Wednesday, September 30, 2015

So Important You Know the Difference between an EMT an EMT Advanced and a Paramedic

Trying to educate people,....

Please read this, it's what I've been saying from another view.
UNDERSTAND (BUT ARE USUALLY AFRAID TO TALK ABOUT)…

It's important everyone understand the difference between an EMT Basic, an EMT Advanced, and a paramedic.

There's a big difference between what a Basic EMT and an Advanced EMT can do in the field, a paramedic can do a few more procedures than an Advanced EMT, but the Advanced EMT can do most life saving procedures that can save a life right now.

According to the National EMS Scope of Practice Model.
An EMT Basic can do basic first aid and an Automatic External Defibrillator (anyone with CPR training) use an oral or nasal airway, but can't secure your airway to prevent aspiration of vomit and severe complications.

An EMT Basic can use an automatic or bag to assist ventilation. They can give you your own medicine, or over-the-counter medication with appropriate medical supervision.

An EMT Basic can give a Diabetic glucose (sugar) and someone having a heart attack an aspirin, and in case of a nerve gas attack they can give you atropine. They can also use anti-shock pants to split a lower limb.

EMT Advanced
An EMT Advanced can do all the above plus....
Advanced airway that can secure your airway.
Use suction on patients already with ET Tube
Insert IVs
Do bone marrow injections in kids
IV fluid therapy Medication Route or Trauma
Nitroglycerin for chest pain
Epinephrine for anaphylaxis Bee String Etc
Glucose for Diabetic
IV D50 for Diabetic
Administer breathing treatments asthma COPD
Narcan for opioid overdose
Nitrous oxide for pain

A Paramedic can do all the above plus.....
A paramedic can secure your airway with an ET Tube
Perform a cricothyrotomy if your skull is crushed can open your throat
Put a needle in your chest if lung collapsed
Use nasogastric tube to let air from stomach
Insert bone marrow cannula
Access large veins for IV Deep Veins Difficult in the Field
IV medications and drips
Infusion of blood or blood products

The few things a paramedic can do that an EMT Advanced can't, are not worth the additional cost and training for the majority of our EMS needs.

A paramedics skill isn't in what equipment or drugs they carry. A paramedics skill is in their ability to do rapid patient assessment, but get it right.

Back in the day, and in this case I mean not that long after Jesus day. Physicians were teachers, that sharing of knowledge was part of being a paramedic when I was trained.

When I took my paramedic oath, it said "I shall also share my medical knowledge with those who may benefit from what I have learned. I will serve unselfishly in order to help make a better world for all mankind" I take that oath seriously.

Sadly that section was replaced with a be nice on social media section.

In my opinion anyone who has been a paid EMT for more than 2 years without advancing to EMT Advanced or paramedic, has no interest in emergency medicine, and needs to move up or move on, we need more than Basic EMT's.

Why would someone NOT want to move up to EMT Advanced or Paramedic? Because they don't want to provide better patient care, they didn't want more money? Why?
EMS Is a Healthcare Career, Not a Fire Department Career
In case someone forgot the “M” in EMS, it stands for medical. EMTs and paramedics are technically classified as allied health professionals, which is a whole different field of endeavor than firefighting. Our true brethren are respiratory therapists, nurses, physicians’ assistants and the like. This means we operate in conjunction with other healthcare agencies, be they doctors’ offices, clinics, hospitals or health departments.
We need to start somewhere, and CPR instructors and a CERT team would be a good start to a better EMS system.

Do your homework look up Community Paramedicine its what we need to work towards.

Tuesday, September 29, 2015

Where To Go From Here

Where to go from here.... The lake Mohave Ranchos Fire District functioned pretty well for some 35 years. When the economy crashed many agencies had problems. It was a combination of factors that caused the problems.

There is some money in the budget, unused money for grants, two unfilled positions and $165,000 for another firefighter shift in Meadview that's planned.

There's the federal money for the land we cover, and half of Meadview isn't in the fire district, that need to be addressed.

You can't wear two hats, we need to separate fire service from EMS. The vast majority of calls to the LMRFD, 70% are medical calls.

We need volunteer EMT paramedics on the ambulance, and our paid firefighters EMTs or EMT Advanced  as support.

Forcing a firefighter to become a paramedic, is like forcing a construction worker to become nurses aid. Even if you manage to get it accomplished, it won't work well, or be very pretty.

