A comment yesterday asked if I could elaborate on Lincoln Fire & Rescue's use of an "alternate response vehicle": a smaller, lighter vehicle like a pickup equipped with basic tools and medical equipment. This topic was in the news yesterday. After a couple of years as Public Safety Director, I now feel that I can do so.
The trend towards deploying these kinds of vehicles is not unique to Lincoln. It is going on nationwide, as more and more fire departments are beginning to respond to the changing nature of the work and the imperative of adapting to the new reality in municipal services, which simply put is this: the account is not unlimited, and no one is running for office on a platform of "I will raise your taxes, so government can continue to do what it knows is in your best interest."
About 76% of all the incidents that Lincoln Fire & Rescue rolls on are medical emergencies. Not only do they not require a huge and expensive fire truck or fire engine burning diesel fuel at 4 MPG, in some ways driving one of these large vehicles is an impediment to an urgent response, rather than an advantage. Sending a truck or engine to a "man down, nature unknown" call (something that happens hundreds of times annually), or to a broken tibia at a softball complex, is akin to sending a SWAT team to a noise disturbance call, based on the theory that it could be a gang war, rather than a loud party. I am sold on the need for a fairly sizable contingent of firefighters and paramedics for medical emergencies, but the type of vehicle they arrive in is for the most part irrelevant to the outcome.
Firefighters have an exceptional ability to think about, plan for, and train for every possible contingency. It is both a worthwhile skill, and an Achilles heel at the same time (isn't that true of most talents?) But in reality, the chance of a fire company catching a call that requires the big rig while on the way back from the senior center or ball field is quite remote. With the exception of rescue calls, almost all medical emergencies can be dealt with sans the engine or truck. For the rare contingency where more or different resources are needed, every firefighter and every rig is equipped with a radio, and there are a few dozen colleagues ready to spring into action at an instant's notice.
The checkbook isn't unlimited, and the ARV is a reasonable response to reality. Early on in my new role as PSD, I overheard a firefighter make a remark that I have now heard repeatedly, both at LF&R and at other agencies: "Firefighting: 200 years of tradition, unimpeded by progress." While not entirely true, I must admit that firefighting is more change-averse than most professions, and it cannot continue on a trajectory like this for long.
Adapt or wither. The choice is clear.
Tuesday, May 28, 2013
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20 comments:
...no one is running for office on a platform of "I will raise your taxes..."
No, they have to lie to the voters by saying they will not raise taxes, get elected (or re-elected) - then raise taxes anyway! It works almost every time.
Interesting stuff. But I think in the second to last paragraph, you meant to say the checkbook "isn't" unlimited, as you said earlier.
9:15,
Thanks for catching that!
Politicians who lie about not raising taxes usually don't raise taxes to benefit public safety (more cops/firefighters).
Speaking of calls that don't really require anything major in the way of equipment, what percentage of dispatches are for lift assists? How about ground-level falls?
I find that sometimes a smaller vehicle can have some advantages.
Glad to see some new ideas finally surfacing at LFR since you became PS Director. Keep up the good work. Your innovation is valuable whether the rank and file recognize it or not.
10:06,
Wasn't really my idea. Several departments around the country have been doing this, and many people at LF&R were aware of the concept. All I really need to do is provide a little encouragement for outside-the-box thinking and a bit of willingness to take reasonable risks when the cost is small and the fallback position easy.
9:49,
221 lift assists in 2011. I haven't run that for 2012, but I suspect it's lower. The staffed facilities are not calling us much anymore since there is now a fee involved. Can't tell you about ground level falls. We probably could come up with that number, but I'd have to divert someone from another task to search it out.
This will work out great until the small truck is sent and the big truck is needed and someone unfortunately dies. It will instantly go back to the big trucks on all runs.
I have a close relative that has Epilepsy plus she is a large woman. She has had several falls during seizures and her husband has had to call 911 for help. She hated it when an incident happened and the firetruck and ambulance both showed up but what can she do? These seizures can result in life threatening situations.
