the need for an engine at MVA's

[pfdff13]

can anyone help me with some ideas on how to make the fire chief and the city council realize that an engine equipped with the hurst tools need to be on scene of MVA's with injuries. For the past 3 years I have been trying to convince our leadership of this need. I kept bringing this up due to very delayed responses to accidents w/entrapment. The excuses for not sending the equipment changed everytime it was brought up. At least a dozen different excuses were used. It all came to a head when I was hit head-on 3 miles north of my hometown and it took 13 minutes to get the proper equipment on scene. A police officer had to respond and verify. Any help would be appreciated. I realize litigation is an option but I would like to be able to implement this change without going that route. Thank you for your time and suggestions
Roger Moss

[sgt128]

I think that it would be tough to work at an MVA without an engine, or at least manpower. While I realize that the vast majority of MVAs do not involve rescue, I feel that it is imperitive to have the engine there to help out with clean up and especially for helping move the patient out of the car. I have tried this with a two person medic crew when the Engine was delayed due to the location of the call.
We dispatch a Squad with the ambulance on all MVAs with injuries. Other companies dispatch an engine, as they don't have a squad. On a calll that is recieved as a PI-Rescue, a medic unit, squad, and engine are dispatched.
The only reason the ambulance would respond alone would be if the call was recieved by police as a Property Damage Accident, and when the police arrived found that there was a slightly injured person in the need of transport, but this is very rare.
Good Luck!

[Robert Olson]

I can not believe an Engine does not get dispatched to MVA's. Currently, our department responds like yours as our TNT Extrication equipment is on our medium duty Resq. But an Engine responds as well due to pure hazard potential and clean-up duties.
Unfortunately it will take on of the council members or the Chief being in need.
I guess the big question is, how PRO-ACTIVE is your Chief?? Who pays his wages, taxpayers and who should he care about??
Good Luck! http://www.firehouse.com/interactive/boards/smile.gif

[LifeRescue]

Nothing surprises me when it comes to politicians, and emergency services administrators, particularly those that get in their positions because of who they know and not what they know. Which brings me to an interesting point. Do the politicians understand why you want the apparatus to respond--do they know what is on the apparatus, and how severe legal repercussions can result against the administration for failing to provide for the public safety of the community? Have you gone to the newspapers? If you make them aware of the story, and how it can benefit the paper to reveal to the community of how their tax dollars are being misused, I am sure you will begin to get the support you need, and the politicians will begin to see how their constituency is being compromised.

[NCKSFIRE]

What is the point in having any of this equipment if you don't use it. We are in the process of switching to pagers (have been using a stone age phone system). The Rural Fire has started to take on the role of Rescue. The Ambulance service has the Jaws tools but does not have the manpower to run it. The hardest point is convincing everyone that we need to page out both the EMT's and Fire. When I get the paging system going I am going to give the dispatchers the protocols for paging. Fire always goes to an accident that the Ambulance goes to and the ambulance always goes to a structure fire. The current thinking is like the situation mentioned, If they need us they will call us. First thing you learn in Extrication is a thing called the golden 20 minutes, and golden hour. 20 minutes are gone by the time the ambulance gets there to decided they need more equipment. Old schools of thought are hard to change. They usually react after the fact but soon forget the lessons learned as time passes.

[tvfdffemt]

I can't imagine an MVA without a Engine there. Whenever there is an MVA we respond with and Engine, Squad and Ambulance. Alot of reasons to look at. We feel that we always need someting to fight fire with in case during an extrication that a fire starts. Also we park so that the Engine is always behind the wreck and the ambulance and squad are in front. This helps to protect the rescurer's and also the victims of the accident. There are plenty of pictures and stories of rescue vehicles being hit from drivers at accident scenes. If nothing else use your pumper as a blocking tool and the manpower never hurts either. Also as said before the main reason we are here is for patient care and why waste more of "the golden hour" than we have to.

[strippel]

Our EMS covers many different fire districts. In the city with the paid boys, we get a rescue engine on ALL injury accidents. If it is reported serious, or with a pin, we get 2 (one for rescue, one for fire supression).

