National Fire Protection Association 1710

Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments

In an attempt to educate the citizens that we service on why we are adopting this standard we have taken excerpts from Across The International Association of Fire Fighters Question and Answer Forum that gives explanation on how it applies to WEMS.

1. Why was the NFPA 1710 Standard created?

The mission of the NFPA is "to improve the methods of fire protection and prevention" and to establish "proper safeguards against loss of life and property" due to fire. While the organization and deployment of fire and rescue services is potentially the most important factor in safeguarding against the loss of life and property due to fire, the NFPA had never previously issued a standard that set forth comprehensive minimum criteria to ensure safe and effective fire and emergency medical response by career fire departments. The NFPA 1710 Standard was created to meet the overwhelming need for just such a standard. It represents the culmination of more than a decade of work by the NFPA Standards Council, its Technical Committees and its membership. The result is a comprehensive, uniform and practical standard governing fire and rescue service deployment by career fire departments throughout North America.

2. What are the time components that must be measured to evaluate compliance with the NFPA 1710 Standard?

There are three time components defined in the NFPA 1710 Standard relating to emergency response system performance. All three components must be measured and documented by departments in their quadrennial report. The components and definitions as follows:

Call receipt and processing time - the interval between receipt of the emergency alarm at the public safety answering point to the moment where sufficient information is known to the dispatcher and applicable units are notified of the emergency. The maximum time for this component is specified in NFPA 1221.

Turnout time - the interval between acknowledgement of notification of the emergency by the units to the beginning point of response time.

Response time - the time that begins when units are en-route to the emergency incident (wheels rolling) and ends when units arrive on scene (wheels stopped at the address). This time component has in the past been referred to as "travel time."

It is important to note that these three time components, if measured cumulatively, have historically been known as "response time." However, to truly evaluate an emergency response systems performance, these components should be measured, assessed and reported individually as described in the standard.

3. Does the NFPA 1710 Standard require all fire departments to provide a basic level of emergency medical service?

Yes, the NFPA 1710 Standard does require all fire departments to provide a basic level of EMS. The standard calls for the department to be capable of responding to emergency medical incidents at the First Responder Level with Automatic External Defibrillators (AED). If the department chooses to provide EMS at a higher level, the standard sets forth operational requirements for that service as well.

Fire departments that provide EMS at any level must establish in their organizational statements the criteria for the types of incidents to which they will respond. The established level of EMS provision must be recognized and the department must allocate the necessary resources to adequately provide the services required by the local jurisdiction and expected by the citizens. Necessary resources include personnel and equipment.

4. If the fire department provides only first responder level services and an agency or private company provides the higher levels of EMS and transport, does the NFPA 1710 Standard still apply?

Where EMS beyond the first responder level is provided by an entity other than the fire department, the higher-level provider must adhere to minimum staffing, deployment and response criteria recommended by the fire department according to the requirements in the NFPA 1710 Standard. These operational requirements must be set forth in both the fire departments organizational statement and any contract or other agreement between the jurisdictional authority and the EMS agency or private company.

. Can the fire department use automatic or mutual aid agreements to meet these EMS requirements?

Yes, the NFPA 1710 Standard is clear that fire departments are permitted to establish automatic and mutual aid agreements to comply with emergency medical response requirements.

6. What are the different EMS service levels referenced in the NFPA 1710 Standard? Does every fire department have to provide every level?

There are three levels of EMS provision recognized in the NFPA 1710 Standard; First Responder with AED, Basic Life Support (BLS), and Advanced Life Support (ALS). The standard also recognizes EMS transport as a service that may be provided by the fire department. It is not a requirement that a fire department provide all levels of EMS service beyond First Responder (AED). However, the standard establishes operational requirements for each level that is provided by a department. For each level, operational requirements are set forth as follows:

First Responder (AED) - a fire department must appropriately train all response personnel at the First Responder with AED capability level and personnel must arrive within a four-minute response time frame to 90% of all emergency medical incidents. The number of personnel must be sufficient to assure adequate care capability and member safety.

BLS - a fire department that provides BLS, beyond the first responder level, shall adhere to staffing and training requirements as set forth by the state or provincial licensing agency. The department must also deploy sufficient mobile resources to arrive within a four-minute response time frame for 90% of all incidents.

ALS - a fire department that provides ALS beyond the first responder and BLS level, shall adhere to staffing and training requirements as set forth by the state or provincial licensing agency. The department must also deploy sufficient mobile resources to arrive within an eight-minute response time frame for 90% of all incidents.

7. Why must first responder/AED units arrive within four minutes to 90% of emergency medical incidents?

This requirement is based on experience, expert consensus and science. Many studies note the role of time and the delivery of early defibrillation in patient survival due to heart attacks and cardiac arrest, which are the most time critical, resource intensive medical emergency events to which fire departments respond. Various study findings and national EMS stakeholder organization guidelines are as follows:

Effect of reducing ambulance response times on deaths from out of hospital cardiac arrest: cohort study (Pell, JP, et al)

This study, with a population of 10,554 patients, showed that a reduction in response time from 15 minutes (90%) to eight minutes (90%) was significantly associated with increased probability of receiving defibrillation and survival to hospital discharge. A further reduction in response times to five minutes (90%) doubled the rate of patient survival to discharge. The study conclusion: Reducing response times from 15 to five minutes or less could almost double the survival rate for cardiac arrest not witnessed by the responding crew.

8. Why must an ALS company arrive within eight minutes to 90% of the incidents to which they are dispatched?

Once again, this requirement is based on experience, expert consensus and science. As stated previously, various studies note the role of time, the delivery of early defibrillation and the provision of advanced care in patient survival from heart attack and specifically cardiac arrest. Some of the study findings and national EMS stakeholder guidelines are documented as follows:

Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care (AHA).

Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (AHA).

For cardiac arrest, the highest hospital discharge rate has been achieved in patients for whom CPR was initiated within four minutes of arrest and ACLS within eight minutes. Early bystander rescue breathing or CPR intervention and fast emergency medical services response are therefore essential in improving survival rates.