Era of Growing Pains For Fire Service EMS
features
The Editor’s Opinion Page
According to the United States Fire Administration, 80 to 85 percent of all pre-hospital emergency medical service is being delivered by the fire service. 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 medium to large cities are delivered by fire departments.
The percentages given above show what has happened in the last 12 years. It was the EMS era of birth and growth. But growth also brings on growing pains which are now starting to be felt and which will probably be felt into the 1980s.
“Compensation, regulation, training, funding and new techniques” are among the problems facing the St. Paul, Minn., Fire Department as you can read in the following pages. And, according to Chief Steve Conroy, who started the St. Paul EMS program in 1971, “the future of some of these (EMS) programs is by no means certain.”
Among the problems facing this “by no means certain future” in St. Paul and elsewhere is appropriate compensation for the fire paramedic. No longer are enough fire fighters volunteering for additional paramedic duty. Solutions to the problem vary from city to city, but they include conscription (within a department), the use of non-fire personnel, reducing paramedic service and providing extra pay (for paramedics). Money, therefore, or the lack of it, is high on the list of problems.
The St. Paul department has long recognized the dual role of its members—fire fighter and paramedic. Supporting this viewpoint is Gordon Vickery, administrator of the USFA who stated that “fire service EMS 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.”
EMS in St. Paul since its inception has had enthusiastic public support and is regarded by the citizens of that city as the most valued service offered by the city. As a consequence of this high regard, the St. Paul Fire Department is currently in the process of creating promotional civil service positions for paramedic and ambulance-related EMT.
St. Paul is probably unique in its approach to the EMS problems. Other cities and towns probably can’t cope with the problems, but help is on the way. As noted in the following pages, the administrator of the USFA feels that “Most fire service programs do not recover costs or receive federal assistance and this makes management (of EMS) an extremely critical concern. We hope to provide the leadership in the proper use of existing resources and manpower.”
