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Study says crew size impacts EMS

Preliminary results of study show larger response crews have faster response time

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Photo Jamie Thompson
Lori Moore-Merrell of the IAFF speaks at the Fire-Rescue Med conference in Las Vegas on Tuesday about the affect crew size can have on response time.

By Jamie Thompson
EMS1 Senior Editor

LAS VEGAS — Crew size impacts task completion times on EMS calls, according to the results of a preliminary study into staffing levels.

Results on the fire crew size aspect of the study were released by NIST last week, which showed that the size of firefighting crews has a substantial effect on the ability to protect lives and property in residential fires.

At Fire-Rescue Med in Las Vegas Monday, Lori Moore-Merrell, of the IAFF and a principal investigator on the study, said preliminary data from the EMS portion also showed impacts.

During a presentation on the study at the conference, 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.”

She stressed the study was not designed to measure efficacy of care, only task completion.

Montgomery County, Md., and Fairfax County, Va., firefighters took part in the study, and both departments committed one engine and one ambulance to the experiments.

Three scenarios were focused on: patient access/removal from the third story of an apartment, a fall from a height of 25 feet, and a cardiac arrest.

Preliminary results on the cardiac patient showed three-person first responder crews with two-person ambulance performed all tasks 1.5 minutes faster than the two-person first responder crews.

The four-person first responder crews with two-person ambulance performed all tasks 2.6 minutes faster than the two-person crews.

Crews with one ALS on the engine and BLS ambulance performed similarly to the crews with one ALS on the engine and one ALS on the ambulance, Moore-Merrell said, and the difference in times when ALS skills were delivered is still being analyzed.

The crews with one ALS on the engine and one ALS on the ambulance performed two minutes faster than the crews with no ALS on the engine and one ALS on the ambulance, the session was told.

Crews with one ALS on the engine and one ALS on the ambulance were able to initiate critical skills earlier and perform them in a shorter time duration, according to the preliminary data. Twelve lead was applied sooner and intubation had a shorter duration to completed.

Four-person FR crews performed both tasks earlier and in less time than other crew sizes, Moore-Merrell said.

She told the study the data is still preliminary and that a full report will be issued in the summer.

“We are still doing some analysis, there’s so much data here, there’s so much to look at,” she said.

The importance of the study overall, Moore-Merrell said, is that little scientific data has ever been put together — that can be presented to city managers — on the impact crew size has on responses and safety.