I have bad knees and hip joints and luckily I have NOT had a fall (yet?) that required me calling 911 but it will happen someday. It is sort of ironic that 49 years ago, when I was wrestling at heavyweight for my team, my favorite escape move was a quick standup. By quick I mean less than a second. Fast forward to today and it takes me three minutes just to roll out of bed. And my bed isn't even on the floor.
Gun Nut
My concern about the LJS article was they gave quite a lot of space to the Captain (forgot his name) who didn't have much of an open mind for new ideas and innovation.
I am sure there are plenty of examples where a crew arrived at a call and if they had been in the small truck, they wouldn't have had the best tool for the job.
However I would be willing to bet that in every single instance, the crew that arrives in the small truck is fully capable and outfitted to stabilize the person or situation during the 7 - 12 minutes that it takes to dispatch a full truck with the necessary ladder, fetzer valve or whatever.
Despite his best efforts, the Captain wasn't able to convince me that there is risk of patient safety. Just a risk that I'll have to wait an additional 10 min before they get me out of that stuck elevator, or my cat out of the tree. (you guys still do that right?)
Director - while I applaud your modesty and giving other people or departments credit for coming up with great ideas - let me at least say that you deserve credit and thanks for fostering the environment to explore and think innovatively.
There have been more than a couple articles here and elsewhere describing that type of innovation - the retrofitting of an older chassis saving some significant $$. This alternative vehicle, some of the innovations you detail with technology, mapping, smartphones etc.
You don't have to come up with the ideas - but allowing them to be considered, tested and implemented is a freedom we don't always see - especially among lifelong veterans of any job.
The mark of a strong leader in part is knowing when to get out of the way and let others spread their wings.
It's much appreciated.
Isn't this deja vue all over again? I seem to remember this same proposal maybe thirty years ago. And it probaby was proposed thirty years before that. This may not be fair, but my guess is that firefighters don't become firefighters so they can drive pickup trucks. Those massive shiny fire trucks symbolize something that's hard to give up. How many photos of firefighters do you see without a fire truck in the background?
Firefighters and paramedics use tools to do their jobs. Maybe we can just consider the ARV another tool in the bag of budget management. If you will...a tourniquet which can help stop the bleeding of tax dollars from a once bloated budget. Bravo to you, Mr. Casady
Clean....Firefighter's aren't driving pick ups to fires. Paramedics are driving them to monor medicals. There will always be a shiny firetruck around for you to stand in front of when they are taking your picture. Don't worry.
great job on seeing this through and applying common sense to this proffession. Now its time to stop paying people to sleep and get rid of those 24 hour shifts. It wont be easy but there is plenty of research out there that supports it as a finacial benifit for the city and a health benifit for firefighters.
To Anon May 31, 2013 at 9:48 AM no the shiny pickup crew is the crew from the shiny engine or truck company not just a paramedic.
To the rest of you, I believe what is not realized here is that the people that have decided to make a carear out of being in the fire service, and have trained long and hard for this service, who often seek training outside of the department because the department can not afford to train us due to the limited budget realize that the number of times that we will be actually called on to risk everything to save some one is limited. It is limited here it is limited in Houston TX it is limited in most cities. All that we are asking is you don't make us bring a knife to a gun fight because that some one may be going to work for may be some one you love but I guarantee it is some one we love.
Since my letter to the editor was published on Wednesday I have had the great opportunity to discuss this issue with several who have worked as a paramedic and they gave me great historical perspective to this issue. ARV’s work, they improve coverage and response times to critical calls. The key is how you staff and deploy ARV’s. The current trial run with four person crews on 24 hour shifts is in efficient. The most efficient way to deploy ARV’s is to use fuel efficient mid-sized SUVs staffed on 8 hour shifts with two person crews, from dynamic locations. This would completely revamp how LFR works currently and the union hates it. No more hanging out at the fire station 2.3 days a week and being able to be sleep and watch movies on the job. These ARV’s would move around the city as needed to be strategically positioned for the fastest response possible. This means working out of a mid-sized SUV (like a LEO). Response times would improve across the board which is good for everyone except those who have to be subject to working out of a SUV.
Mike,
One step at a time.
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