Out with the county volleys, it depends. Most companies will send a rescue AND an engine to all injury crashes. Some just an engine. Others are lucky enough to staff just a squad (which around here is a pick-up truck).

To make it even more confusing, the are other companies that won't go until someone on the scene requests them. Other companies respond 2 or 3 peices (engine, squad, tanker) to a crash unknown.

Although we don't need the calvary, it's nice to have one peice for hazard control, and extra lifting help. An engine makes a nice traffic block.

Is your EMS part of fire? If so, there is no reason your fellow FFs should not be backing you up. You are there to serve, right?

[savedbygracekm]

Even where I live in the poor section of the Appalachian
Mountains in SW VA we have both dispatched when a call comes in. I don't see much since in having one if your not going to use it.
They need a wake up call. Maybe when they are hit head on it will wake them up. Especially on a MVA.

[Bones42]

My EMS Squad does extrication, not the FD, so they have the equipment. They will roll an ambulance with 3 to 4 EMTS, and then their extrication truck with another 3 to 4 EMT's. No manpower problem. ALS is run by a separate, paid, regional service. FD is only called if there are vehicle fluids released or extrication will be taking place. FD will be on scene within 5 minutes as it's a small area. 99% of our MVA's do not require any extrication and that would add about 300 calls per year to my fire runs that are not necessary. Just the way it works around here.

[EFD840]

I would ease off on the entrapment argument and base my argument on scene safety and patient care needs. A few points to hammer home:

1) Traffic control. The big red truck is a great scene protection barrier. Check out www.respondersafety.com (http://www.respondersafety.com) . If they don't already know how dangerous a MVA scene is for responders, that site should enlighten them. Even if you get good law enforcement support, it is still better to have that barrier between you and traffic.

2) Patient care. How many ambulances do you dispatch to a confirmed MVA? If it is like my area, probably one. Great, so when you get on scene and find 3 or 4 patients, who is treating them? An engine company trained at first responder level can take c-spine, address airway problems, etc. Even with a single patient, it sure is a lot safer for the patient to have plenty of hands around when it comes time to move them to a spineboard.

3) Scene safety. MVAs introduce all types of hazards an EMS crew shouldn't have to face alone. Fuel spills, fires, utility lines, etc. Even if the firefighters can't directly fix the problem, they can identify it and make sure it doesn't interfere with patient care or endanger anyone. Power lines are a great example. If it isn't arching, civilians will walk all around it.

4) Public relations. This one should play more to the fire chief. The FD will spend a good deal more time in the public eye. Anytime you're seen helping people, you gain. If you're career, the payoff might be at contract time or the next time you have a tax referendum. If you're vollie, it will be as soon as the next fundraiser. Either way, people will remember.

Finally, at the very end, I would use the entrapment/delayed rescue argument. If you use it as your basic point, those in opposition will probably use call volume statistics against you. I know it shouldn't matter, but if you only run a few entrapments each year and most or all have successful outcomes using the current procedure, then you've lost before you even get started without other compelling reasons.

I hope you win the debate.

[Weruj1]

An engine should go to ALL MVA's and can get cancelled if it is not needed. If for nothing else ..........WHAT IF SOMETHING IS ON FIRE ?
We respond to MVA;s with the following in this order
Medic Unit
Rescue Engine
Second out Engine
Second Out Medic Unit
Safety Officer
and then we are down to the Quint or the SOG vehicle.

[GeorgeWendtCFI]

Originally posted by EFD840
I would ease off on the entrapment argument and base my argument on scene safety and patient care needs. A few points to hammer home:

1) Traffic control. The big red truck is a great scene protection barrier. Check out www.respondersafety.com (http://www.respondersafety.com) . If they don't already know how dangerous a MVA scene is for responders, that site should enlighten them. Even if you get good law enforcement support, it is still better to have that barrier between you and traffic.

2) Patient care. How many ambulances do you dispatch to a confirmed MVA? If it is like my area, probably one. Great, so when you get on scene and find 3 or 4 patients, who is treating them? An engine company trained at first responder level can take c-spine, address airway problems, etc. Even with a single patient, it sure is a lot safer for the patient to have plenty of hands around when it comes time to move them to a spineboard.

