By Lori Consalvo
The Inland Valley Daily Bulletin
ONTARIO, Calif. — A jovial conversation inside an Ontario firetruck was interrupted by a woman’s urgent tone over the dispatch radio.
Within seconds, Engineer Jim Ary, 42, flipped a switch that powered lights and sirens, and the truck bolted past traffic and through red lights.
Capt. Paul Ehrman, 40, and the two other firefighters snapped on their black latex gloves in preparation, and each man channeled his inner hero.
When the truck arrived at the small residence in Ontario, two American Medical Response crew members were getting their gear ready.
The Ontario Fire Department carries four men on an engine, two of whom are paramedics.
AMR, an ambulance service contracted throughout parts San Bernardino County, is dispatched with them and meets firefighters at the scene to offer treatment during medical calls and to transport patients.
The six men walked past family members, who wore concerned looks on their faces, and crammed themselves into a small bedroom where a slightly confused 75-year-old man was resting in bed.
Vital signs were taken, medications reviewed and questions asked.
The call turned out to be a bit misleading - the elderly man had “almost” fallen out of bed, family members corrected.
“I’m not sure why you called us if he didn’t fall,” an AMR crew member said to a family member.
The man wasn’t responding when they spoke to him that September morning, so the worried family called 9-1-1.
The man’s skin was “super dry,” Ehrman said, so he was hooked up to IV fluids and taken to a hospital.
Fire departments nationwide say firefighters spend more than half their time responding to medical calls.
Ehrman said of the 12 to 15 calls Station 5 in Ontario goes on daily, eight or nine are medical.
“It has gone from fighting fires to anything you can imagine,” said Wayne Daunis, a 43-year-old engineer for the Ontario Fire Department. “When people come across something they can’t handle or don’t know what to do, they call the Fire Department.”
Fire departments throughout the country responded to about 25 million calls in 2008, according to the National Fire Protection Association.
Of those calls, more than 15 million were for medical aid. By contract, just 1.45 million were for fire incidents.
In 1980, nearly 30 years ago, firefighters responded to 5 million medical calls out of 10.8 million total.
Officials said medical calls continue to increase based on a combination of things.
“More fire departments every year keep adding more medical service,” said John Hall, division director for fire analysis and research for NFPA. “Add onto that that we have an aging population.”
Shortly before 10 on a September morning, the Ontario crew was dispatched to a report of an “ill female.”
“So what’s bothering you right now?” an AMR crew member asked as he checked the woman’s blood pressure.
“My stomach hurts,” the 70-year-old woman said.
After some prodding, the paramedic learned the woman was a heavy drinker, and her pain and nausea were likely from not drinking for two days.
The small woman was placed on a gurney and taken to a hospital.
“This is probably 90 percent emotional,” Ehrman said as he walked out of the residence.
San Bernardino County sends multiple units to respond to a call, said Bret Henry, president of the San Bernardino County Professional Firefighters Local 935.
While it might not be the most resourceful policy, Henry said it works.
“We’ve talked about a triage system. ... We’ve talked about a set of questions asked by dispatchers,” Henry said. “Some areas have tried those.”
“But it is kind of an imperfect science, and I would say multiple paramedics on scene is a good thing.”
Dispatchers and firefighters said it is almost impossible to assign a minimum number of crew members based on a call because there are communication issues - a location could be incorrect or the call information is wrong.
“A fall victim is the epitome of that,” Henry said. “Half the time, it’s just a fall, and we help them up and go on our way. But other times, (we find out that) they could have fallen because they had a heart attack.”
There is no law saying fire departments must respond to everything, Henry said, but that doesn’t mean there aren’t guidelines.
“There are (National Fire Protection Association) standards we go by,” he said. “Guidelines, but not legal things that we have to do.”
Firefighters, however, tend to err on the side of safety.
“We’re gonna go on every call,” Ehrman said. “Sometimes the ill female is on her last breath, and sometimes she’s been vomiting for two days because she hasn’t been drinking her vodka.”
