Parked outside Los Angeles County Fire Station No. 14 in Westmont is a fire truck decked out with three types of extinguishers and hoses, a 24-foot wooden ladder, forced entry tools among others, and a number of medical kits and drug boxes.
Painted on the front and back of the truck are the words, “It ain’t easy kid.”
With over 1,000 calls being made every single day in Los Angeles County, being a firefighter is a challenging job. But challenges have been compounded as the LA County Fire department finds itself with outdated equipment, lack of funding, and staff shortages.
In a public awareness campaign meant to provide information about the challenges, LA County Fire Department staff shared their personal experiences and of how the challenges affected day-to-day operations.
“Their task is to protect and serve this community and serve the entire county. There are tasks in many instances where they are serving the most vulnerable aspects of our community,” LA County Fire Chief Daryl Osby told reporters on the first stop of the department’s campaign at Fire Station 14.
“It’s incumbent upon us — me as a fire chief, the Board of Supervisors, and our community — to ensure that our firefighters are well staffed, well trained, and have the best equipment possible to allow them to execute their mission,” he added.
In a profession where communication is key, lack of funding and changing technology has meant firefighters using old, outdated, and unreliable radios and communications equipment. Systems dating back nearly three decades has often resulted in incompatibility with more modern digital systems and wireless networks.
Not only has this affected firefighters who rely on communication amongst each other, but paramedics who require direct communication with emergency rooms and trauma centers.
Fire Captain Guadalupe Munoz gave an example of how the company they contract with to provide radios will no longer be making replacement parts starting next year.
“So they’re basically obsolete now,” said Munoz.
The most recent event that tested LA County Fire was during the November 2018 fires that erupted both in Northern and Southern California.
In Los Angeles, the Woolsey Fire — one of the largest and most destructive in the county’s history — torched 96,949 acres of land and destroyed over 1,400 structures across parts of the San Fernando Valley area and especially, Malibu.
LA County Fire was able to save over 50,000 structures and evacuate the more than 250,000 people at risk, but more could’ve been done, said Osby.
In addition to getting fighters out to the spreading fires, the department still needed to ensure there were enough resources in the 175 stations available to protect the rest of the county.
“We had dedicated men and women coming in to work and help, but we ran out of equipment,” said Osby.
Filipino-American firefighter specialist Jonathan Carnero, who is currently an engineer in Lynwood after working as a paramedic, said that many of the trucks are at the verge of being inoperable.
“We’ve got a 12-year-old truck that runs 15 calls a day, which equates to about 5,500 runs a year,” Carnero told the Asian Journal at the campaign’s second stop at Fire Station 31.
“They’re not made to run that many calls and take abuse on the street,” he added. “We don’t have the best streets in our area so it gets beat up, and when it breaks down, we don’t have anything.”
More than just putting out fires
LA County Fire covers more than just fight fires — and the challenges are being felt throughout the department that also deals with paramedic services in the county’s 58 cities and all unincorporated areas. The vast majority of 911 calls made are for medical emergencies including heart attacks, strokes, and car accidents, and the demand for such services has been growing.
Fire Captain Chad Sourbeer, who is responsible for Emergency Medical Services (EMS) training and education, said that out of the roughly 400,000 calls made last year, 345,000 of those calls were for EMS.
“Those were patient care records. Those were the ones that were actual patients,” said Sourbeer.
He said that in the last eight years, they’ve seen a patient load increase of 50%. The number of paramedic units added to the force in comparison has only been 5%. That’s one paramedic up in the north of the desert, and three squads.
“That’s not a lot. So you can see that’s completely unsustainable, and that’s where we’re going,” said Sourbeer. “That’s the future of our department at best.”
One personal story he shared was during his time as a medic, when he and his partner were dispatched to a 15-year-old girl who was alone at home and was experiencing abdominal pains. Upon arrival and finding the girl in the restroom, the girl stood up and suddenly gave birth.
“Baby falls on the floor and I tell my partner, ‘Okay, let’s get into action,’” recalled Sourbeer, adding that the baby was small enough to fit in his hands.
After wrapping the baby, performing CPR, and taking the mother and child straight to the NICU, the baby was saved. A week later, Sourbeer received a thank you card from the mother inviting him to visit the baby girl when she was out of the hospital.
“I want you to imagine what would have happened in that scene if we were delayed. Our response time was four minutes,” said Sourbeer.
