Certifications for members

[F117AN]

I apologize in advance if this is the incorrect place to put this question, but it seemed to be the most closely related area for it.

Regarding the medical certifications for Fire-side members, I can understand the Engine and Squad members are CFR-D (not too sure about the Trucks, but they’ll definitely have if the brass makes them go to CFR runs too), but are the Rescue members (HazMat too) CFR-D or are they trained to EMT-B due to their being part of the 800lb gorilla we know as SOC?

My logic could very well be off, and it may turn out to be that Rescue Medics are given the ticket, but I’ve been wondering if Rescue and HazMat have higher certs just because they can find themselves in more complicated situations than the line companies. I think it was Brian Sweeney of Rescue 1, may he rest easy, who said that they take major trauma runs, but again I don’t know if regular line companies go to major trauma runs if they’re only CFR-D.

Additionally, if any member fire-side in line company has a cert higher than CFR-D, such as EMT-B or AEMT, from being previous EMS, are they allowed to practice to that level if the cert is still active? Or are they forbidden from practicing higher than CFR-D due to equipment and the potential need for the officer of the rig for that tour to also have the cert?

I recognize that I sound clueless, but everything works so much differently up here in Canada.

Thanks for taking time from your day to read and potentially reply to this.

Have a good day or night, wherever you may be.

 

[NikFDNY]

I apologize in advance if this is the incorrect place to put this question, but it seemed to be the most closely related area for it.

Regarding the medical certifications for Fire-side members, I can understand the Engine and Squad members are CFR-D (not too sure about the Trucks, but they’ll definitely have if the brass makes them go to CFR runs too), but are the Rescue members (HazMat too) CFR-D or are they trained to EMT-B due to their being part of the 800lb gorilla we know as SOC?

My logic could very well be off, and it may turn out to be that Rescue Medics are given the ticket, but I’ve been wondering if Rescue and HazMat have higher certs just because they can find themselves in more complicated situations than the line companies. I think it was Brian Sweeney of Rescue 1, may he rest easy, who said that they take major trauma runs, but again I don’t know if regular line companies go to major trauma runs if they’re only CFR-D.

Additionally, if any member fire-side in line company has a cert higher than CFR-D, such as EMT-B or AEMT, from being previous EMS, are they allowed to practice to that level if the cert is still active? Or are they forbidden from practicing higher than CFR-D due to equipment and the potential need for the officer of the rig for that tour to also have the cert?

I recognize that I sound clueless, but everything works so much differently up here in Canada.

Thanks for taking time from your day to read and potentially reply to this.

Have a good day or night, wherever you may be.

You aren't clueless, just NYC's Medical System is a bit of a mess.

First, just some back story, CFR is (almost) completely the same protocol-wise as EMT-B, there are some differences, but a CFR Firefighter (should) be able to keep you alive as best as he can when compared to an EMT. All members of the (fireside) of the Department maintain their CFR Certification until they reach the rank of Battalion Chief.

Members can keep their EMT-B and EMT-P Certifications, but are only to practice CFR-D when operating as an FDNY Member (a lot of members are Volunteer Members in Long Island and other states).

Engines respond to all Segment 1-3 Calls (A lot of the Immediately Threatening Calls), Such as Heart Attacks, Major Bleeding, ped struck by train, childbirth..etc. Truck Companies do not respond to CFR Runs, but many (I believe now all of them?) carry basic CFR Equipment.

There are (apparently) plans to force members coming over from EMS to maintain their EMT-B/EMT-P certifications. (You can read into that here ) The department might possibly want to switch to running things such as ALS Engines like other departments in the country.

Basically, the job for the fire side at Traumas is to keep the patient alive for long enough, to extricate them..etc.

Rescue Medics have nearly the same Hi-Angle, Trench Rescue, and Confined Space Certifications as Rescue and Squad Companies (primarily shorter classes). And may treat in place if they arrive soon enough (Crush Syndrome is a big one). And even then, they could be 10-30 minutes away depending on where this is happening in the city, so often times Field Units will simply stabilize then transport them once extricated.

 

[F117AN]

You aren't clueless, just NYC's Medical System is a bit of a mess.

