By FireRescue1 Staff
The size and configuration of an EMS first responder crew and an advanced life support crew have a substantial effect on a fire department’s ability to respond to calls for emergency medical service, according to a new study.
The study — issued by a range of groups in the scientific, firefighting, EMS and public-safety communities — shows “substantial differences” associated with first responder crew size.
It is the first attempt to investigate the effects of varying crew configurations for first responders, the apparatus assignment of ALS personnel, and the number of ALS personnel on scene on the task completion times for ALS level incidents.
Preliminary results were first released during Fire-Rescue Med in Las Vegas in May. In addition, the NIST-led study also focused how the size of firefighting crews has a substantial effect on the ability to protect lives and property in residential fires.
However, the increasing number of EMS responses point to the need for scientifically based studies to measure the operational efficiency and effectiveness of departments responding to medical calls, according to the IAFF, which led to the EMS portion of the study.
The main findings are:
Field experiments for the new study revealed that crews with three- or four-person first responders completed patient removal between 1.2–1.5 minutes faster than smaller crews with just two first responders. All crews with first responders completed removal substantially faster (by 2.6-4.1 minutes) than the ambulance-only crew.
Four-person first responder crews completed a trauma response faster than smaller crews. Towards the latter part of the task response sequence, four-person crews start tasks significantly sooner than smaller crews.
Additionally, crews with one ALS provider on the engine and one on the ambulance completed all tasks faster and started later tasks sooner than crews with two ALS providers on the ambulance.
For trauma patients, when assessing crews for their ability to increase on-scene operational efficiency by completing tasks simultaneously, crews with an ALS provider on the engine and one ALS provider on the ambulance completed all required tasks 2.3 minutes faster than crews with a basic life support (BLS) engine and two ALS providers on the ambulance.
Additionally, first responders with four-person first responder crews completed all required tasks 1.7 minutes faster than three-person crews and 3.4 minutes faster than two-person crews.
Results for cardiac patients mirror the result for trauma patients.
Regardless of ALS configuration, crews responding with four first responders completed all cardiac tasks more quickly than smaller first responder crew sizes.
In the critical period following cardiac arrest, crews responding with four first responders also completed all tasks more quickly than smaller crews.
The study’s principal investigators were NIST’s Jason Averill, Lori Moore-Merrell of the International Association of Fire Fighters and Kathy Notarianni of Worcester Polytechnic Institute. Other organizations participating in this research include the International Association of Fire Chiefs, the Commission on Fire Accreditation International-RISK, the Urban Institute and the University of North Carolina.
During a presentation on the study at Fire-Rescue Med, Moore-Merrell said investigators wanted to look at on-scene staffing levels for labor-intensive EMS calls.
“Because we are all hazards responders, we wanted to take a look at if size matters on EMS events,” Moore-Merrell said.
“We are having musculoskeletal trauma to firefighters and paramedics because we are not sending sufficient people to EMS calls.”
The report was funded by the U.S. Department of Homeland Security, Federal Emergency Management Agency’s Assistance to Firefighters Grant Program.
The study can be downloaded from the partner websites or may be requested from any of the study partner organizations. The report is also available at www.firereporting.org.