Thursday, August 27, 2015

Waiting for Paid Firefighters vs Volunteer Firefighters and the LMRFD SOP, Standard Operating Procedures

I've asked the LMRFD for a couple documents so we can be better informed at the next fire board meeting.

One is the cost for training, insurance, etc for both paid and volunteer firefighters. The other is the SOP or Standard Operating Procedures for the FMRFD firefighters, and EMS.

I hope to have these documents so we have a better understanding of how our money is being spent, and how it should be spent.

Jay

I received the training costs for firefighter training at MCC not what NACFD and LMRFD paid to train our current volunteers.

Careful, you ask a simple question, and get a political answer.

Wednesday, August 26, 2015

The Perfect Storm... A Fire Call, Then Minutes Later A Heart Attack EMS Call

The Perfect Storm for Dolan was a Fire Call and EMS Call at One Time. We lucked out, This Time, but maybe not the next.

We don't have an effective EMS system with the same two firefighters responsible for fire calls and EMS calls.

Monday August 24th around 7:00 PM (times appropriate) there was a call about a car fire. Engine 411 from Dolan headed South on Pierce Ferry Rd from Dolan. The neighbor who called said they could see 3-4' flames.

I was going to the store in town (Dolan) and could see the fire engine heading my way. I pulled over to watch them go by, and was surprised they were only going 46 mph at they passed 9th street. (I buy and sell police radars on eBay)

I know it's a big fire truck, but 46 mph on the way to a fire.

Shortly after the car fire call, dispatch got a heart attack call off 20th st, and paged the LMRFD ambulance. They were told the firefighters were tied up on the car fire, to send BLS (basic life support) from Meadview.

Meadview Rescue 438 was paged, and AMR ambulance from Kingman, and a medical helicopter from Vegas were called.

Wanting to see how the call played out, after the store, I went to the LDS church  just out of Dolan to watch.

After Engine 411 told dispatch they couldn't locate the car fire, I thought I would see the fire engine running code (lights and siren) back to Dolan Springs to pick up the ambulance and respond to the heart attack call that was the opposite direction.

Engine 411 slowly drove through town to the fire station, parked their fire truck. Picked up the LMRFD ambulance. On it's way to the heart attack call, it was going 48 MPH when they passed me at the LDS church. Again no lights and siren on a heart attack call?

It sounded like we lucked out this time with the fire and heart attack, but what about next time we have two calls? In both fire response and EMS response, time is either property or life, and seconds matter.

These were serious calls, and in both the emergency vehicles were going slower than the normal traffic. To fast isn't good, but 46-48 mph on emergency calls?


Thank You for going to the NACFD meeting


I just wanted to thank everyone for going to the NACFD meeting. I couldn't make it but sent an email to Jean Bishop and the NACFD board.

The upcoming LMRFD fire board meeting will be important so we need to all go. The meeting is September 21st in Meadview, and I'll post a reminder a few days before the meeting.

If anyone needs a ride, let me know. We have room for 4 people.

This is a link to the Kingman Miner Article on NACFD Meeting

Again, thank you all for coming to the meeting.
Jay

It's About Educating People Blog Has 1000 Views from 6 Nations

This blog is about educating local people so they can make an informed decision about what course our fire district should take, or help people from outside the area decide about visiting or moving to the Dolan Springs and Meadview area.

People from all over the world visit Dolan Springs, Meadview, and the Grand Canyon West.

People want to know about their safety, this blog has had over 1000 hits from seven countries in just 25 days.

My TripAdvisor post about the LMRFD EMS problems got an award for 270 hits in it's first week.

This is important to people from Dolan Springs, Meadview, and the world. Please share links to this blog so people can make informed decisions.


Monday, August 24, 2015

Meadview Read High Desert Dirt Blog

If you live in Meadview please read High Desert Dirt blog about the Meadview area.

Saturday, August 22, 2015

Train Local Young People as EMT's Invest in Dolan's Future it's Young People

We need to train local young people as EMT's? They don't need to be firefighters, we have far more EMS calls than fire calls.

There is very little as far as opportunities for young people in the Dolan Springs, Meadview, and White Hills area. Very few jobs, no training, and we lost any high school programs.

It cost $1366 plus books and travel expenses to train an EMT in Las Vegas, less if we did the training here. The training can be as short as two-weeks or can take a couple months to complete depending on the training days and location.

When I checked today there were 106 EMT jobs in Las Vegas. Some are as security guards, but many are working for EMS or physicians. We could make an agreement with young people that if we train them as EMT's, they volunteer for X years.

They could continue their training as a paramedic using student grants, loans, and out assistance. Again with the agreement they volunteer x years for the LMRFD EMS.

Once they complete their paramedic training and have a year or so of experience, they can go to Mohave Community College, and in two semesters, they're an RN. Not only an RN, because when most RN's get out of school, they have had very little patient contact.

These RN's would be experienced RN paramedics, capable of doing critical care transports making $50 -$75 an hour right out of school.

One of our young people may even surprise us, continue another 18-24 months of training to be a physicians assistant, or nurse practitioner, and come back to start the clinic we need.

There must be some young people in the area who want to be a EMT, paramedic, nurse, or doctor. We need to invest in them, they live here, or grew up here.

Dolan isn't culture shock to them. Outsiders don't get it, what do you mean they haul water?

HUD even has a program where firefighters get 50% off their home, so young people could be homeowners too.

Law enforcement officers, pre-Kindergarten through 12th grade teachers, firefighters and emergency medical technicians can contribute to community revitalization while becoming homeowners through HUD's Good Neighbor Next Door Sales Program. HUD offers a substantial incentive in the form of a discount of 50% from the list price of the home. In return you must commit to live in the property for 36 months as your sole residence.


Thursday, August 20, 2015

Couldn't Make it to the NACFD Board Meeting COPY of Email I Sent to NACFD for Tonights Meeting

NACFD Board
cc Jean Bishop

Please read this at the meeting tonight or cc the other NACFD board members. We couldn't make it to the meeting.

Jay Fleming
Dolan Springs
Former firefighter, paramedic

Not everyone in Dolan Springs and the LMRFD wants the consolidation with NACFD. Chief Moore and Mr Flynn have done a great job of fixing our money problems, but they're busy people.

They have failed to pursue volunteers, rather heading toward consolidation. I asked at several fire board meetings about volunteers, the answer was no until this Monday when 50 people showed up at the fire board meeting. Then they said they weren't opposed to volunteers.

Without volunteers the LMRFD can't meet the NFPA guidelines of 4 people on both fire and EMS calls. With one sometimes two firefighters on a call it violates the guidelines, if a firefighter or citizens was injured or killed, OSHA fines could reach $50,000 like those for an Oregon fire district.

A two man ambulance crew can't do CPR while moving or loading a patient. You need one person to drive, one to do CPR, and one to watch the heart monitor, and push medications. Two people can not provide the standard of care for a cardiac arrest victim.

A two man fire crew can't do rescues on initial attack, without violating OSHA and NFPA guidelines. Chief Moore and Mr Flynn told us at the LMRFD meeting a firefighter could enter on initial attack for a rescue, and I disagree according to NFPA 1710 NPFA 450 Guidelines for Emergency Medical Services.

