Wednesday, October 12, 2011

Firefighters not much help on medical calls

A newly released independent study done on behalf of the association that oversees paramedic services in this province has found that firefighters are useful at about 2% of all medical calls.

The study — commissioned in February by the Association of Municipal Emergency Medical Services of Ontario (AMEMSO) — reports that firefighters are trained only enough to offer “critical” time-sensitive assistance with life-and-death threat Code 4 events.

According to the study, that comprises only about 1% to 2% of EMS call volumes across the province.

The study also cites findings that tiered medical responses provided by Toronto Fire could be cut by a whopping 83% “without adverse patient impacts.”

“There’s a role for Fire in EMS but that role is limited to a small subset of immediately life-threatening calls ... typically cardiac arrest and pre-arrest,” said Norm Gale, former chief of EMS in Thunder Bay and now president of AMEMSO, which has 50 member EMS departments.

He adds that the study’s findings offer no evidence to support any move by firefighters to expand their role in responding to medical calls — on the assumption that this will save more lives.

Gale said the study found no evidence either to prove firefighters get to a medical call quicker than paramedics all the time.

“If you look at average response times, EMS and fire are remarkably similar in many municipalities,” he said.

Gale said they commissioned the study because they wanted to be part of the discussion, up to now driven by firefighters, on how to give people the care they need, delivered in an efficient manner.

Mind you, when the consultants endeavoured to contact eight municipalities to provide “apples to applies” comparisons between Fire and EMS on response times and what patient care is provided on scene, six fire chiefs refused, including Fire Chief Bill Stewart.

Hmmm. Wonder why. Could it be that the results wouldn’t exactly support his constant mewlings for more firefighters to man all those potentially out-of-service trucks that now spend 56% of their time speeding to medical calls (compared to 6.4% for actual fires) where they’re not qualified to intervene but on a very minor share of patient procedures.

(Rest assured, that is bound to get the firefighter brotherhood and sisterhood all fired up yet again, as they do anytime I dare criticize them.)

I asked Gale what firefighters can do at the scene.

He said they have been trained in advanced first aid to control bleeding and they have a defibrillator to resuscitate patients but they can’t provide “nearly the level of care a paramedic can” — adding that firefighters learn their medical skills in a week or two compared to two to three years for a paramedic.

“Sending firefighters to more medical calls does not reduce the burden on paramedics ... the fact of the matter is that firefighters are ill-equipped to respond to many of the medical problems faced by paramedics,” Gale said.

That certainly challenges many of the claims made by the Toronto Professional Fire Fighters Association (which should also be named the Toronto Professional P.R. Association) on their website — put in place in September to defend their right to be immune from any cuts, never mind 10%, and to defend their important role as emergency care providers.

TPFFA president Ed Kennedy was highly defensive when asked to comment on the findings. No surprises there.

He said Sunnybrook hospital regularly reaffirms that firefighters play an “effective role” in saving lives and that firefighters “have all the necessary skills to assist patients” at medical calls.

I had to repeatedly ask Kennedy to spell out what firefighters do at a scene before he responded that they conduct CPR and defibrillation.

Then he was back to his mantra about seconds counting and that they’ve “played an integral role in saving many, many lives” in the past year.

“In their time of need people don’t care whether its an ambulance or fire truck (that responds),” Kennedy added. “They just want an emergency care provider.”

Even if they’re there just to hold the elevator door for the paramedics as they did on Bloor St. this past week, I guess.

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