Cities" are covered by a private contract ambulance company for it's hospital transportation services.
Although of course a fire department "first responder" response is usually the case.
Sometimes, if necessary, a firefighter/emt will ride with the ambulance unit assisting during transport to the hospital.

Also, some smaller towns here have a totally separate volunteer organization, solely responsible for it's town wide ambulance service.

Many of the smaller towns use only volunteer firefighters, who respond to the firehouse and then take the ambulance to the call.
Others have hired one or two full time, or part time firefighters, for both fire and ambulance coverage, particularly for "weekday coverage".

Recently I was in Providence, RI, where the fire department there covers the city with Seven BLS ambulances.
A very busy city when it comes to it's fire responses, and certainly it's medical responses

I find it interesting, that city has no problem manning those very busy ambulances. Why ?
The ambulances (which are called Rescue's) pays it's firefighters an extra bonus if they are working those very busy ambulances.
In talking with two members manning a rescue recently, they told me there is very little problem getting members to work them.

That is unlike how it used to be, when the least senior members were assigned to them.
There is also a very good mutual aid system set up with the surrounding cities/towns, which also brings in "out of town" Rescues into the city (and visa versa) - with the large number of EMS related calls.

It is my hope that perhaps you might like to tell us how the ambulance service is operated in YOUR Area.
Perhaps we can learn from YOU to make it better in our communities or for fire departments.

 

[Bulldog]

That's an interesting question and I've been through it in many different wave in different parts of the country I lived in. Here in Louisville it's been a state of flux recently.

I grew up outside of Rochester New York and it was all volunteer ambulance and volunteer fire departments. I have now evolved into paid on both sides with some volunteer backup. It seems to work quite effectively.

When I would lived in upstate South Carolina all the fire department right which were volunteer and we had a paid independent ambulance service which was contracted by the County to provide services throughout the county.

Where I live now in Louisville, it used to be that the city of Louisville fire department in the ambulance department for the city of Louisville (all paid) and of suburban fire districts were just fire departments with some EMS response, they are both paid and volunteer. Then the ambulance service was spun off of the city fire department to become a countywide system, all paid. Recently many through word for departments and merged into larger organizations and several of them including the one bit response to where I live have also added ambulance service. We are now in a very strange situation where we actually are paying for 2 ambulance services, the one through our county taxes and the one through our fire department taxes. We are double taxed and don't receive much service from either of them because we're the affluent end of town in the ambulances as well of police are needed in the high crime part of town. Even the ambulances from our side of town are called across accounting to help in areas where they are not even being paid to help! It's a screwed up system and no one seems to have an idea how to solve the problems.

Just these examples you can see that there is no across-the-board solution to providing ambulance service to our communities and no one plan seems to work everywhere. There needs to be a solution for this issue, it keeps evolving in different areas at different speeds with different solutions. I personally don't believe that the fire department running the huge volume of calls a run to provide 1st responder status is necessarily the best solution but right now it's certainly the one that gets help to people the quickest!

 

[Lebby]

I understand that it's unrealistic in many communities, especially those who use insurance money from EMS to pay for their firefighters, but fire based EMS does everyone a disservice. The two professions are unique and have very limited overlap, that if a member is doing both corners must be cut in training, equipment and service provided. If a fire department is to provide EMS then I support a model like FDNY or Elizabeth, NJ where it's a separate bureau avoiding many of the above mentioned problems. That said some of the most successful EMS agencies seem to be independent municipal services like Boston or Pittsburgh.

 

[Sfdc111]

Work in central Mass, small job, 4 groups of 5, minimum of 4. We staff 2 ALS ambulances, it’s a rotation, ambulance, engine, ambulance, engine and on and on. If we transport to Worcester, about 25 mins away we back attempt to backfill to 4. We don’t have a dedicated engine company.

 

[zpppe]

My department in central Ohio does both Fire and EMS, like the vast majority of departments in the area. EMS is 80+% of the runs we go on. Getting hired is initially a part time (24 every 6th day) position requiring Firefighter 2 and EMT, and full time (24 every 3rd day) is a promotion, with Paramedic certification required within a certain time-frame of a full time appointment. Ambulances are all ALS and staffed with 2 Medics, Fire pieces are ALS equipped as well as most personnel are medics and can respond to EMS calls. Likewise, those assigned to the ambulance have their bunker gear and SCBA on the ambulance, and on a fire the first due ambulance will typically be assigned to a firefighting assignment unless there is an immediate need for EMS. The way our staffing works, personnel are assigned to a station and shift, but not a specific apparatus/seat. So personnel (with the exception of Officers who are always on a fire piece) rotate between working both the ambulance and a fire piece. There's no additional incentive to ride the ambulance, it's just expected as part of full time employment. I suppose part time personnel are paid a modest hourly wage with no benefits on half the normal hours per pay period, whereas full time have a very respectable salary and benefits package, so that's an incentive to get a Paramedic certification, but not specifically to ride the ambulance. There are plenty of people who very much enjoy EMS and a handful who work as nurses on their days off, which is not uncommon for other area departments.