When the ambulance is out of town, Dolan is without EMS or fire protection for hours. Check out staffing lawsuits at FireLawBlog.com It's only a matter of time.

Without volunteers the LMRFD can't provide basic fire protection, or emergency medical services to the area.

E. Jay Fleming
Dolan Springs, AZ

NACFD Board Meeting Tonight Aug 20th 2015 Against Consolidation

NACFD Board Meeting Aug 20th 2015 2045 Northern Ave Kingman at 6PM.

If you don't agree with consolidation please show up and tell the NACFD board.

If you can't make the meeting call or email
Jean Bishop
Mohave County Supervisor District 4
jean.bishop@mohavecounty.us
main: 928-753-8618

Jay

No One At the Fire Board Meeting Knew Where an AED Was

Really, no one knew where an AED was?

If the LMRFD consolidates it will just add more government. When people at the last fire meeting asked about volunteers, we were told they had looked. Everyone at the meeting said they didn't look in Dolan. 

I understand the LMRFD was broke, but Mr Flynn said it costs $165,000 to add a firefighter. CORRECTION It costs$165,000 to fund a shift of three firefighters.

The LMRFD is big 144 sm's, the LMRFD nonprofit ambulance covers over 2000 sm's. Without volunteers there is no way to cover the 144 sm fire district for fires, and certainly no way to cover the 2000 ms ambulance area.

We need local control. When I asked where the AED's (Automatic External Defibrillator)  were in the Dolan Area, no one knew. There might be one at the library. The current management donated 6 AED's to Kingman schools. They were only valued at $200 for trade in, but we could have used them in Dolan.

New AED's cost $1200 to $5000, it costs $100 to $300 each to replace batteries and pads. It still costs $1200 up for AEDs, and we don't have $7000 to buy new AEDs.

Dolan depends on tourist. We should have AEDs at the Community Center, gas station, both civic clubs, and both restaurants.

You need to apply an AED within 6 minutes. If it's not on the wall ready to go, chance of survival is slim. By the time you call 911, and they dispatch someone it usually takes 3 minutes or so. You do the math, you only have 6 minutes.

The worst review Dolan Springs can get is, my husband died 2 blocks from the fire station in Dolan Springs because no one knew where an AED was.

No one in Kingman is going to care about the little things in Dolan, only people from Dolan know what we need.



NOT RIGHT Firefighters Don't Live In The Fire District

PLEASE SHARE

This should make people mad. I hope it does, this is why we need local control. First 6 AED's get given to Kingman, now we find not one paid firefighter even lives in the fire district.

We learned at the fire board meeting that paid fire fighters don't have to live in the fire district, That is not right.

Volunteers must live in Dolan Springs or Meadview, why not paid firefighters. Resident deputies are required to live in the area they serve.

Why should they care, this isn't their community. The property taxes they pay go to another fire district, or pay no property taxes to any fire district.

When they don't live in Dolan or Meadview the $500,000 in salary goes right to Kingman, the money isn't spent locally at D&D, Vinny's, the Dollar Store, and restaurants.

The worst thing is they know when they're out on a call and Dolan or Meadview are unprotected, their families have EMS and fire protection, because they live in Kingman.

All we heard from the firefighter who posted was about him. If he cared about Dolan and Meadview, he would live where here and works and pay tax to support the fire district.

I wondered why LMRFD never paged extra firefighters when the station was empty. Now we know, our paid firefighters live too far away. Why should they care?

Like the firefighter who posted, nothing was about Dolan or the people here, only about what he needed, and fires, nothing about EMS. Do a search for "firefighters don't fight fires"

All it would take is a major weather event, and the majority of our firefighters could be unable to make it to Dolan or Meadview to help us. There are washes between Kingman and Dolan that could close US93. A large fire like we just had in Mohave Valley could close roads leaving us without firefighters.

Are there not young guys like the guy at the meeting who wanted to volunteer, who need a job that pays $76,000 a year? If you work for the LMRFD you should be required to live in the fire district. This is why we need local control.






Tuesday, August 18, 2015

What You Need To Know About Two Man Response

A firefighter replied to my post, Consolidation Between LMRFD and NACFD Needs to be Sent To A Vote of the People.

I hoped he would talk about needing volunteers so he could actually do CPR while moving or loading a patient. Or that like every NFPA and OSHA safety standard says, more than two firefightrs are needed on a fire for the safety of citizens and firefighters. He only talked about himself.

Then I noticed that the firefighter Mike Pettway was a Chief in the LMRFD before we went broke. He was part of the problem, so taking advice on the LMRFD spending from him may not be wise.

He said we should consolidate because "he can't handleworking at lmrfd if it continues the way its going".

That he needed more pay, I agree. He said he needed better benefits, I agree. I also see he started as a volunteer firefighter, now doesn't want others to have the same chance to serve their community.

He feels fustrated not being able to respond to fires, people in Dolan feel fustrated not having anyone to respond to EMS calls.

Calling 911 to be told a firefighter will be there in half hour or so from Meadview. Then canceling the fire department, and driving your husband to Kingman with chest pain, hoping you make it.

He said he wanted to save peoples homes, I'm sure he would love to save people's homes. Truth is, with today's building material, ignition to a fully involved structure fire is 10-12 minutes. It doesn't matter if we had 100 firefighters at the fire station, it doesn't change, you will not save a structure fire in a rural area.  If so, show me one.

He said he can't respond without a tone out. It's not that people don't call when their home is on fire. On some calls dispatch can take over 2 minutes (2:20) to tone you out, it can take E411 over 5 minutes to get in route (5:25). So with almost 8 minutes to get out the doors of the fire station, a home is fully involved in 10-12 minutes, that combined with long responses is why they can't save homes.  It's not their fault.

I DIDN'T HEAR HIM SAY ANYTHING ABOUT EMS, or SAVING PEOPLE
I didn't hear him say anything about EMS calls or saving people, only about fire calls. That's one problem, firefighters are required to be an EMT or paramedic.

He didn't say how without 3-4 people he can't effectively do CPR when moving, loading or transporting a patient while CPR is in progress, and a volunteer could make the difference. Each time CPR is stopped the chance of survival drops.

It's great to have firefighters, but we only had 37 fires in the last 34 months, but we had 1344 EMS calls. We need volunteer EMT's and paramedics who are not required to be firefighters.

At the meeting when I ask the chief where an AED, an Automatic External Defibrillator was in the area, he didn't know. Worse yet, no one in the 50-60 people there knew for sure where an AED was.

An AED or Automatic External Defibrillator is used to correct life threatening heart rythems. If used within minutes of a witnessed sudden cardiac arrest, the chance of survival is very good.

When the firefighters left on a call during that meeting, if someone would have had a sudden cardiac arrest right there, if we couldn't find the AED and apply it within 6 minutes, their chance of survival drops to near zero.

Our EMS system is broken. No other fire district in Arizona has firefighters who close the only fire station in town, and take the ambulance 50 miles outside the fire district.

As with fire calls the National Fire Protection Association recommends having four people on EMS calls.

If the patient needs CPR you need three people to transport them with any chance of survival. One to do CPR, two to load the patient with little to no interruption in CPR.

