Washington DC FD/EMS is perhaps the worst for poorly managed fire based EMS, but elements of what they have done wrong can be found in many fire based EMS systems, and to not keep an open mind to that possibility here in Boise is somewhat blind. I have been around in many systems over my career. I can tell you there are problems with many fire based EMS that are specific to fire running the show, on top of the problems that face all EMS. These have been discussed here ad nausem before.

There are no (zero, nada, nich, nein) ….safegaurds in the BFD to prevent a similar flawed and dysfunctional system from starting here. In fact, there are plenty of signs that that is exactly what will happen here.

And just because ACP is not fire based does not mean its not doing an excellant job. In fact , a 91.4% (If I recall correctly) response time success and 41% cardiac arrest save rate speak to that. There are many systems , including fire based systems , that would love to have that.

SO I would submit that perhaps to your lists of Lewiston, Idaho Falls, and other examples of EMS you admire, perhaps you should add Ada County too?

Most fire departments do dabble in EMS; no argument there. The leadership within the fire circles woke up and saw the writing on the walls years ago that they were becoming irrelevant. Doing something because you have to doesn’t make it right. What’s your point?

I think if you explore the more efficient (less drain on the taxpayer) EMS services around the country, you will not find them in the fire service. Fire Departments, by their very design (based on legacy) are bloated, inefficient organizations.

Could BFD run an efficinet EMS service (as you said, with different leadership structure, etc…)? Sure they could. When you throw out all of the entrenched leadership that they currently have, it would work great!

No problems in Lewiston?! Have you been reading the news?! lol. The Lewiston Fire EMS debaucle is all over the local news up there.

Idaho Falls… they are reliant on an ordinance very similar to the one you slammed ACEMS for trying to put in place. If the ordinance were challenged in court, it would go the way of Kuna/Ada County and Idaho Falls would lose their monopoly.

Pleasure as always. Peace

SouthWest Ambulance (RuralMetro) has the city ambulance transport contract for Salt Lake City, SLCFD runs Paramedic Engines and Rescues…NO Problems. Lewiston (Id) FD runs ALS Transport for 4 counties in Idaho and Washington with 4 ALS Ambulances…NO Problems. Idaho Falls Fire covers 3 counties (pop. 100+K) with 5 ALS Ambulance…No Problems.

Meridian was considering contracting a private ambulance service for transport in city limits (if the Kuna vs Ada County lawsuit went bad), WHY?…They weren’t satisfied with the attempt by ACEMS to take over EMS Authority County Wide. Over 80% of the Career, Combination and Volunter FD’s in the country operate ambulance services…Sounds like somebody in the fire service is doing something right.

Sounds like you need to get out more… Squad 51… lol

Seriously though, are you suggesting that LACO rolls fire apparatus with 2 on board? An engine with 2 on board? That would seem to be a contradiction to NFPA1710 wouldn’t it? For instance NFPA 1710.5.2.2.1.1 and 5.2.2.2.1:”These companies shall be staffed with a minimum of four on-duty personnel” NFPA 1710.5.3.3.4.4, et. al. allows 2 person EMS responses, but not fire apparatus.

We have a model service here, with tiered response and shared governance. I get the idea that the issues are at the top and not between line fire services and paramedics, focused on care and not turf issues. Physicians are active and support the current service. If physicians have to reestablish trust, we risk the chance that they may not happen. Understanding the physiologic issues facing the human body undergrowing stess is complex. The ears and eyes of the physicians in the field is what saves lives. We will be set behind three years, if the chain of field command is changed, I have seen this happen and lives will be lost.

What takes preciednt on EMS call or a fire call. The recent Saturday morning 2 alarm further down town would logically stress medical coverage. Diluting the county system threatens back up.

Overall, we need to be sold on the beter, faser cheaper argument. Differant EMs servces will be very costly, unless we see a realistic
plan that suppots the change, threatening the loss of highly qualified indivifuals with lower cost fire personnel – which does not appear to be fact.

Everybody needs to take a breath and get rational, versus enotional. Running dats is not that challengng. One needs o compare the costs and create a viable plan. I am not saying it cannot be done. I just need to see it, as should evey other citizen paying taxes to the agencies.
Tiered response saves lives. I dare anyone to refute that statement with facts. Keep it working in the same choreograohe systend as we see it is today, unless a need an presented and debated

Box… Would the systems in Europe that Nemo elluded to meet NFPA standards? No… Would the IAFF entertain allowing an aparutus to roll without being fully “manned”? Heck no… Is there any science behind the “standards”? Heck no!

Lisa… Allow your mind to break out of the box it currently lives in AND smile… it’s all good!

I never seen a CAFS (Compressed Air Foam System). Interesting side note here on CAFS. Phoenix FD was one of the first FD’s in the U.S. to use CAFS for initial attack on structure fires, again under Bruno’s watch. Bruno also started what today is ICS (Incident Command System) but PFD called it “FireScope”.

I don’t think Europe can take credit for 2 Person fast attack truck. LACO has been using 2 person “Squads” since the early 70’s, where as LA City Fire has their own “Recue Ambulances.

No I don’t think FedUp is up to speed on U.S. Fire Advances, he’s probably been watching “Emergency” re-runs on TVLand. They don’t even make Ward Lafreance Ambassador Pumpers anymore…Ward Lafrance went belly up over 20 years ago.

Whay Fed Up was likely referring to is the fact that there are several locations in europe that are VERY SUCCESSFULLY using either motorcycles or 2 man fast attack trucks (kinda like brush trucks).

Since most fires are garbage can size or smaller, they can be handld by “a man with a 10 pound can” fire ext. I have read of one fire service that uses Motorcycles with Compressed foam systems on them.

In these systems, they have “heavy” resources with their trucks, tankers, and ladders in farther (10 minute or so)locations that respond and dump on any given fire. Remember that this works and I would wager they have more fires than us due to their older buildings. Here, in the US, especially the west…where Major fires are less of an occurrence, it makes even more sense. Their initial response is as fast or often quicker than US Fire Departments.

And these systems cost significantly less. And they work very well.

On the EMS side, the UK, Parts of Canada, and the Aussies all have higher standards for paramedics (degrees), they have cost saving Advanced Practice Paramedics providing well checks on frequent fliers, and many other innovations that would work well over here we can just “open our eyes”.

And by the way, in these systems, the fire service is well respected too, but they simply stay with BLS care. No friction. And excellent medicine.

That is what Fed is speaking of. (we must read the same journals, list serves, and research.)

That said my point remains on the selection of a chief to run a county wide department.

Also interesting point about the cement truck analogy.

I was reading the way they treated Chief Brunacini after his retirement, and the way Phoenix is “reverting”….shame.

I have to admit the man understood customer service.