“If we did not have the personnel that we need — and you can see the 50% growth versus the 5% — what would have happened in that scenario?” added Sourbeer. “This is happening over and over and over. Any type of delay, even if it’s two minutes or four minutes, that’s life or death.”
A little known fact is that LA County Fire was the first in the nation to install a paramedic program when former county Supervisor Kenneth Hahn convinced then California Governor Ronald Reagan that there was a need for paramedics and ambulatory medicine 50 years ago.
“It’s hard to imagine a time before we had paramedics — before we could expect the highly trained and capable paramedics to come to us when we were hurt or sick. We take these life-saving services for granted these days, but it was not that long ago that the idea of paramedics was considered unconventional and was even ridiculed,” said current county Supervisor Janice Hahn, Kenneth Hahn’s daughter.
“The fire department budget is stretched too thin, and the department is understaffed and equipment our fighters and paramedics depend on is outdated,” she added. “These are serious problems and we want to continue to offer the excellent Emergency Medical Services and Fire Protection that we provide today for our residents. We have to address this resource problem.”
A big focus in EMS training and service has been on cardiac arrest. Paramedic firefighters are specially trained to read an electrocardiogram (ECG) and determine whether a patient is having an ST-segment elevation myocardial infarction (STEMI), a serious type of heart attack.
Dr. Marianne Gausche-Hill, medical director of the LA County EMS Agency, said that over 8,000 cardiac arrests occur in Los Angeles every single year.
“That dispatcher who gives those pre-arrival instructions to help a family do chest compressions or CPR increases that patient’s chance of survival by three times,” said Gausche-Hill.
Another big focus has been on strokes of which roughly 6,000 occur in Los Angeles per year. Efforts to address strokes include a regional system that looks to bring heart attack patients to any of the county’s 36 STEMI Receiving Centers and additional stroke centers.
Training has made it so paramedics can evaluate and determine if patients are experiencing a significant stroke, and taking them to a hospital able to remove the clot and significantly increase the chances of the patient going from being unable to talk and being completely debilitated, to walking out of the hospital neurologically intact.
One call Gausche-Hill recalled having was from family members of a 70-year-old who was experiencing a stroke, and was taken to one of LA County’s comprehensive stroke centers.
“Literally an hour later, she went from not speaking and moving to being able to talk to her family and having dinner with them,” said Gausche-Hill.
Dr. Clayton Kazan said that the department is striving to be a world-class provider of cardiac arrest care and has been successful with multiple pilot projects and winning grants. But with the increase in call volume, Kazan — the department’s only physician — said it’s hard to spread out resources at all levels.
The New York City Fire Department, in comparison, has nine medical directors and two fellows. Out in the field, Kazan said it isn’t uncommon for paramedic squads with just one apparatus to average more than 25 calls a day.
“They really stretch the limits of human performance because the busier they get, the less sleep they get. The more they worry about errors and things like that,” said Kazan. “They do an amazing job, but we need to get in there and fill that funding gap because if we don’t, there’s going to be a breaking point where our errors are going to start to occur.”
On the dispatcher side, staff shortages mean distressed people on hold.
“We don’t want the civilians in the public waiting for 911. If your parents or your children are sick and the phone is ringing and ringing — we don’t want that,” said Kristen Smith, an LA County Fire dispatcher.
But LA County Fire is doing what it can in the meantime through efforts like promoting diversity and equality, making mental health support a priority, and encouraging those interested in a career at the department to see what opportunities they have.
“If you’re interested in a career that’s going to provide you with something different every day, that’s going to be challenging, that’s going to expose you to different parts of the state and different parts of different communities, then do ride-alongs and see if this is something that would interest you,” said Carnero.
Currently, LA County Fire is funded through a mix of county property tax revenue and contracts for service with individual cities, according to the department. While the awareness campaign was meant to inform the public of the challenges, LA County Fire District is considering a local funding measure as a means of generating additional resources.
“It’s been over 20 years since our department has gone to the public to really talk about these challenges as they relate to additional funding, but some of the challenges I just articulated, I think it’s time to really consider that,” said Osby.
He added, “Because then I believe that this is a local challenge that we’re not going to be able to rely on state or federal government assistance. It’s up to us to make the determination the level of staffing, the level of equipment, and the expertise that will allow [our firefighters] to provide for their communities.”