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Fire and
Emergency
Medical Care
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Objectives (1 of 3)
• Describe how the delivery of
Emergency Medical Services (EMS) fits
into the mission of the fire department.
• Describe how EMS delivery can be a
customer service issue.
• Distinguish between basic life support
and advanced life support.
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Objectives (2 of 3)
• Identify the skills performed by
advanced life support EMS that are not
performed by basic life support EMS.
• Define the two levels of EMS training
within basic life support.
• Define the two levels of EMS training
within advanced life support.
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Objectives (3 of 3)
• Explain why EMS can work well within a
fire department.
• Differentiate a combination EMS system
from a fire department EMS system.
• List three groups that interact with an
EMS provider.
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Introduction
• Role of the fire department in providing
EMS varies.
• To become an EMS provider, you must
take an approved course.
– This chapter will introduce you to the EMS
system and help you understand the fire
department’s role.
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Importance of EMS to
the Fire Service and Community
(1 of 3)
• Fire department’s mission is to save
lives and property.
• High percentage of emergency calls are
EMS-related.
• Most fire departments provide some
level of EMS.
• Fire department involvement in EMS
varies.
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Importance of EMS to
the Fire Service and Community
(2 of 3)
• Same fire stations, emergency vehicles,
and fire fighters that can respond to
fires can also be used to deliver EMS.
• The citizens of the community are your
customers.
– Their support is vital to fire suppression
and EMS activities.
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Importance of EMS to
the Fire Service and Community
(3 of 3)
• From the caller’s
perspective, this is
an emergency.
• EMS providers must
be supportive of the
patient in all types of
EMS calls.
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Two Major Levels of Service
• Basic Life Support
– Initial assessment
– Non-invasive treatment
– Intervention support
• Advanced Life Support
– Initial assessment
– Medications
– Intravenous fluids
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Basic Life Support: Limited
Emergency Skills (1 of 2)
• Skills include:
– Scene control
– Scene safety surveillance
– Patient assessment
– Basic airway management
– CPR
– Oxygen administration
– Splinting
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Basic Life Support: Limited
Emergency Skills (2 of 2)
• Skills (continued):
– Bleeding control
– Bandaging
– Treating for shock
– Lifting/moving patients
– Transport to hospital
– AED
– Selected approved interventions
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Advanced Life Support: More
Complex Skills (1 of 2)
• Skills include:
– Advanced airway
management
– Endotracheal
intubation
– Intravenous fluids
– Medication
administration
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Advanced Life Support: More
Complex Skills (2 of 2)
• Skills (continued):
– Cardiac rhythm monitoring and
interpretation
– Cardiac pacing
– Defibrillation
– Thoracic decompression
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Training
• Most fire fighters need some EMS
training.
• Many FD’s require all personnel to be
trained.
• Level of training depends on the
system.
• Based on DOT National Standard
Curriculum
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EMS Training: Levels
• Basic Life Support
– First responder
– EMT-Basic
• Advanced Life Support
– EMT-Intermediate
– EMT-Paramedic
• Continuing Education
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Training: First Responder (1 of 2)
• Provides assessment
and provides basic care
• Typically requires more
than 40 hours lecture,
skills practice
• Includes airway
management,
CPR/AED, bleeding
control
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Training: First Responder (2 of 2)
• Covers same topics as EMT but in less
detail
• Does not prepare for working on an
ambulance
• Designed for those under the direction
of an EMT
• Can be certified in some states and/or
nationally registered
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Training: Emergency Medical
Technician-Basic
• Involves more than 110 hours of lecture,
skills practice, and clinical observation
• Basic patient assessment, treatment,
and transport skills
• Minimum level required for ambulance
duty
• After training, student can be state or
nationally certified.
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Training: Emergency Medical
Technician-Paramedic (1 of 2)
• Teaches advanced life
support skills and
techniques
• Most require at least
one year to complete
and build on the EMTBasic course
• Covers causes and
treatments of diseases
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Training: Emergency Medical
Technician-Paramedic (2 of 2)
• Includes clinical time in the hospital and
working on an advanced life support
unit
• Can be state-certified or nationally
registered
• Work under direction of physician
medical directors
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Training: Emergency Medical
Technician-Intermediate
• Limited advanced life support skills
training
• Skills vary by state.
• Can be state-certified or nationally
registered
• Work under direction of physician
medical directors
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EMS Training Agencies
• Training may be offered through:
– Community colleges
– Vocational training centers
– Hospitals
– Fire departments
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Continuing Medical Education
(CME)
• Also known as CEU’s
• Ensures proficiency
levels and awareness of
changes in protocols
• Allows for discussion of
previous calls
• May count toward
recertification
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EMS Delivery Systems
• May be provided by various agencies
– Law enforcement agencies
– Volunteer ambulance services
– Commercial ambulance services
– Hospitals
– Fire departments
• May have a cooperative system
• Determined by local and state officials
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Advantages of a Fire
Department Delivery System
• Entry requirements assure quality
personnel.
• Already has health and fitness
mechanisms
• Already has base infrastructure in place
• Already familiar with the community
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Combination System
• Fire department provides medical first
response only.
• Separate agency provides transport.
• May be offered at the basic or advanced life
support levels
• First response by engines, trucks, or
specialized units
• Requires good relationship between fire
department and transport agency
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Fire Department EMS System
• Provides on-scene care
and patient transport
• May provide basic or
advanced life support
• First response by
engines, trucks, or
specialized units
• Easier coordination of
personnel
• Some use cross-trained
personnel
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Interaction with the
Community
• You must strive to
provide equal
service.
• You must provide
prompt, efficient,
competent care.
• Your attitude will
affect the patients.
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Medical Director (1 of 2)
• Authorizes providers
to deliver medical
care
• Determines
appropriate care
procedures
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Medical Director (2 of 2)
• May be online (direct communication
with physician)
• May be offline (through protocols and
standing orders)
• Determines appropriate training
requirements
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Interaction with Hospital Personnel
• Patient information
must be transferred
to the hospital staff.
• Good working
relationship
improves patient
care.
• Understanding the
hospital’s policies is
important.
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Summary
• Fire fighters have an important role in EMS.
• EMS may involve basic or advanced life
support.
• Most fire fighters need some medical training.
• There are many methods of delivering EMS.
• It is important to provide prompt, efficient, and
competent care without bias.
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