3) Scene safety. MVAs introduce all types of hazards an EMS crew shouldn't have to face alone. Fuel spills, fires, utility lines, etc. Even if the firefighters can't directly fix the problem, they can identify it and make sure it doesn't interfere with patient care or endanger anyone. Power lines are a great example. If it isn't arching, civilians will walk all around it.

4) Public relations. This one should play more to the fire chief. The FD will spend a good deal more time in the public eye. Anytime you're seen helping people, you gain. If you're career, the payoff might be at contract time or the next time you have a tax referendum. If you're vollie, it will be as soon as the next fundraiser. Either way, people will remember.

Finally, at the very end, I would use the entrapment/delayed rescue argument. If you use it as your basic point, those in opposition will probably use call volume statistics against you. I know it shouldn't matter, but if you only run a few entrapments each year and most or all have successful outcomes using the current procedure, then you've lost before you even get started without other compelling reasons.

I hope you win the debate.

I have worked plenty of MVA's w/o benefit of an engine. I would suggest to you that cleanup, potential hazards (there are no such hazards at the overwhelming majority of MVA's), public relations and the like are not emergencies. Traffic control is not the FD job. Also, the majority of FF up here are not trained in first responder, second responder or any responder, so they would be useless.

From the other standpoint, an engine can cause more traffic problems, place more people at risk and complicate what may be a simple incident. I have observed a need on the part of some (stress some) responders' part to have as many units respond to an incident as possible, solely out of a unspoken and subconscious need to make an incident appear serious.

Also, in the area where I vollie'd, there could be 2-3 MVA's per day. For a volly FD, this would be a dramatic increase in call volume. After awhile, there will be a problem getting a good response if the call volume is not matched by a dramatic increase in members.

Bash away, but you guys know that at least 75% of all MVA's can be handled w/o an engine. For the other 25%, by all means dispatch them.

[Weruj1]

ok George

[jaybird210]

I guess I would say the same thing here that I said in the Fire-based EMS thread.

It is specific to your area. Do what your area needs. To get out the big brush and say: Your way is wrong and/or stupid is ignorant, short-sided and arrogant.

Does it make sense to run an engine to every MVA? In New Jersey, I don't really know. I don't live there. But from what I've seen, I would say George is right. Most MVAs in the populated areas are probably easily handled by one or two medics.

I can tell you in my area, we absolutely must run an engine. I have been on the side of the road when some a:mad::mad:hole comes racing by at 60 MPH cause he has to get home and you damn firemen are blocking the road. I've been to crashes where we got dispatched for the one car crash and get there to find it four patients, all reds, and our M/A is 15-30 minutes out. So we run an engine, like Josh does, as a matter of course. Too much call volume? Well, then maybe it's time to make the transition to FT. But again, that's a local decision that I have no right to comment on.

[PgfdCo34]

all injury accidents on local streets get an engine and ambo, all reported pins and rollovers on streets an engine, rescue, ambo, and medic, all accidents on highways get 2 engines, 2 ambos, 1 resuce and a medic. 1 engine and ambu responds other direction of the highway to make sure its not in a diff location.. works out great

[Resq14]

A MVC with either unknown injury or confirmed injury in our district generates the response of a rescue-engine and an ambulance. Other personnel stage at the station with a second engine and second ambulance which are rarely needed.

If there is confirmed entrapment, a second rescue-engine or squad is started mutual aid "just in case."

We allow first responding police units to evaluate the need for fire/EMS, and we may be "cancelled en-route" if no one is requesting an ambulance and if there are no hazards. Our officers all have EMT training so this works out very well. Other law enforcement agencies know to err on the side of caution if they aren't sure whether EMS is needed.

While directing traffic might not be the FD's job, George, in many areas there isn't enough available law enforcement to safely protect a scene or handle traffic control duties. If the ambulance is out there, I feel there should be a BRT behind it. The big red truck with an appropriate buffer between it and the ambulance can provide a safe zone in which the EMS crew can work.

