Metropolitan Fire Brigade (Melbourne)

Metropolitan Fire Brigade

The MFB Logo
Established:	1891
Specialities:	Combatant Authority for Fire, Rescue and Hazmat
Volunteers:	None
Paid Staff:	1639
Location:	Melbourne, Victoria
Website	Official MFB Website

This page is about the Melbourne, Australia based fire service. For the fire service which operated in London between 1865 and 1904, see London Fire Brigade.

The Metropolitan Fire Brigade (MFB), also known as the Metropolitan Fire and Emergency Services Board, provides firefighting, rescue, and hazardous material incident response services to the metropolitan area of Melbourne, Victoria, Australia. The MFB's headquarters are located with Fire Station 1 (Eastern Hill) in East Melbourne.

History

In 1890, the Fire Brigades Act was passed in December after several serious fires in the previous year. The aim was to unite rival fire brigades in Victoria. The first meeting of the Melbourne Metropolitan Fire Brigade (MFB) board was held on 6 March 1891. This led to the disbanding of the 56 volunteer brigades in Melbourne on 30 April 1891 with an invitation to join extended to any fire fighter who wished to.^[1].

The first Annual Report of the MFB stated the strength as "59 permanent firefighters, 229 auxiliary firefighters, 4 steam fire engines, 25 horse drawn hose carts and 58 hose reels... 33 horses and 48 stations". In 1950, volunteer and partly paid fiefighters were disbanded for only fulltime firefighters. September 1988 saw the first female firefighters introduced to the MFB^[1].

Structure

An MFB firefighter wearing breathing apparatus

The MFB currently has 47 fire stations in four zones: central, northern, southern and western. These zones cover an area of 1,096 square kilometres in the Melbourne metropolitan area^[2].

Despite now being regarded as part of Melbourne, outer metropolitan areas such as Dandenong, Melton, and Werribee are serviced by the Country Fire Authority.

As of 2005, the MFB had 1639 operational staff, 245 corporate staff, 49 temporary staff, and 22 trainees and apprentices ^[3].

Appliances and Equipment

A Mk 5 Pumper, the MFB's current frontline appliance.

The MFB operates a range of appliances to match the varied firefighting and rescue roles it provides. All stations have at least one Pumper or Pumper Tanker, while some stations also have more specialised appliances such as Water Tankers, Ladder Platforms, Telebooms, Heavy Rescue trucks, or other support vehicles.^[4]

Emergency Medical Responder Program

History

"The introduction of an Emergency Medical Response (EMR) role is arguably the biggest change the MFB has experienced in its long history" - Commander Denis Rich

It was a change that was not initially welcomed when first proposed by the (then) Chief Fire Officer, Jeff Godfredson. However, the benefits to the community since its introduction as a core function in 2001 cannot be denied and by the end of 2007, the number of saved lives is approaching 100.

“The aim of a first responder program should be to save lives additional to those that can be saved by optimal level of ambulance response” - Dr. Ian Millar.

“First Responder” is a term sometimes used to designate teams of personnel who have the equipment and skills to undertake an initial response to some particular emergency situation. The term implies that a “second response” will follow, incorporating teams with specialist personnel and equipment.

The EMR program is part of an organised emergency medical system where the MFB responds simultaneously with the Metropolitan Ambulance Service (MAS) to all life threatening medical emergencies (i.e. Heart attacks, drowning, suicide, drug overdoses and severe breathing difficulties).

The origins of a Fire based EMR role have developed over many years, and whist the medical First Responder concept is relatively new within Australia, a wide range of successful First Responder programs exists throughout the world. There is now considerable evidence that trained First Responders’ who are organised and integrated into the mainstream Emergency Medical Service (EMS) can respond quickly to medical emergencies and initiate life saving procedures.

The concept of the EMR is to save lives additional to those that can be presently saved by the current emergency ambulance response. Emergency Medical Responder skills and equipment are designed to prolong life for the first few minutes after a collapse and prior to the arrival of ambulance paramedics who are needed to provide a more advance medical response, treatment and transport to hospital.

