Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Cross-Training for More Diluted Skills

Image credit.
The ultimate in cross-training and fast.

There are many people who have wanted to be firefighters and paramedics since they were little kids. We should not ask them to grow up and make a choice. We should accommodate them and use that as an excuse to skimp on service.

Does cross-training as a firefighter improve the ability to provide medical care?


Does cross-training as a paramedic improve the ability to fight fires?


Does cross-training as a police officer improve the ability to fight fires?


Does cross-training as a firefighter improve the power of the IAFF (International Association of Fire Fighters)?


Does cross-training as a firefighter decrease the municipality budget for both services?


This is about money – not about quality.

4. Our staff is dual-trained, as both firefighters and paramedics. This creates a faster response time to both fire and EMS calls.[1]


Even the editorial does not attempt to push the fiction that this does anything positive for quality of care.

Fast care, not high-quality care.

5. There will always be a paramedic in-house on duty to answer questions, take blood pressures, and be available to assist the residents of Ashburnham.[1]


Are they going to pay a paramedic just to sit in the station and take blood pressures, or is that for the inevitable times when there are second calls, or when a paramedic is fighting fires and unavailable for medical calls?


8. TIME! Full-time paramedic coverage in town can make, and has made the difference between life and death. Early ALS intervention, a faster response time, and the personal touch of familiar faces from our own town can make a huge difference in the outcome of an emergency situation, not only medically but emotionally as well. It will take the nearest private ambulance service about 12-14 minutes just to reach the center of town.[1]


Fast care, not high-quality care.

Again – there is no mention of quality.

This is the big problem with diverting training to things that are not medical.

It is extremely difficult to produce high-quality paramedics.

Coming up with non-medical tasks for paramedics does nothing to improve the quality of care – it interferes with quality.

Medical skills, assessments, and treatments are constantly increasing. Time is needed to maintain the quality of new graduates, provide them with experience, and develop expertise over their years as paramedics.

Irrelevant job duties do not contribute to excellence, they distract from excellence.

While fire departments have been using cross-training as an excuse to take over ambulance services for a while, we are beginning to see police departments take over fire departments using the same excuses.

It is no surprise that the IAFF, and others who advocate for fire departments taking over ambulance services, are suddenly opposed when their people are the ones being taken over. I do not defend the police take-overs, but I do appreciate the irony and the exposure of their hypocrisy.

We do not require nurses to be cross-trained. We do not require doctors to be cross-trained.

We consider medicine to be too important to require nurses and doctors to be cross-trained.

When will we consider prehospital medicine to be too important to require paramedics to be cross-trained?


[1] Eight reasons to have 24/7 paramedic-firefighter coverage in Ashburnham
Sentinel & Enterprise
Posted: 04/22/2013 06:31:51 AM EDT

[2] Another Police and Fire Department Merger to Improve Law Enforcement and Fire Safety
Thu, 20 Dec 2012
Rogue Medic



  1. I find this interesting, though unsurprising. I’m a full-time software engineer. That is where my core skill-set lies. I’m a volunteer EMT as well, with an ALS service (1 EMT, 1 Paramedic per unit). A number of my EMS co-workers have asked me why I’m not going to medic class. They know I could do it. I know I could do it. Hell, I could go to medical school if I wanted to.
    It’s simple: The amount of continued exposure to maintain the level of skills required to do a *good* job as a Paramedic is greater than the ~10 shifts/month I currently put in for EMS. As an EMT-B, I can maintain the skill level I require reasonably easily with that time investment. If PA ever offers the AEMT program I will take it. Absent a complete career change, I cannot justify the risk to my patients by becoming a Paramedic without also being willing to invest the time and energy to maintain my skills at a high level of proficiency.

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