Fire Department Partnership

Stanford and Local Fire Departments Create Web of Support

When a 911 call is placed, medics usually have just eight minutes – the typical interval for an alarm clock snooze button – to reach a patient in cases of cardiac arrest. And cardiac arrest is a common call.  

The first on scene is often not an ambulance, but the fire department. Why? Firefighters are dual-certified as EMTs or paramedics, and fire stations are more numerous, reducing the time from activation to arrival – that critical eight-minute window. In fact, the majority of calls fire departments respond to are medical, not incendiary.

Because they are so often the first to arrive, firefighters must stay current on medical techniques. Enter Stanford Department of Emergency Medicine.

Typically, each individual fire department contracts with one local physician to serve as medical director in their off hours. Putting a new twist on an old process, Stanford has partnered with eight local fire department to provide training on cutting-edge techniques and protocols.

Kim Roderick, EMS Chief for Palo Alto Fire Department, comments “In the past our field personnel rarely saw or interacted with the agency Medical Director. Since our collaboration with the University, we have physicians directly train our personnel. This allows a higher clinical dialogue and better delivery of medicine overall.”

Roderick had initially approached Dr. Peter D’Souza of Stanford Department of Emergency Medicine with a request to serve as a multi-station medical director. The timing was off; D’Souza and his wife were expecting their first child in three weeks. But D’Souza suggested the collective resources at Stanford University could provide the comprehensive support Roderick was looking for.

Some benefits were obvious from the start.

There was the addition of experts; Stanford’s Department of Emergency Medicine includes three faculty members board-certified in Emergency Medical Services, a surprisingly small field of just 400 or so around the country, and a rarity in fire departments. Additionally, Dr. Justin Lemieux on Stanford faculty is trained in tactical EMS. Fire departments also benefit from access to resources, in particular, face-to-face training and tools for education.

In addition, by providing support for multiple fire houses, Stanford quickly and consistently disseminates new protocols and methods, like a new approach to CPR.

High-performance CPR employs specific techniques to optimize resuscitation from cardiac arrest, a common call for fire departments. The goal is not to simply resuscitate, but do so in a way that minimizes loss of brain function. Techniques focus on micro-compression rate, depth, recoil, a CPR fraction above 80%, and other methods that go beyond basic CPR. As a result, patients often can resume their lives with minimal lasting damage. Following Stanford emergency training, Palo Alto fire department has already rolled out the techniques, resulting in several saved lives. 

Chief Roderick adds, “Another priceless benefit to the partnership is the ability to close the loop on critical patients or challenging field diagnosis that include EMS treatments. Patient outcome data has been the missing link since EMS started decades ago. In order to move EMS medicine forward, reviewing ‘Total Patient Care’ will dictate the on-going clinical changes occurring in our dynamic field of medicine.”

To date, the response to the pairing of a university and fire departments has been positive, and contracts have been established with Palo Alto, Milpitas, Santa Clara, South Santa Clara County, Mountain View, Morgan Hill, and Gilroy fire departments. Looking ahead, plans are underway at the Stanford Department of Emergency Medicine to expand classes and provide additional resources.