In route to the hospital you need one EMT to drive, one EMT needs to operate the heart monitor and push medications, and one needs to do CPR switching with the other EMT as you can't do CPR for 40 minutes..

GUIDELINES FOR EMS
NFPA 450, Guide for Emergency Medical Services and Systems, 2009 edition, Chapter 5, Section 5.5.2.3.4: “Most experts agree that four responders [at least two trained in advanced cardiac life support (ACLS) and two trained in basic life support (BLS)] are the minimum required to provide ACLS to cardiac arrest victims.”


WHAT CAN WE DO
We need to teach everyone CPR, especially all employees in local stores. We need AED's at the community center, Vinny's, both service clubs, and both restaurants. You have 6 minutes to locate, hookup the pads, operate the defibrillator. King County Washington has a 62% sudden cardiac arrest save rate, most of the nation is 8-10%.

The worst review Dolan Springs could get is, "my husband died in Dolan Springs, 2 blocks from the fire station". The Dolan Springs business area is small. There's no reason we can't give visitors a chance of survival.

WHY NOT TO CONSOLIDATE
Chief Moore and Mr Flynn have done a great job of getting the LMRFD back on track. Hopefully we learned our lesson, and citizens will attend more fire board meetings, and watch over things better.

The main reason not to consolidate is we give up too much control of the fire district and our EMS to people outside the area. Giving up control to people (except one fire board member) who cover such a large area, and a chief who is very busy, we lose control of many decisions.

At the August 15th 2013 Fire Board meeting Chief Moore asked the board to donate 6 AED's to Kingman High Schools. They had a trade in value of $200 each, my guess at the original cost is between $2000 and $5000 each.

We need a local fire board who knows the area, and that AED's would have been better used at several business in Dolan Springs. The cost for new batteries and pads for most AED's is $75 to $300 each, much better than the original $2000+ cost each, or the $1200 to $1800 each for new units.

We could have placed older but usable units in businesses for between $450 and $1800 less, or about the cost on one new AED.

When the NFPA 1710 One-In-One-Out rule came out it was called
"The most important advance in firefighter safety in decades" they also said it's
"a regulation that goes a long way in making one of the most dangerous professions safer" Why would any fire district ignore all the firefighter lives it took to learn that lesson?

If anything is not correct, please let me know. Some people have said there's bad information going around.






Monday, August 17, 2015

Big Turnout At Fire Board Meeting

Thank you to the community for showing up in such numbers at the fire board meeting. There must have been 50 people or so at the meeting.

This is important for Dolan Springs, Meadview, White Hills, and everyone who travels US-93.

A question was asked if only two fire fighters were at a fire could they go in and rescue someone. The Chief and Me Flynn said yes.

Here is a fire department that didn't follow the tow-in-two out rule, it cost lives and $50,000
http://www.firehouse.com/news/10538843/osha-fines-ore-fire-department-50k-in-fire-that-claimed-three-firefighters

Question
Why does it costs $166,455 to fund one firefighter, if the salary and benefits for one firefighter is $55,485 how does it cost an additional $110,970?

CORRECTION
The $165,455 funds 3 fire fighters. Funding one position is funding 3 firefighters.

It didn't sound right to one person at the meeting and he was right. We need clarification on what it costs to fund one firefighter.


Saving Structures
Someone referred to the fact that the LMRFD doesn't save the primary structure often.

That's not fair to the firefighters. With today's building materials a structure fire ignition to fully involved is about 10-12 minutes.

Jay

Sunday, August 16, 2015

Fire Board Meeting Aug 17th

There will be a meeting of the LMRFD Fire Board meeting August 17th at the LMRFD station at 16126 Pierce Ferry Rd at 1:30 PM.

If you live in the fire district this effects you, if you live in the area served by the LMRFD it effects you too.


Fire Staffing is a Need, not a Want

This is an article from Fire Engineering Magazine about how fire department staffing is a Need, not a Want. Please read this article.

As a firefighter I'm more protective of the lives of firefighters than most people. Until you lose someone you worked with, you can't really understand.

The last paragraph of this article sums it up, it says "We cannot continue to ask our fire departments to protect our communities with inadequate resources. We will continue to see the number of injuries and fatalities of firefighters and civilians increase in future years until we get the staffing we need, not just want"

FIRE DEPARTMENT STAFFING: A NEED, NOT A WANT
08/01/2009
http://www.fireengineering.com/articles/print/volume-162/issue-8/features/fire-department-staffing-a-need-not-a-want.html

BY KEVIN “WILLY” WILSON
The saying “Do more with less” seems to have been the unofficial motto of the fire service for more than 200 years. The fire service has continued to be a very talented and resourceful group of individuals. No problem is too big or too small for us to solve; if for some reason we get stumped, we use our resources to find the answer. However, one serious dilemma we face regularly is acquiring adequate staffing to do our job safely and protect our community. When the public calls for our help, we run to their aid, but who will run to our aid when we need help?

We can call an additional alarm or rely more on mutual aid, but only if the companies are available. Will they be readily available when we need them? There will come a time when we will be able to do only so much before our resources are depleted. From fires to EMS calls and everything in between, no matter how you look at it, the fire service is the last line of defense when it comes to a community in an emergency situation. So the mentality of doing more with less is not appropriate in our job.

When fewer than four firefighters arrive on a fire scene, the first company is faced with a critical decision. Does it initiate an interior attack without adequate staffing and unnecessarily risk firefighters’ safety, or does it delay the interior fire attack until additional resources arrive, causing further fire damage? Neither response is appropriate.

The U.S. Occupational Safety and Health Administration (OSHA) two-in/two-out rule (CFR 29 1910.134(g)(4)1-3) is also cited in National Fire Protection Association (NFPA) 1500, Standard on Fire Service Occupational Safety and Health Program, 2007 edition, and in NFPA 1410,Standard on Training for Initial Emergency Scene Operations, 2005 edition.
The 2007 edition of NFPA 1500, page 24, section 8.5.7, states: “In the initial stages of an incident where only one crew is operating in the hazardous area at a working structure fire, a minimum of four individuals shall be required, consisting of two individuals working as a crew in the hazardous area and two individuals present outside this hazardous area available for assistance or rescue at emergency operations where entry into the danger area is required.”

Section 8.5.8 states: “The standby members shall be responsible for maintaining a constant awareness of the number and identity of members operating in the hazardous area, their location and function, and time of entry.”

Section 8.5.9 states: “The standby members shall remain in radio, visual, voice, or signal line communication with the crew.

The NFPA and the National Institute for Occupational Safety and Health (NIOSH) have reported that fire departments across the nation lack adequate staffing, which has contributed to millions of dollars in time-lost injuries, thousands of on-the-job injuries, and dozens of line-of-duty deaths (LODDs) each year.

Unfortunately, several firefighters will pay with their lives before the staffing issue will be brought up again for serious discussion.

In 1990, the Providence (RI) Fire Department conducted a study that showed that the only nationally recognized staffing standard at that time was from the NFPA.1 It recommended a minimum of four firefighters responding on or with each apparatus. The NFPA reported at that time a 71-percent decrease in time lost because of injury using four-person staffing when compared with three-person staffing. Even though the study is more than 18 years old, it shows that the staffing level today throughout the United States is an issue that still has not been resolved.

