Dublin Fire Brigade operates 12 emergency ambulances in Dublin with all operational Firefighters rotating from fire to ambulance duties. Firefighters are registered Paramedics with the Pre Hospital Emergency Care Council.
Shifts are from 0900 to 1800 hours on days and 1800 to 0900 on nights with the frequency of time spent assigned to the ambulance depending on the number of personnel in the station. Due to the number of hospitals and travel time in Dublin ambulance response and travel times to hospital are low and consequently the number of cases they do is high with the busiest ambulance of Dolphins Barn doing of nine and a half thousand cases per year.
Two Advanced Paramedic vehicles also operate on a part time basis at present with Advanced Paramedic interns from around the country travelling along as part of their internship and doctors from time to time overseeing intern APs.
(Note: For a full explanation of the different levels of training you should visit the Pre hospital Emergency Care Council's (PHECC) site at www.phecc.ie who are the governing body for ambulance personnel in Ireland.
The Medical Director for the Dublin Fire Brigade is Doctor Peter O' Connor the Accident and Emergency consultant at the Mater Hospital.
The major advantage in having all personnel ambulance trained is that a pool of over 140 personnel trained to Paramedic level is available 24/7 as the need arises. This is very obvious when responding to a Cardiac Arrest or a road traffic collision (RTC) as all personnel can operate closely together understanding what needs to be done for the patient and using true teamwork. At any time should an ambulance requires assistance for a lift or rescue that have not been automatically dispatched as a part of a pre determined attendance then fire engines and rescue units are available by contacting the Eastern Regional Control Centre (ERCC), which is also manned by operational Firefighters stationed in HQ.
Dublin Fire Brigade has achieved accreditation under the I.S.O. 9001/2000 Quality Management System (International Standards Organisation) for its ambulance service.
With Firefighters operating the ERCC a fire engine and other vehicles are sent at the same time as an ambulance if the situation requires them.
For example any cardiac arrest, non minor road traffic accident, possible spinal injury etc. a fire appliance with up to five Paramedics on board is dispatched automatically along with the ambulance.
These extra Paramedics means that a much greater level of patient care can be given during procedures such as resuscitation or spinal log rolls which require extra trained practitioners.
The extra personnel also can assist with lifting heavier patients especially from upstairs or more inaccessible locations.
With all fire engines in Dublin carrying experienced Paramedics and medical equipment such as defibrillators and oxygen therapy patient treatment can begin immediately at Paramedic level by a fire appliance crew, as they may often be the first on the scene.
Dublin Fire Brigade has an ongoing fleet replacement policy to CEN compliant vehicles (pictured above). In line with the idea of emergency use only, the ambulances currently being purchased are single trolley only with two patient seats. All ambulances in DFB are single trolley.
The O' Brien Institute in Marino Dublin is the training centre for the DFB and from 1995 all ambulance training for the fire brigade has taken place there. Initially the course for the EMT-B was started by the North Eastern University of Boston Massachusetts (who have now withdrawn from Ireland) but the instructors consist now mainly of a mixture of DFB tutors, external instructors and lecturing doctors and consultants. In 2002 Dublin Fire Brigade began a partnership with the Royal College of Surgeons in Ireland called the DFB-RCSI Training Institute and it now provides our Paramedic and emergency medical services training from the same location. All ambulance crews in the Republic of Ireland operate under the Pre-Hospitals Emergency Care Council's clinical practice guidelines.
The Paramedic Programme classroom component is 9 weeks fulltime and is followed by a PHECC multiple choice and OSCE (practical) examination (1st exam). An undergraduate internship consisting 4 weeks 3rd person supernumerary, 16 weeks attending practitioner, 2 weeks clinical placement and 1-week trauma life support course follows successful completion of the first exam. At the end of the undergraduate internship the Paramedic intern sits the final PHECC exam, which consists of a short written answer and further OSCE (practical) examination. The Paramedic intern then commences a yearlong internship during which they complete three competency assessments and professional development modules. During the undergraduate/internship the Paramedic intern will keep a learning portfolio for return the certification authority.
In 2005 the Advanced Paramedic Training Programme commenced in Ireland, several of these courses have taken place to date, with members of Dublin Fire Brigade taking part along with our colleagues from the Health Services Executive Ambulance Services.
Becoming an Paramedic with Dublin Fire Brigade
It is possible to become a Paramedic as an individual doing a course with either Dublin Fire Brigade or the National Ambulance Training School in the Phoenix Park. You should contact the training section of either for up to date information.
A very short history
Formation of the DFB Ambulance Service
From 1862 any fireman injured at a fire was transported to hospital by the Brigades tool cart or hose wagon. A tour of inspection in 1898 by the Chief Fire officer and a subcommittee which took in brigades of England and Scotland gave the groundwork to an improvement plan for the brigade which was presented by the CFO Mr. Purcell to the corporation.
The corporation accepted the plan and began to implement it's recommendations.
The unhygienic tool cart as a medical transport was dropped and the Corporation commissioned a horse-drawn ambulance and the firemen were trained in first aid. A second ambulance was purchased in 1901.
The calls that first year of operation stood at 537 and increased each year along with the population of Dublin. 100 years later and Dublin Fire Brigade had eleven emergency ambulances responding to over 90,000 emergency calls in 1999.
The ERCC receives over 90,000 emergency calls a year requesting emergency medical assistance through the 112/999 system for the Dublin area. (In 2007 this translated to 78,864 actual separate incidents where 1 incident may require several ambulances.)
Dublin Fire Brigade
Paramedic Training Program
Obviously as protocols change and medical advances are introduced this will change to some extent but it is here only to give the reader a general outline of the course. Contact the DFB - RCSI Training Institute for more information.
Hospital rotation is also a requirement of the course with places in an adult & paediatric accident and emergency departments as well as a coronary care unit and maternity department placement
Paramedic Training Programme
General course outline.
Introduction to pre-hospital emergency care
The wellbeing of the Paramedic
PHECC code of professional conduct and Ethics and Medico- Legal issues
Legislation, PHECC standards of documentation and the Clinical Handbook
Anatomy and physiology
Respiratory emergencies - Management of airway and ventilation
Advanced airway management
Scene size up
Baseline vital signs & SAMPLE history
Focused history and physical exam - medical
Anatomy and physiology
Cardiac First Response - Practitioner level
Infection prevention and control
Anatomy and physiology
Anatomy and physiology
Altered level of consciousness and seizures
Allergies and anaphylaxis
Poisoning and overdose
Anatomy and physiology Lab
Principles of lifting and moving
Bleeding and shock
Soft tissue injures
Head and spinal injuries
Pregnancy and pre-delivery emergencies
Childbirth and neonatal resuscitation
Basic patient care
Infants and children
Hazardous material incident
General Skills review and examination preparation