Editor’s Note:Over the next year, we will bring you “system-at-a-glance” profiles that showcase EMS systems around the nation. Our goal is to provide you with some quick insight into the structure, stats and activities of leading EMS organizations around the country.
Long regarded as a pioneer of emergency medical services, the Houston Fire Department (HFD) began formally providing EMS and transportation in April 1971. It’s one of the largest fire departments in the nation, with more than 3,400 certified EMS personnel.
HFD has played a key role in significant medical research activities, which have helped define the role of contemporary EMS providers. HFD’s research studies date back to the use of the medical anti-shock trousers (MAST) suit. HFD has also conducted research on stroke patient outcome improvement, fluid resuscitation and occupational stress in the industry. Current research activities include participation in an international resuscitation study and the evaluation of the use of prehospital thrombolytics for STEMI patients.
HFD is more than 3,000 members strong — and they’re looking for more through an active recruitment program. All of the department’s EMS providers are certified firefighters. If you’re looking to work for a large fire-based EMS provider, and you like to run calls (more than 235,000 in 2008), HFD may be the place for you.
Associate Medical Director Dr. Chris Souders and Firefighter/paramedic Jason Gander provided the following detailed department specs.
Houston Fire Department EMS at a Glance
Unique Characteristics:HFD is actively engaged in several programs to more effectively and efficiently provide EMS care to the citizens of Houston. They use a TeleHealth Nurse project, in which certain low-priority calls are diverted to a nurse to attempt to rectify the caller’s problem. For recurrent high-volume users of EMS, the CareHouston project teams EMS with the health department and directly engages these citizens to determine better ways to manage their chronic health problems. Lastly, a systemwide emergency ambulance routing system will begin shortly to provide real-time awareness of all EMS transports in order to give individual units the information they need to make proper hospital destination decisions.
Fire Chief:Phil Boriskie, FFT/EMT EMS
EMS Chief:Adrian Trevino, FFT/EMT-P
Physician Director:David Persse, MD
Associate Medical Director:Chris Souders, MD
Assistant Medical Director for Pediatrics:Paul Sirbaugh, DO
EMS Organizational Structure:Separate medical direction and administration. Medical direction is headed by an EMS physician director with a staff of 17 physicians, administrators, educators, systems consultants and staff analysts. EMS administration is headed by an EMS chief with a staff of 36 captains, firefighters, administrators, customer service representatives and regulatory compliance personnel.
Primary Service Area:City limits of Houston (618 square miles)
Population Served:2.2 million, 3.3 million during the day
ALS Ambulance Staffing:Two paramedics
Number of BLS Vehicles:57
Number of ALS Transport Vehicles:27
Number of EMS Supervisors:10
Number of ALS Non-transport Vehicles:18
Number of EMTs Certified:2,547
Number of Paramedics Certified:870
Number of EMS Calls Annually:235,285 (2008)
Average Response Time:6.22 minutes (2008)
Starting Salary of FF/EMT:$38,390.82
Starting Salary of FF/Paramedic:$45,590.82
Protocol Highlights:CPAP, induced hypothermia, STEMI protocol
Current Research Activities:Thrombolytics for prehospital STEMI, CIRC study
Current Challenges:Transitioning from traditional lecture-based training/CE for large numbers of people to a hybrid model of lecture/online and skills assessment training. The hybrid training program is a combination of online CE all paramedics/EMTs must take to fulfill state certification requirements, plus five 10-hour classes in person, per year on overtime. The class material is determined by the medical director’s office. It’s a combination of lecture and skills training/evaluation. The challenge has been training the large numbers of paramedics off duty, in a fire department atmosphere, and having worthwhile educational experiences. Despite this, implementation has been successful thus far.
EMS Philosophy:The “Holder Rule” — Treat patients and their families as if they are a member of your own family. This “rule” is named after long time HFD EMS Assistant Chief Dennis Holder, who died during his tenure as EMS assistant chief. It’s a belief he frequently espoused and has now been turned into a rule and placed in the HFD patient care protocols.
Unique or Specialty Teams:EMS Bike Team, EMS Surge Team. The bike team goes to mass gatherings and other public events, and provides BLS level care. The surge team is a group of approximately 60 personnel who can be activated if there’s an EMS incident that’s expected to be prolonged (24-plus hours). This could be an MCI, extrication or other event. They have a mobile field hospital setup they can deploy and house dozens of people in a protected environment.
Currently Recruiting?:Yes
Recruit Requirements:60 hours of college, two years’ active duty military experience or already certified as an EMT/firefighter in Texas
Contact for Employment Information:713/495-4266