Labor boards and at least one court have found that a minimum staffing agreement or ordinance is reasonable for ensuring the protection of the public and personnel. However, many fire departments in the past made no provisions in their staffing rosters for covering scheduled absences; fire companies were allowed to run shorthanded, seriously compromising their operating efficiency and firefighter safety.2

My hope is that the information presented in this article will enable fire service members, community members, and government officials to better understand why adequate fire service staffing is a need, not a want.

WHY MORE STAFFING?
Residential and business communities continue to grow at a rate that makes it impossible for many departments to serve those additional needs. We cannot continue to do more with less. We need enough firefighters to do the job in a safe and appropriate manner.
NFPA President James Shannon cited in testimony before the U.S. House of Representatives that fire departments have insufficient staffing on responding fire apparatus to safely and effectively fight a fire inside a building in accordance with NFPA 1710, Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments, 2004 edition, and NFPA 1720, Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Volunteer Fire Departments, 2004 edition.3 He pointed out also that at least 65 percent of our nation’s cities and towns don’t have enough fire stations to meet the widely recognized Insurance Services Office (ISO) response time guidelines. Shannon told the representatives that that was the reason he supports the Staffing for Adequate Fire and Emergency Response (SAFER) Act of 2003. Information on SAFER is at www.firegrantsupport.com/.

MINIMAL RECOMMENDED STAFFING LEVELS
Following are minimal staffing levels recommended by standards and fire service and related organizations.

NFPA recommendations are based on data from actual fires and in-depth fire simulations wherein fire company effectiveness was critically and objectively evaluated. These studies indicate significant reductions in performance and safety when crews responded with fewer members than recommended.

NFPA 450, Guide for Emergency Medical Services and Systems, 2009 edition, Chapter 5, Section 5.5.2.3.4: “Most experts agree that four responders [at least two trained in advanced cardiac life support (ACLS) and two trained in basic life support (BLS)] are the minimum required to provide ACLS to cardiac arrest victims.” As a side note, a medical call requires just as many personnel as, if not more than, a fire call, so if we can meet the medical need, why can’t we meet the fire need?

NFPA 1710: Four on-duty personnel for fire companies whose primary functions are to pump and deliver water and perform basic firefighting at fires, including search and rescue.
Five or six on-duty members in jurisdictions with tactical hazards, high-hazard occupancies, high-incident frequencies, geographical restrictions, or other pertinent factors as identified by the authority having jurisdiction (AHJ).

Four on-duty personnel for fire companies whose primary functions are to perform the variety of services associated with truck work, such as forcible entry, ventilation, search and rescue, aerial operations for water delivery and rescue, utility control, illumination, overhaul, and salvage work—ladder or truck companies. Five or six on-duty personnel for these companies in jurisdictions with tactical hazards, high-hazard occupancies, high-incident frequencies, geographical restrictions, or other pertinent factors as identified by the AHJ.

For ALS emergency responses: two members trained at the emergency medical technician-paramedic level and two members trained at the emergency medical technician-basic level arriving on-scene within the established response time.

•NFPA 1720(volunteer departments): “The fire department shall identify minimum staffing requirements to ensure that a sufficient number of members are available to operate safely and effectively …. Upon assembling the necessary resources at the emergency scene, the fire department should have the capability to safely commence an initial attack within two minutes 90 percent of the time.”

The complete NFPA 1710 and 1720, 2004 edition, standards are at nfpa.org/categoryList.asp?categoryID=999&itemID=24345&cookie%5Ftest=1/.

•NFPA Fire Protection Handbook, 19th edition (2003):
Fire department emergency medical service transports need additional personnel to maintain basic fire company strength. Some smaller communities may have a relevantly high staffing ratio per population protected because of the need for sufficient on-duty personnel for effective initial attack and rescue operations. A fire department in a large city may operate one engine company per 15,000 to 20,000 population and still have a large number of well-distributed fire companies, whereas two engine companies cannot properly protect a city of 30,000.

In general, each engine company should have a minimum of four firefighters on duty, including an officer. It would seem inappropriate to dispatch an engine company to a fire if the crew could not start firefighting and rescue operations because of safety concerns.
An increasing number of fire departments, in recent years, have established minimum staffing levels for each fire company or each duty shift. Many fire departments have established policies that state engine or ladder companies will not operate with fewer than four firefighters, including an officer, on duty. In rare cases, the minimum is five persons on duty per company because of the workload and the population and values protected per company. (2)

• NFPA Fire Protection Handbook, 20th edition (2008)4: recommends the following minimum numbers of firefighters/officers to do the job safely. If this sounds like a lot, keep in mind that firefighters will always work in pairs, if not more, to complete the several tasks to get the job done as safely as possible. This includes such tasks as water supply, search and rescue, ventilation, rapid intervention, and so on.

Between 19 and 23 personnel typically constitute the first-alarm assignment to a confirmed single-family dwelling fire, as observed by evaluation teams.
Not fewer than 24 firefighters and two chief officers, one or more safety officers, and a rapid intervention team(s) should respond to high-hazard occupancies (schools, hospitals, nursing homes, explosive plants, refineries, high-rise buildings, and other high-life hazard or occupancies with large fire potential).

Not fewer than 16 firefighters, one chief officer, a safety officer, and a rapid intervention team should respond to medium-hazard occupancies (apartments, offices, mercantile, and industrial occupancies not normally requiring extensive rescue or firefighting forces).
Not fewer than 14 firefighters, one chief officer, a safety officer, and a rapid intervention team should respond to low-hazard occupancies (one-, two-, or three-family dwellings and scattered small businesses and industrial occupancies).

At least 12 firefighters, one chief officer, a safety officer, and a rapid intervention team shall respond to rural alarms (scattered dwellings, small businesses, and a farm building).
• U.S. Fire Administration (USFA): recommends that a minimum of four firefighters respond on or with each apparatus.5

• The International Association of Fire Chiefs (IAFC): advocates a minimum of five persons on engine and ladder companies. Noting that the reduction of members per unit and that the number of units has reached dangerously low levels, the IAFC says it would be “inappropriate” to accept or support further reductions.6

• The International City Management Association (ICMA): states in “Managing Fire Services” that at least four and often eight or more firefighters, each under the supervision of an officer, “should respond to fire suppression operations.” Further, it says, “If about 16 trained firefighters are not operating at the scene of a working fire within the critical time period, then dollar loss and injuries are significantly increased, as is fire spread.” It has found five-person companies 100-percent effective, four-person companies 65-percent effective, and three-person companies 38-percent effective.7

• National Institute for Occupational Safety and Health (NIOSH) LODD Reports: almost every NIOSH LODD report recommends to “provide adequate firefighter staffing to ensure safe operating conditions.”