Firefighters now serve a much broader role, Ehrman said, acting as nurses, doctors, hazmat officials, the electrical company or the bomb squad.
Dave Gillotte, president of the Los Angeles County International Association of Firefighters Local 1014, said it is beneficial to have firefighters with so many traits.
The Los Angeles County Fire Department service is a tiered dispatch, Gillotte said. When a call comes in, dispatchers send an engine company with four EMTs, a two-person paramedic squad on a utility truck, and two ambulance attendants from a contracted ambulance service.
“I think it’s a good model,” Gillotte said. “You don’t know what you’re getting based on a phone call.”
All eight crew members respond - whether it’s a car accident, a heart attack or a stomach ache - to make an assessment.
“We are essentially bringing the emergency room to your front door or to a car accident,” Gillotte said.
Units are dismissed as the call progresses.
“We can cancel paramedics to free them up if we can handle it by ourselves,” Gillotte said.
At 11:45 a.m., the Ontario crew was dispatched for another medical call - a woman was reportedly having a seizure in front of a nearby business.
When firefighters arrived, employees told them the woman had walked away.
The crew lugged all of their equipment through an alley behind the business and found the 63-year-old homeless woman barefoot and sitting in her car.
“I don’t want to get checked out,” the woman told firefighters.
She claimed she had been punched in the stomach, but said she was fine.
After verbal assurance that the woman did not want to be transported, the crew packed up their gear and got back into the truck.
“We had a fall that wasn’t a fall. A seizure that wasn’t a seizure, and what was our first call? A woman who was sick from not drinking,” Kyle Licata, a firefighter/paramedic, recapped as the crew left. “You basically have to keep an open mind (about each call).”
Licata, 24, is one of those guys who always wanted to be a firefighter.
While the second-generation fireman spends most of his time working medical calls, Licata must always be prepared to fight a fire.
“We’re training for something that might never happen, or for something that rarely happens,” he said. “But it’s more about what we can do, what we have to be able to do.”
Licata said he definitely gets an adrenaline rush when fire is mentioned over a scanner.
“When we’re called upon to do it, we have to be ready.”
During lunch, Licata sat around the table and talked with veterans about how the job has changed.
Daunis, who has been an engineer for about 23 years, was asked if he still enjoyed the job.
“Every day,” he said.
In the past, residents would call their doctors about flu symptoms, La Verne fire Capt. Pete Jankowski said.
“People don’t have health care anymore, so they call the Fire Department,” he said.
Now, firefighters have to give basic medical evaluations to see if the situation warrants a trip to the hospital.
“When I was a kid, I saw a firetruck and an ambulance once on my street, and that’s because someone’s grandma fell down a full flight of stairs,” Jankowski said. “Now, we go for cut fingers.”
Maybe the job just isn’t what it used to be.
“I think a lot of people are disappointed with what the job is now,” said La Verne Battalion Chief Alan Chandler, who has been a firefighter for 29 years. “They thought it would be putting out fires and kicking in doors, but it’s not. Today it’s scrubbing toilets and cleaning house (at the fire station) and holding old ladies’ hands.”
The profession might have changed, but the desire to become a firefighter is as popular as ever.
There are about 1,300 students enrolled in the fire technology program at Mt. SAC during an average semester.
When Jerry Austin, fire chief at the school and director of the program, started teaching in 2003 he said, there were about 900 students.
The demand is still there, he said, regardless of the current job requirements.
“We are teaching them (the majority of calls) are medical,” he said. “They have to have the ability to work in conditions that they cannot really think about, but just react to it.”
Austin said a lot of students recognize that 9-1-1 is part of the fire service, and when they become firefighters they are the ones responsible for responding to those calls.
To be good at what they do, firefighters have to realize that the job requires creativity and ingenuity.
“There is not a book out there to prepare them for what they’ll be doing.”
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