[Granville-Hough] 4 Sep 2009 - Fire Departments and EMS

[Trustees for Granville W. Hough]

Date: Fri, 04 Sep 2009 08:21:01 -0700
From: Granville W Hough <gwhough at oakapple.net>
Subject: [Fwd: Fire Departments and EMS] -4 Sep 2009
Content-Transfer-Encoding: 7bit

    Last evening, our electricity went off for the second time in this 
hot period of the summer.  I walked out to a vantage point so I could 
see if the outage was local or general, and I could see no lights 
anywhere.  Far to the north, there was a faint red glow where the 
immense Station Fire still burns.  Two fireman died there, and the blaze 
is now considered to be arson.  There was a bright moon, but otherwise 
darkness.  Then I heard the sirens of our local fire department coming 
into Leisure Village on a medical emergency.  When the sounds stopped, I 
knew they had reached the people in need.  Four times either I or my 
wife called 911 and then listened for those sirens, and we got to our 
local hospital in time for the emergency.  Last night, I thought: "Who 
is waiting, on the darkest of nights, under any conditions, to help you 
in an emergency?"
    Then, this morning I received this attached message from my first 
cousin, Tom Richardson, Retired Captain of the Durham, NH, Fire 
Department.  It shows one facet of an on-going national debate about 
health care.  I know, and you know, that health care must be reformed.  
I cannot predict what the reform will look like, but I support our 
President in moving forward, making as much improvement as we possibly 
can. (All indications are that this is a safe attachment to open.)
    I think highly of preventive care, though I am a beneficiary of 
terminal care.  Think about one little child with drug-resistant TB, 
whether she be citizen, illegal immigrant, or visitor.  She can pass it 
to all she contacts.  I believe in universal preventive care for all us 
who live here, and it has to be affordable.  Who pays the cost?  We all 
do, now or later!
    So, may God bless the firemen, and sustain them in their work.  
Granville

From: Tom Richardson
Subject: Fire Departments and EMS
Date: Fri, 4 Sep 2009 09:19:25 -0400

> 	Rarely do I burden extended family with politics or fire service =
=20
> issues, but this (read below) is a good article from the front page =20=

> of the New York Times.  The issue is very real.  The one glaring =20
> omission in the article is the failure to mention that the =20
> statistics are almost the same in wealthier communities.  In =20
> Durham, I believe it is the seventh wealthiest community in New =20
> Hampshire (a relatively wealthy state) about 55% of fire department =20=

> responses are for medical emergencies. All members of the fire =20
> department, from the chief to the newest rookie, are EMT's and at =20
> least one firefighter per shift is a paramedic.  The departments =20
> busiest vehicle is the medical aid truck.  All of the "real" fire =20
> trucks carry all of the medical equipment and drugs that one would =20
> expect to find in a well equipped ambulance.  Fire and technical =20
> rescue training play second fiddle to state mandated medical training.
>
> 	Although our town hosts about 14,000 University of New Hampshire =
=20
> students the medical responses are frequently, more than one per =20
> day, to elderly residents.
>
> 	It should be noted that our fire department does not operate the =
=20
> three local ambulances and one paramedic car. Ambulance service is =20
> provided by a combination paid / volunteer service that could not =20
> handle the volume of calls if it were not for the services of an =20
> endless supply of local university students that want to practice =20
> the skills they learn in the the four credit Emergency Medical =20
> Technician course that is required for some UNH degrees.
>
> 	Over the past 35 years the services of doctors house calls, =20
> visiting nurses, local clinics and nursing homes have frequently =20
> been shifted to fire departments and firefighters.
>
> Tom Richardson
> Captain, Durham Fire Department (Retired after 30 years and not =20
> missing the 3AM medical aid calls and multi page medical aid report =20=
> forms)


