I recently responded to two calls that had me scratching my head. Both had me wondering about allocation of resources and how they are used. One was a structure fire, and another was a routine medical run.
The fire call was a mutual-aid run for a house fire. The house was a single-story, ranch style with some additional porches and a finished basement. Initial scene size-up said the building was about 20 by 40 feet with heavy smoke showing on arrival. It was a “bread and butter” type call that quickly escalated to four alarms with some special assignments, and I am not sure why. For my department, it was four fire districts away. From the time of the tone until we parked the engine, 57 minutes had passed. I should also add that we got called to the scene two hours into the event. An excavator, which ultimately flattened the remains, was already staged at the scene by the time we arrived.
I am never one to Monday morning quarterback any decisions, especially on a mutual-aid call, and I won’t now, but I have to say, there was an impressive number of apparatus at the scene. As we pulled up along the long, straight section of the two-lane highway near the fire site, it looked like a July 4th parade was forming.
Apparatus from at least a dozen different fire departments, some with multiple units, from two states, and two ambulances made it to the fire. It should be noted that apparatus from two additional stations were summoned for station coverage assignments. It was an extraordinary response for anything in my area. To be fair, there were extenuating circumstances, such as frigid weather and what could be described as a hoarding condition in the building that may have prompted the enormous response. But it was still just a small, ranch-style, single-family home.
By my estimates, there was probably at least $10 million in apparatus and countless personnel dispatched for the call. It made me wonder if the response matched the hazard. Per command, my crew went to the front of the fire building with hand tools. We gazed at the smoldering remains. Minutes later, our crew was released, and we returned to the station. Total run time was 2½ hours. Our $497,000 engine was covered with white salt dust from the commute to and from the fire and we burned a quarter of a tank of fuel. For what reason?
Please understand, I am all for mutual aid, and we NEED to help each other. We all responded, eager to help our neighbors, and we’d do it again tomorrow if asked. However, because resources are so tight, we have to make sure our requests match the need.
The med call happened to be the very next day, and that, too, had me wondering about resources. We received a 911 call to a residence in town for an elderly man who was sick and unable to move. That’s a pretty typical, almost generic, call for many EMS agencies. There was nothing unusual about this one, except one thing: There really wasn’t any medical emergency. A home health care provider decided her client needed care beyond what she could provide and needed in-patient rehabilitation—a reasonable conclusion. So, she activated the 911 system. That wasn’t a reasonable solution. A transfer crew should have been scheduled to take the patient to an appropriate rehab facility rather than activating an EMS crew and a $200,000 ambulance staff with an EMT and a paramedic for emergencies. We spent an hour at the scene trying to find a solution and we thought we had one and cleared with a signed patient refusal. Ironically, three days later, the same ambulance and a similar crew were dispatched to the same address. This time, the patient was transported to the local emergency room. It seems the health care system failed to match services with need and the patient may have unnecessarily suffered.
All of us connected with public service, whether it be fire protection, EMS, or any other related agency, need to manage resources with efficiency and great respect for the people who pay for it and provide it. We certainly must deliver to our “customers” the best protection and care possible, without question, but we need to be aware that allocating a convoy of apparatus or burdening an ambulance crew with red tape and repeat responses means diminished resources for others who might need services urgently. It’s a balancing act, but we have a sworn duty to serve our citizens and allocate equipment and staff with efficiency. The public has entrusted us with their hard-earned tax dollars. Let’s do everything we can to respect that trust.
