By: Emergent Team
As fire departments evolve to meet modern demands, many are embracing the integration of emergency medical services (EMS) under the same roof. Known as fire-based EMS, this model blends traditional firefighting with EMS delivery, often using cross-trained firefighter-paramedics to respond to a wide range of emergency calls. While this system isn’t without debate, fire-based EMS is increasingly shaping how communities respond to medical emergencies.
So, what exactly does fire-based EMS mean—and is it the right approach for your department or community?
What is Fire Based EMS?
Fire-based EMS refers to a system in which emergency medical services are managed and delivered by fire departments. In this model, fire departments are not only responsible for fire suppression but also handle EMS calls using cross-trained personnel and shared resources.
Most commonly seen in municipal departments, fire-based EMS enables rapid deployment by leveraging fire stations already positioned throughout the community. It also allows for a unified command structure, potentially streamlining operations at the scene of an incident.
Benefits of Fire Based EMS
The primary advantage of fire-based EMS lies in speed and efficiency. Fire stations are often closer to residential and commercial areas than separate EMS facilities, which leads to faster response times—a crucial factor in life-threatening emergencies like cardiac arrest, trauma, or respiratory failure.
Additionally, fire-based EMS systems:
- Reduce redundancy by combining fire and EMS services under a single administrative structure.
- Improve coordination on-scene, especially in incidents that require both fire suppression and patient care.
- Make better use of existing infrastructure and personnel, minimizing overhead costs for some communities.
- Provide career stability for cross-trained firefighter paramedics, who can contribute across multiple disciplines.
These operational advantages have led many departments—and major fire organizations like the IAFC—to support the continued expansion of fire-based EMS systems.
Challenges with Fire Based EMS
Despite its strengths, fire-based EMS is not without challenges. Combining two demanding services into a single entity creates pressure points for leadership and personnel alike.
Some of the most common concerns include:
- Training demands: Firefighter-paramedics must maintain proficiency in both fire suppression and advanced medical care. This dual training can be resource-intensive and may lead to skill decay in one area if not carefully managed.
- Role identity conflicts: In some departments, tension may arise between fire and EMS responsibilities, particularly when one aspect begins to dominate operational focus or resource allocation.
- Equipment and budget constraints: Integrating EMS into fire operations may require significant investment in ambulances, medical equipment, and additional staff.
- Burnout and fatigue: As the volume of EMS calls continues to outpace fire calls in most regions, some argue that this model places excessive strain on firefighter-paramedics. Critics point to mental health, fatigue, and declining retention as red flags that departments must address.
Examples of Successful Fire-Based EMS Integration
Many departments across the U.S. have successfully integrated EMS into fire operations and now serve as models for others exploring the transition. Large municipal departments like the Los Angeles Fire Department and Phoenix Fire Department operate under fire-based EMS systems, providing rapid, unified response across diverse urban settings.
Additionally, the IAFC’s Fire-Based EMS Toolkit offers resources and data from other communities that have seen measurable success in areas such as reduced response times, improved patient outcomes, and operational efficiency.
The Future of Fire Based EMS
The ongoing shift in call volumes—where medical calls make up more than 60% of total fire department runs—suggests that fire-based EMS will continue to grow in prevalence. Departments exploring this model will need to consider not only logistics and training but also the long-term wellness and retention of their teams.
Technology will play a pivotal role in optimizing fire-based EMS systems. From CAD integrations and RMS platforms to real-time incident dashboards, modern software is helping departments streamline dispatch, reporting, and post-incident reviews. With the right tools in place, departments can make better use of data to improve response efficiency and reduce operational stress.
At Emergent, we support fire departments as they navigate the growing demand for integrated services. While every community’s needs are unique, fire-based EMS offers a compelling model for unified, fast, and coordinated emergency response.
To learn how Emergent can support your agency’s evolving operations—whether fire, EMS, or both—reach out to our team today for a demo.
