[iso1631]

Seems so weird to me to read that a request for extra medial staff would go to firefighters. Intellectually I know the US has a combined Firefighter/Paramedic crew, but it's still jarring to read it.

Do other countries merge firefighting and ambulance functions or is it a US only thing?

[rootusrootus]

There's a good reason firefighters are cross trained, so it probably does happen in other places too. Go look at the dispatch log for your local fire department. For every fire they put out, there are probably 100 or more medical emergencies, car accidents, etc. They may go for days at a time without seeing anything that even looks like a fire. If the only thing they were allowed to do was fight fires, they'd be idle most of the time.

[chrisseaton]

I think it’s pretty unique to the US. In most places you have a police service, a fire service, and an ambulance service, all separate but working together. Makes sense they’re separate - different roles to specialise in and they move between different locations and leave the scene at different times.

[rtkwe]

The US is largely the same but fire services are sent out to a lot of those because they also have the tools to deal with getting access to patients and making the scene safe for ambulance crews. Sending them out immediately means you don't have to wait for them if the patient's door is locked or their car is all smashed up and you need fire services to peel the car apart to get to them.

[LorenPechtel]

But you actually need police, fire, rescue, and ambulance.

We group fire and rescue together because you sometimes have to get trapped people away from a fire.

[datavirtue]

Incidentally, from my experience helping to manage a fire department payroll and being the son of a nurse, firefighters and nurses are paid about the same for a given area.

I'm not trying to make a point, just provide some context.

[JshWright]

Firefighters yes, paramedics, no...

It's not uncommon for the firefighter/paramedic on the engine who shows up and treats the patient for a few minutes before the ambulance arrives to be making _significantly_ more than the paramedic on the ambulance they hand care over to.

Outside of unionized, municipal departments, paramedic pay in the US is generally pretty abysmal (and well below that of nurses).

[MichaelCollins]

The suggestion that other countries don't do this seems weird. Are paramedics in other countries trained and equipped to cut open wrecked and burning cars? Many sorts of accidents will require both firefighters and paramedics, so you may as well encourage firefighters to be trained paramedics as well (not all American firefighters are, but many of them are.)

[chrisseaton]

> Many sorts of accidents will require both firefighters and paramedics

Yeah so both attend. Makes sense they're separate vehicles as the ambulance would ideally leave while the fire brigade are still sorting out the scene. And normally the police as well, for a road accident. If you can understand the police being separate you can understand the fire and ambulance being separate.

[MichaelCollins]

Police in America often have paramedic training as well, for a reason. You say "both attend" but somebody gets there first. Sometimes police get there first, sometimes firefighters get there first. All should be encouraged to get trained.

All three would receive firefighter training too, if not for the obvious issue of their vehicles and equipment being specialized and expensive. But all of them can be trained to render first aid, so that is encouraged.

[chrisseaton]

Maybe it's different in the US but in the UK 'paramedic' is a full-time thing, professionally registered and monitored. You'd seriously struggle to combine that with any other full-time profession. They do it in the military is the only place I know that combines it. I can't see it as being realistic to train everyone as a paramedic for our definition of it. I doubt most people could pass the training.

[MichaelCollins]

Obviously paramedics are registered and obviously not everybody is cut out for it. That should go without saying. There are grades of paramedic and I think most firefighting paramedics are likely not the most specialized of all of them, but I feel confident in asserting that nearly any paramedic firefighter in America is qualified to monitor patients in the waiting room of a hospital.

As for the rest, I have a lot of gripes with the American system of healthcare, but the quality of first responders is not among them. If I ever have a heart attack while driving and crash into a tree, I'll be very happy if the volunteer firefighter who cuts me out of my car is also a paramedic. My complaints about the American system will be reserved for the private for-profit doctors they bring me to.

[chrisseaton]

Ah right maybe we in the UK only use the word 'paramedic' to mean the most specialised, advanced trauma life-support level and you use it more broadly. I'm sure all police and firefighters here do get advanced first-aid training.

[JshWright]

"Paramedic" means roughly the same thing in the US and UK. UK training standards are a bit higher, but in both cases they are professional roles, with ongoing training requirements, etc. They have a very similar scope of practice, both providing advanced level care.

In the US it's pretty common for fire departments to require EMT level training, with some folks then going on to get their Paramedic certification. Agencies that require everyone to be a paramedic are rare (but they do exist).

[JshWright]

The US is a little unique in the extent to which "firefighter/paramedic" is a common role, but it's very typical for firefighting personal to have at least some level of medical training, even if it's just the "first responder" level.

It's not clear to me from the story if the personnel sent over by the fire department were paramedics at all. The actions described would be well within the scope of a BLS first responder.

If I had to guess, the chief sent a BLS engine company, which would typically consist of 3-4 people, all trained to the EMT/FR level.

[LorenPechtel]

That's my impression, also. It doesn't compromise their primary job because if they're actually needed at a fire they can roll from the hospital rather than the station.

I've seen plenty of fire/paramedic/ambulance crews doing various things while awaiting a call. So long as they're ready to jump on the truck and roll quickly dispatch simply needs to know where they are so as to determine what unit is closest.

[nerdponx]

The US doesn't, we have dedicated EMTs. But firefighters might have first aid training too, and are more likely to be available on a random night.

[JshWright]

The US absolutely does, it just depends on the agency.

I'm a firefighter/paramedic who sometimes rides a fire truck, sometimes rides an ambulance, and sometimes switches from one to the other mid-call as the situation warrants.

[ejb999]

Yes the US does - it varies by state and even by town/city.

Many of the towns near me you need to actually be a paramedic to become a firefighter and vice-versa - can't be one without the other in some areas.

Not sure I necessarily agree with this, but it does happen. I see the benefit, but also think there are a lot of people that would be good firefighters, but may not have the willingness or ability to do the classroom and testing required to be pass a full paramedic course.

[kayodelycaon]

We have firefighters cross-trained to handle first aid so there are more people available in spread out areas. Often a fire truck is on scene faster than the ambulance. Once the ambulance is on scene, firefighters can assist paramedics.

[Waterluvian]

Modern firefighters are far far more than just for fighting fires.

In my region EMS is separate but the firefighters still have plenty of first aid training and would be able to provide the response they did in this article.

[ubercore]

It totally depends on where you are -- some municipalities have their own EMTs, some are attached to fire, etc.