It has almost become routine to read about leo's, ff's, and medics getting hit by cars. Being "aware" while you're out there is probably the most important thing, but you can't always jump out of the way of an out-of-control driver. I say park the BRT for safety and to make traffic slow down. Respondersafety.com has some great information.

Of course, I'm all for staying off the highway as much as possible.

[Kobersteen]

Working right off of I-95 (the major North-South corridor on the east coast), I find that an Engine and/or Squad on an MVA is an absolute necessity. I cannot count the number of times that, regardless if traffic is moving at 5 mph or 70 mph someone tries to run us down at the scene. Are we helping the gridlock of the Washington, D.C. area? Most likely not. Do my wife and children care? Not as long as daddy comes home at the end of the shift.

In addition, this is not just a problem on the interstate, I've had the same experiences on side roads. Very little stops a speeding car like a big fire engine with 750 gallons of water.

As for having it there on the off chance that something lights off (non-extrication, I'm talking), I can't go for that. In 13 years in the fire service, I have yet to roll up on a dispatched 'simple' MVA and find the need to 'wet stuff for red stuff'. Then again, every DC area citizen is born with a cell phone melded onto their ear and they will let us know if there is even a hint of fire/smoke/steam/etc.

[ALSfirefighter]

You got that right Kober, I've spent my time on 95 down in Spotsy, very interesting.

Everyone had excellent points, even George who made a case on the opposite side of the equation. Fact is this, is it absolutley necessary to have an engine or any apparatus on every MVC, no, is it a damn good idea, yes it is. I agree with George that the extrication argument isn't the strongest and thats the first thing that came to mind. Safety is the best argument. When I roll to a MVC with an engine as a firefighter, not medic, my responsibility is to assist EMS and rectify any hazards or potential hazards and make their life safer and easier, we have the tool if need be, but that's not the primary reason we are on the response, even if it comes in as an entrapment, scene safety is always first, the rescue part comes 2nd or even really 3rd after making it safe, and stabilization.

George, your right the majority of MVC's could be handled without an engine, heck, we have higher percentages of calls that could be handled (on statistic like stated)with one engine, but there are places that send 2, 3 and even 4 or 5. How about repeat malfunctions from the same facility/building, could a chief check that out without sending anything? (and I'm not bashing you George, I think I made it clear)
Traffic control is the FD's responsibility if it is part of the operations/SOG's, in many states once FD is on scene they are responsibile/liable for scene safety, I'd be willing to bet that includes safe passage of traffic if its moving. Traffic back ups aren't even in my vocabulary until I know I can control movement safely or all hazards or potential hazards have been removed. Yes in the am and pm rush I am aware that it can cause severe snarls but I do not let that effect my thought process, no matter what PD or Trooper is bugging my ear.
___________________________________
IACOJ Bureau of EMS Chairman

[GeorgeWendtCFI]

George, your right the majority of MVC's could be handled without an engine, heck, we have higher percentages of calls that could be handled (on statistic like stated)with one engine, but there are places that send 2, 3 and even 4 or 5. How about repeat malfunctions from the same facility/building, could a chief check that out without sending anything? (and I'm not bashing you George, I think I made it clear)

I didn't take it as bashing. I have posted my thoughts on those subjects in the past as well. I think that there are a few progressive FD's who are beginning to handle calls on a non-emergency basis because it makes sense. Instead of planning for that once in a career exception to the rule, respond with the due diligence of the safety of the public for the every day situation.

You should have seen the stir I started once when I advocated non-emergency response to CO detector alarms. Hell, we have FD's here that respond to CO detectors hot with a full structural response. It's nuts.

[Ohiovolffemtp]

George,
I think alot depends upon the characteristics of your response area. Is your area primarily urban with relatively low speed impacts and on flat, paved areas? If so, you are much less likely to need multiple personnel on scene for extrication, pt. removals up hillsides, traffic control, etc. I'm guessing that being from northern NJ, that may be the case for you.

