Archives: February 2008

IAFF Fire based EMS conference - Houston, TX

It has taken me a while but I have finally completed the report about my trip to the conference. Here are some of my observations...

The IAFF EMS conference was held in Houston, Texas this year. The EMS conference is designed to showcase fire based EMS services throughout the US and Canada. In the words of IAFF President Harold Schaitberger... "Fire based EMS is - and will continue to be - the most efficient and effective system for responding to medical emergencies and improving overall public safety. The IAFF is engaged at all levels of government to assure that appropriately trained and equipped personnel are available to respond to all types of emergencies."

Dr. Paul Pepe (Medical Director Dallas, TX), Dr. David Persse (Medical Director Houston, TX) and Col. David Barrillo were opening plenary speakers that spoke about their respective services, where fire based EMS has come from and where it is going.

One of the most interesting speakers was paramedic Mike Taigman and his experiences in Israel. Mike spent approximately a month with EMS crews in Israel and the pictures and stories he brought back were incredible. Some of the highlights were...

- There were 5500 incidents in the last antifadah (uprising) that included bombings, rockets, and snipings
- In an event, all fire/EMS pagers are activated in the country and members respond directly to the scene or station
- Law enforcement respond to the scene and look for secondary devices that are designed to kill rescuers (happens very often)
- EMS personnel are armed - one story Mike told was of a paramedic that shot a sniper in the street and then proceeded to treat him as a patient.
- One hospital in Tel Aviv can handle up to 36 ambulances at a time, and can do 12 open chest surgeries at a time - they have had 13 traumatic arrest survivors over the past few years.

Houston Fire Department - host local

- 3800 firefighters, paramedics and EMT's, housed in 89 stations. 57 ambulances and 5 physicians on staff.
- 1 dedicated Haz Mat station, 4 airport rescue stations. Call volume - 52,000 fire calls, 224,000 EMS calls.
- Interesting points - Houston has 27 'rotation stations' where members rotate between the pump and ambulance. Use increased pay as incentive for members to maintain competencies as paramedics and EMT's. Have used paperless PCR's since 1998. They run a BLS/ALS tiered system. Undertake many EMS studies - ie. MAST pants, stroke studies, cardiac arrest survival, hyper-tonic solutions, and intubation studies to name a few.

Montgomery County, Maryland

- An entire presentation dealing with maintaining and improving members morale by rotating paramedics and EMT’s onto fire apparatus...mmm

Dublin, Ireland

- although they never presented at the conference I had the opportunity to talk to several of their members about their service.
- Some interesting points were...hey have been a joint service since 1898, they serve a pop. of 1.2 million people, 12 fire stations, 12 ambulances with a call volume of 90,000 EMS calls a year. That's 7500 calls for one ambulance/year. They have few ALS providers with the majority being EMT's. They work 9hr days and 15 hr nights and I believe it was a four-on four-off rotation.

Salt Lake City - Trolley Square Incident

- Salt Lake Fire personnel relayed the circumstances of the shooting incident that occurred on February 12, 2007 at the Trolley Square shopping center.
- Members of the department responded to the scene...ith some confusion in communications, members were in an unsafe area when they realized the shooter was not incapacitated. Police were with the medics and provided cover while the medics treated patients.
- The lessons they learned was...lways try to maintain as good of communications as possible, always remain calm, and train with police often.

Closing remarks by Dr. Franklin Pratt

The report 'Prehospital 9-1-1 Emergency Medical Response: The Role of the United States Fire Service in Delivery and Coordination' was completed by Dr.'s Paul E. Pepe, Steven Katz, and Franklin D. Pratt. This report gives a brief history, current state, and the future of fire based EMS in the US. The report gives some good insight into US Fire based EMS systems. There are some similarities to us in Canada but there are also some significant differences. Read the article for yourself and see.

My Opinion

The Fire EMS conference was an informative conference that offered an excellent networking tool between firefighter/paramedics across Canada and the US. For those of you that aren't aware, I gave a presentation highlighting the Lethbridge Fire Department. It's history of Fire based EMS since 1912, how our system operates, challenges we face and what the future holds. I had many good reviews of the presentation and I would like to thank Lee Sagert for allowing me to use his excellent video as part of my presentation.

There is a much bigger push in the US to have Fire based EMS than in Canada. Alberta is the only province to have any real concentration of fire based EMS services. Manitoba has Brandon and Thompson, and Winnipeg has just placed paramedics on some of their pumps to assist in medical emergencies (the largest fire service in Canada to do so). New Brunswick had one Fire based EMS service but they recently lost the ambulance service there.

What I found interesting is the fact that Lethbridge appears to be the oldest Fire based EMS service in North America. The only other Canadian Fire based EMS service that is close to us in age is Brandon, MB (began transporting patients in 1917) and the oldest in the US is probably Virginia, Minnesota (1947). Additionally, Alberta paramedics are some of the most highly trained in North America - some of the paramedics in the US have six weeks of training and are qualified as paramedics.

We have a lot to be proud of here in Lethbridge. We may not think of ourselves as 'trendsetters' in the EMS field but from my experience at this conference we are much farther ahead than many of our fellow colleagues in the US and even the rest of Canada. It would be my hope that we continue to have some input at this conference. I feel we have a lot to offer.

Be proud of what you do.

Dana Terry