An Orange County Grand Jury report, “WHERE’S THE FIRE? Stop Sending Fire Trucks to Medical Calls,” asks fire departments to do just that.
Throughout the county, the report shows, nearly 80% of all 911 calls to fire departments are of the medical variety.
“Even though 911 calls are categorized by severity, responses by most Orange County fire departments do not change accordingly,” the report says. “Current protocol requires sending multiple vehicles to the scene which involves not only additional personnel but also expensive fire equipment. This is the case even when an ambulance or rescue squad vehicle could provide all the necessary medical supplies and personnel.
“Sending a 36,000- to 60,000-pound fire engine or aerial ladder truck down residential streets for strictly medical calls is not only dangerous and costly, but it also results in unnecessary wear and tear on our streets.”
Other findings:
-Despite fire departments throughout Orange County having evolved into emergency medical departments, most have not updated their emergency response protocols accordingly, but have simply absorbed emergency medical responses into their existing fire response models.
-Despite use of a tiered dispatch system, OCFA’s deployment of resources for medical responses are the same for nearly all calls, resulting in unnecessary wear and tear on expensive fire-fighting equipment and public infrastructure.
-ALS-staffed ambulances or smaller squad vehicles are often the most appropriate response to medical calls and do not compromise the quality of medical care.
-There has been a breakdown of communication and trust between OCEMS and Orange County Fire Chiefs.
-Over-deployment of firefighters for medical calls contributes to the current climate of forced hiring and firefighter fatigue.
-Code 3 response is overutilized by OCFA, unnecessarily putting the responders and public at risk.
-Since the outbreak of the COVID pandemic, there has been an emergency medical personnel shortage. The pandemic also has contributed to longer wait times at hospitals resulting in firefighter personnel being out of service for longer periods.
-There are specific areas within Orange County, such as Laguna Woods and Seal Beach, that have an extremely high percentage of medical calls which, under the current model, results in the stations servicing those communities to require two engines.
-OCEMS has the authority and responsibility to inspect all for-profit ambulances operating in Orange County; however, publicly owned ambulances are not automatically subject to OCEMS oversight.
-Placentia’s changes to the emergency medical response protocols after leaving OCFA have resulted in improved medical call response times.
Grandy Jury’s Recommendations:
-As recommended in the 2012 and 2014 OCFA Standards of Coverage and Deployment Plans, as well as other studies, the Grand Jury recommends that, by 2024, all Orange County fire agencies utilize criteria-based dispatch protocols and send a single unit response to those incidents triaged as non-life-threatening.
-By 2024, OCFA should station a paramedic squad vehicle, which is more nimble and less costly to operate, in place of a second engine in stations with high volumes of medical calls.
-OCFA should immediately stop the practice of requesting Code 3 responses on all non-life-threatening calls.
-While OCEMS should recognize how certain policy changes may pose operational challenges to emergency responders in the field, fire leadership should recognize and respect the independent oversight authority and expertise of OCEMS.
-Departments with publicly owned ambulances should allow OCEMS to inspect their ambulances for compliance with State EMS guidelines and adopt OCEMS recommendations. F9
