What happens when I call 911 in San Diego County?

When you call for emergency help, your call will typically be received in a police dispatch center first. This is done so that law enforcement can be alerted quickly to potential crimes. If the dispatcher determines that the call does not need police, they will route it to Fire and/or EMS dispatch center.

Typically, if the emergency requires a medical response, the closest fire apparatus (engine or ladder truck) and ambulance will arrive. There are usually 3-4 people on the fire apparatus, and 2 people on the ambulance. Anywhere between 1 to all of the people will be licensed paramedics.
 

Why such a broad range of people that may respond to a 911 call?

 
There are many different ways to deliver fire and medical services, and with a large number of fire departments in San Diego, depending on which community you live in you may see a vast array of service deliveries. It’s very hard therefore, to accurately describe what happens when you call 911, because it depends on where in the County you are when you call for help.

Medical Aid

A call is placed to 911 and is fielded by a dispatch center. Through a series of scripted questions, the call taker is able to determine the type of emergency, acuity, and some basic information (gender, age, pertinent medical history). An alert is sent through the computer system to the appropriate resources for a typical medical aid. This is one fire apparatus and one ambulance, as described above.

There are various methods to house these apparatus. Some regions have their fire and ambulance resources stationed together, others have those resources in separate locations. Therefore, while both the ambulance and fire apparatus respond to the same call, they may be coming from different parts of the city.

Typically the fire apparatus will arrive first to scene, and the crew will work together to assess the needs of the patient. The firefighter/paramedic(s) will make contact with the patient and begin the assessment. The Engineer will help to bring in gear, take vital signs, and help the ambulance crew when they arrive. The Captain may ask questions of a bystander so as to help get the story behind the emergency, but ultimately will provide for scene safety and maintain radio contact with dispatch throughout the call.
 

Description of a typical call:

 
When the ambulance arrives, they may bring in extra gear to address the emergency and will wheel the gurney in with them. Patient assessment continues. Some medical conditions can be corrected right there on scene – through drug administration, bleeding control, or airway management. Other problems call for the patient to be seen by a doctor, or be taken to a hospital with certain equipment and/or capabilities.
 

Aren’t all hospitals the same?

 
Yes and no. Yes, in that they all provide health care for patients and typically have some type of emergency room. No, in that some hospitals within San Diego County are designated radio bases, and still others are designated trauma centers.
 

There are 22 hospitals in San Diego County.

 
Of the 22 hospitals in San Diego County, 7 have a Base Station Radio Nurse (BSRN). These nurses field the radio report made from the field by the responding firefighter/medic. 5 hospitals in the county are trauma centers, which means they have a trauma surgeon and a full team ready to address the worst of the worst medical emergencies 24/7. It is no coincidence that the trauma centers are also base hospitals. The hospitals that serve both capacities are a great place to work as an EMT as this will get you familiar with what will await the patients you hope to someday treat in the field.

When the medical issues are corrected and the patient is being moved from their position onto the gurney, it is called “patient packaging”. While this is taking place, one of the firefighter/medics or ambulance employees will begin a radio report to the nearest base hospital with a full report of what they arrived to find, vital signs, medical attention applied and the requested destination hospital. By law the patient can request a hospital of their choice, within reason. As long as the medical emergency doesn’t require the patient to be taken to a special hospital, the request is honored.

 With the patient packaged and being wheeled out to the ambulance on the gurney, the responding crews pack all their equipment back out to their respective apparatus. The ambulance goes to the emergency room and the fire apparatus goes back to the station.

Fire Response

A call is placed to 911 and is fielded by a dispatch center.  Through a series of scripted questions, the call taker is able to determine the type of emergency, acuity, and some basic information. If it is determined that a structure or a region of rural territory, is actively on fire, an appropriate response is dispatched through a computer system.   The computer-aided-dispatch (CAD) will determine the resources that are needed and will alert the nearest ones.

Structure Fire response

This is generally broken down into a few categories:  single-family residence, multi-family residence, commercial structure or high-rise.  Each of those structures, in order, typically require more resources than the structures that precede them in the list – in other words, it takes more firefighters and apparatus to put out a fire in a commercial structure than it does to attack a multi-family structure fire.

When responding to a single-family residential structure fire, there will typically be 3 fire engines (with hoses and water), 1-2 ladder trucks (with ladders and forcible entry equipment), a rescue (designed to effect citizen & firefighter rescue) and a battalion chief (who will take command and give orders) sent to the structure.   In addition, an ambulance will usually be dispatched in order to administer medical care to any victims or firefighters.

These apparatus will all arrive to the structure at different times since they are typically responding from different areas of the city.  The goal of all the responding units is to affect any necessary rescues first, to extinguish the fire second, and to preserve property and environment last.  This is accomplished by the engine companies pulling hose lines and putting water on the fire; by the ladder trucks cutting holes in the roof to help the hot air and smoke escape; by the rescue company searching the structure for potential victims.

When those 3 actions are performed in concert, a structure fire can typically be extinguished and/or mitigated within about 45 minutes of arriving on scene.

Wildland Fire response

Every day in San Diego County, Cal Fire announces the level of fire danger that is posed by the weather conditions.  The County can be in a High, Medium or Low wildland response state of readiness.  The corresponding fire protection response will be predicated on the level of danger announced by the County – there will be more fire crews ready during a High danger time period than during a Low danger time period.

When a wildland (or vegetation) fire is reported, the response will vary tremendously from region to region.   This variation in response is due to the fact that some regions within SD County are staffed 24/7 with paid personnel, while other regions depend on reserve or volunteer firefighters that only report to a station when there is a confirmed fire.  In general, however, 2-3 Type III fire engines, 2-3 Type I fire engines, 1-2 battalion chiefs, and some type of air apparatus (helicopter or fixed-wing) will respond.

All apparatus will usually arrive at the fire at different times since they are typically responding from different regions within the county.  The goals of a wildland fire response mirror the goals of a structural fire response:  to affect rescues first, to extinguish (or contain) the fire second, to protect property and environment last.

This is accomplished by responding engine companies pulling hose into the vegetation in an effort to put water on the fire; with other engine companies positioning themselves within nearby neighborhoods to protect against home loss; with “hand crews” (small groups of firefighters) walking around the fire and removing the fuel (in this case, the vegetation) from it’s path; from airdrops of water or retardant from helicopter or fixed-wing fire apparatus.

When fighting a wildland/vegetation fire, a combination of one or more of these firefighting techniques is used in concert to mitigate the threat.  These fires are, in large part, driven by 2 factors: topography (the landscape) and weather.  Depending on conditions, even the best, most coordinated fire attack, can only reduce fire loss, as opposed to eliminating loss altogether.  Therefore complete extinguishment, or containment of these fires can take anywhere from 30 minutes to weeks to accomplish.