Medical calls constitute 80-to-85 percent of responses for fire departments that do both fire and ems service. In other words, 8 to 8.5 out of every 10 calls are medical in nature. As the population increases and ages, the number of calls for service increases. I can remember, in the late ‘70s to early ‘80s, that Fire Station No. 1 ran 500 calls in a single year, which ranked it as one of the busiest stations in the county. Now, that number is probably 4 to 6 times greater. I will keep the math simple, if the number of calls for a station is 3,000 per year, then 2,400-plus calls are medical. The large majority are basic life support calls. In other words, no IVs, no meds, no cardiac monitoring, and, in some cases, no oxygen is needed for a patient to be transported to an emergency room. I cannot tell you the number of times that firefighters have told me that the department that I retired from in 2010 is not the same department today as it was then. The point is that fire and EMS agencies are far too busy to serve as a personal taxi. There are multiple other alternatives to use other calling 911 by default.
Although there are still many volunteer fire and EMS organizations in Virginia, the large majority of departments have had to hire full-time or part-time personnel to handle the large number of calls received for service. Public service looks very different throughout our region, with some departments being predominantly fire response only, while others provide fire and EMS service. Some localities may have a salaried fire department and a volunteer ambulance service or vice versa. Whatever the make-up of public service in your locality, the greatest number of calls for service is going to be medical. 911 service in Chesterfield County will get you a fire unit, ambulance or a police officer, depending on the information that you provide to the emergency communications operator. Chesterfield County even trains its ECOs to give pre-arrival, medical instructions to family or bystanders, until first responders get on the scene.
System abuse is using a fire or EMS organization in a way that it was not supposed to be used.
I will use these examples to talk about wide-scale abuse. Think about the person who calls with chest pains and gets a full Priority 1 response, which consists of the closest Advanced Life Support unit, the closest Basic Life Support unit and an ambulance. That might be one ALS ambulance or it could mean two fire engines and an ambulance. On arrival, first providers find that the patient has been dealing with a pain for months, and for whatever reason, decided to call 911. There are some that might stub their toes at 3 a.m. and think that the best option is to call for an ambulance! Emergency service is available to citizens who need it, 24 hours a day, 7 days a week, 365 days a year. If you need to call 911, then call, just don’t abuse it.
Public servants deal with many things in the course of a shift during their careers. They see the worst of the worst, and have to learn how to process those things in order to remain mentally and emotionally healthy. The problem, for many, is that it is not the bad call that causes the greatest stress, but the calls that should have never occurred. Maybe it is the person who has made bad life choices, which causes that person to become a “frequent flyer,” overtaxing an already overtaxed system. It is in a public servant’s DNA to serve, but don’t take that for granted. The other side of the equation is that when you tie up units on an unnecessary response and a true emergency comes in for the same area, units have to come from a greater distance to reacg someone who really needs the help.