Resources Should Be Reallocated from Fire Suppression to EMS

Resources Should Be Reallocated from Fire Suppression to EMS
The imbalance that currently exists is readily apparent. While over 70 percent of the calls to the BCFD are medically related, there are three times as many first-line fire engines and trucks as medic units.

Fire Suppression Equipment
First-Line Fire Engines 40
First-Line Fire Trucks 21
Total First-Line Fire Engine & Truck Companies 61
Emergency Medical Services Equipment
Total First-Line Medic Units 18

Further exacerbating the imbalance is the fact that each fire engine and truck company requires four trained firefighters, while each medic unit has two paramedics. Therefore, BCFD has over six times as many firefighters as paramedics staffing its first-line units.

As a result, the average fire suppression response time and the ambulance response time are in stark contrast. The fire response time is slightly over four minutes, while the response time for emergency medical units is nearly nine minutes. The fire response time is comfortably below typical urban standards, and the emergency medical response time is dangerously above industry standards.

The in-service time for fire and medic vehicles likewise reflects the decided imbalance. First-line fire suppression engines and trucks are used, on average, about 1 hour and 45 minutes out of each 24-hour day. Medic units, on the other hand, are often in service nearly full-time, averaging between 14 and 15 hours on the street during a 24-hour day.

This imbalance is even more striking when it is recognized that nearly one half of the fire suppression responses are for purely medical incidents. In 1999, fire suppression trucks and engines were dispatched about 49,000 times for ambulance assists. On these ambulance “assists,” a first-line fire company responds in order to stabilize the patient while waiting for a medic unit which can actually transport the person to a nearby hospital. Thus, the in-service time for equipment responding to fires (as opposed to medical emergencies) is considerably less than 1 hour and 45 minutes per day. The practice of dispatching fire engines and trucks, staffed by firefighters, to medical emergencies is a reaction to the existing imbalance, but an expensive one. The complex fire equipment costs two to five times that of a medic unit and is staffed by four firefighters. It is preferable to have the less expensive, more effective ambulance and paramedics respond promptly.

Introduction: Fire Department
Baltimore City Needs More Emergency Medical Resources
Resources Should Be Reallocated from Fire Suppression to EMS
The City’s Firefighting Bureaucracy can be Streamlined Without Sacrificing its Effectiveness
Achieving Economies Will Enable the BCFD to Improve and Modernize the Department