Understanding Proper Staffing and Response Time for Medical Emergencies
February 20, 2019

All Fire Departments try very hard to meet the NFPA standard that designates a recommended staffing level for emergency medical response and transport to nearby hospitals. Each community should not automatically assume that their local Fire and Ambulance Department can meet these standards in service to their residents. The public must understand the capabilities of the local department and decide if they can support service at the recommended levels. These standards cannot be met if their local fire department does not have the necessary funding for resources and/or staffing.

The recommended standard requires that staffing for Advanced Life Support (ALS) emergency medical responses must include a minimum of two members trained at the ALS level (Paramedics). Additionally, the standard requires that ALS responses include a minimum of two BLS trained providers (EMT). Therefore, at least 4 personnel should respond to these incidents. All response personnel must arrive within the recommended response time that is established in the standard for Advanced Life Support delivery of care. The recommendation is that BLS (EMT) units equipped with an automatic external defibrillator (AED) device arrive within four minutes (240 seconds) to 90 percent of emergency medical incidents, and the requirement that an ALS company arrive within eight minutes (480 seconds) to 90 percent of the incidents to which they are dispatched, are based on experience, expert consensus and science.

The staffing requirement for ALS responses is based on scientific research, experience and expert consensus that time-critical ALS calls require more personnel resources on scene for assessment and initiation of care than those required for BLS level incidents and for all transport. Additionally, the American Heart Association (AHA) has long-established guidelines for response to the most time-critical incident—cardiac arrest. The AHA recommendations, which were reviewed by the NFPA Technical Committee, are contained in several AHA publications. Following scientific research conducted by cardiologists and universities throughout the United States, AHA guidelines note that, “in systems that have attained survival rates higher than 20 percent for patients with ventricular fibrillation (cardiac arrest), the response teams have a minimum of two Advanced Cardiac Life Support (ACLS) providers plus a minimum of two BLS personnel at the scene.” Experts agree that four responders (at least two ALS and two BLS) are the minimum required to provide care to all critical medical emergency calls. Minutes Matter!

For a complete overview on the recommended standards for staffing and response times to both Fire and Medical Emergencies, please download the attached report.

Attachment NFPA Implementation Guide.pdf  (2,235k)
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