In the areas where I run, most crashes occur in 35 to 60 MPH zones. That's a speed at impact of 35-80 (speed limits are often exceded) on crashes into fixed objects or T-bones, and 70-150+ on head ons. Fire/EMS (almost all depts are dual role) often arrives before PD, and PD typically only has 1-2 officers respond. So, we usually need multiple units and their personnel.

Since dispatch, even with medical priority dispatch, doesn't always give a good picture of the true severity of the incident, we typically start with 1-2 ambulances and 1-2 engines or rescue co's. If they're not needed, they're disregarded.

And - I totally agree with single unit cold responses for CO activations with no reported symptoms.

[EFD840]

George,

In my area, traffic control is the FD's job by default. My town has at most 2 police officers on duty at any time. Sometimes it is only one. The county only has a few deputies on duty at once, and there is usually only one state trooper covering the entire county. The LEOs are great, but they can't perform traffic control with their staffing levels.

I agree completely that the response level should match the situation and your capabilities. In this case, I'm guilty of assuming you're responding with people trained to at least the first responder level. Our response to an accident with confirmed injury is 1 engine and our light rescue. If we're called to assist with traffic control, clean up a spill, etc. we will respond non-emergency with the light rescue and usually the brush truck. Just like traffic control, we take care of these situations because there isn't anyone else to call.

As with nearly every other issue discussed here, there isn't a one-size-fits-all solution. What we're doing works for us.

Edited to add this thought: Those running hot with full responses to CO alarms ARE nuts.

[Bones42]

You guys make me love my town that much more! My local PD is our 911 dispatch also, so they will always have at least 2 cars on their way while we are being dispatched. Small, flat town, so mostly minor MVA's involving little cleanup if any at all. FD does not do extrication. EMS handles that along with patient care. At average of 180 FD calls per year, adding 300+ for minor MVA's simply to block traffic will kill us. Then again, if we were on highway's with cars at higher speeds, I would rather have a big truck behind me then the little police car. As someone said earlier, it really matters where you are at and what you have to deal with. Blue Canaries (oops, PD) are on scene 99.99% of the time first. 1/2 of them are also FF's and give very good updates, 3/4 of them are EMT's.

[Weruj1]

George, I dont often agree with you .....but that IS nuts !

[ALSfirefighter]

Actually, George I agreed with you on those forums about cold response and caught some of the same "heat." I find myself responding hot to less and less calls. In fact I have been trying for about a year to get to send only the first due engine hot on all AFA's, but of course its like talking to a deaf ear. I just didn't want you to feel I was jumping on you, because I agree with most of what you say. I'm just one of those guys that think its always a good idea of having an engine at a MVC.

[Resq14]

Originally posted by ALSfirefighter
Actually, George I agreed with you on those forums about cold response and caught some of the same "heat." I find myself responding hot to less and less calls. In fact I have been trying for about a year to get to send only the first due engine hot on all AFA's, but of course its like talking to a deaf ear. I just didn't want you to feel I was jumping on you, because I agree with most of what you say. I'm just one of those guys that think its always a good idea of having an engine at a MVC.

ditto to the above.

[DrParasite]

I think one of the reasons George, Bones, and I will say you don't need an engine at an MVA is that most vol FDs in NJ don't respond to MVAs. Extrication has traditionally been handled by the Rescue Squads, which also do EMS. As times have been changings, more FDs are taking over extrication at MVAs in some towns. but the majority of the FDs (particularly the vol FDs) don't do EMS.

I'm from central NJ, and my squad runs about 4500-5000 calls a year. the FD (3 seperate districts) run maybe 2,000 calls total. for them to respond to all MVAs would cause an unneccessary burden for them. we can have maybe 4+ MVAs a day. having 3 ambulances on calls at once isn't uncommon. so it's pretty busy. I can (and have) handled a 2 car MVA with just a 2 man ambulance. it's not ideal, but it can be done. more people are nice to have, but not required. I'm not going to turn away help, but i'm also not going ot tie up resources when i could operate without them.

btw, in regards to traffic control, my FF1 course didn't teach it. the only thing they taught was apparatus placement. and with all the talk about people getting hit doing traffic control, I'd rather not be that person. as a the lead person on the ambulance, I will not endanger any of my crew by having them to traffic control. I will light flares, and that's about it (if someone wants to plow into a flair, that's their problem. traffic control, like making sure a scene is safe and secure, is a job for PD.

