Firefighter paramedic Ryan Clark waits to learn if there are any victims needing his assistance at a fire in Washington, D.C., in the United States. Until summer 2013, the D.C. Fire and Emergency Medical Services Department required that all members of the department be a firefighter. Emergency medical services were integrated into the department in the 1950s, at which time firefighters were trained as paramedics (who can offer the highest level of life-support) or emergency medical technicians (EMTS, who can offer basic life-support). Generally, paramedics and EMTs in the District of Columbia do not fight fires, except in an emergency.
With shrinking budgets and staff cuts going on all over the place the idea of cross training firefighters and paramedics is increasing in popularity. Whether we like it or not the idea is alive and well, but is it a good idea?
The main reason we are seeing the push for cross training is because it can save money by having the same person fill two roles. Instead of paying a firefighter and a paramedic why not just have one person fill the two positions? Instead of paying an entire salary we can give them a couple thousand dollar stipend and call it a day.
Oh wait, what if we have a fire and EMS call at the same time?
When you try and fill two positions with one person something is going to suffer. When the same person is counted on to extinguish a fire, perform an extrication, handle a haz-mat situation, and perform EMS duties all in the same shift it is going to be tough on that employee and the quality of care and job performance are going to go down.
Call volume will take its toll, and when a sweaty tired firefighter arrives to start an IV and give you important ALS care you won’t feel quite so confident.
With the duties of EMS and fire suppression being so different it raises the question if the two jobs are even related. Fire suppression is dirty, EMS should be clean. A guy that climbs ladders and chops a hole in the roof is a lot different than the guy that should be bandaging your wound.
A doctor and a construction worker don’t share job responsibilities so why do we put firefighters and paramedics in the same class? We put them together because the emergency part of the two jobs is the same. We need to have both services geographically spread out, and they need to be available all the time.
How can we combine these two different jobs and make it work?
I have seen both of these jobs performed exceptionally by the same individual. I don’t think that either job is too complicated that the same person can’t do both well. There are those that like their own specific fire or EMS role, and there are some that like to switch things around and get involved in both fields.
I don’t know of anyone though that likes to switch from an ambulance to fire apparatus depending on what the call is. You get in a certain mindset based on your role for the day.
When we are at a structure fire with cross-trained personnel we run the risk of using our EMS staff as firefighters and leave the ambulance unstaffed. We always need to have an ambulance available in case one of the firefighters gets injured. Just having an ambulance on the scene is not enough, that ambulance needs to be in full service and staffed properly.
We can do a great job with cross-trained firefighter paramedics. As long as we realize the difference in the two roles and manage them properly it can be a good fit.