• The International Association of Fire Fighters (IAFF): views inadequate staffing and crew size as contributing factors to LODDs and advocates maintaining adequate staffing as proposed in NFPA 1500, NFPA 1710, and NFPA 1720; the NFPA Fire Protection Handbook, 18th edition (1997), Section 10/Chapter 1 (1-34); and OSHA 29 CFR 1910.134 (two-in/two-out).8

CONSEQUENCES OF INADEQUATE STAFFING
Fireground effectiveness may be compromised when staffing falls below four firefighters per company. Tests conducted with the Houston (TX) Fire Department indicated that staffing below a crew size of four can overtax the operating force and lead to higher losses. Jurisdictions with minimum staffing levels may have to take units out of service if they do not have the funds to support the additional personnel overtime. (2)

The District Chiefs’ Technical Advisory Committee (DCTAC) conducted a study of the Houston Fire Department, which determined that fire apparatus staffing is an even greater citizen safety issue than a firefighter safety matter.9 The report termed the understaffing situation a “crisis situation that demands immediate intervention.” Decreasing the number of firefighters without eliminating any of the tasks fire departments are to accomplish causes the department to delay some of the required tasks or to try to perform all tasks unsafely with inadequate staff, according to the study.

The study also noted the following:
“Firefighters working in understaffed environments are too often expected to perform beyond their capabilities.”

Inadequate staffing creates “a cumulative effect” caused by combined delays and lost functions of crews, resulting “in an even greater loss of overall effectiveness.”

Understaffing increases physiological stress on firefighters, as they try to compensate.
Another effect of understaffing is that “fire companies with serious staff reduction generally are limited to using small hose streams until additional help arrives, which may adversely affect containment of even a small fire and conducting effective rescue operations.” (4)

Over the past three decades, fire department response has expanded to include emergency medical services, terrorism response, hazardous materials response and mitigation, natural disaster response, specialized rescue, and responses to other community needs. Fire departments need adequate firefighting resources to be able to design an acceptable level of resource deployment based on risks and service commitment and to continually evaluate emergency response systems, which are crucial to enhancing firefighter operational safety and occupational health and reducing civilian fire fatalities.10

In 2000, Detroit, Michigan, fire officials reorganized the city’s fire department and sought to resolve problems, including a shortage of firefighters. At least 21 people had died during the preceding four years when fire trucks sent to their rescue didn’t work or the closest stations were temporarily closed. Their daily staffing average was well below the number needed to meet the minimum national standard of four firefighters on each truck.

Staffing levels were a key element in two 1998 fires in which three children died; the fire companies nearest to those fires had been closed because of firefighter shortfalls.
The fire department was forced to close fire companies on 61 days that year because of low staffing.”11 As of May 2009, the Detroit News reported that nearly 300 layoffs would occur in the city government and that nearly 500 positions that were then open would not be filled. The article explained: “This is not the final step in the budget process, but a very significant step toward final approval. It will be interesting to see how many positions in the fire department will be lost or not filled. The Detroit Fire Department has been extremely busy with arson fires and abandoned building fires over the past several months.”

Almost nine years later, staffing issues are still unchanged. These stories are those we would like to see changed for the better, not the worse. At this rate, the trend will dig even lower when rock bottom is reached.

ACTIONS YOU CAN TAKE
When responding with an engine with only three persons on duty and on ladder trucks with only two persons, promptly back up such low levels of staffing with off-shift or call personnel or by multiple-alarm response to ensure adequate coverage. (2)

Apply for a SAFER grant and other grants that can be used to fund additional staffing.
Continually inform the community (citizens, fire chief, city council, and so on) of your concerns for civilian and firefighter safety that you are sworn to protect, so when a levy or bond is up for vote, you have a better chance of its passing. Provide them with the facts.
Use new technology. Staffing software and hardware can help with staffing problems. The Vista (CA) Fire Department stated in its 2006 annual report that it had entered into an agreement with a software development corporation for hardware, software, and support for a system that automates daily workforce staffing solutions to improve productivity, reduce the number of personnel needed to manage scheduling activities, and improve management’s ability to make and report on scheduling decisions.12

Use automatic and mutual aid. Work with your neighboring fire departments.
Search online. Search various search engines with key phrases such as “fire department staffing solutions” and “staffing solution within the fire service.”

Read articles/books. The “Advanced Fire Administration” student handbook, a joint project of the Federal Emergency Management Agency, the USFA, and the National Fire Academy, offers suggestions for using creativity in establishing staffing plans, including ”flattening the organization power base with a strong executive team and strong field-level staffing” by eliminating mid-level management positions in favor of direct delivery of services.13

Research magazine articles. A roundtable on budget cuts, for example, relates how other fire departments have responded to staffing issues.14 Another article describes how the first-arriving engine company fulfils the primary tasks of the initial attack. Even though this does not directly relate to resolving staffing issues, it may help you to be more prepared and resourceful.15 Still another article explains how to manage a fire scene with limited staffing; lessons learned are included.16

Look to the standards. NFPA 1500, 2002 edition, A.8.4.11, presented the following examples of how a fire department could deploy a team of four members initially at the scene of a structure fire, regardless of how the team members are assembled:
1. The team leader and one firefighter could advance a firefighting hoseline into the immediately dangerous to life and health (IDLH) atmosphere, and one firefighter and the pump operator become the standby members.

2. The team leader could designate the pump operator to be incident commander. The team leader and one firefighter enter the IDLH atmosphere, and one firefighter and the pump operator remain outside as the standby members.

3. Two firefighters could advance the hoseline in the IDLH atmosphere, and the team leader and pump operator remain outside as standby members.

Train. Attend Strategy and Tactics for Initial Company Officers (STICO) classes locally or at the National Fire Academy. Have your department do hands-on training evolutions to determine what works and what does not work. You won’t know if a drill will go according to plan until after it has taken place. Never give up; keep trying.

•••
I was taught early in my military career that if there is a problem, I should help to find the solution. The above information is presented to help resolve some of the staffing problems but not all of them. No one has all the answers. It may not be easy, but we have the resources, grants, and facts to aid us in this journey. It may take a little work and creative thinking, but I am confident that the solutions are there. We cannot continue to ask our fire departments to protect our communities with inadequate resources. We will continue to see the number of injuries and fatalities of firefighters and civilians increase in future years until we get the staffing we need, not just want.

