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Emergency responders; Medical risk versus cost

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Paramedics with Broward Sheriff's Office Fire-Rescue treat a woman suffering from an injured ankle in Lauderdale Lakes. In Broward County, nearly all firefighters are trained as paramedics, capable of performing invasive medical procedures in the field or non-life threatening conditions such as ankle sprains. Broward employs a one-tiered system where nearly all firefighters are trained on the same level and are capable of doing the job of a firefighter and a paramedic.

Photo by AARON HALE

Paramedics with Broward Sheriff's Office Fire-Rescue treat a woman suffering from an injured ankle in Lauderdale Lakes. In Broward County, nearly all firefighters are trained as paramedics, capable of performing invasive medical procedures in the field or non-life threatening conditions such as ankle sprains. Broward employs a one-tiered system where nearly all firefighters are trained on the same level and are capable of doing the job of a firefighter and a paramedic.

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  • Paramedics with Broward Sheriff's Office Fire-Rescue treat a woman suffering from an injured ankle in Lauderdale Lakes. In Broward County, nearly all firefighters are trained as paramedics, capable of performing invasive medical procedures in the field or non-life threatening conditions such as ankle sprains. Broward employs a one-tiered system where nearly all firefighters are trained on the same level and are capable of doing the job of a firefighter and a paramedic.
  • David Albers/Staff - Captain Nick Ford, of the North Naples Fire Control and Rescue District, dons his firefighting gear as he responds to a medical emergency call from the organization's Station 45 on July 20, 2011. For most Collier County medical emergency 911 calls, both the fire department and EMS are dispatched to the scene where they coordinate their response.
  • King County paramedic student Kevin Miller calls for equipment while treating a patient outside a Seattle jail. Every paramedic in King County must first go through intense training at the Harborview Medical Center, that features a partnership from the University of Washington and the Seattle Fire Department. Paramedics in King County have earned a reputation for elite training and preparation -- even garnering the tongue-and-cheek moniker 'para-magicians.' Part of that reputation comes from a rigorous 10-month didactic and hands-on training program through the University of Washington. Aaron Hale/Staff
  • Dr. Mickey Eisenberg, King County's regional emergency medical director, poses for a photo in his Seattle office. Eisenburg, also a cardiologist at the University of Washington, helped develop the county's two-tiered approach to EMS service -- or as they call it in King County: 'the medical model.' Eisenberg was one of the first innovators in training firefighter-EMTs to administer defibrillation treatment to cardiac patients in the field before paramedics arrived. Aaron Hale/Staff
  • Dr. Nabil El Sanadi is medical director for the Broward Sheriff's Office Fire Rescue and the Fort Lauderdale Fire-Rescue Department, Broward's two largest EMS services. El Sanadi, who is also director of emergency medicine of Broward Health System and SWAT team certified, is praised for his hands-on work with paramedics and a cooperative leadership style. Aaron Hale/Staff
  • Seattle Fire Department personnel and a private ambulance crew assist a seizure patient before he is taken to the hospital. Since this particular patient was in stable condition, he was transported to the hospital by private ambulance. Patients suffering from critical ailments are transported by fire department paramedics. Private ambulances are used in King County in part to save on costs to the public system, but also increase the availability of public emergency service workers. Aaron Hale/Staff
  • EMTs and paramedics for the Seattle Fire Department treat a patient who suffered from an extreme allergic reaction on a public bus. As part of its two tiered system in King County, Wash., firefighter-EMTs arrive on scene to help the patient first, before paramedics arrive to perform any necessary internal medicine and to transport the patient to the hospital. Aaron Hale/Staff
  • Broward Sheriff Al Lamberti leads a swearing-in ceremony for Deerfield Beach firefighters. The city of Deerfield Beach, which had previously run a municipal fire department, recently signed a contract to make the Broward Sheriff's Office Fire-Rescue division the sole provider of fire and EMS services. The Sun-Sentinel reported the move was expected to save the city $2.9 million. As part of the agreement, Deerfield Beach firefighters were absorbed into the Sheriff's office.
  • Redmond paramedic Les Putnam discusses symptoms with a woman suffering from diabetes-related ailments in King County, Wash. The Redmond Fire Department is one of six public agencies that provide paramedic services in King County. Redmond paramedics with the administer advanced life support service and transport for Redmond neighboring cities, towns and fire districts. Aaron Hale/Staff
