In 2009, Deputy Director Michael Putt, of Memphis (TN) Fire Services, presented an idea to Director Alvin Benson he believed would help reduce apparatus repairs and maintain the current life expectancy of the department’s trucks and engines. “Our life expectancy of fire apparatus is 20 years for front-line apparatus and five years as a reserve,” says Putt. The pilot program involved using alternative response vehicles (ARVs) for certain types of EMS calls.
The idea for such a program was not new to the department. In the mid- 1990s, when Memphis started the fire company advanced life support (ALS) program, the department explored the concept. “This is when the department put paramedics on fire equipment and increased the frequency of runs on the fire equipment,” Putt recalls. “The concept was presented by two chiefs who knew the additional run volume would negatively affect the expected life cycle of the apparatus.” He adds that, at the time, the city had a very large capital improvement program (CIP), and the department could purchase apparatus at a rate that exceeded the 20-year life expectancy. So, at the time, the administration did not feel the need to explore the concept.
Today, it’s a different story, according to Putt. “It is apparent that our apparatus is not holding up,” he comments. “The department purchases apparatus through its CIP and, like the general operating fund, these dollars are not as abundant as they were in the late 1990s and early 2000s.” He says that with the department deviating from its 20-year replacement cycle coupled with the increased repair frequency and the complexity of newer apparatus, “something had to be done to curtail what we felt was the coming of a critical impasse to our aging fleet.”
Putt says the pilot program, which began in April 2010, identified advantages and disadvangates of allowing fire personnel to respond to EMS calls in something other than a fire truck. “EMS calls, for the purpose of this program, were illnesess or complaints that did not involve any type of machinery or require any type of rescue,” recalls Putt. “An ARV would be used for sick or injured parties where no tools other than a pry bar to open a door to gain entry to a residence were used.”
Since this was a pilot program, the department did not want to spend any money to determine if it was a viable solution to reduce wear and tear on equipment. The department chose Ford Explorers from its reserve fleet and gleaned EMS supplies for the vehicles from its logistics or training bureau and returned them once the program ended.
The department’s protocols do not change for an ARV response. “A company assigned to a run is out of service for another run until the officer notifies dispatch that it is back in service,” says Putt. He states the only difference is the time lost returning to the station. “If a company responds to an EMS call in an ARV, it cannot return to service for a fire call until it gets back to the station,” he says. “But, if it receives another EMS call en route to the station, it can be dispatched to it if it falls under the definition of an ARV response.” The company officer has the freedom to determine which type of apparatus a call requires.
Issues to Address
Success is hard to define for a program of this nature. For Memphis, the purpose of the program was not necessarily to gauge success but to determine if rolling something like this out would ultimately benefit the city. “This program was a preliminary small-scale study meant to identify the feasibility of an idea and to improve that idea before moving on to the next level of research.” The next phase, according to Putt, was to design an ARV to purchase and run it in real-life scenarios to determine if the design is best for Memphis’s medical responses.
In the meantime, the pilot program identified several issues to be addressed. “For example, a Ford Explorer type of SUV is not a preferred vehicle for response,” Putt claims. “Instead, firefighters preferred a larger vehicle with compartmentation that would make access to supplies more convenient.” But, he says that supplies were still easier to access on an SUV than a fire truck. Firefighters also preferred that the ARV have all four personnel respond instead of two or three personnel.
Positives for the program included increased maneuverability in apartment complexes and parking lots and faster response times. However, firefighters did not like the idea that they could not go in service on the way back to the station if needed for a fire call.
Recommendations from the pilot program include the following:
- Have companies swap into an ARV when the fire apparatus is out of service for repair instead of remaining out of service until the apparatus is fixed.
- Develop a different designation number for the ARV that distinguishes it from the fire apparatus.
- Use four-person companies in the ARV.
- The SUV was not an adequate vehicle. A vehicle similar to the county’s quad cab trucks could be fully equipped with spine boards, head blocks, and so on.
After evaluating the program, the department concluded there were enough positives to move to the second phase, which is to design and purchase ARVs. “We have put eight ARVs out for bid. Two will be built and tested,” says Putt. “If those two meet our needs, we’ll order the other six and place them in service.” Estimated cost for the units is approximately $50,000 each. The department will place them with fire companies that have the highest EMS run volume. “We will track the repairs, maintenance costs, response times, and general conditions over the next year to see what happens,” Putt adds. He believes that the current budget crisis, the anticipated future budget, and the expected savings this program will achieve “make this a viable alternative to responding in fire apparatus.”
Maintaining Fiscal and Safety Levels
According to Putt, Memphis has been responding to EMS calls for decades, and it has always used fire apparatus as its vehicles. “Memphis responds to over 95,000 EMS-related incidents annually when an ambulance is dispatched,” he says. “Fire apparatus accompanies ambulances almost 50 percent of the time. Unless it is a rescue call, firefighters use nothing from the fire apparatus other than basic EMS supplies.” He adds that this means the department uses a $500,000 to $900,000 fire apparatus as a vehicle for travel to almost 50,000 EMS-related incidents annually without using any tools or appliances related to fire or rescue. That is where this program came in. “Our goal is to maintain an optimal level of safety for our firefighters while striving to identify avenues to reduce costs that do not jeopardize the current level of protection for the community,” he concludes.
CHRIS Mc LOONE, associate editor of Fire Apparatus & Emergency Equipment, is an 18-year veteran of the fire service and a captain with Weldon Fire Company (Glenside, PA). He has been a writer and editor for more than 15 years. While with Fire Engineering, he contributed to the May 2006 issue, a Jesse H. Neal Award winner for its coverage of the Hurricane Katrina response and recovery.