References
1. Varone, J, Curtis, “Providence [RI] Fire Department Staffing Study Revisited. An applied research project submitted to the National Fire Academy as part of the Executive Fire Officer Program,” August 1995, http://www.usfa.dhs.gov/downloads/pdf/tr_95v.pdg/.
2. National Fire Protection Association (NFPA), Fire Protection Handbook, 2003, 19th Edition (1:7), Quincy, Mass.
3. Shannon, James, “NFPA president testifies in support of SAFER Act,” June 2003, www.nfpa.org/itemDetail.asp?categoryID=651&itemID=18999&URL=Research%20&%20Reports/Fact%20sheets/Homeland%20Security/NFPA%20resources/Testimony/.
4. NFPA, Fire Protection Handbook, 2008, 20th Edition, (2:12), Quincy, Mass.
5. USFA, FEMA, “Historical Overview,” June 2008, usfa.dhs.gov/fireservice/fatalities/statistics/history.shtm/.
6. International Association of Fire Chiefs, “IAFC 2005 Issues Assessment Survey,” December 2005, iafc.org/associations/4685/files/2005_ChallengesSurvey_Results.pdf/.
7. Compton, Dennis and John Granito, eds., “Managing Fire and Rescue Services,” 2nd Edition, International City Management Association, Municipal Management Series, 2002.
8. Moore-Merrell, Lori; Sue McDonald, Ainong Zhou, et al, “Contributing Factors to Firefighter Line-of-Duty Deaths in the United States,” September 2006, International Association of Fire Fighters, iaff.org/Tech/PDF/Contributing%20Factors%20to%20FF%20Line-of-Duty%20Death_IAFFand%20USFA.pdf/.
9. Houston (TX) Fire Department, The District Tactical Advisory Committee, “Staffing Report Averting a Crisis,” October 2001, monroefirefighters.org/Houstonstaffing.pdf/.
10. USFA, FEMA, “Study of Risk Management Program Development for the Fire Service,” December 2006, usfa.dhs.gov/fireservice/research/safety/EMS_response_study.shtm/.
11. Hurt, Charles and Melvin Claxton “Wilson pledges to fix staffing problems,” The Detroit News, Michigan, November 2000, detnews.com/specialreports/2000/firedept/tueswilson/tueswilson.htm/. “Detroit council to restore 19 EMS jobs,” Detroit News, May 2009, http://michiganfireservice.com/detroit-council-to-restore-19-ems-jobs/338/.
12. Vista (CA) Fire Department 2006 Annual Report. www.vistafiredepartment.com/documents/2006_annual_report.pdf/.
13. FEMA, USFA, National Fire Academy, “Advanced Fire Administration,” August 2002.
14. Fire Engineering, Roundtable, ”Budget Cuts,” April 2005.
15. Roden, Eric and Ray McCormack, “The single-handed engine company,” Fire Engineering, April 2005. See also Bryan, Peter and Pamela Pane, “Evaluating Fire Service Delivery,” Fire Engineering, April 2008.
16. Bonelli, Jim, “Doing the most with the least,” Fire Engineering, March 2006.
Additional References
Insurance Services Office, “Effective Fire Protection a National Concern,” 2004, www.iso.com/dloads/FireProtectionBrochure.pdf/.
Insurance Services Office, “Fire Suppression Rating Schedule (FSRS),” www.iso.com/index.php?option=com_content&task=view&id=699&Itemid=527/.
Insurance Service Office, “Public Protection Classification (PPC) Service,” www.iso.com/index.php?option=com_content&task=view&id=697&Itemid=526/.
Varone, J. Curtis, United States Fire Administration, Federal Emergency Management Agency, “Improving Fire Apparatus Life Span Projections in the Norfolk Department of Fire and Paramedical Services,” December 2006, usfa.dhs.gov/nfa/efop/applied_research/abstracts/tr_94cv.shtm/, fireengineering.com/news/newsArticleDisplay.html?id=157094/.
KEVIN “WILLY” WILSON is a firefighter/paramedic with Camas (WA) Fire & Rescue. His 14-plus years of firefighting experience include having served as a volunteer firefighter in Gladstone, Oregon, and with the Independent Hose Company in Frederick, Maryland; as a U.S. Navy shipboard firefighter (Damage Controlman) in Norfolk, Virginia, from 1993-1997; and as a U.S. Navy fire marshal/paramedic, Naval Support Facility Fire Department, in Maryland. He has been doing extensive firefighter safety research since 2002 and is a firefighter safety survival instructor for Clark County, Washington. He is a hazmat technician and ICC fire inspector I and II and is completing requirements for a B.S. in fire service administration through Western Oregon University.

Friday, August 14, 2015

Consolidation Between LMRFD and NACFD Needs to be Sent To A Vote of the People

The consolidation  of the the Lake Mohave Ranchos Fire District and the Northern Arizona Consolidated Fire District should be decided by a vote of the people it effects, those inside the LMRFD.

Many people come to the various community meetings, but many don't live in the fire district, and pay no property tax to support the LMRFD. It seems like were letting people from outside the fire district make our decisions.

I understand it effects those people, but if they want a say in how the fire district is ran, join the fire district.

People in Dolan Springs are different, but last I checked this is America and it's OK to be different. I don't want a fire board in Kingman that thinks Dolan is just tweakers and thieves.

Every time I ask the chief about volunteers, he tells me no one in Dolan will volunteer, then brings up background checks, and felonies, like everyone in Dolan is a felon and wouldn't pass a background check.

The people inside the fire district should decide if consolidating with the NACFD and letting outsiders make our decisions is going to be better for the district, or if keeping control and showing people a small fire district can work.

The LMRFD spends over $500,000.00 on personal costs, and volunteers cost too much?

The only people who have a stake in Dolan Springs are the people who live here. Any fiefighter who moves to Dolan Springs will most likley use us to gain experience, then move on to a bigger department, with more safety and higher pay.

Let the people in the fire district decide for themselves, by a vote of the people.

Wednesday, August 12, 2015

Why Would Any Paramedic Move to Dolan Springs to Work?

In another post the LMRFD asked me why a paramedic would want to volunteer in Dolans.

I'll do one better, I'll tell you why paramedics don't want to work here, why it takes months to find a paramedic willing to work in Dolan, and why volunteers are needed.

It's no wonder it's hard finding firefighter paramedics for the area. Who would want to move here as a firefighter? There's no advancement, nothing for their kids, we lost the high school.

With the response times for the ambulance, saving someone from sudden cardiac arrest doesn't happen here. You can't imagine how frustrating that is to a paramedic.

You have 6 minutes to use an AED Automatic External Defibrillator or have a paramedic arrive and use a difibrillator. After that 6 minutes, the chance of survival drops to near zero.

The last Saturday community meeting Vince was complaining about people not wanting to move to Dolan because we lost the high school. Why would a paramedic or anyone else with children want to move here?

No high school, when the paramedic would be on calls in Kingman, he would know his family was unprotected for medical emergencies, and fire until he returned.

40 years ago I did my firefighter training on a three story cement training tower. Have you seen the LMRFD training tower? It's that little white wood shack behind the fire station. I know, no money.....

So unless you live here what investment do you have in Dolan Springs. You were either born here, or moved here because you're retired, and property is cheap.

When someone is seeking a firefighting job for the fire district look up Dolan Spring AZ in City Data, the heading is, "Don't Go Here", "Dolan Springs is nothing but retirees, bums, thieves, druggies, escapees from who-knows-what, and other ne'er do wells". (1) NOT MY WORDS

Much of the worst comment I left out, but it goes on to finish, "This is a poor town, a lot of people here aren't able to drive to Kingman all the time. Most of the homes here are ramshackle and unkempt. I could go on, but if you want to move here for the scenery, great---until someone in the next lot over builds a 3 story home and blocks all your wonderful view! Or, if you want to move here for the clean water, go ahead---the prices keep rising and the grossly mismanaged water company doesn't seem to want to run more water lines OR show ya any latest water test results. Or...if ya wanna move here for the clean air, good for you!...the wind blows constantly, dust, pollen and trash blowing everywhere, all the time. Hooooowdy, stranger!" (1)

So please tell me who is going to rush to Dolan Springs to join the LMRFD? The only people who have an investment in the community and care about it's future are people who live here. 

At best the fire district will spend months trying to find someone to work here. They'll use the LMRFD to gain experience so they can advance to a larger, safer, and more progressive fire department, leaving us to start the search all over again.