  • Collier County EMS and North Naples fire officials cart Brandon DeVine, 24, of Naples, to an ambulance to be transported to the hospital following a motorcycle accident in North Naples on Wednesday afternoon. According to DeVine's uncle, Dale Cannon, DeVine 'came across the parking lot pulling a wheelie trying to show off and 'pop'.' Cannon indicated that his nephew collided his Honda dirt bike into a black automotive trailer parked in an empty lot along the 101st block of U.S. 41 in North Naples. Cannon said he thinks his nephew did not sustain serious injury, but added: 'He's going to have a good headache.' Tristan Spinski/Staff
  • A Seattle paramedic inserts IV lines into a patient in route to the hospital. Paramedics in King County have earned a reputation for elite training and preparation -- even garnering the tongue-and-cheek moniker 'para-magicians.' Part of that reputation comes from a rigorous 10-month didactic and hands-on training program through the University of Washington. The rest comes frequent exposure they get to treating critical patients, giving them more opportunities to perform difficult procedures like tracheal intubations and IV insertions in patients. That exposure, King officials say, means they are more prepared.
  • Five Fort Lauderdale paramedics and a trainee treat a man suffering fatigue-related symptoms. Fire-rescue agencies in Broward County aim to get paramedics, who are trained to treat major medical emergencies in the field, on scene to 911 medical calls, even when reported symptoms appear to be minor. Unlike Collier and King counties, Broward County fire-rescue agencies tend not to rely as heavily on cooperation between other agencies because a single department is responsible for all fire and emergency medical services in a given area.
  • Paramedics with Broward Sheriff's Office Fire-Rescue treat a woman suffering from an injured ankle in Lauderdale Lakes. In Broward County, nearly all firefighters are trained as paramedics, capable of performing invasive medical procedures in the field or non-life threatening conditions such as ankle sprains. Aaron Hale/Staff
  • A Seattle paramedic team, accompanied by two paramedic students, prepare to depart from Harborview Medical Center in Seattle after transporting a patient. Paramedics in King County only take patients suffering severe ailments to the hospital in order to preserve public resources. Patients who are stable are typically transported by private ambulance. Paramedics work closely with doctors during patient treatment. In the field, medics call doctors in the hospital to plan patient treatment. Aaron Hale/Staff
  • Witness Amy Adiutori, in the background on left, Carl Osburn, from Blackeyed Pig BBQ, and others watch as Collier County EMS work on a man who was hit by a car as he held a sign on the corner of Pine Ridge Road and Shirley Street on Monday afternoon. Adiutori was driving by when she saw the vehicle strike the man. She said a black SUV driving westbound on Pine Ridge Road jumped the curb as it turned north on Shirley Street, striking the victim and then fled the scene. The victim, a sign holder for Blackeyed Pig BBQ and other area businesses, was transported by med-flight to Lee Memorial Hospital. Lexey Swall/Staff
  • David Albers/Staff - Engineer Dave Jones, second from left, and Firefighter and Emergency Medical Technician Brian Torres, second from right, finish prepping a medical emergency patient before loading her into a Collier County Emergency Medical Services ambulance to be transferred to the hospital on July 20, 2011. For most Collier County medical emergency 911 calls, both the fire department and EMS are dispatched to the scene where they coordinate their response.
  • David Albers/Staff - Firefighter and Emergency Medical Technician Brian Torres, of the North Naples Fire Control and Rescue District, left, loads a medical emergency patient into a Collier County Emergency Medical Services ambulance to be transferred to the hospital on July 20, 2011. For most Collier County medical emergency 911 calls, both the fire department and EMS are dispatched to the scene where they coordinate their response.
  • David Albers/Staff - Engineer Dave Jones, of the North Naples Fire Control and Rescue District, returns to his vehicle after loading a medical emergency patient into a Collier County Emergency Medical Services ambulance on July 20, 2011. For most Collier County medical emergency 911 calls, both the fire department and EMS are dispatched to the scene where they coordinate their response. North Naples has implemented the use of smaller equipped vehicles for some medical calls in lieu of sending a larger fire engine.
  • David Albers/Staff - EMS Coordinator Chuck Bacon, of the North Naples Fire Control and Rescue District, uses the organization's mobile data computer to relay information from a 911 operator to his firefighters en route to a medical call on July 20, 2011. The mobile computer system populates information collected by the 911 operator, provides GPS mapping and lists all available resources as first responders are dispatched to a scene.
  • Paramedics with Broward Sheriff's Office Fire-Rescue treat a woman suffering from an injured ankle in Lauderdale Lakes. In Broward County, nearly all firefighters are trained as paramedics, capable of performing invasive medical procedures in the field or non-life threatening conditions such as ankle sprains. Broward employs a one-tiered system where nearly all firefighters are trained on the same level and are capable of doing the job of a firefighter and a paramedic.

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