Please Read the Article but also the comments, see what paramedics think about being cross trained.
Thoughts on Forced Fire EMS Cross Training

Okay it's hard to find firefighters here, but we don't need firefighters, we need EMT's. By requiring the EMT's on the ambulance to be firefighters, we pretty much limit our volunteer pool to men.

Lets face it, not many women want to be firefighters. The vast majority of firefighters are men, with less than 4% in the United States being women.

Medicine on the other hand is made up primarily of women, nurses, physicians, OR techs. According to the Journal of Emergency Medical Services women make up about 50% of today's EMS services.

So by requiring the ambulance EMT's to be firefighters we severely limit our volunteer pool. We may have a wealth of experienced women with a medical backgrounds out there who have no interest in being a firefighter. We'll never know unless we ask.

I would change the volunteer EMT policy allowing volunteers from the 2200 square mile ambulance CON, rather than the 144 sm fire district. This would not only give us more volunteers to draw from, but cover the ambulance area better with volunteers spread out.

I would work toward Arizona's new Paramedicine Program where paramedics can do more primary care. By treating chronic conditions at home, checking on surgery patients and changing bandages before the infections and ambulance ride.

It's new, and legislation needs changed so paramedics can bill Medicare and insurance.

I know it's about money, but if we don't put lives first, it will cost us more in human lives, and lawsuits if we continue to have one firefighter show up at fires and serious vehicle accidents.

Please read Why this is so important to me

Unless we train and hire locals who know Dolan Springs and Meadview, we will always be looking for people, because they will come get experience and go on to more calls and more money.

I just believe the people deserve better care.

Jay

Saturday, September 26, 2015

It's About Money I Get That.... But the Real Bottom Line is Do People Feel Safe

It's About Money I Get That.... But the Real Bottom Line is Do People Feel Safe? With around 80% of calls for medical services, why require EMT's to be firefighters?

We all want Dolan Springs and Meadview to grow and prosper. One thing we need is for all those tourist who visit and spend money to feel safe.

Until a few weeks ago when people checked the LMRFD web page, it told them the LMRFD had 7 Advanced Life Support ambulances, 4 fire rescue vehicles and lots of paid and volunteer firefighter EMT's and paramedics.

Today it says the LMRFD has 2 ambulances, actually we only have one that's being used.

When someone planning on a visit to the Grand Canyon, especially those with medical problems or children, check on EMS in the area what will they find.

At the North Rim of the Grand Canyon, the NPS has 75 EMT's and paramedics protecting visitors, and River Medical has a full time ambulance in Ashfork.

When they check the West Rim, Dolan Springs, and Meadview and find there's only one ambulance covering the 100 miles from Hoover Dam to the West Rim. That's if it the ambulance isn't gone, or out of service because the firefighters are out on a fire.

With all that's going on in the world today, people are conscious of what law enforcement and emergency services are in the area they're traveling.

Where would you take your family? North Rim lots of NPS rangers, and 75 EMTs, or one part time ambulance?

It's about money, the money we spend to keep people safe, and the money tourist spend in our area.





Thursday, September 24, 2015

Town Hall Meeting October 6th Please Attend

There will be a Gown Hall Meeting on October 6th at 6:00 PM in the Dolan Springs Community Council building.

Consolidation and other options will be discussed.

Please attend, this is very important.
We stand to end up with no representation on the fire board.

