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Fire Department First on Scene After 911 Call

The quicker help arrives, the better the chances for victim’s survival

Time is of the utmost importance when there is a medical emergency, be it a fall, a broken limb or a suspected heart attack. Most people’s initial – and correct – reaction in such a situation is to call 911. But most people are surprised when a fire truck, not an ambulance, arrives on the scene first.

“The quicker help can get on the scene and start rendering aid, the better the chances for a victim to survive.”

When a 911 call comes into the police department’s dispatch center and the caller indicates there has been a event that requires medical attention, the call is immediately switched to the fire department’s communications center. The dispatchers in the center all are emergency medical technicians (EMTs), so they are familiar with medical crises and how to deal with them. When they answer the call, they ask for basic information: name, location, what is happening. While getting this information, the dispatcher enters the address into the system and dispatches the closest fire-engine unit.

If someone calls with a sprained ankle or other non-life-threatening complaint, an ambulance will be sent. However, if it is a high-level incident, such as a cardiac event, the dispatcher will send out a first responder. Fire and ladder trucks can get to the scene of an emergency faster and quicker than some ambulances. The quicker help can get on the scene and start rendering aid, the better the chances for a victim to survive.

Many fire engines are capable of providing everything from fire coverage to first aid. Everyone on the fire truck is at least an EMT, and most of the time there is also a paramedic on the truck. Many fire department vehicles carry automatic external defibrillators (AEDs) and basic life-support equipment, including oxygen. Some carry advanced life-support equipment and drugs such as nitroglycerine, lanocaine and morphine. However, the engines and ladder units are not able to transport victims to a hospital; only an ambulance can do that.

The EMTs start treating the stricken person as soon as they arrive. They attempt to get the patient’s history and do an assessment of their condition. They relay this information to the ambulance, which is usually en route as the EMTs begin to work. The EMTs work to perform critical interventions to stabilize the patient and stop further damage. Care is always transferred up, moving from EMT to EMTP to RN to doctor.

In the ambulance, patients who might be having a heart attack are hooked to a device that does advance cardiac monitoring. This sends information ahead to the hospital so the emergency room staff can prepare for the patient’s arrival. If the patient is conscious, they can indicate which hospital they prefer to go to. In other cases, the EMTs have to make the call about where to take the patient. Every choice is made in the best interest of the patient. If someone refuses treatment, the EMTs do not force them to comply, although they will attempt to convince the patient to at least allow an examination.

Heart-attack victims may be taken right to the cath lab instead of making a stop at the emergency room, since time is of the essence when someone experiences a cardiac event. Bypassing the emergency room and going right to the cath lab saves several steps – and several lives.

By Tanya J. Tyler, Associate Editor

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