Firefighters and Emergency Medical Technicians (EMT) should be merged into the same profession and be equally qualified.

The goal should be to house at least one ambulance in every station. Since most emergency calls are for medical services, it is reasonable for ambulances to be housed at all existing fire stations, unless a hospital-based ambulance is able to cover the same geographical area within 25% of the time as one housed at a fire station.

The number of fires have declined consistently over the decades and the trend is likely to continue and the vast majority of firefighter responses are to medical emergencies. Because fire stations will increasingly become too limited a term, it would be more accurate to call these places ’emergency stations’.

These emergency stations should also be places that people could come to to receive critical emergency medical services. Of course, there would be no guarantee that anyone will be there because they may all be out on calls.

If a station receives a medical emergency call, the required number of members to staff the emergency station’s ambulance would load up and take the ambulance to the medical emergency. If, while the ambulance is in the field, another medical call comes in, the fire fighting team would load into their firetrucks (the only remaining vehicles at the station) with the required number of firefighters and go to that medical emergency. Since the fire fighting equipment is being taken, all members of the fire team would be required to go to this call, even though it is only a medical emergency.  This is because a fire call could come in at any time and since it would be a waste of time to go back to the station and pick up any remaining crew, the entire crew needs to already be together as they roll out to answer the medical call in case a potential fire call comes in later. The idea is for the ambulance to be the default vehicle to respond to medical emergencies and not the firetrucks. Most of the time, the ambulance will be able to go and return in time for the next medical emergency.  More often than not, this will save the fire trucks and the overly large fire fighting crew (usually 3 or 4) from responding to a medical call which only need two people.

Since, ideally, the firefighters and ambulance crews would be trained identically the same in the future (according to this proposal as stated above), the personnel at fire stations could work out a fair schedule to divide the responsibility for doing ambulance duty and rotate often so that the more frequent medical calls do not overburden any of the emergency station staff and lead to a more harmonious coexistence among the staff.

Emergency Station Locations

Emergency stations (mainly fire stations and ambulance stations) should be located at intervals that allow for a maximum 4-minutes response time throughout 75% of their urban/suburban coverage area. However, fire emergencies require more equipment and more space for their storage at stations, and such short response time requirements may not be practical because it would require too many expensive stations, although it should be strived for. Nevertheless, perhaps a fire response time should be set to 6 minutes throughout 75% of their urban/suburban coverage area. Medical emergencies, being by far the most common are also the most critical because it usually directly involves vital human health and often potential brain damage due to loss of oxygen whereas fire emergencies, while they could also involve direct human safety, usually only involve burning structures from which people have already escaped.

Furthermore, given the established location of fire stations, it would be easier to site additional, separate, stand alone ambulance stations because they require smaller lots. Perhaps they could even be sited in people’s home garages, with the ambulance personnel ‘renting’ an additional room in the house, or something. The addition of these ambulance stations, combined with existing ambulances already stationed at some fire stations, hospitals and perhaps other locations, could easily result in response times within 4 minutes for most urban/suburban areas.

Urban, Suburban, Rural Definitions

Because of fundamental resource limitations, it is not possible to provide the same fast response times to every inhabitant in rural areas as can be provided to urban/suburban areas. This is naturally because the lower population densities of rural areas would not justify the expense of additional stations for the relatively few people in its coverage area. But there must be a clear definition of urban/suburban and rural so that precise cartographic information is generated to determine the proper siting of stations.

For purposes of this specific policy proposal, the terms urban and suburban are combined to urban/suburban and are used to describe an area with relatively small parcels of land used for commercial and residential purposes and which are adjacent to each other. ‘Rural’ lands would be such lands as large parks, general agricultural lands, stables, rivers, washes, airports, undeveloped public lands, mines, and other such parcels of lands that have a relatively low population density. Such ‘rural’ lands would not be able to constitute more than 10% of the total amount of land within the defined service area of an ‘urban/suburban’ emergency station. Emergency stations which service areas that contain a higher percentage of such ‘rural’ parcels of land could be defined as rural areas and, depending on the actual percentage of ‘rural’ area in relation to the overall area of the service area, could be allowed a lower percentage of that service area (like 50% or even 25%) to meet the required 4-minute or 6-minute response time. This longer response time would be directly due to the increase travel time neeeded to reach these ‘rural’ inhabitants.