Wednesday, September 23, 2015

Lake Mohave Rancheros Fire District To Whom It May Concern,

Lake Mohave Rancheros Fire District
To Whom It May Concern,

My name is Rebecca Smith and I am a 10 year resident of Dolan Springs Arizona. Two of my sons are serving in the United States Military. My oldest son serves as a Navy SARS member, the other is a newly enlisted member of the Army. My sons believe in Democracy and the Democratic process and are willing to lay down their lives to ensure that you and I always have the ability to speak and act freely. We are free to do something or do nothing. We are free to criticize or to build up. We are free to act responsibly or to hand our responsibilities to someone else.
Regarding the plight of our Fire District;  yes, a board dropped the ball. Some of the same people who SERVED on that incompetent  board are now telling you to consolidate! No responsibility, just let someone else clean up the mess. Yes, some chiefs helped to bring us to insolvency, they are GONE!  We now have an opportunity to do it right. In spite of what you are hearing, we DO have the money and we ARE capable. We have new faces in town and these people bring fresh ideas and energy.  Some of these people are well educated and have served their communities in prior areas.  They can serve here just as well.
Consolidation has been the plan all along if you go back and read the minutes. The idea that we just had to get out of debt so we could 'decide' what we wanted to do was false. This decision can, and may be made by an outside board, and one man with the approval of our supervisors, none of whom live here. This is OUR community and it is time we start acting like it.  A decision made in this manner is a slap in the face of the Democratic process which my sons are willing to sacrifice their lives for.
 To the NACFD board members, are you willing to by-pass the Democratic process in order to take possession of this fire district?  If the decision is made in the aforementioned manner, that is exactly what you will be doing. It was stated in the August NACFD board meeting that consolidation had to be a unanimous vote in order to avoid an election because the fear is that the majority of your own community would not support the consolidation. How is this Democratic???
To those saying that we are trying to undermine the consolidation; after doing further research, we are blatantly and openly opposing the consolidation, not undermining it. We are not ashamed and do not need to hide and undermine this effort. We are more than happy to share our finding with all who will listen at a town hall meeting on October 6th at 6 o'clock p.m. at the Community Center in Dolan Springs.
To the community;  how dare ANY of us sit on our rumps and not participate in this process, thus rendering my sons efforts pointless!!! We must be anxiously engaged in the pursuit of bettering our communities and ensuring that we leave something worth having to our children. I am sick of hearing that we do not have anybody who is willing or capable to serve on a board. I am also tired of being told that procuring volunteer fire fighter/EMT's is next to impossible, or that we cannot staff our district without consolidating with Northern Arizona Consolidated Fire District. That is FALSE information. The only proof we have to show for the inaccuracy of these beliefs is if we all begin to step up and take on our responsibilities as community members. We can rebuild this town. Maybe our supervisors and some of our neighbors do not believe in us, but I do! Do you?

Tuesday, September 22, 2015

When Seconds Matter

This blog is about educating people about the rolls of fire service and EMS in rural areas. People need to understand firefighter safety, and what firefighters, EMT's, EMT Advanced, and paramedics can, and can't do.

Everyone tells me when people moved here they knew what we had. Not True, for over 2 years until August the LMRFD web page mislead people telling citizens and tourist the LMRFD had 7 ALS ambulances, 4 rescue vehicles and lots of firefighters.

Time, in some calls every second counts, the difference between 5 minutes and 30 seconds, and 6 minutes can mean the difference between life and death.

I was so disappointed in our EMS crew responding to a heart attack at 48 mph the other day. On a call 10 miles from the fire station the difference between 48 mph and 55 mph is 1 1/2 minutes. That 1 1/2 minutes could well be the difference between life and death.

Most EMS calls are routine calls were two ambulance attendants can handle the situation fine. But there are those calls were you need more people, that's when every second matters.

This is no time to realize that you need help, then call for assistance from firefighters to move or load a large patient, or do CPR in route the hospital.

Working in law enforcement and EMS I've seen a lot of people die because of something simple could have been done, and someone said no.

Some patients, especially those with serve trauma you know won't survive no matter what you do, are many times eerily calm. Sometimes even trying to calm you as you try to work faster, all the time knowing there's little chance they will survive, and you both know it.

The patients who are the most frightened are those who can't breathe. These patients are scared to death, and you can tell just looking at them.

They're usually sitting up in what's called the tripod position, trying to breathe, their eyes are open wide and when they look you, there's no need to ask how they're doing.

For the first patient all you can really do is stay close and be there, but the second patient you can help.

To make someone who's short of breath wait any longer than absolutely necessary, is wrong. Waiting 30 - 45 minutes is torture when someone close with oxygen or medication could ease the suffering.

Some medical emergencies do require rapid response, assessment, and treatment....
Below are a few........

Sudden Cardiac Arrest (different than a heart attack)
A sudden cardiac arrest is when your heart has an arrhythmia, or bad heart rhythm.

If your heart goes into Ventricular Fibrillation, or Ventricular Tachycardia, you have 6 minutes to have a paramedic apply a defibrillator, or a citizen apply an AED. After 6 minutes your chance of survival drop's to near zero.

Anaphylactic Shock
NOTE ARS 36-2226 Exempts good Samaritans from liability for giving Epinephrine Arizona Anyone can give Epi in Arizona

If you give kids birthday parties then you know a lot of kids have food allergies today, other's are allergic to bees, cats, or something.

A lot of parents carry an EpiPen that contains Epinephrine to reverse the allergic reaction. It's important an EMT be close to make sure mom gave the shot, and follow up with respiratory assistance and transport to the ER.

