Follow Up to 2007 Audit of Philadelphia Fire Department EMS
If you want a shorter version read,
Butkovitz finds EMS responses still badly inadequate
I’m going to include this quote because it underlines what happens when non medical people try to help improve EMS systems.
Butkovitz called on the department to cross-train paramedics as firefighters. Unlike ambulances, fire engines usually arrive at emergency calls within three minutes of calls. But they are not staffed with paramedics
If the problem is not enough available ambulances to meet demand, wouldn’t the answer be to add more ambulances. Sending fire fighters, whether trained as paramedics or not, is a band aid approach to the problem.
Speaking of the problem I am compelled to add a second quote.
Butkovitz echoed the sentiment, saying the department needed to bring its financial resources in line with its need: EMS incidents account for 82 percent of the department’s workloads, but EMS receives only 17 percent of the department’s budget.
Soooo, Mr. Butkovitz correctly identified a need to resource mismatch, but then goes on to recommend a fix that isn’t a fix.
Other cities have had success with paramedics on engines, Butkovitz said.
Define success, Mr. Butkovitz. I’ll be it has something to do with response times, but little to do with outcomes. Has anyone ever done a study to see if there is an advantage to having paramedics on fire trucks. I mean a peer reviewed, blinded, study, not a “White Paper” issued by the hacks at the IAFF.
If there is one, please point me to it. For that matter how many fire based EMS systems publish their cardiac arrest survival rates? But I digress.
Last quote,
Even though more than half of the calls flooding in are for non-emergencies, the department does not have a priority dispatch system, Butkovitz said. Rather, it operates “robotically” on “first come, first served.” And the city’s 311 system has not eased the load on 911, he said.
Even though I very recently pointed out that priority dispatch type systems aren’t always very accurate, they are better than a system that amounts to little more than pulling a number out of a hat.
My thought would be not to get sick or hurt in the City Of Brotherly Love EMS Chaos.
I thought the same thing about MPDS when I read this. I have lots of problems with it, but it beats the crap out of first come/first serve.
Perhaps the paramedic engine model used in DC would be a benchmark for success. At least someone showed up to diagnose people with reflux and croup before leaving them to die. If people in Philly were serious about fixing this, they would hire a real EMS consultant like Fitch and Associates.
DC put together a Blue Ribbon panel of experts and then ignored many of their recommendations. I’m not so enamored with Fitch, or any other EMS consultants for that matter. Consultants generally tell systems what they want to hear, not what they need to hear. I’ll bet that any random five or six urban paramedics could tell them what to do to fix the system. More ambulances, commitment to medical care, not big red trucks, accountability, realization that big city fire departments mostly respond to medical calls, and respect for medics. Stop penalizing fire fighters for preferring to be paramedics, Make the EMS component totally independent of suppression and give EMS supervisors and chiefs the same authority and status as suppression supervisors and chiefs.
A big city Mayor could make waves by hiring an experience paramedic to the “Fire Chief” and have him oversee both sides of the operation with a Deputy Chief over suppression and another one over EMS.
Oh, and stop painting the fucking ambulances RED. In fact, paint all of the apparatus white with orange stripes and mark them “Big City EMS and Fire Department”.
What that happens I’ll believe that the fire service is serious about providing medical care and not just saving firefighter jobs.