> Firefighters Become Medics to the Poor

> Doug Mills/The New York Times
> Firefighters from Company 10 responding to an emergency call in =20
> Washington in late August.
>
> New York Times
> By IAN URBINA
> Published: September 3, 2009
> WASHINGTON =E2=80=94 Peeling off his latex gloves after treating a =
4-year-=20
> old boy having a severe asthma attack, J. R. Muyleart sighed with a =20=

> touch of frustration. It was 3 a.m. and in the past 24-hour shift, =20
> Mr. Muyleart, a firefighter, had responded to at least one =20
> emergency call per hour.
>
> But only two of those calls were for fires; most of the others =20
> involved heart attacks, diabetic sores, epileptic seizures and =20
> people complaining of shortness of breath.
>
> =E2=80=9CI joined the force to battle blazes, not to be an emergency =
room =20
> doctor,=E2=80=9D Mr. Muyleart, 35, said as he and the rest of Engine =20=

> Company 10 drove back to their firehouse, which for most of the =20
> last 15 years has been the busiest in the country, according to =20
> industry surveys.
>
> Among the hidden costs of the health care crisis is the burden that =20=

> fire departments across the country are facing as firefighters, =20
> much like emergency room doctors, are increasingly serving as =20
> primary care providers.
>
> About 80 percent of the calls handled by Engine Company 10 are =20
> medical emergencies because the firehouse serves one of the city=E2=80=99=
s =20
> poorest areas, where few residents have health insurance, doctors=E2=80=99=
 =20
> checkups are rare, and medical problems are left to fester until =20
> someone dials 911.
>
> In many big cities, the problem is compounded by budget shortfalls =20
> that have led to the elimination or proposed elimination of 6,000 =20
> firefighter jobs in the past year, or about 2 percent of all =20
> firefighters, according to the International Association of Fire =20
> Fighters. At the same time, emergency calls have increased by 1.2 =20
> million, or 3.5 percent, compared with the year before.
>
> Washington=E2=80=99s fire department, which has not faced major =
layoffs, =20
> is dispatched along with Emergency Medical Services to almost all =20
> emergency calls in the belief that it can provide the quickest =20
> response. It gets more such calls per capita than just about any =20
> other fire department in the nation, and a disproportionate number =20
> come from poorer neighborhoods like Trinidad, where Engine 10 is =20
> based, in the Northeast section of the city.
>
> In New York City, only about 45 percent of the 473,335 calls =20
> answered by firefighters last year involved medical emergencies. =20
> The city=E2=80=99s Emergency Medical Service handles most medical =
calls, =20
> responding to 1.2 million last year.
>
> Last year, Engine Company 10 handled more than 6,500 calls, about =20
> three times the national average, according to Firehouse Magazine. =20
> The relentless pace is one reason firefighters across the country =20
> compete for a chance to work at the firehouse, which is nicknamed =20
> the House of Pain.
>
> =E2=80=9CWe get our share of fires here,=E2=80=9D said Leo Ruiz, 35, =
as he =20
> finished his breakfast after returning from a call involving a =20
> woman with abdominal pains. =E2=80=9CBut what makes this place =
different =20
> is that in the down time you have to be running 24 hours straight =20
> to keep up with all the other calls.=E2=80=9D
>
> Suddenly, another firefighter yelled =E2=80=9CBox!=E2=80=9D Within 10 =
seconds, =20
> the fire engine was rolling, four firefighters on board, heading to =20=

> the day=E2=80=99s first =E2=80=9Cbox alarm,=E2=80=9D or building fire.
>
> =E2=80=9CThis is what we live for,=E2=80=9D Mr. Ruiz said as he put on =
his =20
> oxygen tank.
>
> At the scene, flames spilled out of a window. In 10 minutes the =20
> blaze was under control.
>
> Shortly after returning to the firehouse, Engine Company 10 was =20
> dispatched again. =E2=80=9CMan down, possible seizure,=E2=80=9D the =
dispatcher =20
> said, to groans from several firefighters.
>
> In the next 24 hours, the company took three calls involving asthma =20=