First, just some back story, CFR is (almost) completely the same protocol-wise as EMT-B, there are some differences, but a CFR Firefighter (should) be able to keep you alive as best as he can when compared to an EMT. All members of the (fireside) of the Department maintain their CFR Certification until they reach the rank of Battalion Chief.

Members can keep their EMT-B and EMT-P Certifications, but are only to practice CFR-D when operating as an FDNY Member (a lot of members are Volunteer Members in Long Island and other states).

Engines respond to all Segment 1-3 Calls (A lot of the Immediately Threatening Calls), Such as Heart Attacks, Major Bleeding, ped struck by train, childbirth..etc. Truck Companies do not respond to CFR Runs, but many (I believe now all of them?) carry basic CFR Equipment.

There are (apparently) plans to force members coming over from EMS to maintain their EMT-B/EMT-P certifications. (You can read into that here ) The department might possibly want to switch to running things such as ALS Engines like other departments in the country.

Basically, the job for the fire side at Traumas is to keep the patient alive for long enough, to extricate them..etc.

Rescue Medics have nearly the same Hi-Angle, Trench Rescue, and Confined Space Certifications as Rescue and Squad Companies (primarily shorter classes). And may treat in place if they arrive soon enough (Crush Syndrome is a big one). And even then, they could be 10-30 minutes away depending on where this is happening in the city, so often times Field Units will simply stabilize then transport them once extricated.

Thank you for taking the time to reply and explain.

I have a slightly different perspective, being both Canadian and more specifically living in a province that recognizes two additional categories pre-hospital cert. My local Job, the Winnipeg Fire Paramedic Service (the parent org of WFD and WEMS), runs Primary Care Paramedics (equivalent to the American EMT-B) on all companies, regardless of whether it’s an Engine, Truck, Rescue (Rescue-Engine or Heavy Rescue, brass can’t have too many pure Rescues apparently), HazMat, a Squad (our squads use the same type of van as the RACs), or safety officer (equivalent to SB01).

Primary Care Paramedics, which are above an EMR, but below an Intermediate Care Paramedic (unique to Manitoba, BLS-ALS hybrid), Advanced Care Paramedic (ALS), and Critical Care Paramedic (ALS-ICU hybrid).

PCPs practice at the same level of a US EMT-B, so they provide the full BLS suite with the ability to tack on extra certs for IV/IO. ICPs are a sort of hybrid between PCPs and ACPs, having a scope of practice that is a copy of the PCP but with a few more things added including cardioversion, cardio pacing, and additional medication-administration permissions. ICPs are typically just PCPs that are on the ACP pipeline and finished their first year of the WFPS ACP program.

In the question I’m about to ask, ACPs and CCPs don’t matter, so let’s pretend they don’t exist.

Is there any way the Job down there could run a similar way, putting EMT-Bs on Companies that roll to medicals not only to take refusals of medical care to free up EMS, but to also provide better quality care in those Segment 1-3 calls where they’re needed most?

Thanks again,

Your Northern Neighbour.

 

[NikFDNY]

Is there any way the Job down there could run a similar way, putting EMT-Bs on Companies that roll to medicals not only to take refusals of medical care to free up EMS, but to also provide better quality care in those Segment 1-3 calls where they’re needed most?

The main difference is very minor in the protocols between CFR and EMT-B (there are overall a few, but much less than what the fire side will generally be operating at). While it can be argued that the Patient will receive a better standard of care if an EMT rather than a CFR FF treats them, there is, I suppose, one main reason: money. If the Department forced every member, or even just a select few, to become, maintain, or use EMT-B, they would need to be paid more than they already are as Firefighters.

 

[F117AN]

The main difference is very minor in the protocols between CFR and EMT-B (there are overall a few, but much less than what the fire side will generally be operating at). While it can be argued that the Patient will receive a better standard of care if an EMT rather than a CFR FF treats them, there is, I suppose, one main reason: money. If the Department forced every member, or even just a select few, to become, maintain, or use EMT-B, they would need to be paid more than they already are as Firefighters.

That is certainly fair enough, given the bean counters would throw a fit and pay even less if they could.

However, let’s entertain the idea, imagining the previously mentioned bean counters are on vacation for this.

