Danville cuts fire department response for some medical emergencies

DANVILLE — As of Oct. 1, the Danville Fire Department does not automatically respond to certain medical emergencies, like allergic reactions, chest pains and diabetic problems, but the new policy concerns members of the firefighter's union.

It is troubling to the Associated Firefighters of Illinois, according to association President Pat Devaney. Speaking on behalf of Danville members of the association, Devaney said most communities are finding ways to offer additional, or a higher level of, emergency medical services rather than reducing them. He said firefighters and fire stations are strategically located, so they can respond more quickly than ambulances.

"It's something we (association members) don't view favorably, nor should the citizens of Danville, in my opinion," said Devaney, who is also a lieutenant with the Champaign Fire Department.

But Danville Public Safety Director Larry Thomason said life-threatening medical calls still require an automatic response by the fire division. Those that no longer require an automatic response are not life-threatening, he said.

The list of automatic medical response calls at one time included 30 types of calls, he said, and that was narrowed to about 24 in 2010. And this year, Thomason and the fire command, which includes the assistant chiefs and captains, collaborated and again narrowed the list to 13 types of medical calls that require an automatic response from the fire department.

Thomason said the reasons for the policy change are safety of fire personnel, safety of the public and preservation of fire equipment. He said the policy would reduce the department's number of calls by 50 percent.

"Every time one of those engines goes out, it's subject to an accident," said Thomason, adding that an accident puts fire personnel and the public at risk of injury and equipment and other property at risk of damage.

Thomason said the new policy does not include life-threatening situations, and if there is any doubt as to the severity or exact nature of a call, the policy is to err on the side of caution and respond anyway.

In a recent memo to all firefighters concerning the new policy, Thomason stated that "we must maintain the current fleet for the purposes it was intended: the primary function of the fire service, fire suppression."

Mayor Scott Eisenhauer said the goal was to identify the medical emergencies that the fire division has the skills and resources to provide true emergency medical assistance and then respond only to those types of calls.

"If a call requires resources beyond our capabilities, then putting the safety of our personnel, the safety of the public and the protection of our resources at risk is inappropriate," he said.

Eisenhauer said Danville has a primary medical responder, Medix Ambulance service, and the fire division is providing support to that primary provider. He said some firefighters have been paramedics in the past, some have been, or still are, emergency medical technicians, but the majority of fire division personnel are not trained and certified at the paramedic level, and the fire department is not certified to carry the same equipment or medicines as Medix ambulances. Also, he said, fire trucks cannot transport patients, so if a 911 call demands an immediate need for transport and a level of medical assistance the fire department cannot provide, then the fire division is needlessly risking the safety of personnel and the public by responding in an emergency vehicle.

Thomason said, for example, in the case of a person with diabetic problems, the fire trucks carry glucose, but if a person is in true diabetic shock, which is life-threatening, that requires an IV, intravenous therapy, and only Medix or the hospital can administer that. He said the same is true for strokes.

"The biggest key is to get that person ... to a hospital as soon as possible where medical personnel can evaluate the entire situation," he said.

But, Thomason said, the most important point is that if there's any doubt whatsoever, the fire department will go. He added that the chiefs and captains are aware of calls going out, and they can always override and send a fire unit.

"It's not like the door is closed off," he said.

Devaney said other communities that have increased the medical level of their fire departments have gone to providing an intermediate level of medical service or advanced life support engines, especially as the population is aging.

He said it's rare for communities to consider scaling back on the number of types of EMS calls to which they respond. Devaney said he also questions whether it will always be obvious from the 911 call whether a situation truly is life-threatening. Doing that type of screening over the phone, he said, callers might not be able to adequately explain their condition.

Devaney said firefighters take their jobs very seriously, and if anyone needs care, they want to be the ones to be there quickly providing it.

"It's devastating to think of someone in need minutes from a fire station not getting help. They are there to help, and they want to be on those calls helping the citizens," he said.

 

Automatic medical response calls

As of Oct. 1, the list of emergency medical calls that require an automatic response from the Danville fire division was reduced from about 24 to 13. In the past, the fire department has automatically responded, along with privately owned Medix Ambulance service, to as many as 30 types of emergency medical calls, according to Public Safety Director Larry Thomason. But a few years ago, the list was reduced to about 24 and, last month, reduced again to the present 13.

Emergency medical calls requiring automatic response from Danville fire division:

Breathing problems

Burns/explosions

Carbon monoxide/inhalation/hazmat

Cardiac or respiratory arrest/death

Choking

Drowning (near)/diving/SCUBA accident

Electrocution/lightning

Falls (possibly dangerous/dangerous/extreme)

Heart problems

Hemorrhage/lacerations (dangerous or possibly dangerous)

Inaccessible incident/other entrapments (non-vehicle)

Stab/gunshot/penetrating trauma

Traumatic injuries

Emergency medical calls eliminated from the list requiring automatic response from fire division:

Allergic reactions/stings, bites

Chest pains (non-traumatic)

Convulsions/seizures

Diabetic problems

Heat/cold exposure

Overdose/poisoning (ingestion)

Pregnancy/childbirth

Stroke

*Traffic/transportation incidents

Unconscious/fainting (near)

Unknown problems (man down)

Source: Danville Fire Division

*Although not an automatic response call, Thomason said the fire division will continue to respond to personal injury traffic accidents and accidents on Interstate 74. He said Danville police are the first to be dispatched to traffic accidents, and they relay whether there are personal injuries or other circumstances requiring Medix Ambulance or the fire department.

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