Volunteers are the only one's who have an investment in Dolan Springs and Meadview.

TRAINING COSTS
The chief said it costs $1500 to run a call.
As I understand it's about $1500 to train a Basic EMT

The nonprofit ambulance bills about $600,000 a year.

Correction ..... The LMRFD billed close to $600,000.00 but only received $237,807.00. Thank you for pointing out our small fire districts nonprofit ambulance lost $362,000.00 that year.

Update October 2016

Another reason the LMRFD can't find paid or volunteer firefighters or EMT's. Their "Drug Free Workplace Policy" that says employees can't consume alcohol even on days off. As I read the policy if it says, "alcohol is included within the meaning and prohibition of drugs" that means it can't be used anytime by employees.

LMRFD Drug Testing Policy
Drug and Alcohol Testing: In order to assure a drug-free work environment, the District prohibits the use, sale, transfer, being under the influence and/or reporting to work after using or ingesting illicit drugs in accordance with department policies. Under District policy, alcohol is included within the meaning and prohibition of drugs. Successful passage of drug testing will be condition for employment and continued employment.

This policy doesn't make sense in a rural area with limited employee and volunteer resources. Last I checked alcohol was a legal substance. To not allow a volunteer to have a beer at the weekend family BBQ will not go you any volunteers. Current firefighters have been seen drinking alcohol with no repercussion. It's a double standard to allow current employees to consume alcohol while telling any new employees or volunteers that "under District policy, alcohol is included within the meaning and prohibition of drugs".












Tuesday, August 11, 2015

Need Information on Fires in Meadview and Dolan Springs

It looks like the fire district is going to want a lot of money for a list of the 73 fires over the past two years or so. I thought there must be a lot more fires than I thought, they said it would be a special report and would take 60 pages per year, and would give me an estimate.

That may be part of the problem. We had 73 fires in the last two years or so, if it takes 120 pages of printed pages to find 73 fire addresses then there's a problem.

Anyway, I need to contact anyone who is aware of a fire, or fire call  in the Lake Mohave Ranchos Fire District.

I was going to cross reference the addresses, but talking to people who's homes burned down rather than just looking at burned down lots is much better.

If you know of a fire, or someone who does, please contact me.

If you know someone who has had to waite an unreasonable time, or the response time caused a death.

Thanks
Jay

Monday, August 10, 2015

Tragedy in Dolan Springs Explosion Only One Firefighter at Propane Blast One Dies from Injuries

There was a tragedy last January as a host of problems caused an 85 year old woman's premature death. She was 85, and had other medical problems, but to die in such pain. A leak combined with a propane tank far too close to an RV caused an explosion.

It was 7:30 in the morning as calls started coming in from travelers on US93, and local residents about a fire and black smoke showing. One caller saying it was an RV, the owners were in their 90's and may still be inside.

77 Year old Paul Mikonis was blown back and his clothes caught fire. He struggled to get his 85 year old wife who recovering from other medical problems, out of the RV. He told me he was afraid of her burnt skin coming off as he pulled her out of the RV.

Paul could hear the siren coming and thought help was on the way. When the fire truck showed up, he was surprised to see only one firefighter on the fire truck, and he was having trouble getting the gate open.


------------------
REPORT ON THE FIRE
On June 23rd 2015 I asked the LMRFD for their report on the Mikonis fire. It took a day to get the correct date to the firefighter looking for the report. He gave me a call saying he had found the report, the fire was January 25th.

I picked up the report on June 25th. I was surprised that the report said it wasn't written on January 25th, the day of the fire. The report said the date of the incident was 01/25/2015, but the report wasn't written until 06/24/2015, a day after I requested it.

This was a fire with serious injuries that turned into a fatality. Yet no one followed up to see if the person survived, or even wrote a report on the fire until it was asked for six months later.

The report being written six months later, the report writer forgot to mention one of the engines that was at the fire. This makes me question what else he forgot when writing the report? If the report came from the LMRFD computer, why was there no copy of a report from the Meadview station who also responded.


Friday, August 7, 2015

Fire With Injuries 17384 Magmolia

On August 6th there was another structure fire where someone was injured. The LMRFD responded with Engine 411 and other fire rigs, leaving the LMRFD ambulance 3 miles away at the fire station.

Like in the Mikonis fire in November, AMR ambulance was called from Kingman. In both fires people with significant burns had to wait 40 minutes for a paramedic ambulance, while the LMRFD nonprofit ambulance sat only miles away.

Thursday, August 6, 2015

Why This is So Important to Me

This is important to me because in my younger years I was a volunteer firefighter, I worked in law enforcement for many years, and on an Advanced Life Support Ambulance, and I've seen to many people die that didn't need to.

I did CPR for the first time when I was 16. CPR was something new at that time. There was no 911, or paramedics, most ambulances ran out of funeral homes. I remember the ambulance attendants hooked up an automatic CPR machine ran from the oxygen tank, they loaded him up and took off.

That wasn't the last time I did CPR, working on an ALS ambulance in Spokane, we did CPR on a regular basis. Emergency medicine is a love hate relationship. You love to save people, and hate to lose a patient.

It's hours and hours of boredom, interrupted only by moments of sheer panic. Then your training kicks in and you get to help people on the worst day of their life, and hopefully make it better.

Being an EMT or paramedic isn't just a job, you hold people's lives in your hand everyday. So you need to love what you do, or go home you're no good to me. I was trained as a Mobile Intensive Care Unit Paramedic at Daniel Freeman Hospital in Inglewood California during the 1984 Olympics.

I learned to deliver babies at Martin Luther King Hospital in Watts, cardiac and respiratory at USC Medical Center in Los Angels, and trauma at Cedar Sinai Hospital in West Hollywood.

It was a serious paramedic school. We took major tests three times a week, if you got under 70% on any three tests, you were out, come back when you're serious. They were, every day there were students missing for the first couple weeks.


PARAMEDICS MAKE MISTAKES
After paramedic school in LA, I did my ride along training with the Spokane Fire Department. I worked out of Station 10 on North Division, assigned to Squad 10 a paramedic rescue truck.

About 30 minutes into my first day we got a call. The dispatch tones rang out, Engine 10, Squad 10, man down North Bowl, 125 West Sinto.

As we signed in route dispatch advised the man down had a history of asthma. We were only about 4 minutes away, it was a straight shot down Division, hang a right and we were there.

I carried in more equipment as the other medic's did a patient assessment. The patients 14 year old son was standing there not understanding what was going on. The patient lungs were really tight, and he went into respiratory arrest, as one of the fire medic's started an IV for medications, the other tried to intubated the patient placing an ET tube to secure an airway.

He placed the ET tube then checked for chest rise and auscultated the stomach then the lungs for bilateral breath sounds, saying he heard them. As soon as the monitor was hooked up, he went into cardiac arrest.

I started CPR as the ambulance arrived and we got him packaged for transport. We loaded him in the ambulance and I continued to do CPR as we took off running code to Sacred Heart Hospital with one of the fire paramedics on board.

I did CPR on the way to the hospital, as the other paramedics monitored vital signs, and pushed medications. When we got to the ER he was still in cardiac arrest, so he was moved to the code room.