Mom's are mom and the last thing they would ever do is hurt their child. Some not wanting to hurt their little boy or girl, wait to use the EpiPen to see if they improve. Sometimes they wait too long, and it's too late, the lungs are too tight by the time they give the EpiPen.

Drug Overdoses
Many older people today take pain medications, please keep your medications locked up, and away from kids.

Overdoses, especially for opioid overdoses there's a wonder drug called Narcan or Naloxone. If you get there in time you can reverse the effects of opioids in seconds.

Not all overdoses are people abusing drugs, accidents happen, children get in to medication.

In the video below Narcan is given to an unresponsive patient with CPR in progress, you'll be amazed at how fast Narcan works.

Narcan Being Given Narcan


Trauma
Take aspirin for your heart? Warning... What protects your heart from clotting, also make's it difficult to stop bleeding in trauma.

Most trauma is not life threatening, some trauma is. If you have internal bleeding it can be life threatening. If it's serious internal bleeding the only thing that will save you is rapid transport and a surgeon.

The four firefighters we would have can't save your home, and in some cases with two firefighters can't save your life.










Monday, September 21, 2015

Meadview Meeting September 21st

Good turn out at the LMRFD fire board meeting today. I was disappointed there wasn't more support from Dolan Springs.

For those at the meeting who Ellen told this was a hate site, it's not. I try and provide accurate information, and apologize for her unprofessional conduct. We need to be able to agree to disagree without name calling.

Please if you're reading this for the first time, start at the beginning.

Someone said no volunteers have signed up in Dolan. I told them people can see the budget for training in 2015/2016 was zero, so why sign up with no money for training, and no scheduled training.


When asked if the Kingman Miner was correct that his budget dropped from 5 million dollars a year, to a little over 2 million a year.

Chief Moore said that wasn't correct, but didn't know what his own fire district budget was.

If you're new to this blog please read these important posts..

Why This is So Important to Me

Why Would Any Paramedic Move Here?

Fire Staffing is a Need, Not a Want

What You Need To Know About Two Man Response

These will give you an idea of some of the problems operating with no volunteers.

The fire district is 144 square miles, the ambulance CON is 2200 square miles. When someone in command sends OUR tax supported firefighters 50 miles out of the fire district for a sprained ankle, and your home burns down, or family member dies, how long before someone files a lawsuit?

Search for firefighter staffing lawsuits, and delayed response lawsuits. With one maybe two firefighters what's our legal and moral liability for people who die waiting for help?

I don't know, but it's something we need legal advice on. An Oregon Fire department was fined $50,000 for violating the two-in-two-out rule, getting firefighters and citizen killed.

The two in two out rule was called the most significant advance in firefighter safety in decades. But it takes 4 firefighters.

Jay




Sunday, September 20, 2015

Good Business Decisions From NACFD? I Don't Think So!

If we consolidate will the NACFD make good business decisions for us? In a recent article in the Kingman Miner With Fire Trucks Relocated, Residents Worried About Coverage Chloride residents weren't happy with their consolidation with NACFD.

The article said the NACFD's budget went from 5 million a year, to a little over 2 million a year.

My question is, if the NACFD can operate 9 fire stations, an administration building, and lots of firefighters on a little over 2 million dollars a year, why can't we run 2 fire stations and a couple firefighters on over 1 million dollars a year? Doesn't make sense to me.

At the September community meeting Chief Moore said the NACFD doesn't want to just expand. So please, tell me how consolidating the NACFD with the Chloride fire district was a good business decision?

The Chloride fire district only pays $24,700 in fire tax to the NACFD each year. That's not $24,000,000 a year, that's only $24,000 a year.

That's enough for 1/2 a firefighter a day. So in my opinion, that wasn't a good business decision.

I'm tired of double talk answers. At a recent fire board meeting when I told Chief Moore that if Rosie's and the gas stations on US93 paid tax to the fire district at the same rate I do, they would pay $10,000 a year to LMRFD.

Chief Moore told me to be annexed into the fire district the property had to be contiguous, or touching our Fire district. That is true.

What the chief didn't tell me was that the businesses could pay a subscription service fee equal to the tax. He also didn't tell me that when he took over the LMRFD he stopped taking subscriptions. Another business decision I don't agree with.

The businesses are out of the fire district argument doesn't work. When Rosie's burned the LMRFD responded. Did we get paid on that fire?

