One thing you can’t miss if you’re around when a medical emergency takes place is the firefighters who turn up to assist. But why are they there? Shouldn’t we just be relying on paramedics and ambulances? Are the firefighters doing the wrong job?
Firefighters are called to and show up at medical emergencies because they are medically trained as EMTs and paramedics and there are usually more fire engines in a given area than ambulances. This allows firefighters to respond first and stabilize the situation before the ambulance crews come to transport the patient.
That’s not to say that these reasons will always be the same. After we’ve looked at the reasons that firefighters attend medical emergencies in detail – we’ll also look at the possibility of change in the future and what that might mean for firefighters going forward.
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Why Do Firefighters Show Up at Medical Emergencies?
We’ve broken our reasons, that firefighters show up at medical emergencies, up into two parts. The first part concerns itself with the firefighters themselves and the skills and experience that they can bring to a medical emergency.
The second part is more concerned with fire departments and the fire service and the more logistical basis for the overlap between fire services and emergency medical services.
So, here are the skill-based reasons that firefighters show up at medical emergencies:
1. Firefighters Are Medically Trained
Possibly, the simplest reason that firefighters show up at medical emergencies is that most firefighters are medically trained.
If you think about it, when firefighters are doing their main job of fighting fires, they’re going to come across people who’ve been hurt, who’ve been suffocating, who’ve been burned, etc. and they need to be able to offer assistance, in case there’s no other personnel available or if it’s critical that assistance is rendered immediately.
That means every firefighter has been given trained in first aid and CPR, the vast majority will have received basic EMT training which extends this skillset with over 100 hours of training and many more have completed advanced EMT training (another 1,000 hours of training).
Also read: EMS vs EMT: What’s The Difference?
In fact, many fire departments now recruit paramedics as firefighters as their preference. It means that a firefighter can offer the maximum value when they’re involved in any kind of call. This requires up to 1800 hours of medical training.
It seems likely that this trend will continue and grow. We’d expect to see a lot more firefighters who are also fully trained paramedics, in the future.
Also read: How to Become an EMT: Expert Guide
2. There May Be a Need For Large Numbers of People
Not all medical emergencies are straightforward when it comes to dealing with the people involved. Sure, if an individual is feeling capable of walking to the ambulance – things are going to be easier, but there are times when large numbers of people are going to be required to provide assistance.
Consider a morbidly obese individual. Sadly, there are many people in this condition in America today and while we have no wish to pass judgment on anyone’s dietary habits – there’s no doubt that someone, who weighs 600 lbs and who has had a heart attack in a shopping mall, is going to require more than a couple of paramedics to lift them on to a stretcher.
In some areas, someone who has had a cardiac incident might need 30 minutes of continuous CPR on the scene before they can be moved anywhere else to be treated.
That might not sound like a lot, but it’s a lot of work and when there are only two paramedics, it’s often more work than they can handle whilst also managing the scene, making assessments as to the wellbeing of their patient, etc.
Thus, rather than stepping on the toes of medical personnel, the EMTs are often very grateful to get some assistance from firefighters who have the appropriate healthcare training and can help to enable them to deliver the highest standards of medical care to their patients.
3. There Can Be an Overlap of Skillsets
Possibly, the most obvious reason that firefighters routinely respond to medical incidents is that they have many sets of skills that overlap with those used at these scenes and that can add real value.
Think about the scene when a person calls 911 from within their home, for whatever reason, and then collapses and is unable to get to the door and open it.
Ambulance crews aren’t particularly experienced in kicking down doors and getting into buildings. Firefighters, on the other hand, do this all the time.
When even a few seconds can make the critical difference between someone living and dying, a firefighter’s ability to act in situations where an EMT cannot easily take action, can save lives.
The same is true at the scene of car accidents. Firefighters are trained and equipped to free victims trapped in cars and other situations. You may have heard some of these special tools referred to as the “Jaws-of-Life”.
Here is a demo of firefighters cutting the roof off a car with these tools:
They can also help ensure that an accident scene doesn’t turn into a bigger crisis. Firefighters can help prevent vehicles from catching fire, they can secure spills and leaks of chemicals and fuel, etc. all things that paramedics don’t have the experience to offer.
So, as you can see – there’s a genuine overlap of skillsets between fire and medical calls when it comes to firefighters on the scene.
Why Do Fire Departments Respond to Medical Calls?
Now that we’ve seen why firefighters are well suited to respond to medical emergencies, it’s time to take a look at why fire departments and the fire service allow their resources to be used in this way.
After all, you might expect them to zealously guard their patch as “firefighting” only, particularly, if TV dramas were to be believed. So, let’s start with a little history.
4. Historical Roots of Medical Care from Fire Services
The Knights of Malta was a non-military organization back in the 11th/12th century C.E. Their original purpose was to act as a charitable medical team to support the injured, poor and sick on the battlefield.
In later years, during the invasions of castles, the defenders would often pour pitch (naphtha) over the walls and set fire to it. The Knights of Malta would ride in on horseback and smother the flames of any burning men by wrapping them in their capes.
Thus, the crossover between firefighting and medical services was born. The “Maltese cross” as a symbol of the Knights of Malta and it can be found on many firefighting uniforms around the world, even today.