Last I heard, your Job down there has 197 Engines, 8 Squads, 5 Rescues, and 1 HazMat Company. Cool, that’s 211 companies. If you operate on a 3-tour system, and want 1 member from those companies to be on-shift with EMT-B at all times, that’s 633 members without margin for error. Add a margin, that’s 844 and the extra member per company is a backup, just like chauffeurs have their hierarchy on tours.

Assuming 10k members OTJ right now, that’s 8.44% of members, give it to the guys on the backstep who aren’t probies and have a couple years on the job, they’re making $29.65-$32.59/hour, so tack an extra $2-4/hr on them. That’s an additional $1,688-$3,376 per day if you paid not only the 3 primaries but also the company backup.

Overall, the amount of money being spent per year on additional pay if it were done would come out to $616,120.00-$1,232,240.00 assuming a decent set of circumstances.

The bean counters would never let that happen, so that then brings me to another option that I’m fairly certain could make you all cringe.

Bring back Battalion Aides full-time and give them EMT-B, as there’s only 53-ish Battalions that I know of, and it’ll turn out to 212 members at the maximum. You’d only need it for higher acuity calls, and BCs can squeeze into places an engine chauffeur could only dream of, regardless of their skill.

It just seems like a waste to send an engine for CFR and turn out only to be capable of saying “Here’s a TQ and bandaid, sorry we can’t do more for you,” meanwhile ambulances are tied up way too tightly by call volume and infrastructure that wasn’t built for the call volume (no stranger to that, EMS and ERs are crumbling up here because of penny-pinching governance, which all political parties are responsible for, and I experienced a 6hr wait time for an ambulance a few months back).

Thanks for replying,

Have a good day or night, whichever it may be for you.

 

[NikFDNY]

That is certainly fair enough, given the bean counters would throw a fit and pay even less if they could.

However, let’s entertain the idea, imagining the previously mentioned bean counters are on vacation for this.

Last I heard, your Job down there has 197 Engines, 8 Squads, 5 Rescues, and 1 HazMat Company. Cool, that’s 211 companies. If you operate on a 3-tour system, and want 1 member from those companies to be on-shift with EMT-B at all times, that’s 633 members without margin for error. Add a margin, that’s 844 and the extra member per company is a backup, just like chauffeurs have their hierarchy on tours.

Assuming 10k members OTJ right now, that’s 8.44% of members, give it to the guys on the backstep who aren’t probies and have a couple years on the job, they’re making $29.65-$32.59/hour, so tack an extra $2-4/hr on them. That’s an additional $1,688-$3,376 per day if you paid not only the 3 primaries but also the company backup.

Overall, the amount of money being spent per year on additional pay if it were done would come out to $616,120.00-$1,232,240.00 assuming a decent set of circumstances.

The bean counters would never let that happen, so that then brings me to another option that I’m fairly certain could make you all cringe.

Bring back Battalion Aides full-time and give them EMT-B, as there’s only 53-ish Battalions that I know of, and it’ll turn out to 212 members at the maximum. You’d only need it for higher acuity calls, and BCs can squeeze into places an engine chauffeur could only dream of, regardless of their skill.

It just seems like a waste to send an engine for CFR and turn out only to be capable of saying “Here’s a TQ and bandaid, sorry we can’t do more for you,” meanwhile ambulances are tied up way too tightly by call volume and infrastructure that wasn’t built for the call volume (no stranger to that, EMS and ERs are crumbling up here because of penny-pinching governance, which all political parties are responsible for, and I experienced a 6hr wait time for an ambulance a few months back).

Thanks for replying,

Have a good day or night, whichever it may be for you.

Battalion and Division Aides are already full-time, they are who speak on the Borough Frequency when the Chief is involved in some form of Incident Command

But back to cfr, their level of care is still great at CFR, below is some of the protocols (I definitly cherry picked them lol). But it seems that the main difference is that:

1. They (obviously) can't transport.
2. They can't obtain blood glucose level.
3. They can't request ALS (this is only in the REMAC protocols fdny units can request als through the fire dispatcher who tells the ems dispatcher.)
4. They can't administer all of the same drugs (or in the same way.) Albuterol, aspirin, epinephrine, naloxone is what they can administer (there may be more but im not looking through the Medication List.) EMT-B's can administer, glucose & ipratropium.

They are going to be able to keep you comfortable (and more importantly, alive) until the ambulance arrives (I've always seen Ambulances arrive either before or just after the CFR Engine).