Genesis of the EMR Program The concept of an EMR role for the Brigade was first initiated during Jeff Godfredson’s term as Chief Fire Officer (1988-1998). This initiative was largely influenced by his association with US Fire Services through his involvement with ICHIEFS, where he sought for the MFB to continually seek opportunities to introduce an expanded range of fire and emergency services. This included increased cooperation with other emergency services agencies, which ensured the use of available resources to improve the delivery of emergency services to the community. At the time, the MFB was also receiving criticism from the government of the time that it wasn't efficient enough, and that firefighters were not adequately utilised in emergency services.

In 1994, the Victorian Government’s Public Bodies Review Committee (PBRC) was the first formal forum in which the possibility of firefighters undertaking Emergency Medical Response was raised. In its Report of the Public Bodies Review Committee into the Metropolitan Fire Brigades Board (1994) the recommendation was for the MFB to "extend its role to include an emergency medical 'First Responder' role in support of, and at the request of the Metropolitan Ambulance Service."

Based on this recommendation, the MFB under CFO Godfredson’s stewardship actively supported the implementation of a First Responder program that provided early access to Basic Life Skills, particularly early defibrillation, in cases of suspected cardiac arrest.

With 47 strategically placed fire stations, an impressive fleet of primary response vehicles, and 1,400 professional firefighters, to Godfredson’s mind, the MFB’s set-up was a natural fit with emergency medical response services.

The Public Bodies Review Committee agreed, noting the uniform distribution of MFB staff across the metropolitan area and the MFB's response standard of 7.7 minutes, and the capacity of firefighters to perform emergency medical response services. The committee also stated that saving life is the most important objective, regardless of who does it.

In addition to the above, the MFB commissioned KPMG Consulting in 1996 to review its emergency response function and identify the model of emergency response which best suited contemporary needs. The review outcome recommended the MFB take on a range of duties, which provide benefits to the community, labelling it as a ‘public safety model’. Under the model, it further supported the proposal that the MFB include a medical First Responder function.

Early Opposition The EMR concept was introduced during a period of significant inner turmoil for both the MFB, and the United Firefighters Union (UFU). New awards and enterprise bargaining agreements were being negotiated, unpleasantries were being exchanged and industrial disputes were becoming the norm.

A radical change in an organisation with long-standing traditions was always going to be difficult, but in this environment, it was intensely difficult. Needless to say, the UFU and the Ambulance Employees Association (AEA) were initially wary of the idea of EMR.

The AEA, having recently endured government cost cutting measures and industrial disputation, was concerned along with the UFU that EMR was being introduced as part of this process and that its members could lose jobs to firefighters. On this basis, the AEA and UFU initially refused to support the MFB’s proposal, it took time, careful negotiations and many hours of consultation before the unions gave their full support to the MFB's first EMR pilot program.

During 1994 the MFB and UFU had entered into a period of enterprise bargaining (EB) where EMR was incorporated as part of an EB package. At that time the EB on offer was rejected by the UFU. This subsequently meant that the EMR proposal was also rejected and training stopped.

When EB negotiations broke down completely, the Australian Industrial Relations Commission intervened, and on 4 December 1996, the commission handed down a decision on the EB package that included the introduction and trial of an emergency medical response role for firefighters.

The undertaking of an MFB EMR role began as a pilot in 1998 under the supervision of a Government appointed committee, which incorporated 5 sub-committees (operations, medical, training, media/pr and finance) chartered with overseeing the program’s introduction. The program was confirmed as a core activity of the MFB within the Metropolitan Fire District (MFD) in October 2001.

Training and Equipment In October 1993 a small dedicated MFB Emergency Medical Services (EMS) project team was appointed by the then CFO Jeff Godfredson. The team (later to become the EMS Department), consisted of District Officer Denis Rich, Station Officer Allan Morton, Medical Advisor, Dr. Ian Millar (January 1994). Subsequently in 1996 Leading Firefighter Brian Whittaker and David Shugg from Monash University Centre for Ambulance and Paramedical Studies (MUCAPS) also joined the Department. This group became responsible for all facets of the EMR First Responder program; including the development and implementation of the role, training of emergency response personnel (skills acquisition, continuing education and recertification programs), development of operational and clinical procedures, researching, developing and sourcing of equipment and development of specific support services.