The American fire service, fairly obviously, doesn’t date back as far as the Knights of Malta but has existed for a long time and some of its earliest and most memorable moments were in the Civil War.
There is a monument from the Battle of Gettysburg which shows a solider and a firefighter and contains the motto “Firefighters in peace, soldiers in war.”
The fire service at this time was the Fire Zouaves, and they also operated field ambulances during the war.
Before 1970 in America, you’d find that many ambulance crews consisted of volunteers and many of these volunteers were firefighters. There was already some formal crossover in responsibilities between the two services.
While private ambulance services began to blossom in the cities in the 1970s, the rural areas, which were poorer and bigger and thus, less profitable to serve with ambulances, still mainly relied on fire services for emergency aid.
The Vietnam War, however, had shown America something very important – that the speed of care and transport were paramount in saving lives. Firefighting and emergency medical care remained entwined and do so to this very day.
5. The Number of Fire Stations
One of the reasons that fire departments are so valuable in terms of medical emergencies is that there are many more fire stations around the nation than ambulance stations. This is because even though there’s been a lot of progress over the decades, it’s still not terribly economic to place ambulances in many locations.
Whereas fire departments, which depend on taxes, are required to be spread out with enough resources to handle a large fire when one breaks out. It doesn’t matter where you are in the country, a fire can spread and swiftly endanger many other people and their property, it must be swiftly attended to.
So, there are more physical locations served by the fire service. In addition to this, there are more fire engines than there are ambulances for much the same reasons. Each fire station requires a crew and the equipment to do the job, otherwise, why have a fire station at all?
This means that in many places, the fire department is simply capable of reaching the scene of a medical emergency, whatever it may be, in a more timely fashion than an ambulance team can. This, of course, means that a firefighting crew is better placed to save lives in these cases.
It’s not a question of firefighters encroaching on the EMT’s territory, much of the time, if people had to wait for an ambulance for a medical emergency, they might die while waiting for a response.
Why Do They Still Need Ambulances?
So, why haven’t firefighters simply replaced EMTs? After all, if they can get to the scene faster and help to save lives and they have the medical training, why not just do everything and abandon ambulances altogether?
Well, it’s because though a firefighter is trained to help a patient, the fire engine isn’t built for securing people and transporting them in a time of medical emergency.
Note: There are some fire departments that operate their own ambulance service, but this isn’t very common.
Firefighters can provide CPR and other forms of aid on the ground but when it comes to taking a patient to hospital – that’s the job of an ambulance and it’s a job that an ambulance does supremely well.
However, many people acknowledge that it’s often better for a fire engine to get to the scene first and to secure the scene and conduct an immediate action before an ambulance arrives. The two services aren’t necessarily in competition with each other. They often work best when employed together in harmony.
6. Why Fires Are Not the Only Priority For Firefighters
Hang on, wait a minute. With all this talk of firefighters attending medical emergencies, why aren’t they busy attending fires?
Well, the truth is that the number of fires in the United States has fallen dramatically over the last few decades. In fact, there may be about 75% fewer fires than when compared to the 1980s.
That means that while fire departments are still absolutely essential and that their first priority is, of course, to tackle fires, there is quite a bit of time when fire departments aren’t tackling fires because there aren’t any fires.
Now, it’s impossible to estimate exactly how many fires will take place at the same time, so it’s not always a good idea to cut back on firefighters and replace them with paramedics. While a firefighter may be trained to do a paramedic’s work, the same is not usually true in reverse.
You can’t send an ambulance crew to tackle a fire – they don’t have the right equipment and gear to even consider it.
7. A Lack of Ambulance Paramedics
Another problem with the idea of hiring more paramedics is that there aren’t that many paramedics available in the first place.
In fact, in many big cities, there’s a serious shortage of paramedics and that means many paramedics on duty are being paid large amounts of overtime (which is costly and eats up budgets).
This means firefighters can be sent to medical emergencies to stabilize the patient while waiting for the ambulance to arrive. Remember, some of these firefighters are paramedics as well.
Also, the longer a paramedic stays on duty, the more risk there is of them burning out. They might like the overtime money, but falling asleep in the middle of a drive to the hospital is not going to be conducive to their patient’s health or their own health for that matter.
Firefighters helping to take up some of the workload may be in the best interests of everyone involved.
Also read: Firefighter vs Nurse: Which Job Is Better?
There May Be Change Coming
Now, it is possible that there will be changes to this model in the future. Certainly, in some major built-up areas there are discussions underway to try and work out the most effective mix of emergency services.
The key question that needs to be answered before efficiency and cost concerns can be answered is “will the supply of firefighters be enough to tackle massive blazes (particularly those with the risk of major structural collapses)” once changes have been made and this isn’t something that’s very easy to answer.
So, will there be change? We don’t know. We just know that it’s being discussed.
So, there you have it, our 7 reasons firefighters show up at medical emergencies. As you can see, much of it is simply commonsense. Firefighters already have a very similar skillset to EMTs (though it’s not identical) and they can add a lot of value at the scene of almost any medical emergency.
There are also historical and logistical reasons that firefighters are needed at the scenes of these emergencies, alongside the simple fact that there are fewer fires in modern America than there were only a few decades ago (something that we ought to celebrate).