USFA to Give Top Priority To EMS in Fire Service
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Seattle Times Photo.
“It’s time fire service EMS receives the attention it deserves. There has been no national leadership in fire department-provided EMS and I believe many veteran fire department programs have given up on national support for their activities.
“While training programs and equipment guidelines have been provided by the National Highway Traffic Safety Administration. . .and while HEW has provided emphasis for regionalization and wide area coordination. . .the NFPCA virtually ignored fire service EMS. Now as the United States Fire Administration, we will totally turn past practices around and make fire service EMS one of our major priorities.”
These forceful words delivered recently by Gordon Vickery, USFA administrator, signal a greater role for the fire administration in EMS.
Strong supporter of EMS
As co-founder of Seattle’s well known Medic One program and the originator of the equally famous citizen CPR program (Medic-11), Vickery is one of the nation’s strongest supporters of fire service EMS. He feels that the fire department is a natural provider of prehospital emergency care.
“In time of an emergency of any type, the first contact is usually the local fire service,” he stressed. “Whether it is a natural or man-made disaster, it requires the complete utilization of fire service pesonnel and resources. For the trauma and emergency medical problems, it is the fire service that is first on the scene. It simply follows that the fire service should be the provider of acute pre-hospital EMS.”
Vickery sees many of the fire service EMS needs as significantly different from those of other EMS providers.
“To start with, the manager of a fire service EMS program must consider the dual manpower role—fire fighter/ paramedic—and in this era of tightened budgets, this is an important and critical factor,” he said.
Unique needs
“Fire service EMS also has unique needs. An EMS response may involve fire, rescue and delivery of emergency medical care, and fire fighters must be prepared to deal with all three simultaneously. A private EMS provider can wait until the first two tasks are accomplished, then act. This can’t be true with fire service EMS.
“Most fire service programs do not recover costs or receive federal assistance and this makes management an extremely critical concern. We hope to provide the leadership in the proper use of existing resources and manpower,” the USFA administrator stressed.
To assist in this ambitious program, Vickery has appointed Michael F. Olsen as USFA’s emergency medical services consultant. Olsen is the former senior medical services officer and EMS administrator of the Seattle Fire Department. In Seattle, he was responsible for the city’s total EMS effort, including training. He also had responsibility for directing the area’s CPR program.
More recently, Olsen has been responsible for program evaluation and review for the EMT apprenticeship program jointly sponsored by the International Association of Fire Chiefs and the International Association of Fire Fighters. In carrying out this responsibility, he traveled extensively throughout the nation, visiting and providing technical assistance to both large and small fire departments.
Cities fire service work
Like Vickery, Olsen is outspoken in his support of USFA involvement in EMS. “While some continue to question the need for fire service EMS, the fact remains that 80 to 85 percent of all acute pre-hospital EMS is being delivered by the fire service,” Olsen stressed. “Figures also show that 65 to 70 percent of all fire departments are now delivering some level of EMS, and nearly all successful advanced life support programs in the medium to large cities are delivered by fire departments.
When you add to this the fact that the primary emergency response (including emergency medicine) to 90 percent of the nation’s nuclear generating plans is provided by volunteer fire departments, you begin to understand the magnitude of fire service EMS.”
Yet in spite of this total effort, no one has offered guidance in program design or operations for the fire service EMS provider.
As part of the early assistance to fire service EMS programs, Olsen has outlined a detailed one-year project. It includes the publishing of an EMS Resource Bulletin. (The first is already in the mail). This will be a periodic newsletter designed to keep the fire service current on EMS developments.
Task force to meet
Then in early December, a 15-man task force will meet in Montgomery County, Md., to identify the broad scope of fire service EMS, the unmet needs, and the particular disciplines needed for implementation. A report on the conclusions will be published shortly after the meeting.
Olsen also plans to establish a catalogue of resource materials. Letters have gone out to more than 40 departments requesting them to report locally developed resources for cataloguing and inclusion in technical assistance systems.
“It is obvious that the best solutions to EMS problems have been developed at the local level,” Olsen stated. “However, there’s an identification and coordination problem. As an example: a fire department with some type of EMS question may not be aware that in a nearby state a solution has already been developed. We need help in identifying resources that have been developed in existing EMS systems.”
He also stressed that anyone having ideas on methods of meeting EMS needs within the fire service should contact him.
Academy already involved
The National Fire Academy is already deeply involved in EMS. Phase I of a new management training project will present an EMS management overview for both the fire chief and his EMS operations officer. It is designed to educate these officers as to what EMS really is, its history in the health care field, how the fire department relates to the system, and some of the major planning implications that occur in an advanced system.
For the chief new to EMS, the management course provides a critical orientation. For those already providing basic life support, it establishes guidelines—criteria—for comparing operational efficiency and details what may be expected when more EMS responsibility is assumed.
Phase II of the course will be designed for the EMS operations officer, the individual who will supervise and administer the daily EMS operation. This phase will include instruction in communications, public relations, hospital coordination, personnel management, call screening, labor management relatihns and the psychological and emotional effects in the delivery of fire service EMS.
Plans for coming year
Olsen’s 1980 plans include four regional fire service EMS management resource workshops for fire department EMS managers, technical assistance to departments in designing and upgrading local EMS programs by using system experts from throughout the nation’s fire service, a workbook (resource directory) to be used in establishing or upgrading a fire service EMS system, a training course—targeted to volunteer departments—in acute EMS management of a nuclear accident, and a national EMS reporting system—one that complements and integrates with the national fire incidence reporting system.
He would also like to develop a public education package to promote fire service instruction to the general public in such areas as basic life support (CPR), system access (whom and when to call) and national hypertension screening.
“This will be a major undertaking by the USFA,” Vickery concluded.
“We feel it will be a very valuable contribution to the entire nation. It’s a service long overdue and we have every expectation that fire service EMS will be greatly improved.”
Seattle Times photo
