Go Home Already: Shouts and Murmurs
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Morning Roundup: Second Helpings Edition
Fire at 17th and L NW Forces Evacuations
Read this fascinating story from The New York Times on the D.C. Fire Department's Engine Company 10, by all accounts the busiest firehouse in the country. These Trinidad firefighters at the "House of Pain" spend most of their time not fighting fires, but rather serving as emergency medical responders.
About 80 percent of the calls handled by Engine Company 10 are medical emergencies because the firehouse serves one of the city’s poorest areas, where few residents have health insurance, doctors’ checkups are rare, and medical problems are left to fester until someone dials 911.
The story also makes the point that due to a trending decrease in the number of fires nationwide, many fire departments rely on these medical calls to keep their firefighters employed. Still, it's hard not to see the underlying truths of the current health-care reform debate: our poorer residents don't get good, regular medical care, and the burden of that broken system ends up in the laps of our emergency responders and emergency rooms.
I also had never heard this term for the corner of 14th and H Streets NE: 'The corner is known by the firefighters as the "vortex of sickness" because the dispatcher sends them there five or six times per shift.'
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it's absolutely true. when i moved into the neighborhood last month, one of the first things that one of my neighbors told me was to not worry about the fire trucks and ambulances that would be dispatched every day on our block. he said that there's just an old couple that freaks out and calls for an ambulance every day, and the EMTs are obligated to come out and make sure everything is OK.
if we want to fix healthcare in the US, trinidad might just be the place to start...
Hell yeah DCFD. The story's look at an average morning at Engine Co. 10. is definitely worth a read. Makes me want to buy a DCFD t-shirt emblazoned with my local station's logo. Although the "Hookers and Hose" one for Engine 9 is probably the best.
NPR did a piece on this firehouse two weeks ago...(may have been WAMU-generated but was aired on national NPR program)
Yeah, I heard the NPR piece on Aug. 22. Either NY Times was "inspired" by their story, or someone put out a press release.
I've always had a lot of respect for firefighters but now they are elevated up another level. It is a shame that the tin foil hat brigade opposing health care reform don't read the NYT.
Nice article for The Dime.
I do love, however, when reporters unthinkingly mention firefighters putting on their "oxygen" (as opposed to air) tank. It would be not awesome to take a suck on that mouthpiece and have your entire faceplate fill with flame as your backpack became a sort of ass-mounted blowtorch.
Another bizarre manifestation of this is you're starting to see a few "transport engines", which are full-on pumpers that can carry a stretcher in the passenger compartment - which is just - that vehicle shouldn't exist.
Hell, sounds like there's competition with Engine 16 (1018 13th St, NW). They get called out (EMT and firetrucks) almost every 30 minutes. I even start worrying if I don't hear their sirens go off more than 5 times in the middle of the night. On a side note, I do love the smell of their BBQ grilling outside each time I pass by on the way home.
If we have so few fires and so many medical emergencies, why do we have so many firetrucks and so few ambulances?
only i would move across from the busiest fire engine company in the country :-/
Why are fire trucks called/ needed for medical issues?
It's a capacity utilization problem. In order to respond before enough people are down from smoke inhalation, etc., to make for a major rescue problem, or before a fire gets uncontrollable (they grow in seriousness pretty much exponentially,) you'd like to be hitting a box alarm with 2 - 3 engines and 2 -3 trucks within 4 to 5 minutes.
In a high-traffic urban area that means you have to build a whole bunch of stations, provide so much staffing, etc. to be pretty sure you can get that for some typical number of fires.
But since you have to do all that planning based on "peak" (capacity) vs. utilization, most of those pieces will be idle 95% of the time. Since cross-training the crews to do EMS is comparatively cheap (EMT-B is 120 hours of class, and they're already on the same radios, use the same command structure, can handle that level of pressure etc.,) you can "fill in" the troughs on their usage by sending them on EMS calls.
This is also OK, because it's not uncommon for one patient to need more than 2 responders - at least for a while. A driver + single EMT in the back can maintain someone in an ambulance to the hospital. But that's *after* they're down the stairs, out of the house, on a backboard, had their relatives or bystanders placated, etc.
Different counties handle it differently - you sometimes for instance see the opposite - an EMS ambulance pulling up to a fire, the EMTs getting out, putting on their turnout gear and SCBA, and joining up with their (otherwise understaffed) engine that's already on scene.
The more difficult part of this is that the fire truck *itself* (as opposed to the people) is obviously a silly & not useful thing to send on a medical call. But the alternative - having to send people back to the fire station to *get* the engine - is also not great - no one's figured this out definitively. You see a lot of different strategies
(In PG County, Kentland's "mini-pumper" pickup truck ends up doing almost entirely EMS - a much less expensive way to get people on the scene at EMS while leaving them in a truck that could do a structure fire (albeit not alone, as it has almost no water onboard and usually only two people.)
It's all a hugely complex operations research issue...
WOV is right - you have to staff for maximum capacity, not minimum. In MoCo, where I'm a paramedic, a basic house fire dispatch gets 5 engines, 2 ladder trucks, 1 heavy rescue, 1 ambulance and 2 chiefs, plus a working fire will get an additional rescue, medic and ladder truck. What happens if you get 2 house fire at once? Or a house catches fire during, say, the metro crash? You have to be staffed for those contingencies.
The question of how and whether to send fire apparatus to medical emergencies is much more complex. Agreed, it seems absurd to send engines to medical calls, but there are few viable alternatives - simply increasing the number of ambulances is one solution, albeit an imperfect one. Providing preventive care and increasing the number of free, accessible clinics is also key, as it prevents people from getting to the point where their diabetes/asthma/angina/CHF/etc. necessitates a 911 response.
In point of fact, calls to fire-emergency units in cities across the country average 70 to 80 percent medical. Using pumpers and hood-and-ladder crews to handle this volume of medical calls is absurd and expensive, but DC refuses to field sufficient ambulance units.
That fire station you have in the photo is closed currently and supposedly under construction, though, no construction has begun. Those firefighters that were working there have been relocated to the fire station at the corner of 6th & Florida Ave., next to Gallaudet U.
Also part of this is that in most combined Fire / EMS services (and you see this a bit in the article,) there's this weird cultural thing where firefighters *don't like* doing EMS (because it is gross / tedious / frustrating / unglamorous, and because they think of themselves as firefighters, damnit, not EMS workers,) but are pretty aware that their salaries are hard to justify w/o EMS. Note how often the ambulance is referred to as "the bus."
@Mike Licht - see above; it ain't easy to get the right mix. But, yes, seeing a dual-steer 100' ladder sent to somebody's seizure makes you feel *something's* definitely gone wrong.