MISTAKES In INFO FROM COMMUNITY MEETING
At the community meeting they handed out a lot of information. Two of the pages had calculation mistakes making it look better if their favor. I hope this was just a mistake.

On the page titled Personal Cost Analysis January 2015 with "Current" in the top right corner. They told us the cost for full time firefighters with John and Chief Moore was $802,795.71. That wasn't right, when you calculate it correctly the total is $859,327.00 not $802,795.71.

The other page titled LMRFD Projection W/Fire Chief Instead of JF NACFD with "Stand Alone" in top right corner. This page tells us the cost full time firefighters and a fire chief would be $852,786.52

So when you recalculate the employee cost with the fire chief it was actually $6541.00 less than the current figure.

Someone please tell me why the administrative assistant is paid $16.20 an hour, when a firefighter paramedic with 2000 hours of specialized training only gets $13.95 an hour?

Spending Other People's Money....
The information from the September community meeting also said the LMRFD needs a new ambulance.

It says the chief wants to spend $75,000 on a new truck chassis to put one of our old ambulance box on, so they wouldn't have to spend $150,000 on a new ambulance. In case you don't know a truck chassis is just the truck part with no box or bed installed. We put our old ambulance box on the new truck part.

Again I don't think that's a good business decision. There are many nice used ambulances for much less of OUR tax money. This is an example of a 2006 Ambulance with only 26000 miles for $20,000 Not $75,000 for a chassis, or $150,000 for a new one. It's your money, what would you do?

There's nothing wrong with the ambulance above, except how the Federal Government works. If you get $100,000 this year, and only spend $80,000, all you get next year is $80,000. So the feds get rewarded for not saving money, and someone gets good deals.

They also donated six of our AED's Automatic External Defibrillators to Kingman schools. They cost $1500 - $3000 new, they only had a $200 trade in, but it will cost a minimum of $9000 to replace them, and we needed them here.

We were broke and they give them away? Why didn't they sell them on eBay? Worse yet, there are no AED's I'm aware of in Dolan to save people from sudden cardiac arrest.

Consolidation is a bad idea in my opinion. The only acceptable way would be to separate the fire service from EMS.

We have no supervision, look how the firefighters treat people.

No matter what the Chief said, the NACFD wants to expand their district.

The LMRFD operated fine for 50 years until we stopped paying attention. Were paying attention now, and we need to keep control of our fire district.

We need local volunteers who care about the people, not arrogant firefighters who disrespect the citizens asking for help. If NACFD takes over how far do you think complaints about firefighters would go?

We paid off almost $1,000,000 over the last two and a half years, and we need to thank John and Chief Moore for their help.

The chief tells us he can't fill 2 positions he has open. I did a search for firefighter jobs in Dolan Springs, Mohave County nothing. Unless you search for "Lake Mohave Ranchos Fire District" job, you can't find the job openings.

The LMRFD survived for 50 years growing with the community needs. It wasn't just a bad board, but also a failing economy, and lack of citizen interest.

We're paying attention now, so please read the whole blog, give the other side a chance.

Jay








Friday, September 18, 2015

Fire Board Meeting September 21st

Please attend the LMRFD Fire Board Meeting 1:30 PM September 21st at the Meadview Civic Association 247 Meadview Blvd

This is very important, we need to ask some questions.

Jay

Thursday, September 17, 2015

I'd rather have a hill billy in a pickup truck who cares, than a paid EMT in a fancy ambulance who doesn't

The more I thought about how the firefighters we pay $77000 to $88000 a year were treating people, the madder I got.

The attitude of the firefighters is unacceptable, the chief said they were mad. I'm sorry but if you work in public safety or emergency medicine you don't get the luxury to be mad, people's lives are at stake.

The LMRFD firefighters are paid more than anyone else in Dolan or Meadview. That's almost $90,000 a year to be a firefighter in Dolan Springs, and they're mad so they respond to heart attack call at 48 mph. Tell a lady to not call until her husband was dead when she tried to give them his DNR, Do Not Resuscitate orders.

On some calls it takes the firefighters 5 minutes and 25 seconds to leave the fire station after receiving a page. The NFPA standard for Turnout Time, the time it takes from when they receive the page for a call, to when they are in route is 60 seconds, NOT 5 minutes and 25 seconds.

At 7:20 or so in the morning the ambulance got a call at mp5 on US93. After turning North on US93 law enforcement on scene asked for an ETA. The EMT told the dispatcher their ETA was 45 minutes ot an hour. Dispatch told them to cancel, Lake Mead was going to respond.

