Countdown to Survival:
The Milwaukee Fire Department Role In Emergency Medical Service Delivery
By Local 215

Many Milwaukeeans are alive today due to the skill, timeliness, and cooperative efforts of Milwaukee Fire Department Engine Companies, Ladder Companies, and Paramedic Units. When a citizen is in medical distress or suffers some sort of trauma, a simple telephone call to 911 sets in motion a rapid, well-oiled, multi-faceted response, the sole purpose of which is to save the life of the victim. The inner workings of this nationally recognized system are detailed below.

911 calls to MFD’s Dispatch Center are handled in extremely short order, with responding units dispatched with critical information within a minute. In addition, MFD Dispatchers offer pre-arrival instructions to callers who indicate a willingness to assist the patient before the arrival of Engine or Ladder Companies. This often overlooked but critical component, the Dispatch Center, is responsible for getting the correct resources to the correct location in the shortest possible time.

Alarms sound in the stations housing the closest Engine or Ladder Company and the closest Paramedic Unit. Every station does not house a Paramedic Unit, and so the Engine and Ladder Companies, generally staffed with 4 cross-trained Firefighter/Emergency Medical Technicians, respond to initiate Basic Life Support, including CPR, defibrillation, oxygen delivery, and a variety of other medical interventions. Because the Engine or Ladder Company usually arrives several minutes ahead of the Paramedic Unit, critical life-saving can begin earlier, much to the advantage of the patient. Most Engine and Ladder Company responses occur within three to five minutes.

Upon the arrival of the Paramedic Unit, the EMTs from the Engine or Ladder Company work collaboratively with the two Advanced Life Support Paramedics to continue and expand the scope of treatment, all the time preparing to transport the patient as needed. The Paramedic Unit brings with it a wide range of medications, skills, and treatments and could rightfully be referred to as an Emergency Room on wheels. In complex or extremely dire circumstances, a second Engine or Ladder Company will be requested to the scene to assist with CPR or patient movement.

When the time comes for transport to the Emergency Room, the Engine or Ladder Company is sometimes taken along to drive the Paramedic Unit, freeing up both Paramedics to provide ALS care in the back of the ambulance. This dedication of resources results in a staggering “save” rate, meaning a high percentage of patients live as a direct result of the care they receive from the Milwaukee Fire Department.

In days gone by, prior to the arrival of Mayor Tom Barrett and Fire Chief Doug Holton, most Engine and Ladder Companies arrived at emergency medical scenes with five firefighters. Paramedic Units once responded with three Paramedics or two Paramedics and a Firefighter Driver. Now that Mayor Barrett and Chief Holton are closer to their goal of slashing frontline staffing by a full twenty percent, the vast majority of Engine and Ladder Companies respond with only four firefighters and all Paramedic Units respond with only two Paramedics.

The end result of this is the need to call an additional Engine or Ladder Company to a scene to assist with CPR, a situation that never occurred prior to the Mayor’s and Fire Chief’s reduced staffing initiatives. This leaves that Engine or Ladder Company’s response area uncovered and susceptible if another medical or fire emergency occurs. Furthermore, in those cases where a patient’s condition is dire and the Engine or Ladder Company must provide a driver to assist the Paramedic Unit, that Company is totally out-of-service and not available for another call until their full crew is returned from the hospital. These are very real occurrences affecting emergency service delivery to the entire City of Milwaukee on a regular basis.

Despite the total void where normally there would be support from a Mayor and Fire Chief, the frontline Milwaukee Fire Department membership has continued to perform at an award winning level. In a study by the Journal of the American Medical Association, our system ranked second out of ten regions in survival rates of cardiac arrest patients. Numerous studies cite the importance of each of the levels of care provided by the MFD in the success and outcome of cardiac, stroke, and trauma patients. This is no small feat, given the ongoing blows to our Engine Company, Ladder Company and Paramedic Unit staffing.

From an economical standpoint, it makes perfect sense to augment and support EMS staffing on BLS and ALS companies. When run correctly, emergency medical services are revenue generating operations. This means that upon completion of service delivery, the City of Milwaukee bills to recoup the costs associated with the care and transport, such as oxygen, medications, and mileage for transport.

Working together and with the support of the citizens, we can continue to provide the high level of EMS care that Milwaukeeans deserve. Please contact your Alderperson and Mayor Tom Barrett and let them know that you support your Milwaukee Firefighters and Paramedics. Tell them that enough is enough when they continue to play games with your lives.

For more information, visit Local 215’s website at: www.local215.com.
Thank you for your support.