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Medical Calls Dominate San Diego Fire Department

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— Firefighters are known for rushing into burning buildings and battling flames. But successful prevention efforts and better building materials mean fewer fires to fight. So how are San Diego firefighters spending most of their time?

Special Feature Watchdog Institute Investigative Report

The progress San Diego was making toward improving fire response times has stalled since the city started idling fire engines to save money in February, a data analysis has found.

Special Feature Check Fire Response In Your Neighborhood

Search more than 80,000 San Diego Fire-Rescue engine responses to emergencies in San Diego. The response times are for all incidents the department calls Level 1 and Level 2 Fires, which includes calls for structure and vehicle fires as well as calls for elevator rescues, ringing alarms, fuel spills and gas leaks. The department has grappled with poor response times for the better part of a decade, and says a lack of resources is to blame.

A siren screams as the San Diego Fire and Rescue Department’s Truck 10 speeds down College Avenue on its way to a reported apartment fire. Once there, the four-man crew jumps out of the rig and runs to an apartment with smoke streaming out of the windows. An engine arrives on the scene and the firefighters quickly decide that the gated security door and the front door behind it need to be forced open.

Inside, it turns out there’s no fire, just a lot of smoke from a plate left sitting on the stove. But the call did provide a good real life experience for the two rookie, or probie, firefighters that are part of the crew. And these days, actual fire calls don’t happen as often.

Data complied by the Watchdog Institute at San Diego State University shows that more than 82 percent of the department’s calls are for medical emergencies, not fires. The number of medical calls has also shot up, from about 65,000 in 2004 to more than 78,000 last year. Fire Chief Javier Mainar said he’s not sure what’s behind the increase.

"I don’t know to what degree people’s access to health care has a bearing on that," he said. "For some people, unfortunately because they don’t have access to a regular physician, we become their physician."

The number of fire calls has stayed relatively flat for the past six years, between about 3,600 and 4,600. In fact actual fires accounted for just about 4 percent of the department’s calls in 2009. Mainar says given that fact, it makes sense to respond to a wider variety of incidents.

"Rather than just sit there and say, oh it’s not a fire, we’re going to park ourselves right here and do nothing, those units go out," he said. He said the practice reduces the number of ambulances needed and the overall cost of providing emergency medical care. He said it also gets care to people more quickly.

San Diego began thinking about blending the medical and fire response systems in the 90s. Dr. Jim Dunford is the Medical Director of San Diego’s EMS system and a Professor of Emergency Medicine at UCSD. He says in 1996 the decision was made to put a paramedic on every fire engine and truck in the city.

"There were parts of the city of San Diego where the ambulances simply couldn’t get there in time," he said. Dunford said under the old model there were two paramedics on ambulances and none on fire vehicles. He said there were areas in North County and South Bay that were particularly effected. Dunford says San Diego’s new system has been used as a model by other cities.

But while the system is working well for people in need of help, there’s some concern the fire department is being stretched too thin. Along with medical and fire calls, the fire department is responsible for other duties, like hazmat response. Wildfire season can also add additional strain. Chief Mainar said it can be difficult to get everything done.

"Because our mission scope has expanded from strictly being firefighters to now being EMS, Hazmat and all these different kinds of specialties. There’s far more training that we have to do. So it’s been a struggle to get the training done effectively," he said.

The fire department is having to work with fewer engines too. Last spring it began idling up to eight fire engines a day as part of a cost cutting plan. Council member Marti Emerald said she believes the department needs to be re-built from the ground up with more stations, equipment and firefighters. But she’s concerned the city’s financial situation is causing it to move in the opposite direction.

"We wound up with these deficits each year and I’m afraid we’re going to be stretched so thin we won’t have the resources where we need them when we need them," she said,

So far the fire department’s average response times haven’t risen dramatically during the brownouts. Both medical and fire responses hover around five minutes on average.

But Mainar said he could use an additional 300 firefighters to cover the city and between 11 and 22 new stations. He said city hall is telling him public safety is a priority. But right now there’s no money available to make improvements a reality.

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