> attacks, five for chest pains or shortness of breath, two for =20
> assaults and six for unconscious people on the sidewalk. The only =20
> other fire was a small one in a trash hauling bin.
>
> =E2=80=9CGuys complain about all the medical calls, but to me it=E2=80=99=
s =20
> work,=E2=80=9D said Lawrence Jones, 24, a firefighter who grew up in =
the =20
> neighborhood and has been on the force two years.
>
> Indeed, the shift in firefighters=E2=80=99 duties, which has been =20
> occurring for decades, is not without its up side for fire =20
> departments.
>
> Advances in consumer protection rules and fireproofing technology =20
> have led to a drop in the frequency of fires, so medical =20
> emergencies have helped keep firefighters employed.
>
> Fire departments nationwide responded to almost 1.5 million fire =20
> calls in 2008, compared with 3 million in 1980, according to the =20
> National Fire Protection Association. Fire departments went on =20
> about 15.8 million medical calls in 2008, up from about 5 million =20
> in 1980, a 213 percent increase. The shift has occurred as cities =20
> realized that firefighters could respond more quickly than =20
> ambulances, and more cities trained firefighters as emergency =20
> medical technicians.
>
> For Engine Company 10, drug addiction and violent crime are added =20
> reasons there are so many medical emergencies. Last year, the =20
> neighborhood had so many drug-related shootings that the police set =20=

> up checkpoints to inspect cars that entered or left the area.
>
> Around 3 p.m., a call took Engine 10 back to 14th and H Streets, =20
> northeast. The corner is known by the firefighters as the =E2=80=9Cvorte=
x =20
> of sickness=E2=80=9D because the dispatcher sends them there five or =
six =20
> times per shift.
>
> =E2=80=9CDrug overdoses, passed-out drunks, car accidents, heart =
attacks, =20
> seizures,=E2=80=9D said Lt. Donald Mayhew, a fourth-generation =20
> firefighter. =E2=80=9CIt all converges right here.=E2=80=9D
>
> The four firefighters from the House of Pain arrived first to find =20
> a glassy-eyed man lying drunk on the sidewalk. Soon the police and =20
> an ambulance arrived, but the firefighters were already checking =20
> the man=E2=80=99s vital signs and trying to persuade him to stand up =
and =20
> move along or go to the hospital. Eventually he stood and stumbled =20
> away.
>
> =E2=80=9CLook around,=E2=80=9D Mr. Muyleart said. =E2=80=9CWe have an =
ambulance and =20
> two cop cars here. Do we really need a fire engine and four =20
> firefighters as well?=E2=80=9D
>
> Some cities have questioned the cost of dispatching fire engines to =20=

> medical emergencies, but most have determined that it is too risky =20
> not to always send the closest emergency personnel.
>
> In St. Louis, Emergency Medical Services and the Fire Department =20
> merged in 1997 to save money. But the city fire chief, Dennis M. =20
> Jenkerson, still sends fire trucks on most medical calls.
>
> =E2=80=9CPeople call and say, =E2=80=98I=E2=80=99m having trouble =
breathing,=E2=80=99 =E2=80=9D =20
> Chief Jenkerson said. =E2=80=9CCan they afford to wait five and a =
half, =20
> six minutes, for an ambulance? No. Seconds count with most medical =20
> emergencies.=E2=80=9D
>
> Most other departments also dispatch fire trucks to medical calls =20
> because firefighters are trained emergency medical technicians, =20
> cities have more fire trucks than ambulances, and fire stations are =20=

> located throughout the city, said Lori Moore-Merrell of the =20
> International Association of Fire Fighters.
>
> =E2=80=9CIf it=E2=80=99s a serious medical call, a fire, we sprint, =20=

> regardless,=E2=80=9D Mr. Muyleart said as he hustled to the truck =
after a =20
> caller reported chest pains. =E2=80=9CIt just seems like so many =
people =20
> use us as their primary care providers.=E2=80=9D
>
>
>
> Al Baker contributed reporting from New York.