Medical alarms When the Honolulu Fire Department put automatic defibrillators on all of its firetrucks in 1997, the number of medical calls firefighters received nearly doubled, exceeding the number of fire calls for the first time.
dwarf fire calls
Portable defibrillators have
changed the role of
today’s firefightersBy Nelson Daranciang
ndaranciang@starbulletin.comThis year is expected to be the sixth straight in which medical calls will exceed fire calls, and Honolulu Fire Chief Attilio Leonardi could not be happier.
"The public is getting a bigger bang for their tax dollars. Firefighters are getting more training in other areas to better serve the public while still maintaining their firefighting skills," Leonardi said.
The Fire Department does not receive additional funding to respond to medical emergencies. But Leonardi said the additional service has not cut into the department's ability to respond to fires.
Stricter building codes, sprinklers, more frequent inspections and better public fire education has helped contain the number of fires, giving firefighters more time to provide other services, Leonardi said.
"Without (medical emergencies), what would we be responding to? We're not adding any more hours to their jobs," he said.
Anyone who joins the Fire Department just to fight fires is in the wrong job, Leonardi said, because the job also entails rescues, hazardous materials and medical emergencies.
The department's newest firefighters were the first recruits to undergo basic emergency medical technician training, a 160-hour course, and receive EMT-B certification.
The department hopes to have all of its firefighters EMT-B certified and is offering the course to firefighters on a voluntary basis. The rest of Honolulu's firefighters are certified to operate automatic defibrillators as advanced first responders.
When Leonardi joined the Honolulu Fire Department in 1971, firefighters were only required to complete a 16-hour course in basic first aid.
The number of medical calls to the Fire Department has been increasing in recent years. But the number of calls to the city's Emergency Ambulance Service has remained constant. People 65 years and older are responsible for an increasing percentage of the calls.
In 1998, HFD and the city's Emergency Medical Service signed a new agreement detailing when ambulance dispatchers will ask firefighters to co-respond.
Police, lifeguards and callers to 911 can also ask firefighters to respond to medical emergencies.
Firefighters are asked to respond to about 25 percent of the calls for an ambulance, said Robin McCulloch, the city's EMS chief.
"The number of referrals to (HFD) has increased because they're more interested in medical," he said.
McCulloch said there is a greater confidence in what firefighters can do in a medical emergency because of their increased training.
Also, with more than twice the number of fire stations than ambulance stations, in most cases firefighters can respond faster.
"We have 42 stations. Our average response time is under five minutes," Leonardi said. There are 18 ambulance stations on Oahu.
Honolulu police are also expanding their responsibilities to include medical emergencies.
When Honolulu Police Chief Lee Donohue suffered cardiac arrest at the department's Training Academy in Waipahu in 1999, the department had just two automatic defibrillators. An officer assigned to one of them was at the academy and was able to use it to stabilize Donohue's condition until he was taken to a hospital.
The department now has 250 automatic defibrillators assigned to officers. When callers to 911 ask for police, operators ask them whether it is an emergency and if anyone is unconscious.
If callers indicate someone is unconscious, dispatchers broadcast an all-points bulletin for officers with automatic defibrillators to respond.
Police, fire and emergency medical officials meet regularly to work out responsibilities in emergencies, McCulloch said.
"What you're seeing is a greater interdependence among agencies. We all realized, even before 9/11, there is no one agency that can do the job anymore. If there is a big emergency, all will have to work together much more closely for situations that are much more broad in scope."
