IC尖叫预防计划

BY ALAN BRUNACINI

During my career, I have had a ringside seat to closely watching the birth of two brand new fire service characters: the paramedic and the incident commander (IC). The paramedic was the product of our developing the modern emergency medical response system. Since the beginning of our service, we have delivered very primitive first-aid services to the community. Mrs. Smith called us when she was out of balance for a variety of reasons that in some way involved her physical safety: fire, rescue, medical, or any unplanned emergency physical disruption. We make very rapid house calls, so who else would she call? When I was a young firefighter, we responded mostly to structure fires; occasionally, we would respond to “resuscitator calls.” We had a toolbox full of bandages and a gigantic resuscitator that weighed 95 pounds that was too large to fit in a big foot locker. We would arrive, start working, and then continue treatment until the local mortician who operated the ambulance system showed up and transported the customer to the closest hospital. We responded quickly and were gentle with Mrs. Smith, but we were not very medically skillful.

Starting in the 1970s, we watched how the military provided battlefield medical support, developed training and service delivery programs, and we imitated, adapted, and applied those systems to our community. We historically and currently have a very trainable workforce; a long-standing emergency service delivery system; and a very positive, trust-based relationship with the Smith family. We sent our firefighters to paramedic school, and they learned very practical and effective advanced life support (ALS) skills. Before the advent of paramedics, we delivered very basic medical services a lot like we had been doing for the past 250 years. The major difference between pre-paramedic and post-paramedic was that a certified paramedic physically appeared at Mrs. Smith’s front door and could do basically in her living room most of the emergency treatments that the hospital down the street could do. Our paramedic students were selected directly out of our workforce - they did not come from Mars. The whole experience was a lesson that we could positively revolutionize a critical service delivery capability by increasing the knowledge, skills, and abilities of a single person.