In the UK the TV show “Cops” is on a lot. I’ve a question though about how US Emergency Services work.

If someone in the UK is stabbed and the police arrive then an ambulance is called. Now in the US if someone is stabbed it seems that the Fire Department is called and a fire engine (tender) arrives first then the ambulance.

As someone from the UK this seems really strange and I’ll try and explain why: Our fire fighters do primarily two things. Fight fire and cut people from wrecked cars. They are not really paramedics. Paramedics take the form of fast response units (on a bike or in a car) and in normal ambulances. It would always be one of these that went to a stabbing etc.

So why do US fire departments seem to have multi-roles? Are ambulances just too busy or are ambulance crews not paramedics?

As far as I know, fire department, ambulance medical staff, and police are sent to every 911 call.... But I may (and probably am) wrong... There may be certian reasons to send fire department and medical staff (other than fires).

Depending on what area you are in in the US, each department may have a different policy. Where I worked the Firemen were all cross trained as EMT's and paramedics. They would be dispatched at the same time but would have to wait for us (law enforcement) to clear the scene. In my particular area we had alot more Fire units available immediately than ambulance crews so they would almost always arrive first then stabilize the patient for the ambulance crew. In some areas the law enforcement were cross trained as EMT's as well.

If you've ever had a chance to see the old (1970's) US TV show EMERGENCY you'd get a better feeling for it. It is about the then experimental introduction of EMT-trained firefighters (Emergency Medical Technicians) into a Fire Department Company in Los Angeles - because the FD was usually a first responder to a call for help. These firefighters were trained and capable of administering medical assistance on scene before the ambulance team could arrive.

I'm not sure if it's that FD Engine Houses are spread out evenly in a community and the Fire Department can respond faster - or that Ambulance Crews tend to be used more frequently transporting patients to and between Healthcare Facilities, and often further away from calls for help (which is my experience from working in hospitals).

Gunnie

One of my friends is a volunteer firefighter in my township. He says most of their calls are EMT ones. Its actually kind of rare to go fight a fire.

In Texas, in an area called the Mid-Cities in the Dallas/Fort Worth Metroplex (specifically North Richland Hills) they rotate duty as firefighters, paramedics, and police officers, and are obviously trained in each. As my friend (who was NRH SWAT as well) explained to me, it's helpful when you go into a house to fight fire, and see other things lying around that you normally wouldn't.

Many areas have what is called a tiered response to 911 calls. Police, ambulance and fire all attend until it is determined what will be needed. This often happens when a 911 dispatcher is unable ascertain the exact nature of the call. In todays world fthe fire dept will often find "things" that our officers are very interested in like grow ops

Darryl

EMS began in the US in the '70's building on lessons learned in Viet Nam. Paramedics were first based in fire departments because they already were established in the commmunity. As the prehospital medicine began to work and flourish, private services sprang up to absorb the call volume. Most cities still use some type of fire based EMS response simply there are fire stations dispersed all over the city, and a fire crew can probably be on scene before a private ambulance.

Now, depending on where you live, the fire deparment's delivery of prehospital care will vary. I work for a fire department in a small town of about 5000. We provide ALS (advanced life support) care as well as transport. Some departments provide ALS, but do not transport, choosing to wait on a private ambulance service to transport. Some deparments deliver only BLS (basic life support) and have the private ambulance transport.

The EMS side of things is variable in the US on a state by state basis. Each state's application of EMS is different than the next. For example, here in Alabama, I cannot give the same drugs that a paramedic in Georgia can give. There is a national standard developed under the guidelines of the Department of Transportation and governed by the National Registry of EMT's. Again, whether or not a paramedic can practice up to the guidelines of the NREMT's is mandated on a state by state basis.

My answer is longer than it should have been, but for once, I knew the answer. I've been a field paramedic for 17 years, and a firefighter for the last 7 of those. If you have any more questions, I'm ready to help.

Patrick

Here in my part of the States we have paid Firemen who are stationed 24/7 . They are also trained EMT's and called First Responders..they stabilize until the First Aiders arrive. Most Ambulance Squads are volunteer and could take a bit more time for them to get the crew and get to the scene. Firemen dont transport but at times will also be volunteer First Aiders. Then a Fireman will be driving the ambulance.....Easy for me to understand!

I remember the good old days when the cops put you in the car and drove you to either the hospital, or jail....

Very interesting, I didnt know how it worked in the US either.

Its a very different system to Britain.

When you dial 999 (our emergency number) the operators will try to get as much info from you as possible, and will usually only send what is required (ambulance, fire engine etc)

The ambulance will give whatever aid is required at the scene and evacuate you to the nearest hospital.

We have the National Health Service, which is state funded and provides free health care to anyone, so the concept of private ambulances seems strange to me.

good question, and great answers. not a lot i can add, but here goes.

i work in arlington, texas as a paramedic.

the fire department responds to all life threatening emergencies, as well as an ambulance. the fireman are paramedics or intermediates. the ems responders are rated the same.

if it is a criminal call, or a domestic violence call, fire and ems units will stand by until the scene is secured.

if fire shows up to say an auto accident, they can evaluate the people involved, and then cancel or upgrade any ems response.

we are a private company contracted to the city, and we and the fireman work together on 80% of all calls, and if a patient is too heavy, we can call upon them to assist, or to ride in with us if we need more than one pair of hands to help someone.

hope this helps you.

reb in texas..........