What do you think? It was 7:30 in the morning and they get off at 8:00. They were 36 miles from the call at mile post 5 on US93, at 69 MPH it would take 33 minutes, at 75 MPH 28 minutes, and at 80 MPH only 28 minutes. Are they really that bad a judge of distance and time, or they didn't want to go on the call.

When the lady at the community meeting went to the fire station to give the EMT's a copy of her husbands DNR, and the EMT told her he didn't want it, to just wait until she was sure he was dead to call, that was just wrong.

An EMT should never do anything to violate the trust a patient has in them. To do so violates everything we are taught as EMT's and paramedics, and damages us all as professionals.

A DNR is a Do Not Resuscitate Order telling EMT's not to use life saving methods.

It DOES NOT mean for EMT's to do nothing. Many cancer patients suffer severe pain, and the EMT had better treat them like it was their dad dying of cancer. Make them comfortable, take care of the pain, and if they should code on the way to the hospital, follow the DNR and do nothing life saving. Just hold their hand and let them know someone was there who cared when they died. People arn't afraid to die, people are afraid to die in pain.

After thinking about how she was treated by the firefighter we pay over $77,000 a year, I got mad. If we consolidate we lose control. If NACFD takes over without volunteers for backup, we can't even fire one of these guys.

If I need an ambulance, I'd rather have a hill billy in a pickup truck who cares, than a paid EMT in a fancy ambulance who doesn't.

The mindset of a firefighter is that of public safety. Firefighters are required to be EMT's. The mindset of an EMT is that of a health care professional, and their primary concern is patient care.

On the worst day of my life, when I have to call 911, I don't want someone coming to help who had to take the test.

In the article Firefighters Don't Fight Fires it tells us over the past 35 years fires have decreased by more than 40%, while carrer firefighters increased by more than 40%. Medical calls on the other hand have gone up, so to justify all the money fire departments got into EMS.

Problem is firefighters don't want to be ambulance attendants. Read the Links to Firefighter EMS Links page look at the What Firefighters Think About Being Forced to Be EMT's or paramedic's.

Over 70% of calls for service to the LMRFD are medical calls. We need to seperate the ambulance from the firefighters, and use volunteer EMT's to run the ambulance. 

I don't know about you, but I don't want some EMT who drives up here from Lake Havasu to help the poor folk in Dolan Springs, then drives back home to Havasu.

Firefighters should be required to live where they can be at the fire station within 30 minutes in we need them. Not 100 miles away.

What We Need
What we need is a volunteer community paramedic program Rural Assistance Center Community-paramedicine program information.

Dolan Springs Meadview White Hills are in a special taxing district. We need to educate the people and those who agree draw a boundary and vote for an effective EMS system and a clinic.




Wednesday, September 16, 2015

Need Volunteers for CERT Citizens Emergency Response Team

I spoke to Mike Browning at Mohave County Emergency Services. He said there will be a training course for a local CERT Team, or Citizens Emergency Response Team coming up in January 2016.

It was apparently setup for Chloride, and training will be in Chloride or Kingman. If we get enough people, we may be able to talk them into having some classes here.

He needs around 20 people. So now is the time to show everyone there are good people in Dolan and Meadview who will volunteer.

The fire district needs to support a CERT team. I guess we'll see who wins the consolidation and if we really get volunteers.

Mohave County CERT Team Information

Contact Mike Browning
Please if you contact Mike to volunteering let me know at leapspeaker@gmail.com

Thanks
Jay

Tuesday, September 15, 2015

Fire Board Meeting September 21st Meadview

Please attend the Fire Board Meeting September 21st @ 1:30PM at the Meadview Civic Center 247 E Meadview Blvd Meadview AZ

The course our fire service and ambulance takes will decide the fate of many of our friends and neighbors when they call 911.

Will you get a firefighter who's required to be an EMT, or an EMT who's a healthcare provider?

Here's an article on how some firefighters feel about being an EMT. In my opinion any firefighters who are required to be an EMT, and haven't advanced to paramedic in a short time, to provide better patient care, and make more money, have no interest in EMS, they're firefighters, not healthcare providers.