How about repeat malfunctions from the same facility/building, could a chief check that out without sending anything? and what do you say when after 3 false alarms, the chief decides to investigate alone, and pulls up with smoke pouring out the windows? start them cold, you can always have them upgrade or have them return.

[tripperff]

Absolutely! In my years in the Fire/EMS service I HAVE rolled up on a scene to find smoke rolling out from under the hood of a vehicle. Traffic control is also our responsibilty by default, we cover a village, four seperate townships in 2 different counties, so the wait for law enforcement can be lengthy, and then it's usually one officer unless it's a serious incident, so a big white fire truck (yes ours are white, at least they aren't yellow or slime lime) on the scene does tend to make things a little safer for us in the long run. Our run card for an MVA is Engine, Heavy Rescue and Tanker. I'm hoping to get the standard for MVA's to be Engine short of the vehicle/s to block and make initial size up (we usually get at least 1 EMT on the Engine) Rescue past the vehicle/s, Tanker behind the Engine (1600 gallons of water will stop a car better than 750 gallons).

[Kobersteen]

btw, in regards to traffic control, my FF1 course didn't teach it. the only thing they taught was apparatus placement. and with all the talk about people getting hit doing traffic control, I'd rather not be that person...

You prove my point exactly. Vehicle placement entails placing the Engine and/or Heavy Rescue to block the scene plus one or two lanes.

I will light flares, and that's about it (if someone wants to plow into a flair, that's their problem. traffic control, like making sure a scene is safe and secure, is a job for PD.

Actually, they run through a flare and into your scene, it is more than their problem. They run into an Engine or Heavy Rescue, that would be their problem.

[EMTAC834]

For the most part I am happy when the police show up for a MVC in the town I work in. If we need extrication we call for the fire department, but to be honest they have very little practice cutting cars and alot fighting fires. There have been times that I have been told that if there was any injuries to let PD know where they went and they will get the report later. They, the PD is about as overworked as we are. PD answers 100,000 + calls a year with a less then 90 man dept. EMS gets its share 2 BLS on at any given time with a call volume between 15 and 20k calls a year. We get a structure fire at least every 2 weeks sometimes more. Not bad for a 2.8 sq mile town

[FireGirl444]

Right now I run with a volly squad in a rural area, and we just had a huge debate on MVA run cards. We have four districts, two that are less rural and two that are more like the middle of nowhere. In my district, one of the less rural ones, we have a brand new state of the art heavy reascue(squad) that carries every extrication tool known to man. Each of the other companies carries Hurst tools, one set on a ambulance and the other two on engine companies. For MVAs in the two less rural areas with more manpower, we roll ambulance, engine, and squad. In the other two districts, everybody goes. Sometimes it gets to be a bit much...two ambulances, three engines and two squads. But I guess it's better to have the calvary on the way and turn back who you don't need, than wait and call for them when companies such as mine are at least 20 minutes out.

The thought of responding to an MVA with just an ambulance is absurd, and to agree with everyone else, it's not just about extrication...manpower and scene safety are equally important things to consider.

[eyeOthestorm]

Originally posted by jaybird210
I
I can tell you in my area, we absolutely must run an engine. I have been on the side of the road when some a:mad::mad:hole comes racing by at 60 MPH cause he has to get home and you damn firemen are blocking the road. I've been to crashes where we got dispatched for the one car crash and get there to find it four patients, all reds

Most of the time our FD's will beat us to the scene and have saved peoples lives by just opening an airway. In one county I work for we do not get any kind of EMS dispatch until it is confirmed injury. That means that if someone drives by and sees a car over the embankment but is too afraid to stop(don't get me wrong in this day and age I understand that in rural America)... they can't tell dispatch if there are injuries... dispatch waits for a deputy to come all the way across the county to confirm one way or another....:mad: At least send someone closest to confirm one wau or another...

