Why the Red Trucks?

It’s one thirty in the morning and you’re suddenly shook from your peaceful sleep. Your husband of 10 years is making a weird noise. You throw on a light in a panic and look at him, he’s not breathing right. You don’t know what or why but he looks sick to you. Terrified you shake him, “John wake up.” When he doesn’t wake up you sprint to the phone, shaking you dial 911. You talk to a calm voice who takes down your information and says emergency crews are on the way. Two fire trucks show up to your house and strange men and women you have never met before start walking into your home that you’ve built with your husband carrying bags and machines. You think to yourself “Why did they send fire trucks, where is the ambulance?” They greet you and calmly ask “Which way to your husband ma’am?” They calmly start their work. They begin CPR that you have seen on TV before and hook your husband up to all kinds of tubes and wires. You hear one of them on the radio say “Please advise the ambulance that we have CPR in progress.” The ambulance arrives, the fire crew talks with the ambulance crew and they continue to work together like a well-oiled machine. Before long your husband is breathing on his own and they load him into the ambulance and head to the hospital for advanced care.

It’s one thirty-five in the morning and you’re suddenly shook from your peaceful sleep. Engine 12, Rescue 21, Ambulance 33 you’re needed to 123 America Street for an unknown medical problem, wife reports weird breathing sounds and looks ill. You get dressed expeditiously and walk to the truck. You start the truck turn on the lights and sirens and away you go. “America Street is the one off of Freedom Way right?” your conversation with your partner goes on as you respond to the call. You arrive on scene to see the wife waiting for you on the front steps of the house. Each one of you knows what specific medical equipment to grab, and you had heard the ambulance was just clearing the scene of another call so it may be a few minutes until they get to you. You grab your gear and head toward the house. As you approach the front stairs you say, “Hello ma’am my name is Eddie, I am a paramedic with the fire department. Which way to your husband?” She leads you back to her husband lying in bed unresponsive with no evidence of breathing. He is that eerie cardiac gray. You palpate for a pulse and find nothing, you move him to the floor and immediately begin CPR. Another firefighter hooks up a bag valve mask to some oxygen and begins breathing for him. Another firefighter hooks up a defibrillator and prepares to administer a shock. The Captain gets on the radio and says “dispatch please advise ambulance 33 that we have CPR in progress”. You rotate through the positions ensuring to rest and provide high quality CPR. Minutes later the ambulance arrives, IVs are started medicines are given along with more shocks and eventually you have a return of circulation. The patient is breathing on his own. You load the patient onto the cot and head him off towards the ambulance for high quality post arrest care. As your heading out to the ambulance you hear a neighbor say, “Why did they send the fire trucks?”

Why do they send the fire trucks when you call for help? There are multiple reasons but they can be broken down into three broad reasons: for your quality of care, for your safety, and for our safety.

First for your quality of care. Studies across the nation currently conducted by a wide range of institutions indicate that the more medical providers on scene the better. Concepts such as “Pit Crew CPR” that were really pioneered in places like Seattle, Washington and Salina, Kansas show that having 5-8 rescuers on scene greatly increases a patients chance for survival. Looking at response times, sometimes an ambulance arrives at your house and then a fire engine. Sometimes a fire engine arrives at your house and then an ambulance. Sometimes you have to wait a considerable amount of time for either one. The truth of the matter is that nationwide the requests for service from fire departments is increasing. Busier departments mean thinking outside the box to make sure that when you call for help, someone shows up to help you. Our standard is that no matter the emergency, no matter the time someone shows up to help you with your emergency. John Eversole of the Chicago Fire Department said, “Our department takes 1,120 calls every day. Do you know how many of the calls the public expects perfection on? 1,120. Nobody calls the fire department and says ‘send me two dumbass firemen in a pickup truck.’ In three minutes they want five brain-surgeon decathlon champions to come and solve all their problems.” That is the quality of service we aim to provide you with. Firefighters that are trained as EMS professionals are trained to administer medications, insert airway devices, clear obstructed airways, breathe for you, compress your heart for you, and the list continues on and on. By improving response times, providing high quality care upon arrival, and improving the number of qualified medical providers on scene we improve your quality of care. Imagine you walked into an Emergency Room with a medical emergency and a whole team of well-trained doctors, nurses, and technicians all sprang to your assistance and you immediately had a full team of medical professionals working on you. That would make you feel safe, that would be good customer service. When you see a fire engine and ambulance pull up outside your house and a group of strangers climb off and come to your aid, look at it like a whole team of medical professionals (most firefighters are licensed by the state to provide some type of EMS care) showed up to help with your problem. Let it help you feel safer, look at it as good customer service.

Second, for your safety. Think about the layout of your house. The steep stairway, the small bathroom downstairs, the narrow hall way. Almost every house has one room that is difficult to maneuver in. When lifting and moving you from your house to the ambulance we want to ensure that you are moved without fear of being dropped. We also want to make sure you are moved smoothly so as to not injure you further nor cause you severe discomfort. Unfortunately sometimes you will experience discomfort regardless but we do strive to minimize your discomfort as much as we can. We do this by ensuring we have enough providers on scene to lift and move you safely.

Third, for our safety. The number one cause of career ending injuries on EMS calls is improper lifting of patients resulting in back injuries. In order to keep us safe so that we can keep providing you the highest quality of care we bring enough providers to ensure we can lift you properly. Having two or three firefighters help lift you doesn’t mean that you are overweight and we do not mean it as an insult. As I mentioned in the paragraph above it is for your safety, and it is also for our safety. In addition combative patients and bystanders pose a legitimate risk to medical providers. Whether it be from toxic drug ingestion or some type of mental health condition patients at time become combative and more medical providers on scene leads to safer management of the call for both the patient and the responders. Combative bystanders also pose a risk and by having additional medical professionals to tend to bystanders as well as the patient improves safety for all involved as well.

In closing our aim is to provide you with high quality emergency response for all hazards fire, rescue, hazmat, or EMS. We hope that by sharing information we can help the public understand why we do things the way that we do. Next time you see the big red truck responding with an ambulance you can say, that is a well-trained medical team responding to a request for service and you can feel blessed that your department(s) care so much as to do everything possible to provide you with the best service they can.