One question that residents often ask is why firetrucks and police cars respond when 911 is called for a medical emergency. It does not make sense to them to send a firetruck with hoses and ladders when someone is having a medical emergency. Uncertainty surrounding the actual problem or complaint, the need for additional resources, and the close availability of first responders are just a few of the reasons why you may see firetrucks and police cars responding to medical calls.
When emergency dispatchers receive a 911 call, they are often not given precise or complete information. Given this uncertainty, dispatchers are especially careful in selecting the type and amount of help to send. Ultimately, the responding units have no way of knowing exactly what they will encounter until they arrive. The emergency response starts with general knowledge about the emergency and ends with the specific details.
According to the National Fire Protection Association, only about 5% of fire department calls involve actual fires. Sixty-five percent of their responses are medical calls. The result is that fire departments have become all-hazards departments, with staff trained to respond to fires, emergency medical incidents, hazardous materials, and much more. Many firefighters are certified as emergency medical technicians and most departments certify all of their firefighters with basic first aid and CPR/AED training so they can begin patient care before the ambulance arrives.
The availability of resources is another reason fire personnel respond to medical emergencies. Locally, Westerly Dispatch — the only regional dispatch center in Rhode Island — provides EMS and fire communications for five towns in Southern Rhode Island and Eastern Connecticut. These towns have 10 fire departments and four ambulance services.
Westerly Dispatch is responsible for about 142 square miles of land and 62 square miles of water. Ambulance crews may be handling multiple calls or may be some distance away from an emergency, but other fire and police first responders are available to respond quickly and begin patient care. They can be on the scene quickly with emergency vehicles and first aid equipment. In addition to providing patient care, early arriving first responders can give information to the incoming ambulance, provide traffic control, and verify the correct address of the call.
This is especially important with cardiac emergencies. Cardiac arrest occurs when the heart malfunctions and unexpectedly stops beating. To improve the victim's chances for survival, CPR must be started immediately, an automated external defibrillator must be used, and further treatment by emergency medical technicians must begin.
Here is a protocol established by the Center for Emergency Medical Services of the Rhode Island Department of Health and the Rhode Island Ambulance Service Advisory Board: “Regardless of proximity to a receiving facility, absent concern for provider safety, or traumatic etiology for cardiac arrest, resuscitation should occur at the location the patient is found. Resuscitative efforts should continue for a minimum of 30 minutes prior to moving the patient to the ambulance or transporting the patient.”
Basically this means that victims who suffer cardiac arrest not related to trauma or serious injury MUST be treated in the location that they are found for at least a half hour. This MUST occur regardless of how close patients are to a hospital or where they are located. In our area, most cardiac arrest calls result in an automatic joint response by the nearest police department, nearest fire department, and nearest ambulance service.
It is important to note that many emergency scenes benefit from the presence of additional personnel. Most ambulances respond with just two emergency medical technicians, so these procedures can be accomplished more efficiently with additional personnel. Assessing the patient, obtaining vital signs, providing oxygen, carrying the patient down stairs, placing advanced airways, monitoring cardiac function and administering drugs intravenously are a few of the many procedures sometimes required for just one patient. Ambulance personnel are often grateful for a few more helping hands.
Again, the original details from the call may have been vague or inaccurate. It is not unusual for EMS personnel to find that the patient is alone and unable to get to the door to allow entry, and the door must be forcibly opened. As an all-hazards agency, first-line fire apparatus are equipped with equipment to ensure rapid access and high-quality care to patients in need. Firefighters are trained to handle scenarios like this and to accommodate the unexpected. Once it is determined that the fire and police units are no longer needed at the scene, and the ambulance personnel can handle the patient care, they are released and put back into service as soon as possible.
So the next time you witness several vehicles responding to a medical emergency, be assured that it the best interest of the patient. We are all here to serve you! The extra personnel and equipment at the scene of a medical call could mean the difference between life and death.
This column was written by Jane Perkins, Fire Safety Specialist for the Rhode Island Southern Firefighters League and Captain of the Watch Hill Fire Department. If you would like to see a question answered in this column, please e-mail her at email@example.com