[firemedicgm]

A couple comments were posted that really bother me. Someone (okay, so I'm too lazy to look it up) stated that most FF's in their district had no EMS training, so they would be "worthless" at the scene.

My issue with that statement: It doesn't take EMS training to grab a handle on the longboard and help lift your 500-lb patient out of the vehicle.

And I can agree with George's point about FF's not being NEEDED at most accidents. That is true. However, most days, I don't NEED a smoke detector in my house, but I'm going to keep them around anyway - just in case. Most trips, I don't NEED to wear my seat belt. I haven't had an accident in 15 years. But I think I'll keep wearing it anyway.

My district is all volunteer (except for a paid chief). Our guys have NEVER complained about being called out when they weren't needed - even for those 4 AM accidents. I'm surprised that the chief is against sending an engine to the scene. Our chief would love it if our dispatchers were directed to send fire to every accident. However, other entities in our city/county have decided that the dispatchers will wait until law enforcement confirms that the fire department is needed before paging them.

In their defense, however, I do have to say that our dispatchers (incidentally, I'm one of them, in addition to being a firefighter/EMT) are trained to gather information from the caller - how many vehicles, is anyone trapped, do injuries appear to be serious, what type of collision (head-on, rollover, etc.). All of this info allows them to make an educated decision whether or not to page the fire dept. They have the authority, based on the information they receive, to dispatch any services they deem necessary.

Just two nights ago, we had a fatality on a rural highway south of town. The fire department was paged, because it was reported as a car vs. semi head-on collision. We did not need to extricate and there was no fire, but the fuel tanks on the semi were torn open, and about 150 gallons of diesel was spilled on the road. In addition, the road was littered with debris for about 150'. One person had been ejected from the car, and we did not know if there had been other occupants. Law enforcement was doing traffic control, EMS was attending to the semi occupants - who was left to search the ditches for additional patients? Who was left to clean up the highway? DOT was about an hour out. After combing the ditches for bodies, our firefighters swept the road clean with push brooms. You don't have to be a paramedic to push a broom.

[joejoe33]

Our Standing Operating Guideline (SOG) gives an engine company response with a MICU on all major accidents. Our terminology defines a major accident as an accident with injuries and a minor accident as an accident without injuries. Sometimes it is dispatched as an unknown major or minor accident. It still gets an automatic engine and MICU response. The MICU is usually on scene first and can disreguard the engine company if not needed.

We are fortunate in our city in that all engine companies are paramedic engine companies. This will give the MICU extra EMS help if needed. The engine companies primary task is to provide fire protection, extrication, and set up a helicopter LZ if necessary.

Our Fire/Rescue personnel assigned to the MICU carry full protective firefighting turnouts and SCBA's on the MICU. Some things to think about when utilizing an engine company can be, but are not limited to some of the following. Engine companies can secure the scene and set up a critical incident area usually 100 feet in diameter around the incident. This may mean placing the engine company uphill and upwind from the incident. This is important because of HazMat and spills. Lanes of traffic may need to be closed down. The engine company will utilize police for this task and this will keep police and any bystanders out of the critical incident area. The engine company may carry cribbing or wheel chocks to stabilize the vehicle prior to extrication. A rule of thumb to remember about extrication. If a vehicle is so badly damaged to require extrication of its occupants, that vehicle may also be damaged enough to be a potential fire hazard. If the Amkus or Hurst tool is to be utilized off the engine company,it is a good idea to pull and charge a one and a half inch or one and three quarter inch hose line off the engine company. This will protect occupants of the vehicle and EMS and Fire personnel in or around the vehicle from the potential of fire. Engine companies carry tools for disconnecting batteries etc. Engine company personnel may be utilized for packaging and extrication of patients from a vehicle. Our paramedic engine company paramedics may stabilize multiple patients prior to other MICU's or ambulances arriving on scene.

Our engine companies carry oil absorbant and may be utilized for controlling some spills. The engine company is also capable of doing washdowns of the area afterwards.

I have not covered every possible scenario for use of engine companies. I just made a few suggestions that work for our organization.:rolleyes: