r/Firefighting 14d ago

Ask A Firefighter Do firefighters have to work as Emts?

Hey everyone, this may be a very stupid question, and it may even vary department to department, But in metro areas, Is it common for firefighters to have to do ambulance rotations? Or is that not a thing at all? I’m asking as someone looking at getting into this career field, and could have swore I saw on a website for a local metro fire dept that they require new hires to rotate between the roles. Thanks in advance!

18 Upvotes

63 comments sorted by

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u/metalfan192 14d ago

Yes around here, (DFW TX) pretty much all depts do firefighter/paramedic and you ride both. Many smaller depts don’t run ambulances but you still need an EMT basic cert to be a firefighter and ride an engine as you help EMS with medical calls.

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u/No-Toe9634 14d ago

Appreciate the reply, I never realized they rotated like that, but makes perfect sense. Do the paramedics typically rotate as well, or are they pretty cemented in that singular role? Thanks again

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u/pizzaerry2days 14d ago

The answer is it really depends. In a lot of DFW departments you could be on any of the rigs any day. Others “bid” to a spot and are mostly there

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u/metalfan192 14d ago

yes dependent on dept policy. Mine we rotate assignments

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u/GhostCatcherSky 14d ago

Yep 3rd the whole dependent on department/area. My area every fire station has an ambulance so they employ ff - medic who primarily ride on the ambulance but you best bet if you’re needed on the rig you go on the rig. We’ll rotate assignments but a lot of the time a good amount of the people don’t have their medic and just their emt so ambulance it is

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u/metalfan192 14d ago

One other thing to note is the big depts where you have to do EMS typically pay more.

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u/koalaking2014 12d ago

see I usually see it the other way

FDNY, NOFD, CFD, Louisville, etc, all have 3rd service ambulance and the firefighters are generally at most EMT level providers.

Its all the mid-small cities and "county FD" (i.e smaller cities in the DC/new England area, and other suburban depts), generally require paramedic and have their own ambulances.

Shit even some of the middle level cities like Milwaukee, detroit, etc, and most of the EMS on the west coast does BLS for private. Ik on FDNY firefighters arnt even EMT, they are CFR (Certified Fire responder).

Also im suprised you didnt think of ATC EMS. they are one of the largest 3rd service ambulances.

So for OP, to answer your question, it mainly depends on where you go. a lot of places require EMT at a bare minimum as they send engines on med calls as there usually more available than ambulances, and the extra manpower is nice on things like Codes, GSWs, etc. A select few like FDNY will only require CFR, although I think FDNY and maybe Chicago are the only ones.

Id say if you want to get into the fire service your gonna have to accept EMS is apart of it more than ever now. If you go in with the mindset that your job is just to fight fires, your gonna get burnt out quick. Its a public service and compassion based job (not just EMS side but also through fire prevention, teaching, etc).

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u/Elegant_Disaster_834 11d ago

Chicago has fire medics and paramedic engine companies.

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u/[deleted] 14d ago

I would say that arguably it has become the standard at this point. Fire departments have experienced a ton of responsibility creep over the last few decades to the point that "fire" isn't really even accurate anymore. We're more like all hazards departments. With the absolutely chaotic way ambulances are handled in the US, with them being provided by private companies, hospitals, cities, or counties, all with varying response areas, it is almost a certainty that in many cases a fire department will get to patients faster.

Whether or not we think we should, or whether or not a lot of us even want to, responding to medical calls is just the job now.

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u/wehrmann_tx 14d ago

No decent pay would be justified with just non EMS responses.

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u/No-Toe9634 14d ago

Appreciate it. Thanks for the taking the time to reply

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u/Forgotmypassword6861 14d ago

Depends on the area

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u/Shwacker51 14d ago

This is the only real answer. 100% area dependent.

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u/Owlrightythen_84 Fire Plug 14d ago

True story. Our combi department doesn't run an ambulance service but, it's required to at least have a minimum of EMR licensure for everyone within a year. Most of the full-time staff are EMTs or NRP.

I'm glad we don't run an ambulance service but, we auto-aid all medicals in our district with EMS.

I worked at an ambulance service for about 8 or 9 years as a side gig and to get better with my skills as an EMT when I wasn't on shift.

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u/No-Toe9634 14d ago

Appreciate it

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u/JudasMyGuide 14d ago

I think generally speaking in your metro areas if fire dept don't run their own ambulances they work alongside a private ambulance company and either lead the medical calll as EMTs and/or medics and hand the patient off to the private. Or assist the private company as EMTs and medics. As it's been said before, it depends where, but in many metro areas, yes many firefighters are also EMTs and paramedics.

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u/No-Toe9634 14d ago

Thank you

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u/ReplacementTasty6552 14d ago

We do not. We have a few EMTs No medics. The rest have just some basic first responder training. 50,000 population 30 paid FF’s 2 stations. Grossly understaffed but we only run life threats. Heart attack. Not breathing. Stroke. We don’t do bumps and bruises or lift assist anymore.

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u/Huge_Monk8722 FF/Paramedic 42 yrs and counting. 14d ago

Only if that department has a EMT in the job description.

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u/RedditBot90 14d ago

As others said, department dependent. Most, you will have to at least BE an EMT. Some require Paramedic. Some departments have their own ambulances and will have you do rotations onto the ambulance, some don’t.

Many volunteer departments have EMR as the minimum, or no EMS requirements

Exceedingly few career departments don’t do any EMS / don’t require EMT certification

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u/[deleted] 14d ago

[deleted]

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u/No-Toe9634 14d ago

Understood, thanks for the response

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u/ModeratelyTortoise 14d ago

like 85-90% of calls are medical calls in most places

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u/yourname92 14d ago

Most areas do some level of EMS. To what degree it varies they are not there to just fight fires or get cats out of trees. Most places now a days have higher level EMS providers like paramedics and off ambulance services. Why? Because areas are cheap and they can consolidate the two. Why pay who different people when one can do the job.

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u/daly831h FF/PM 14d ago

I work for an agency and we’re pretty much all paramedics. We don’t have ambulances though, so we don’t have to transport. A private ems company does the transports. But we go on all the medical calls, vehicle accidents, fires, etc

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u/Eclectic-Eel 13d ago

Im curious, do you have to fill out ems reports when you respond to a call, or does the transport company handle that?

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u/daly831h FF/PM 13d ago

So for us, if we beat the ambulance on scene we write a pcr. If the ambulance is already there and we do any type of intervention we also write a pcr. If they beat us and we don’t do anything or get cancelled, we don’t have to write one.

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u/Eclectic-Eel 13d ago

Honestly sounds like a great balance. It seems like it would cut down on a fair bit of the paperwork for bullshit calls.

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u/__Wreckingball__ 14d ago

No, you can work as a paramedic. Basically every firefighter has to be at least an EMT in career departments within the US.

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u/Typical-Efficiency31 14d ago

Only if their department requires them to work as an EMT

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u/krzysztofgetthewings 14d ago

At my non-metro department, all personnel are required to have FF1 and EMT-B at a minimum. In theory, EVERYBODY is supposed to rotate through EMS calls. But it's really up to each shift's captain who actually rides the ambulance.

One friend that works in a metro department says that you get hired on as a FF/EMT, then you are stationed on a particular unit and you stay there for an extended period of time. Rookies ALWAYS get put on an ambulance. Once you get some seniority, you can request to be moved to a different piece of equipment.

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u/Comfortable-Fig5930 14d ago

Here in California in order to be a full time FF you have too have a paramedic license. Since mostly here in socal you’re running medical calls most of the time. Sometimes you switch what you do one shift you’ll do the paramedic side and then another shift you’ll be doing firefighting

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u/EverSeeAShitterFly Toss speedy dry on it and walk away. 14d ago

Most commonly yes, but not everywhere.

Some will have single role EMS staff that works for the FD but deals only with EMS.

Third service refers to a separate (and not private) EMS service that is separate from police and fire departments.

Private companies like AMR are often used for IFT transports but they can also work within the 911 system and have units dedicated for emergency responses.

1

u/roushstage1 14d ago

Depends on the department. My department requires everyone at least have emt, and lots have medic, but we don’t transport. If you find a non transport dept then obviously you wouldn’t be riding medic units if they don’t exist. My local system the transport is generally handled by the county ran ems agency.

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u/FireHammer09 14d ago

In North Carolina all professional departments require EMT and they respond to medical calls (engine goes unless they're out). Our departments usually don't have ambulances because the state mandates that counties run their own Paramedic staffed ambulances with like 2 exceptions that got grandfathered in cause I think the local hospital does it and one got caught doing shady shit.

1

u/AFirefighter11 14d ago

One of my departments is a combination department. On the fire side, all career employees must have FF/EMT. On the EMS side, it's another company contracted with my city that is specifically EMS. No firefighters have to ride on the ambulances, but we do run QRS calls when the ambulances are all unavailable.

It seems most of the big cities, though, do require rotations on ambulances. Any of our career guys who have gone off to big city departments like DC have mentioned this.

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u/capcityff918 13d ago

You’re correct about DC. When hired, you’re expected to ride ambulances. You end up on the engine or truck more often than the ambulance but each company provides one guy for a spot on one. So in a double house, the engine and truck each provide a person. Then vacancies are filled with either overtime or random details based on the amount of EMS hours you have for the year.

If you promote to technician or become an officer, you no longer ride them. You’re either permanently driving, as technician, or riding the seat as sergeant, lieutenant and captain.

There are also still some EMS only employees left that staff only ambulances and we also use third party EMS with AMR.

1

u/Boujee_Italian 14d ago

I’m about to start my EMT school in a couple weeks because it’s required before being able to go to the academy.

I also plan on knocking out paramedic school after I get EMT certified.

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u/jojodancer25 14d ago

The 4 rescues ride with 2 other personnel, usually one medic and EMT. Sometimes we ride with 3 , but rarely. All engines a ALS so they have a medic everyday . Everyone is at least an EMT out of 110 personnel

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u/Impossible_Aside_439 14d ago

Yeah in phx area we have rescues which are crewed by firefighter/medics and they’ll rotate who’s on the ambo which shift vs who’s on the engine, ladder, etc.

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u/Whatisthisnonsense22 13d ago

It depends on th e department. At the suburban department, I'm with. Yes, the newer folks rotate between ambulance and engine shifts. Once you get several years on, that stops, unless you want to take someone's ambulance shift.

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u/Forward2Death I miss my Truck 13d ago

Often, yes. I'm on a county non-transporting FD, have to have EMT.

1

u/silly-tomato-taken Career Firefighter 13d ago

For a career firefighter, I'd say it's extremely rare not to have at least your EMT.

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u/Drainsbrains 12d ago

The answer is; every department is different

In my state every ff is at least an emt. Some departments also have their own transport. If they do, then yes you’ll be working on a box half the time. If you’re a medic you’re probably working on the box 80% of your career unless more medics come in and forces stop.

If your department does not transport there’s 2 possibilities. 1) as an emt you’ll never be on the box, but if you’re a medic you’ll only ride on an acute patient or if requested by the box medic. 2) as an emt you’ll still never ride the box, but if you’re a medic and the contracted ambulance is BLS and it’s an ALS call then you’ll be doing the full continuum of care.

Note: you actually could ride the box at a non transport agency as an emt. But mainly to do compressions or ventilate to free up medic hands

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u/Electronic-Load-4002 12d ago

Yes it’s common practice unless they have AO’s.

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u/not-a-person-people 12d ago

My department is a medium sized and has a county ambulance. However, all FF’s in this area (in this system) are EMT-B

So it is possible to find a non-transport agency. However, larger departments you are going to find EMT-B to be a common theme. Small departments may not.

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u/mojored007 11d ago

You have to be a EMT just to get hired you may? Have to ride the box..lots more f CPR as well

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u/davethegreatone 14d ago

(this isn't an important rant, but I can't sleep so you get a big rant as an answer)

A bit of clarity on the ambulance factor - many (most?) metro areas in the USA made the mistake of going with private contractors for the actual transportation part of EMS, so most of the firefighters don't do *ambulance* rotations - that's the domain of the private company that has the contract and gets to charge your elderly neighbor the cost of a nice used car for every ride.

BUT - nearly all firefighters in the USA are EMTs first and foremost (paramedics are a type of EMT. They used to be officially called "EMT-P"). 80-90% of all responses are medical in nature, and because those private ambulance companies put the bare minimum number of ambulances on the road they can legally get away with, the fire department is usually going to be closer in an emergency (our national goal is to have a fire station no more than a 4-minute drive in an urban or suburban area, because time really really matters when a fire is getting bigger by the second).

Fire stations are expensive to build and REALLY expensive to staff. A small fire station costs about three million dollars a year in salary alone. Another couple million in benefits and insurance and the cost of maintaining certifications and training and whatnot. Call it six million bucks to bare-bones put people in the building, preferably in so many locations that one is a no more than a 4-minute drive from every residence in the city.

Now, modern fire codes, smoke detectors, going into elementary schools to teach kids how to avoid fires, requiring mattresses to be fire-resistant, a decline in tobacco smoking and a million other things have acted together to reduce the number of house fires nationwide, so cities look at all these people sitting around costing millions of dollars and generally not fighting many fires, and the budget people say "man, that's a lot of cash to fork over just to have some dudes with mustaches watch TV all day and work out."

Hence, the pivot to saving lives via emergency medicine. Saving lives is our main job, and the main threat to the people we protect is medical emergencies.

The actual workday for most of us is that we train, do maintenance, and several times a day go START the EMS process. We get there first, stabilize the patient, and then when the ambulance shows up - we load the patient into the back and go home. If the patient is in really dire straits, typically one of us rides to the hospital in the ambulance while the fire engine follows them to pick our FF up after, but that's like one call out of every couple hundred.

So all this is to say - almost every full-time FF in the USA is primarily a reach-and-treat EMT who occasionally dabbles in firefighting as a side gig. But most of us don't actually go IN the ambulance all that often.

My department has our own ambulances and honestly it works so much better that way. We put one crew at most stations, and 4-5 vehicles. When the 911 call comes in, we jump in the engine, brush pumper, ambulance, water tender or specialty rig that is needed and roll out. So technically, every day I staff a fire engine, but also an ambulance and all the other things. It's nice to have variety.

I would be so amazingly bored if all I did was fire. Most fires are over in five minutes (followed by several hours of rehab and maintenance) because of fire codes, early 911 activation, sprinklers, etc. We show up, kick the door, spray stuff, and then ... just carry things around and organize equipment and shovel out all the insulation in the attic and generally just do boring manual labor. That first five minutes sure is cool, but it IS just five minutes.

Occasionally, multiple weeks go by without a fire call of any sort on my shift, at my station. Months can pass between significant working fires on my shift (during the rainy season only, but still). We run three shifts, so the *department* may never go more than a couple days without a fire, but any individual station and any individual shift at that station can be really under-worked without EMS.

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u/FishSpanker42 emt, mursing student 14d ago

Sounds like we should split fire and ems. What an idea…

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u/davethegreatone 14d ago

Why on Earth would you think that? 

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u/keep_it_simple-9 FAE/PM Retired 14d ago

Depends on the department and their role in the EMS system.

Pay is often better for fire departments that handle EMS versus departments that are single function fire only

1

u/throwaway926988 14d ago

Depends where you work. In my city they are totally separate departments

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u/JosephStalinMukbang 2.5 on the streets, 1.5 in the sheets 14d ago

Some do, some don't. The neighboring department doesn't require a basic at all.

0

u/Grande215Lump 14d ago

Buddy every tour maybe even twice. Welcome to hell. When the EMS side of the department doesn’t discipline members for taking off whenever they want and they have to back fill a squad with a fire fighter every fucking day and night. Major metro fun.

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u/No-Toe9634 14d ago

Got it, thank you for the reply man.

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u/Grande215Lump 14d ago

It’s all good though, just gotta know what you’re signing up for. I’ll still take 3/4 nights working the engine. The reality of modern fire fighting in most places is your main responsibility is being an EMT that gets to fight fire occasionally.

0

u/Strict-Canary-4175 14d ago

It depends. But in general, if you want to make a good living, yes.

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u/joeyp1126 14d ago

We all have some level of EMS cert from Basic to Paramedic in the department I work in. However, we do not staff ambulances in my city. That being said we are the exception around here and not the rule. I do think many agencies are starting to hire single role EMS now though.

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u/username67432 14d ago

Were a large city and have single role medics that staff the ambulances. On the fire side everyone has to be an emt but they can’t operate on an ALS ambulance. From time to time FF/PMs will get sent to the ambulance to cover a vacancy usually from someone going home sick or injured, but it’s not a regularly scheduled thing.

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u/JimHFD103 14d ago

In my County, we have a separate Third Service EMS Dept... and we as the FD still run 80+% of our call volume on medical aids as EMTs with them.

We don't have to do any transports or ALS stuff, but yup, EMT is a huge part of the job.

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u/Living-Metal-9698 14d ago

Most cities have at least FF/EMTs. A a lot have FF/Paramedic. Some departments have new hires work the squad the majority of their first year. This is to help them become familiar with their district, certain buildings & typical layout of the homes.

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u/flashdurb 14d ago

Yes it is definitely not possible to be a paid firefighter without having at least your EMT. Some departments require Paramedic.

-1

u/Short-Kitchen-5755 14d ago

Most are pushing towards firefighter medics. Would have to find depts that have ambulances as a third party but would probably still need to do emt