The first things they do in the ER is draw arterial blood for blood gases, and take an x-ray to check placement of the ET tube. That's when they called the code. There was no point in going on, his blood gases were way off because when he was intubated the ET tube was placed in the esophagus rather than the trachea.

We had pumped oxygen into his stomach all the way to the hospital, rather than into his lungs. It was something I swore I would never do.

During my training at USC Medical Center I trained with physician's and PA's learning medicine and putting hands on patients for the first time too.

The most important lesson I learned was that emergency medicine is learning from your mistakes, and never doing them again, because that lesson may have cost a life.

Another paramedic made a serious mistake when I was working as an EMT for Mercy Ambulance. We got a call that a retired fire captain had injured his back mowing the lawn. The worst thing you can do as a paramedic, is assume anything on a call.

In Spokane back then when you called for EMS you got the closest engine company, a paramedic squad, and private ambulance to transport. When we arrived in the ambulance the engine company was getting ready to leave, and the fire paramedic's told us he pulled a muscle mowing the lawn. They told us he was all ours, and followed the engine company down the road.

The paramedic I was working with, Mark Romero was a sharp paramedic. The fire captain told us he was mowing the lawn when he got a tearing pain in his low and mid back. This didn't sound right, so Mark took his blood pressure in both arms.

It wasn't good, there was quite a difference between the BP in his arms. Mark said we needed to get MAST pants on him, and get two large bore IV's going ASAP. He said we needed to get him to the ER now, I think he has a dissecting aortic aneurysm.

The fire medic's were shocked when they heard us advise dispatch we were code 3 to Sacred Heart Hospital with MAST pants in place, and two large bore IV's. That we wanted surgeons standing by to rule out a dissecting aortic aneurysm. He was in surgery within 15 minutes of hitting the ER doors, he lived.

EMT's and paramedics are not doctors, far from it, so after every call paramedics need to review, discuss, argue about, and then adapt to make the next call better.


This is important to me because:
As a firefighter, police officer and paramedic I saw the limitations of government in day to day problems, and especially when major events happen. We cannot depend on outside resources if we have a major event like an earthquake, flash flood or the 6000 acre fire burning in Mohave Valley.

Where would we be, how fast could a small fire get away with our limited resources.

I've seen good EMS systems and bad EMS systems. I know we can have a good EMS system in the Dolan Springs, Meadview, and surrounding area. But we need to think out of the box.





Tuesday, August 4, 2015

We Need To Think Out Of The Box

If we ever hope to provide emergency medical services to 2000 square miles of rural Arizona, we need to think out of the box.

The Department of Health's Bureau of Emergency Medical Services has a new program called Community Paramedicine. It's where EMS systems are allowed to make the community paramedicine program their own, to tailor the community paramedicine program to community needs.

Community paramedic's could do more primary care, like checking on people in their home who recently had surgery. Work with KMRC to catch problems before they become serious, and an ambulance ride is necessary.

Currently many people won't call the LMRFD nonprofit ambulance if they're unsure they really need to go to the hospital.  They fear if the ambulance paramedics do so much as assess you, or take your blood pressure they charge you $1350.

I have never worked where fire paramedics wouldn't come out and check you out for free. Even when I worked for private a ambulance, we didn't charge you if we didn't transport you. It was always patients first, we felt it was our duty to check on patients, and if they don't want to go, they sign AMA against medical advise, and we left.

We may have firefighters who are paramedics, but we don't have firefighter paramedics.

When they get in the fire truck, they're only a firefighter. When they get in the nonprofit ambulance, they're an EMT or paramedic.

We need to separate the fire service from the nonprofit ambulance. The firefighter paramedics need to respond with a paramedic rescue truck inside the 144 sm fire district, and volunteer EMT's and paramedic's should run the nonprofit ambulance, leaving firefighter paramedics to protect the fire district..

The only way to cover 2000 sm's is with the help of volunteer EMT's. They could respond from home to do a rapid patient assessment, then if serious call for an air ship, and cancel the ambulance keeping it in service..

If you pay your taxes to the fire district, who do you think should be held accountable, if the firefighters are miles away responding outside the fire district, and your home burns down?



Monday, August 3, 2015

Web Page Tells Visitors they're Safe LMRFD has 7 Ambulances, and 4 Rescue Vehicles

It's been two years or so since the LMRFD went broke and was taken over by the county.

Yet the LMRFD home page continues to tell people thinking of moving to the area, or visiting the SkyWalk at the Grand Canyon that, "Our main station is located in Dolan Springs, Arizona. We have three stations that are fully staffed under normal conditions"

Truth is there's two stations, one in Dolan Springs with one or two fire fighters, and one in Meadview I'm told has one firefighter most of the time.

The medical page tells people "We operate seven ALS ambulances and four rescue vehicles with extrication capabilities". 

Truth is there's one ambulance, not seven, and on some calls only one person showed up in the ambulance.


It's been two years and still people are being told they're safe coming to the area. Would you move here, or visit knowing in an emergency you might get an ambulance within 20 minutes to an hour 98% of the time.

Aug 15th
I see the LMRFD web page has been updated to show the current status of the fire department.

Thank you, now people can make informed decisions.

www.lmrfd.org/fire
www.lmrfd.org/medical

Lake Mohave Ranchos Fire District Problems

A couple years ago the LMRFD went broke. At the time they had 3 or 4 fire stations, seven ALS ambulances, four rescue vehicles, and lots of man power. Today we have 2 firefighters in Dolan Springs, most of the time, and 1 in Meadview.

One problem is the same two firefighters tax payers pay for fire protection and EMS in the 144 sm fire district, also run a nonprofit ambulance that must cover 2000 square miles, leaving the fire district unprotected.

The 2000 square mile Certificate of Need covers a very dangerous 50 miles of US93, the main highway between Las Vegas and Phoenix. On a good day people involved in an accident will get one or two EMT's, one may be a paramedic, in 20 minutes 50% of the time, and within 60 minutes 98% of the time.

When I ask the chief about volunteers. He says it's too expensive to train firefighters, no one in Dolan will volunteer, and they need to run a mile. At one fire board meeting he said it costs $1500 to run a call.

Responding to property outside the fire district
The LMRFD responds to anyone who calls, no one checks to see if the parcel is in the fire district, and many in Meadview are not in the fire district. In Meadview the fire district is a checker board. Many are not contiguous to the fire district, but that's another law, and another story.

If you look at Meadview you'll see many parcels are not in the fire district. It's not fair for people who pay no tax to the LMRFD get the same services I do paying $200 a year.

As you can see from the LMRFD district map below where I marked the meadview fire station location. There are properties within a few blocks of the fire station. These people pay no tax to the LMRFD, yet get better homeowner insurance rates than I do paying $200 a year, and being 2.5 miles from a fire station.




Below is a link to a map of the whole fire district... you need Windows with Silverlight to view the map. The Fire District is Shown as Red polygons via a Graphic Drawing


http://mcgis.mohavecounty.us/Silverlight_1_9/?Viewer=moh&Project=0803e1c8-e9a8-40ae-aef4-f121fecba7ab <http://mcgis.mohavecounty.us/Silverlight_1_9/?Viewer=moh&amp;Project=0803e1c8-e9a8-40ae-aef4-f121fecba7ab>