r/Firefighting • u/Launch_Rockface • Jul 10 '25

General Discussion Unpopular Opinions In the Fire Service

I am curious what other peoples unpopular opinions of the fire service are? I know there are alot of things we are doing or trying to do to improve the fire service as far as training and wellness, but I also know alot of it is just not that great in my opinion.

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u/McthiccumTheChikum FIREFIGHTER/PARAGOD Jul 11 '25 edited Jul 11 '25

All transports should be closest appropriate facility.

If your medics can't discern "appropriate facility" you have much bigger problems.

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u/Ok_Buddy_9087 Edit to create your own flair Jul 11 '25

Appropriate is relative. Abdominal pain, nausea/vomiting in a colon cancer patient? I have no problem going to where their oncologist is, even St. Farthest, and neither should you.

Nosebleed on Coumadin and you want to go to where your PVP is 20 minutes away instead of the city hospital 10 minutes away? Yeah, your PVP doesn’t gaf about your nosebleed.

13

u/SmokeEater1375 Northeast - FF/P , career and call/vol Jul 11 '25

Mixed opinions on this and it’s probably system dependent but being in a busy suburb and only two ambulances, we can’t really afford to go 40 minutes into the Mothership of hospitals in Boston when theres hospitals 5, 10 and 15 minutes from us. We’re doing a disservice to the other tens of thousands of people in town - especially since these ambulances also cross-staff a ladder truck.

BUT I have no problems going in for very specific reasons. Most recently a cancer patient started an immunotherapy drug that morning and had terrible side effects that night - to the mothership we go. But for something like generalized abdominal pain even in a colon cancer patient, they could have it for plenty of other reasons. I’d rather let the local hospital do tests/imagine etc etc and discern if they can handle it or not and then from there decide to transfer the patient. They’re an emergency department and that makes it an appropriate facility. Appropriate doesn’t always mean highest levels of care - if that was the case I should be taking every patient to Boston to some of the best hospitals in the world. I feel as if my cog in the system is to get them definitive care and let the doctors do what they do to decide the best patient care plan. Unless a very relevant reason or clear correlation between a condition/procedure and an acute complaint, I like to stay local.

Then obviously the need to go to a level 1 trauma or burn center….then again, into the city we go. Fine with that.