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Emergency Medical Services in the Fire Service | SKFR Guest Column
During recent weeks there have been articles in the Port Orchard Indepedent regarding our Standard of Cover and Accreditation. As they explained, we use those documents to analyze our department so that we can provide the best possible response and service to our community. As the Medical Officer for South Kitsap Fire and Rescue I would like to take this opportunity to explain a few things about how the EMS side of our department operates.
More than 70 percent of our calls for help are medical in nature. Seconds do count when your heart stops, you have uncontrollable bleeding or you’re having difficulty breathing. SKFR has 84 career line firefighters, 19 of them are duel trained as paramedics and the other 65 are Emergency Medical Technicians. These firefighters work on a 24 hour shift rotation. In our 118 square mile response area, we have 7 staffed stations with 2 firefighters and one is staffed with 4 firefighters. The small crew size allows for a quicker initial response time and allows for us to stabilize a patient quicker. Each station has an ambulance and a fire engine to respond to emergencies. Depending on the nature of the call, the firefighters respond in the appropriate vehicle. We call this cross-staffing.
Accreditation dictates that we use a system called critical tasking to determine the effective response force needed to provide the proper staffing, equipment and treatment to have a successful outcome for each type of emergency. This is why you may see a single fire engine, single ambulance or a combination of vehicles at any given emergency scene. Anytime someone calls 911 the closest available station responds first with two firefighters, but some EMS calls require up to six firefighters which we deploy through a layered response system.
For example, a fall that may not require a trip to the hospital is coded as a basic life support medical call. This requires 2 firefighter EMTs, so the closest available BLS qualified unit would respond. Ambulances and fire engines are qualified BLS units. If the call required treatment and transport, in addition to the closest unit we would also send an ambulance with transport capabilities. When the call is dispatched as an advanced life support call, such as heart problems or respiratory distress, 4 firefighters are needed and one must be a certified paramedic. These same numbers would apply to calls with multiple patients; this is why you may see one, two or even three ambulances at the scene of a car accident. If that same accident has a fire or extrication rescue potential then there may also be one or two fire engines at this call.
It is interesting to note that SKFR serves a population of over 72,000 people who call South Kitsap their home. Our EMS calls are divided into two basic categories, Advanced Life Support and Basic Life Support. Per our Standard of Cover 55 percent of medical calls are dispatched ALS and 45 percent are BLS. Our top four requests for medical assistance for the last six years have been traumatic injuries, cardiac issues, respiratory emergencies, and abdominal problems.
South Kitsap Fire and Rescue is committed to keeping units available to respond to your emergency but at the same time we must have the proper amount of people on a scene to properly mitigate an emergency in accordance with our industry best management practices.
SKFR is internationally accredited because it meets or exceeds these best management practices. This ensures that SKFR provides the best emergency services with the funding our citizens entrust us with. In the past six years we’ve hired firefighters and staffed stations in the Bethel and Manchester communities, which have reduced our response time district wide by more than three minutes. We have also used good spending practices by remounting and refurbishing our ambulance boxes on new chassis rather than buying new vehicles. We have ten ambulances in our fleet and this saves us over $50,000 each year.
Battalion Chief / Medical Officer
South Kitsap Fire & Rescue