 

[AuxWarYearsCapt]

Uncle Willie..... From what l am reading is seems as if you talking about ambulances that are assigned to firehouse outside of NY... YES it's great to have a bus respond with the Engine but of course in some states it's a NO NO.

In 1974 l followed in my old man's footsteps and joined the Middle Village Volunteer Ambulance
Aka... M.V.V.A.C..... During the 70s and 80s l worked the Saturday shift into Sunday
1400 thru 1400 hrs. On the first shift l did the driving. I would take my crew and the bus to the
firehouse back the bus into one of the bays and respond out of there until 2400 hrs then go around the block to our headquarters and monitor the FD..PD..EMS radios. If 319 went out on a run we would be right behind them.
** this is when the civilians waited 2 hrs or more for a bus. If l told you guys the advantage of a bus being in quarters is a plus.
I got so many stories l don't no where to start.
STAY SAFE EVERYONE...DOUG

 

[nfd2004]

THANK YOU to all who have contributed your stories of "Fire Department Provided Ambulance Services".

First let me add, "as we all know, Covid has made EMS much tougher over the last two years or so".

As mentioned in the first post, MOST Connecticut Career Fire Departments throughout the state DO NOT Provide Fire Department Ambulance Service.
Instead most rely on a Private Contract Services such as American Medical Response, aka AMR, Nelson Ambulance, or in my area, American Ambulance, for transporting patients to the hospital. Many of those private contract services also provide paramedic service as well.

There are a few Connecticut Fire Depts that DO provide ALS Medic service, but do NOT Transport
Such is the case in New Haven (Four Non Transport Units - ?) and nearby Hamden, Ct. (Two Units - ?)

One of the FEW Career Fire Depts that "DO" provide ambulance transportation is the NEW LONDON, CT Fire Dept
A small, but very active career department consisting of 3 Engines, 1 Ladder truck, 1 Battalion Chief, and 2 BLS ambulances.
New London Requires ALL Firefighters to be EMTs.
Each firefighter (excluding officers) rotates on the ambulance for a one year basis.
Each member of the department works their assigned shift during their one year ambulance duty and share with other members of that same shift during their yearly ambulance duty.
They also rotate as the Driver and Rider position during their one year ambulance duty.
There is also a small pay incentive during that time. I think about 5% more

Also - the ambulance personnel are used for fire duty.
The first due usually does forcible entry and searches.
The second due assist the Truck Co with ventilation if needed.
Otherwise they are used on the floor above.

After a member has 20 years on the job, they must still maintain their EMT status, BUT they are no longer required to be assigned on the ambulance rotation.

Last year (2021) the Ambulance called "A100", responded to 3,351 calls, and Ambulance, "A200" responded to 2,999 calls.

Within the City of New London is Lawrence & Memorial Hospital which is the primary hospital for New London and several other surrounding towns.
That hospital maintains a paramedic service of non-transport vehicles.

I believe there is "Medic 11", "Medic 12", "Medic 13 - which I believe used for special events", and "Medic 14".
On the West Side of the Thames River, L & M medics serve New London, Waterford, Old Lyme, and East Lyme.
On the East Side of the Thames River, L & M medics serve Groton, Stonington, North Stonington, and part of Ledyard.

Let me also add that I've read the previous replies here.
I think it is certainly interesting to hear how different places around the country provide ambulance or non-transport EMS around the country.
I hope that our members will continue to contribute telling us how it works where they are from.
Whether it be "Fire Department Provided Ambulance Service" or even "Non Transport EMS services".

Many years ago, as a newly hired firefighter, I remember NO FIRE DEPARTMENT RESPONSE To Medical Calls.
Just prior to that, many of us might remember the popular TV Series called; "Emergency" ( I know our member "johnny gage", Dan P., remembers it)
It was that show that changed the fire service forever. As we know, EMS runs now account for Most fire dept activity in most departments.

