Increased Costs

“Firefighter medics” are significantly more expensive to train than traditional firefighters.

AFD ambulances at Alexandria Hospital.

The cost of cross-training just one civilian medic to become a “firefighter medic” is significant, and includes the cost of backfilling their position (over $6,500) while they undergo firefighter training. Cross-training traditional firefighters to become “firefighter medics” is also expensive (sending one firefighter to paramedic school costs approximately $8,000), including staffing costs incurred to fill their position when they are in class.

Dispatching a heavy fire apparatus and four firefighters, responding with lights and sirens—simply to deliver a “firefighter medic” to the scene of an EMS call—increases the risk of vehicular accidents and is dangerous to both firefighters and others on the road.

Using fire engines to deliver ALS care is costly, inefficient, and dangerous.The cost to equip just one fire engine to deliver ALS care (including a cardiac monitor, ALS equipment, and medications) is in excess of $50,000. This initial cost, however, ultimately pales in comparison to the added fuel and maintenance costs that are incurred by routinely sending an additional fire engine to EMS calls. More importantly, dispatching a heavy fire apparatus and four firefighters, responding with lights and sirens—simply to deliver a “firefighter medic” to the scene of an EMS call—increases the risk of vehicular accidents and is dangerous to both firefighters and others on the road. For these reasons, several fire departments that deploy “firefighter medics” are now shifting back to deploying smaller ALS response vehicles.[i]

Incurring additional costs to staff “firefighter medics” on fire engines utterly fails to meet the needs of City residents, who require an ambulance—not a fire engine—when they request EMS.

Spending money to create ALS “response capable” units will do nothing to meet the demand for emergency transport to the hospital.

The Fire Chief’s goal—to increase the number of ALS “response capable” units (i.e., fire engines staffed with “firefighter medics”)—is a solution in search of a problem. Over 73% of the EMS calls in the City result in a patient being transported to the hospital.[ii] Incurring additional costs to staff “firefighter medics” on fire engines thus utterly fails to meet the needs of City residents, who require an ambulance—not a fire engine—when they request EMS. Worse, since being implemented, the Fire Chief’s plan has actually decreased the number of ambulances available to respond to calls on multiple occasions, when a second ambulance has had to be dispatched to supplement an understaffed “firefighter medic” ambulance.

[i] Baker, M. (February 2014). Rightsizing. Journal of Emergency Medical Services. 60-63.

[ii] Data for 2014 reported to Alexandria EMS Council.

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