What Firefighters Think About Being Forced to Be EMT's or Paramedic from EMS World
Forced EMS is a killer. Just having to ride the meat wagon as an EMT is bad enough, but here in PG they changed the job title of Firefighter to Emergency Rescue Technician. Upon being hired you have to sign a contract saying you will acquire your Paramedic certification in a certain amount of time which is 3 years I think. This certification has to be obtained on your on time and expense. This has killed recruitment and retention here. They have already lowered the entrance exam score in order to try and attract more people. When they do get a class, by the time it’s time for them to have their Paramedic certification they are leaving for surrounding departments that don’t have this requirement. 
PG is now being used as a stepping stone. Get hired by PG, get trained and get some time on the job and head for greener pastures when it’s time to become a Paramedic.
EMS has always been a part of the service but it’s crazy to force people that want to be a firefighter to become Paramedics also. 
http://www.firehouse.com/forums/t35852

Saturday, September 12, 2015

Good Turn Out at Community Meeting

There was a good turn out at the community meeting. The LMRFD provided everyone a thick packet of information, unfortunately the information I had asked for wasn't included.

 The good news is that a focus group being setup to gather facts to help us decide on what course to take.

The focus group will provide the information they gather at a Town Hall Meeting October 6th. I'll post more information on time and place soon.

Jay


Tuesday, September 8, 2015

Links To Firefighter EMS Links

Links to Firefighting and EMS Information.

It's about educating you about what firefighters and EMT's do, and how they do it. The more you know, the better decisions you can make about what direction our Fire district should take.

Check back as I will add more links.

Why We Need To Take the Fire Out of Fire Department

What Firefighters Think About Being Forced to Be EMT's or Paramedic from EMS World
Forced EMS is a killer. Just having to ride the meat wagon as an EMT is bad enough, but here in PG they changed the job title of Firefighter to Emergency Rescue Technician. Upon being hired you have to sign a contract saying you will acquire your Paramedic certification in a certain amount of time which is 3 years I think. This certification has to be obtained on your on time and expense. This has killed recruitment and retention here. They have already lowered the entrance exam score in order to try and attract more people. When they do get a class, by the time it’s time for them to have their Paramedic certification they are leaving for surrounding departments that don’t have this requirement. 
PG is now being used as a stepping stone. Get hired by PG, get trained and get some time on the job and head for greener pastures when it’s time to become a Paramedic.
EMS has always been a part of the service but it’s crazy to force people that want to be a firefighter to become Paramedics also. 
http://www.firehouse.com/forums/t35852

http://www.emsworld.com/article/10323946/the-redheaded-stepchild-does-ems-belong-in-the-fire-service

http://connect.jems.com/forum/topics/is-hospitalbased-ems-a-better

My Note: I've known a lot of firefighter paramedics over the years. Some love firefighting, some love EMS, and most are great at one or the other, but not both. When it comes to your life, you really want someone who loves their job, not someone who had to take the test.



+++++++++++++++++++++++
This is a MUST Read Article
Six Minutes to Live or Die
http://usatoday30.usatoday.com/news/nation/ems-day1-cover.htm

Map of LMRFD showing the checker board mess in the Meadview area ... you need Windows with Silverlight to view the map. The Fire District is Shown as Red polygons via a Graphic Drawing


Firefighter Line of Duty Deaths.. When Firefighters Die
As a deputy sheriff we were concerned about officer safety at all times, it seems like firefighters would put safety first.

http://apps.usfa.fema.gov/firefighter-fatalities

http://www.firefighterclosecalls.com

Sunday, September 6, 2015

Got Tired of Asking For Public Records

I've asked the LMRFD for documents to help us make good decisions. So far I've got a few documents, but have been given excuses why I can't have other documents.

The law is very clear on public records, citizens can review public records for free, and the cost for copies of documents must be reasonable.

When I asked for the LMRFD SOP or Standard Operating Procedures Manual this is what I was told, "Like I said, I do not have a copy of NACFD's SOP's.  The SOP's for the LMRFD from 2.5 years ago, which may or may not be relevant at this point,  are 124 pages total.  I have not found a way to quickly download and send them directly from our reporting service.  I will need to print, scan and email them.  I am hesitant to do that, not knowing if they even apply any longer.  Ellen"

These are public records, our public records. No one has the right to decide if a public record is "relevant", they only need to follow the law and provide access at a reasonable cost. $2 per page is not reasonable.

I'm sorry she doesn't know how to operate a computer, but printing documents is a very basic computer skill, citizens shouldn't be charged high prices because she's incompetent with computers.

I have filed a complaint with the Arizona Ombudsman's Office to gain access to public records we have a right to see.

