The Dallas Morning News Steve Blow Column: Dallas Fire-Rescue’s Shift in Duties Warrants Medical Attention

By Steve Blow, The Dallas Morning News

Feb. 8–Here’s a quick quiz for you: What’s the primary job of the Dallas fire department?

Well, duh, you say. Who’s buried in Grant’s tomb? Fire departments fight fires, of course.

Wrong.

Grant may be buried in Grant’s tomb, but fire departments are mostly in the health care business these days.

We may still call them firefighters, but their major work is as medical caregivers. And Dallas wants its paramedic service to be a whole lot better.

As my colleague Blanca Cantu reported this week, Dallas Fire-Rescue is in the midst of a “vision process” aimed at making its emergency medical service the best in the country.

Ambulance service is one of those things no one thinks about — at least, not until you need it. But once you have needed it, the issue becomes really important to you.

And I’m a guy who really, really needed it.

Not to be overly dramatic, but you can’t quite imagine the importance of an ambulance until you have knelt beside the lifeless body of your son on a downtown sidewalk — waiting, waiting for paramedics to arrive.

And how’s that for not being too dramatic?

I try not to dwell too much these days on Corey’s out-of-the-blue cardiac arrest three years ago. But needless to say, I continue to be boundlessly grateful for every step in the process that allowed him to have a complete and total recovery.

One of those steps was the swift response of a Dallas Fire-Rescue ambulance and the fervent, skilled work of its crew in restarting Corey’s heart en route to the hospital.

So, yes, as you might imagine, I read with special interest Blanca’s stories about the improvement plan. And I followed up in a long talk this week with Dr. S. Marshal Isaacs, medical director of Dallas Fire-Rescue.

The good news is that no one contends that Dallas has bad EMS service now. “In fact, we think it’s good,” Dr. Isaacs said. “But we don’t have a lot of data to prove that.”

So one of the keys to the improvement plan is creating a system for measuring performance.

Dr. Isaacs can make some informal comparisons. He arrived in Dallas a year and a half ago after 12 years as EMS medical director in San Francisco. And he said he was impressed by what he found here.

But a couple of things jumped out at him: “I couldn’t believe how many runs the ambulances were making in a 24-hour period. That, and how demoralized the paramedics seemed to be.”

First impressions proved accurate. Dallas paramedics are, in fact, overworked and feeling underappreciated. The improvement plan will seek to remedy both.

Looking ahead, the plan seeks to improve morale by making sure fire department recruits understand what they’re getting into — that it’s more health care than firefighting.

As Dr. Isaacs put it, “We need to change the brochure. It’s not all about putting wet stuff on hot stuff any more.”

Thanks to improved building codes, greater fire safety and other factors, there are far fewer fires nowadays. Hooray for that. On the other hand, calls keep climbing for emergency medical treatment.

About 70 percent of calls to Dallas Fire-Rescue are for an ambulance.

Under the improvement plan, recruits will be psychologically screened to make sure they are as suited for tending to a patient as they are for battling a blaze.

And then there’s a public-education component of the plan. Cellphones make it awfully easy to be a casual good Samaritan these days. Dallas paramedics respond to a lot of calls on minor traffic accidents in which no one was injured. They also get to wake up a lot of people merely sleeping in a car or on a bench.

By all means, call an ambulance when needed. But make sure it’s needed before calling.

The bottom line is that good ambulance service is important to think about — before that terrible moment of need.

—–

To see more of The Dallas Morning News, or to subscribe to the newspaper, go to http://www.dallasnews.com.

Copyright (c) 2008, The Dallas Morning News

Distributed by McClatchy-Tribune Information Services.

For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.