Okay, listen, I confess. As a fan of ladder company apparatus, nothing makes me happier than seeing a beautiful red tiller or Aerialscope screaming its way down the street. Effective truck work is, in fact, one of the key indicators of a fire department that has it's s*&t together, so hey, bring on the ladder companies.
However, there seems to be an increasing trend of these apparatus being utilized for non-critical EMS runs as first responder vehicles. As much as I love it when Ladder Companies get twenty runs in a day, this is just not an effective use of the apparatus or the personnel who are riding it. In fact, the only thing that makes less sense than sending two paramedics in a $300,000 ambulance to a BLS emergency lights and sirens through the streets is sending a $1,100,000 ladder truck with them.
First, if its a BLS run and you can get someone there in ten minutes or less-- you are winning! Save the very expensive ladder company for the more serious run in that same area or if the ambulance arrives and needs some type of help. Then you will likely be able to send them non-emergency-- a much more effective and safe proposition. (We must get smarter about time in the fire service-- not every event needs to be responded to in the exact same way as a five alarm fire with nuns and puppies trapped and a dynamite factory as an exposure)
Second, if you really want to be progressive, how about this? Assign (5) people to the ladder company and give them a Rapid Response Vehicle to chase EMS runs. The capabilities of this vehicle can be determined by your local conditions. It could double as a brush truck, light rescue, parking garage response vehicle, or your citywide EMS chase vehicle. This may be an option in communities where the Ladder operates as a Quint and there is no engine in the same house. If you have a fire run and the second piece is in, all five personnel go with the Ladder. If it is not available, then the three personnel in the station can respond with the Ladder Company. And yes I know, three people is not ideal on a Ladder Company. However, three is better than zero or a town that has to buy a $1,000,000 piece of equipment every 7-8 years instead of every 15-20 because its wheels are getting run off chasing EMS calls so it can't afford new turnout gear or staffing or a replacement firehouse.
There are other options as well, such as the dreaded "cross staffing". Leaving the ladder behind while the crew responds in an alternate apparatus. This is probably not ideal, especially if that Ladder happens to be the only one in a department or in an area. The risk of what happens when the crew is miles away from the apparatus they really need is a little too great for my taste.
To sum up, we need to be effective stewards of our personnel, our resources, and our communities. Some things we do make a lot of sense. As EMS runs continue to climb, however, we need to think about ways to meet the demands of the public and maintain our capabilities to respond to all emergencies and fires in a reasonable manner. We have to learn to think in new ways about how we prioritize EMS runs and admit that sometimes the difference between a five minute response and seven minute response isn't all that important. Doing so will only help us be more effective when the seconds really do count!
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