Thursday, December 27, 2012

I Called for an Ambulance. Why is There a Fire Engine Outside?

By Lieutenant Robert Furst

Currently, in The 1st Battalion, there are six fire engines staffed 24 hours a day 7 days a week with four firefighters one of whom is a paramedic. These fire engines are housed at Downtown Silver Spring (1), Hillandale (12), Burtonsville (15), Four Corners (16), Montgomery Hills (19), and Colesville (24). Officially, they are named ALS First Response Apparatus (AFRA). On the radio, they are called Paramedic Engines.

As seen in this picture, the fire engines are equipped with a full complement of Advanced Life Support (ALS) equipment. This includes a cardiac monitor with 12-Lead capability with the ability to transmit said ECGs to the receiving hospitals. Also carried is a complete set of emergency medications and equipment with which to start IVs and place advanced airways in patients. For patients with trouble breathing, all of the paramedic engines carry a Continuous Positive Airway Pressure (CPAP) device. The AFRA carries everything a medic unit carries and complies with the minimum requirements for ALS units in the State of Maryland.

These four person paramedic engines serve multiple purposes. They can respond as the first paramedics to arrive on the scene while awaiting a medic unit, thus providing emergency medical aid minutes sooner (every second does count), or they can respond to satisfy the assembly of one or two paramedics and a transport unit on the scene of a medical emergency. If the paramedic is required to upgrade the ambulance, and help render aid to the patient enroute to the hospital, the fire engine will remain in service with a staffing of three firefighters.

The four person staffing is also instrumental in significantly reducing the amount of time to place an attack line (fire hose) operational to start to extinguish a fire sooner. This was proven in a National Instituteof Standards and Technology (NIST) study and in the recent battalion drills.


Shirl said...

I'm relatively new to Montgomery County; I live in the North Bethesda area. I'm a bit confused about how the Fire/EMS is structured here. I've seen several volunteer firehouses in the area. Do these function as adjuncts to the county's professional (e.g., full-time) fire department? Is every part of the county "covered" by
Montgomery County Fire & Rescue, or are parts of the county serviced by volunteers only?

Anonymous said...

Thank you for explaining and the pictures are nice, but still this does not make sense.

Anonymous said...

More than just the NIST study should be required to justify four person staffing. You are then adding additional risk of 25%.

billd said...

Thanks everyone for your comments. Re NIST study- as mentioned in the article, testing was also done here as well. NIST was very real world and lots of science behind it. The risk is actually reduced by adding that 4th person for a variety of reasons to include the reason mentioned in the blog post.

billd said...

@Shirl Welcome to Montgomery County! Our department is what is called a combination department. In the majority of stations, they are staffed 24/7 by career firefighters with volunteer firefighters augmenting usually on nights and weekends. There are a couple of stations who have career staff during the weekdays and volunteer staff who cover nights and weekends.

Anonymous said...

to Anoymous, almost every county in the wash-balt area has 4 on there engines. The extra hand helps on fire calls. as for ems calls its always nice to have a extra hand for those heavy people, even if it ends up that the medic isn't needed. But I will say Where I am there's no BLS units all are Medic units. The Volunteers will put a BLS unit in service once in a while.