On a very frequent basis, fire and EMS apparatus are responding to calls for service to assist a person in their time of need. Unfortunately in the world today, many think we have become the taxi service for Americans health care abusers, which leaves many EMS providers jaded. I agree something may need to be done, however we must remember that we as the public “servant”, must not allow ourselves to define an emergency instead of the complainant. Instead, we must train ourselves to embrace EMS care, and learn everything we can about what our individual levels of certification and skill set brings to many different styles of emergencies.
Often, crew members need to be reminded, that in a thankless world of EMS that their services do make a difference. Although I hate to say it, EMS is where we help the most people, most of the time; and realistically the true justification for our paid existence in today’s business world. If you have Paramedics in a Paid, Combination, or Volunteer system; extend a heartfelt thank you for their sacrifice. Remember, they probably get less sleep, endure more stress and mental fatigue, and in some cases do not get compensated in respect to the responsibility they possess. Moving forward, how can we assist these medics on routine calls; but more importantly prepare ourselves for the “main event” when the tired excuse of “that’s not my job” meets “your all we got” on the emergency scene.
Taking a break from the sexier and most talked about firefighting training topics, let’s focus on the other 85% of what we as responders do. What happens when you must use your training or basic certification to save a life when help is far away or not available. Examples I can think of are Mass Casualty events like the Boston Bombing or Civil Unrest, House Fires with numerous rescues, and extrications with multiple patients; just to name a few. Here are a few ideas to use on the next training day, to help reinforce some basic yet important skills.
1.Go over the equipment you carry on YOUR apparatus and review its use. This is as simple as back boarding a crew member, focusing on strap placement and C-Collar placement. Does your unit have an AED, and how does it work. Also, does the medical bag have a Bag valve mask and does your crew know how to hook up the oxygen? When was the last time you reviewed the insert of an oral or nasal airway? These are simple ideas to start your review, but essential to Basic Life Support.
2. Mass Casualty Identification System- What system of identifying patients of a mass casualty does your department use. More importantly, review the color system and drill with your crew the importance of first arriving functions. Express the idea that they may have to move on from a seriously wounded person to save another. This is only reinforced through training. 3.With a Paramedic or Advanced provider – Open the Drug and IV medical boxes and review the contents. Explain what each drug is used for, and explain the sequence that the drug is used on a call (EPI, Atropine, ETC). During a cardiac arrest or serious call, understanding what you’re looking for will provide confidence and speed. In addition, if applicable, try and practice IV skills. IV skills used to be practiced on each other, however now can be used on a mannequin arm if available. Using crew members will build confidence, as they will gladly explain your shortcomings.
4.Lastly, hold a drill of some sort to show the effects of quickly overwhelming available resources. With mass shootings and the threat of domestic terrorism, it’s not if, but when. Having a plan and practicing that plan will build confidence and eliminate unnecessary chaos. Invite local hospital members and law enforcement to solidify the team concept. This will provide insight to what each stakeholder expects from the response and mitigation effort.
These are just some ideas to help build your next drill day. As you sit around on a cold or rainy day, remember that the next incident is brewing and could happen any second. Basic skills and training is the best way to help the people we swore to protect. Regardless of your certification, we have a duty to act and help when needed. Providing service excellence should not be restricted to fire calls, but any call we are summoned to.
Over the years, the increase in EMS calls has created a poor attitude for the cause. Abuse of the 911 system has led to decrease in Medic staffing and increase in burnout and fatigue. For those remaining in the fight, thank you and you’re definitely appreciated. For those thinking of taking the plunge to seek higher certification, remember why you joined the Fire Service. Every Rookie school I have helped teach, the resounding reason for entry was to “help People.” What I didn’t hear was, to “help people from fire, unless on the medic”. Remember the mission, remember the need to help, and challenge yourself. Gaining a higher certification, unless sponsored by your department, does not obligate you to the medic and will make you an asset to the emergency scene.
LIVE MOTIVATED, KEEP LEARNING, and STAY VIGILANT…………