Jay


Saturday, September 5, 2015

The World is Watching 1500 Views Nine Nation's

The world is watching our little community's EMS Problems. I'm surprised how many people are interested in our community's Fire EMS troubles.

In a month 1500 people have viewed this blog from the US, Japan, Germany, France, Poland, Philippines, Ukraine, Malaysia, and Belarus where ever it is.

Please keep reading and sharing the information.
Don't forget the Fire Board Meeting September 21st

Jay

Wednesday, September 2, 2015

Community Council Meeting September 12th 9:30 AM

Community council meeting September 12th 9:30 AM

Please attend the meeting, this will be about the LMRFD and its important we voice our opinions.

We currently have no volunteer program as it was changed recently turning volunteer firefighters into support personal.


Volunteer Pool The valuable resource LMRFD forgot, women

Volunteer Pool

Until a few months ago, about the time I started going to fire board meeting's and asking about volunteers, Meadview had six volunteer firefighters, but they were recently changed to support personnel because of insurance costs I'm told.

At the fire board meeting the chief said he wasn't opposed to volunteers, but at the same time, he took our few remaining volunteer firefighters and changed them to support personnel.

It's our fire district and anyone who wants to volunteer should be asked their skills. Lots of people have computer skills, yet we were paying for an IT guy.

I'm sure they're a lot of smart people around with a lot of valuable skills, but you have to be open to suggestions.

It's our fire district and we need to get involved and pay attention to how it's ran.

VOLUNTEERS and WOMEN
We keep hearing how hard it is to get volunteers in Dolan Springs and Meadview. So again we need to think out of the box if we want to cover 2000 square miles.

The vast majority of calls to the LMRFD, 70% are medical calls. We need volunteer EMT's on the ambulance, and our paid firefighters on a paramedic squad as support.

 Okay it's hard to find firefighters here, but we don't need firefighters, we need EMT's. When we require the EMT's on the ambulance to be firefighters, we pretty much limit our volunteer pool to men.

Lets face it, not many women want to be firefighters. The vast majority of firefighters are men, with less than 4% in the United States being women.

Medicine on the other hand is made up primarily of women, nurses, physicians, OR techs. According to the Journal of Emergency Medical Services women make up about 50% of today's EMS services.

So by requiring the ambulance EMT's to be firefighters we severely limit our volunteer pool. We may have a wealth of experienced women with a medical backgrounds out there who have no interest in being a firefighter. We'll never know unless we ask.




Tuesday, September 1, 2015

NO Standard Operating Procudures for LMRFD -- No Rules No Job Description for Firefighters? WHAT

Apparently there is no guidance, rules, or regulations for the firefighters to follow in the LMRFD. No wonder they do what they want.

On August 27th I told you I had requested the LMRFD Standard Operating Procedures, or SOP. The SOP is something every agency must have.

The SOP tells firefighters how they should do everything from how to wear their dress uniform, to how they are to drive vehicles, and the chain of command.

This is the reply from the LMRFD

"Like I said, I do not have a copy of NACFD's SOP's.  The SOP's for the LMRFD from 2.5 years ago, which may or may not be relevant at this point,  are 124 pages total.  I have not found a way to quickly download and send them directly from our reporting service.  I will need to print, scan and email them.  I am hesitant to do that, not knowing if they even apply any longer."  
Ellen

Since it's still the LMRFD, and NOT the NACFD yet, the SOP from 2 1/2 years ago is still valid. The firefighters still work for us, and we have a right to a current copy, an old copy, or any copy of the SOP for the LMRFD.

I'm tired of being told we can't have public records. If they don't want to tell us what's going on now, if NACFD takes over, Dolan and Meadview will get even less information.

Like the others at the last fire board meeting, I've let calls for the chief, and never received a call back.

This is more mismanagement, I don't know of any agency that doesn't give employees copy of their SOP on the first day of work. By not giving firefighters an SOP they have no guidance on how they are to operate vehicles, wear uniforms, or keep equipment clean.

Worse yet, with no rules, you can't get in trouble for doing something if you didn't know it was wrong.

We need to know if the firefighters were ever given an SOP, we need a copy of the SOP so we know the rules too.

UPDATE.  Who's Hiding What
The LMRFD apparently doesn't want us to know what firefighters are supposed to do. Rather than let me review the SOP they want $248 for a copy of what every firefighter should have.

It's OUR fire district, withholding public information isn't right.

We should be able to review documents without it costing $248...

What are they hiding?

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

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.