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Training, Calls Intensify in Maine

PORTLAND, Maine -- When Tony Russo joined Ladder 1 on Munjoy Hill this week, he came on board with training that reflects the Portland (Maine) Fire Department's changing mission.

Russo and the rest of Portland's 18 new firefighters are all trained in advanced life support, able to offer life-saving techniques and drugs even before an ambulance arrives.

''There was a lot more training and a lot more skills involved,'' Russo said, referring to the intermediate EMT certification he got before joining the department.

Rescue calls account for an increasing share of the Fire Department's work as Portland's population ages and the number of fires declines.

The number of medical calls almost doubled from 5,066 in 2001 to 9,549 last year, according to Fire Department statistics, though the numbers are approximate because of changes in reporting requirements and computer software.

Medical calls grew from 59 percent of all fire department calls in 2001 to 69 percent in 2007.

''We do a lot more medical calls a day than we do fire calls,'' said Deputy Fire Chief Larry Libby.

Portland added a fourth ambulance last summer to meet the growing demand, but many of the ambulance shifts, which require at least one person at the intermediate EMT or paramedic level, were being filled with overtime.

Since Portland combined its fire and rescue operations, almost every member of the department has been cross- trained to work in emergency medicine and fire suppression. But until now, new members were required to be certified only as basic emergency medical technicians, which requires 130 hours of training.

The intermediate level requires an additional 250 hours of training, which includes clinical experience. Such training programs are hard to find, so the department conducted its own.

The additional medical training meant the latest class of recruits spent almost 6? months in training, far more than the customary 12 weeks for fire suppression drill school, said Fire Chief Fred Lamontagne.

''The big thing is, they're able to do some cardiac monitoring, advanced airway management, start (intravenous fluids) and deliver certain medications,'' Lamontagne said.

Increasing the medical skills of new firefighters is a response to changing needs, Lamontagne said, not an effort to cut overtime costs, which in 2006 led him to shut down fire stations for 12 and 24 hours at a time.

The concept behind intermediate EMT training is to increase the number of rescue workers who can keep patients alive in trauma situations, without requiring trainees to take the two semesters of study that are necessary for a paramedic.

Having more intermediate EMTs in the department means more people can work in ambulances or on firetrucks, he said. It also ensures that a higher level of medical care can be provided at the scene of a car accident or other medical emergency.

An ambulance crew can be busy with one call when another comes in, meaning the first emergency personnel at a scene may be firefighters.

''A majority of the time, the engine arrives before the ambulance,'' said Tim Nangle, a firefighter who is certified as a paramedic.

He said, ''There are 10 fire companies and only four ambulances. Engine 1 on Munjoy Hill will get to a call on North Street before Medcu 5 at Central Station just based on geography.''

For such situations as heart attacks, drug overdoses or severe bleeding, the faster the patient can get advanced treatment, the better the chances of survival. Intermediate EMTs can do advanced procedures under the guidance of a physician over the radio.

The new class of Portland firefighters has 16 men and two women.

Each person hired spent some of the past five months riding along in the department's ambulances and at hospitals.

''It was very hard work and very demanding, but at the same time we got quite a bit of knowledge out of it,'' Russo said. ''The medical stuff was more mentally challenging and the suppression more physically challenging. Both areas are really important for the city.''



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