Why Fire Trucks Go Out On Rescue Calls

Fire Chief Henrikson and Deputy Chief McGillivray explain.

Many times, over my career, I have been asked, “Why it is necessary to send a fire truck on an ambulance or rescue call?” This is the Most Frequently Asked Question of the fire service. As the answer is not readily apparent to our taxpayers, I would like to explain why we send the fire truck on rescue calls.

All of the firefighters of the East Greenwich Fire District are cross trained to respond to both fire and emergency medical incidents. Every firefighter is an Emergency Medical Technician–Cardiac (EMT-C) licensed by the state. They are required to maintain their licensure throughout their careers. The EMT-Cardiac performs all measures of Advanced Life Support (ALS) Care as approved in the Rhode Island Pre-Hospital Protocol and Standing Orders.

When responding to a medical emergency, the Fire Engine (two people) responds along with the Rescue (two people) to assist with carrying all the necessary equipment, assisting with the treatment of the patient and possible transport of the patient to the rescue. In the more life-threatening cases, such as a CPR in progress, engine personnel may accompany the rescue during transport to the hospital. The engine may then also go to the hospital to retrieve people to become available for future incidents.

Some of this begs the question; is it really necessary for a rescue and a fire truck to respond to many of the minor injuries? It seems wasteful to drive a very fuel-inefficient fire engine to an incident where the additional personnel may not be needed. While there are some calls for emergency medical assistance that can easily be handled with just the two personnel on the rescue, there are many more that require additional help.

The practice of sending both a rescue and a fire engine, equipped with defibrillators, oxygen, and other first-aid essentials, to a medical call is widespread nationwide. And the reason, as most fire chiefs would say, is simple: With fire stations located strategically throughout a city or town and EMT’s often tied up for an hour or more on a single call, firefighters, even firefighters driving a bulky ladder truck, can often get to an emergency faster than a rescue and provide life-saving treatment as soon as possible.

Nearly every Emergency Medical Service (EMS) system sends a unit to “assist” the ambulance for a number of reasons. Many times there is not always enough reliable information on the patient’s condition to determine if additional help is needed. Valuable time may be lost if additional personnel are not dispatched until the rescue arrives and makes an assessment. Also, even so-called “routine” medical calls require the patient to be removed from their home and lifted into the back of the rescue. Even if the patient is not obese, it is safer for the patient and for the backs of the EMT’s to have additional help to assist with moving and lifting.

Another example is when a fire engine and a rescue respond to auto accidents. The engine has many duties at this type of call including blocking traffic to ensure the safety of all first responders, stabilizing and making the vehicle safe to work in and around, perform heavy rescue tasks utilizing tools such as the Jaws-of-Life, and assisting with the treatment and removal of any injured occupants.

Another taxpayer concern is cost. The Fire District, as the provider of the town’s fire protection and emergency medical services, has already invested in the fire truck, the advanced medical equipment and medicines they carry, the salaries for the firefighters, and the fuel in the trucks, therefore, it would be imprudent to NOT send the fire engine and its personnel on what would even seem to be a minor medical call. When the fire truck is not needed on an incident, it is released to go back into service as soon as possible, or even respond to another emergency – whether a fire or rescue call. The cost of the fuel, to have the extra help immediately available when it is needed, is a small cost when compared to the loss of precious minutes when a life is on the line.

Chief Peter F. Henrikson
Deputy Chief Russell McGillivray, Jr.

Petar_1 S August 01, 2012 at 06:34 PM
Rich-Padding runs may not be a concern but changes in run volume should be: less runs makes it more difficult to justify a budget. The perception that all we do is "sleep & eat" is rampant and difficult to break (it's not the big red bed for nothing). ISO and NFPA are concerned, those are all good and well but let's be honest: few (if any) departments in the state are at NFPA staffing levels and the standard means nothing when the costs to maintain the standard aren't sustainable. You want to meet the standard, find a way to make it work financially or face a lot of uncomfortable situations. "Too busy", I find that hard to believe. Your annual report lists 2976 calls with 67% (~1993) being EMS and the balance (983) are "everything else." Rich, you're an EMS department that runs fire calls. In comparison, Lincoln Rescue ran about 3600 calls a year, Cumberland Rescue runs a similar number and both provide significant mutual aid to urban areas including Pawtucket, Woonsocket, Central Falls and even Providence. They are a full time service as a stand alone town based entity. But, they're embedded in fire districts which are combination departments. If we look at your non-EMS runs, I find it hard to believe you couldn't manage less than 1000 runs between two stations as a combination department. Your tax base allows you to be a career department for now but that may well change and you could easily find yourself in the same difficult spot as the rest of us.
Petar_1 S August 01, 2012 at 06:42 PM
Jack, in many (if not most) European countries the fire service does not service as an EMS provider or as the primary EMS provider. In the UK for example, the fire brigade does not get involved in EMS unless there is a technical rescue related issue. In most cases government standards are set centrally and dumped on local organizations or sent as an EU mandate. Scott, think of an EMT-C as a state level Paramedic-lite. We can do almost all the things a NREMTP can do but the education/training length (and cost) is significantly less. For a state with, typically, short transport times to a PCI capable hospital or trauma center the system works. Since the ambulance advisory is essentially stacked with out union's members (in part coded in law) there is little risk of change.
Scott K. August 01, 2012 at 07:04 PM
Jack - In England, for example, transport is a last resort. To calls determined as lower priority, occasionally single medics in fly cars are sent. They have more options regarding transporting non-priority patients (and in some cases not transporting them at all). EMS is regulated there from a medical stand point not a fire stand point. They might have Fire Standards that dictate fire response but as Petar stated, they are largely seperate.
Rich August 01, 2012 at 07:26 PM
Let me clarify. I'm not a EG firefighter. If I accept your 1993 numbers (run volumes have increased) I still maintain that a career/on call FD would represent a decrease in protection for the residents of EG and considering how poorly staffed the career EGFD dept is in the first place the savings wouldn't justify the increase in adequately staffed response times nor the general decrease in protection. It's a difference of opinion I suppose.
Scott K. August 01, 2012 at 07:29 PM
To clarrify, the 1993 number is not the year the statistic was taken from it is 67% of the 2,976 calls. So the department's volume is 1,993 EMS calls and 983 making up "everything else."


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