I also remember as a young firefighter reading an article in one of the fire service related magazines talking about that subject.
That article pointed out;
"If a piece of fire apparatus can respond to a trash can on fire, then why couldn't they respond to a person having a life threatening heart attack or other life threatening medical emergency".

The article also pointed out that firefighters are trained to deal with various emergencies as part of their job.

 

[Lebby]

Up until last year Newark, NJ didn't go on any EMS runs.

 

[entropychaser]

The City of Baltimore had the first city fire department operated ambulance service.
It opened for business at 8:00 am , June 15, 1927 using five Buick or Studebaker rigs. Injured citizens would no longer be carted to the hospital by the "paddy wagon". These units were stationed at Engine Co's 23, 11, 13, 19, and 26.
The first run was 87 minutes later to Lexington and Holliday Streets for an injured construction worker at the New Municipal Building. It would take nine days for the first ambulance to be wrecked at Linwood and Eastern Avenues, injuring two details from Engine 11.
In 1961 the Municipal Ambulance Service under the command of Captain Martin Mcmahon would respond to 32,000 calls with 12 ambulances and 75 firefighters.

 

[entropychaser]

Martin C. McMahon
The father of modern fire department EMS
Everybody involved with FD-EMS should know his story.

Known by everyone as simply "Marty" he joined the Baltimore City Fire Department in 1940. He was promoted to Lieutenant in 1947 and was assigned to Engine Co. 26 where he crossed paths with Municipal Ambulance No. 5. He was promoted to Captain in 1951 and placed in charge of the Municipal Ambulance Service. Promoted to Battalion Chief on June 1, 1961, he ran BCFD-EMS for 24 years until he retired on June 5, 1975. He died in 2005 at age 94.

During his tenure he:

1) Demanded and got total BCFD control over EMS operations.

2) Worked with Dr. Peter Safar, an anesthesiologist at Baltimore City Hospital. Dr. Safar developed the concept of mouth-to-mouth resuscitation and "ABC". He proved the procedure worked by doing mouth-to-mouth breathing on paralyzed volunteer medical students. Chief McMahon then introduced this technique as well as airway intubation to BCFD personnel in the early 1960's.

3) Saw doctors at Johns Hopkins Hospital in 1959 doing closed chest cardiac message. He worked with Dr. Alfred Blalock (who taught cardiac surgery to Denton Cooley) to teach this technique to his men for use in the field.

4) With the help of Dr. Safar (who designed Resusci-Anne), in August, 1963 introduced the first specially built ambulance to allow care during transport. Built by SWAB Wagon Co. in Elizabethville, Pa., it was a 9 1/2 foot all steel box mounted on a 1-ton Chevrolet chassis. It was all red with Fire Department graphics and cost $7,000 fully equipped.

 

[nfd2004]

Up until last year Newark, NJ didn't go on any EMS runs.

Thanks Phillip, "Lebby" for that information.
Newark certainly gets their share of work, but I thought they were also responding on medical calls.

As a young probie, hired in a small 60 member career department back in 1975, I was hired under one condition.
That was to become an EMT within One Year. There was no pay for attending many of the classes on my days off.
I would be only 12 of the 60 guys to be qualified as an EMT.

The other guys would say; "We're No Doctors - We are Firemen, We put out fires".

The only rig that had Two EMTs on it was the departments Rescue 1.
Actually it was an ambulance that "could" transport if necessary.
Inside the rig was some very basic medical equipment
But outside was our extrication equipment etc.

As time went on, the department started sending Engine companies on medical calls and required at least One EMT to be on each Engine Co.
That gave a lot of guys the incentive to become EMTs.
Now of the three guys, a officer and two firefighters, ONE Member had to be an EMT.
When the EMT was off, a separate list of "Firefighter/EMTs Only" would be called to work overtime to fill that spot.
It was job for job.
During my days, I think I transported a patient maybe only three different times.
A private ambulance company normally did the transporting.

Sometime around 1990/91, the rescue company was eliminated and the extrication equipment was put on an Engine Co, called Squad A.
Since then, on a much smaller basis, that Squad A operates similar to an FDNY Squad Company.

Now, ALL the members of the department are required to be EMTs and the training goes on within the department.
But during my time, I remained an EMT even though I wasn't required.
I never minded going out to help someone in need of medical assistance.
I felt a lot of satisfaction in trying to do my best to try and maybe save someone's life.
For me, "it never got old".

Of course like most fire depts and ems providers, we had our share of the usual, somewhat entertaining, medical request by some individuals, who we would know on a first name basis.
Sometimes referred to as "Frequent Fliers".

I would also like to Thank "entrophchaser" for his story regarding the Baltimore City Fire Dept and the late Battalion Chief Martin McMahon.
Chief McMahon apparently served his life time calling just as it was meant to be.

 

[Shoey124]

Henrico county Virginia. I'm a firefighter/paramedic in a dept of over 500 people. 21 firehouses and 16 of them have medic units. Usually there are 3 medics assigned to each shift with a medic unit, so I ride the medic every 3rd shift. The other days I'm assigned to the engine. I get a 15% pay increase for having my paramedic and this money is also figured into my retirement. I don't mind riding the medic since we have our turnouts and air packs on the ambulance and we get dispatched to fires. We ride with an EMT who is the driver, but will also ride in the back for BLS calls and then I'll drive to the hospital.

 

[ChiefMike]

I'm the chief in a small (45 memebers, 2 stations) career department in the New Hampshire Seacoast. We operate paramedic transport service staffed by firefighters. All our firefighters rotate through shifts on the ambulance, engine and ladder. Many of the career FDs in this part of NH operate in a similar manner. Most have had paramedics since the mid 1990s/early 2000s.

 

[Oh Bah Gahd]

If you want a real weird one, Pittsburgh has a city EMS service that is a separate entity from the Fire Bureau. They have 2 heavy rescues that the Fire Bureau doesn’t have and they’ve been getting into some pretty hefty jurisdiction issues with each other.

 

[Bulldog]

If you want a real weird one, Pittsburgh has a city EMS service that is a separate entity from the Fire Bureau. They have 2 heavy rescues that the Fire Bureau doesn’t have and they’ve been getting into some pretty hefty jurisdiction issues with each other.

The same thing happens in NYC between the FDNY and NYPD units since they both have heavy rescues.

 

[entropychaser]

If you want a real weird one, Pittsburgh has a city EMS service that is a separate entity from the Fire Bureau. They have 2 heavy rescues that the Fire Bureau doesn’t have and they’ve been getting into some pretty hefty jurisdiction issues with each other.

I'm surprised that Local No. 1 allowed that to happen. Maybe the bigger insult is that the two rescues are quartered in two closed firehouses.

 

[Lebby]

The same thing happens in NYC between the FDNY and NYPD units since they both have heavy rescues.

As far as I'm aware the Battle of the Badges is over, everyone stays in thier lane and helps each other when needed. Especially nowadays as ESU is increasingly tied up on EDPs. We had a pin job a few years back where the car plowed into the 28 PCT, wedging itself between the wall and a police van after hitting numerous officers private vehicles. I crawled in through the back window and started bagging the unconscious patients in the front seats, switching back and forth. ESU 2 was pulling up as we got there and went to work, then 40 Truck pulled up and jumped right in. Finally Rescue 1 started cutting, no arguments just discussion on how to best succeed. Everyone worked together and there was plenty of work to go around. I've had plenty of jobs with both groups and never a single raised voice. ESU and SOC are two of the most professional organizations around, I'm sure every now and then they butt heads as is the case with all type A personalities but that's an exception not the norm.

 

[entropychaser]

The same thing happens in NYC between the FDNY and NYPD units since they both have heavy rescues.

Decades ago, on the third floor on W181st Street, was hung on the wall the front page of the New York Daily News. It showed a full page photo of an easily identifiable member of Big Blue taking a swing at a NYC Health Dept. Medic next to a tractor trailer hanging off an overpass on the Bruckner in the middle of the night.

 

[nfd2004]

As far as I'm aware the Battle of the Badges is over, everyone stays in thier lane and helps each other when needed. Especially nowadays as ESU is increasingly tied up on EDPs. We had a pin job a few years back where the car plowed into the 28 PCT, wedging itself between the wall and a police van after hitting numerous officers private vehicles. I crawled in through the back window and started bagging the unconscious patients in the front seats, switching back and forth. ESU 2 was pulling up as we got there and went to work, then 40 Truck pulled up and jumped right in. Finally Rescue 1 started cutting, no arguments just discussion on how to best succeed. Everyone worked together and there was plenty of work to go around. I've had plenty of jobs with both groups and never a single raised voice. ESU and SOC are two of the most professional organizations around, I'm sure every now and then they butt heads as is the case with all type A personalities but that's an exception not the norm.

Very Well Presented Phil "Lebby".

Telling it based on your own experience, where "Team Work Makes The Dream Work"

Thank You and please be safe out there.

So many people are counting on your skills in their most desperate moments

 

[Oh Bah Gahd]

Here’s a couple links on new videos about the ‘beef’ in Pittsburgh.