The first EMR First Responder training programs for firefighters were undertaken with the Ambulance Officers Training Centre (March 1994) and then Deakin University, (July-November 1994). Both these training programs were subsequently ceased due to firstly political intervention and then EB industrial disputation (November 1994) which resulted in the whole EMR program being stopped by the then CFO, Jeff Godfredson due to the UFU rejection of the Enterprise Bargaining package on offer.

During this period of cessation of the training, various overseas study tours were undertaken by members of the EMS Project Team researching the operations of Fire Service based First Responder Programs:

1994 – Denis Rich (MFB) and David Ryan (MAS), - UK and USA (Joint Emergency Services Foundation Scholarship)
1995 – Dr. Ian Millar – USA and Canada
1996 – Denis Rich, Allan Morton, Dr. Ian Millar – Wellington, New Zealand
1996 – Allan Morton - USA (MFB Scholarship)
1999 – Denis Rich and Allan Morton - USA

In hindsight, the delay to the training program and the ability to study overseas models worked in favour of the development of a more suitable training program for the Melbourne environment. Training was purposely developed by the EMS Project Team to ensure the actual training delivery emphasised emergency medical life saving skills that was more appropriate for firefighters style of learning. This approach differed markedly from the traditional health science approach of emergency medical personnel, in that, training emphasised assessing and treating presenting life threatening problems without a need to diagnose the underlying condition.

Following the 2 year hiatus, training recommenced in 1997 with MUCAPS, retained to deliver the training program. Faced with the mammoth task of training over 1300 operational firefighters within the required timeframe, a training course and schedule was developed to integrate with routine on-shift operations. This involved firefighters attending courses on rostered day-shifts over a 32 day period. To facilitate this, courses were run concurrently 7 days per week in blocks of 4 incorporating all platoons. A training program and schedule of this scale in such a new skill area was an historical first for the MFB, and has subsequently set the standard for all Brigade training programs to follow.

The training program involved each fire fighter receiving a short pre-course self-paced preparatory package (anatomy and physiology) and 8 days of classroom and practical training. The assessment of First Responders involved progressive appraisal of practical skills throughout the course, with theory and practical assessments conducted on day 8 of the course. This consisted of a written theory examination, testing of crucial basic life support and equipment skills, a viva voce interview and a real time practical scenario. Training sessions were led by an ambulance paramedic Principal Instructor, with theoretical and practical sessions facilitated by selected ambulance paramedics on a sessional basis and MFB EMS Department staff. The overall program was managed and directly supervised by the MFB EMS Department and a Training Course Coordinator, David Shugg, from MUCAPS.

EMR First Responder certification is for a four year period and subject to actively participating in Continuing Education (CE) and Skills Maintenance programs. The CE program ensures firefighters maintain their skills through monthly training sessions facilitated by visiting MAS ambulance paramedic Clinical Instructors, with on-going case audit and quality assurance involving ambulance personnel working in conjunction with the MFB’s EMS Dept. and MFB’s EMS Medical Advisor.

All qualified EMR First Responders are also required to complete a two day recertification program every four years. The introduction of the requirement to undertake a Recertification Program for EMR skills was a groundbreaking initiative for the MFB EMS Department, as previously in the history of the MFB this had not been a condition for firefighters in other core skill areas.

The sourcing of equipment for firefighters to undertake the EMR role was particularly challenging. Available ambulance and off-the-shelf First Aid and Oxygen Resuscitation kits were found to be unsuitable for firefighter requirements, leading to the MFB EMS Department developing their own purpose designed and built kits. These kits have since been proven to be very successful in their ease of use, robustness and storage in firefighting appliances.

The cornerstone of the EMR First Responder program is the rapid application of defibrillation to the patient. The MFB was the first Australian Fire Service to utilise Automatic External Defibrillators (AED’s) which made the key clinical decisions automatically and could be used effectively with minimal training. The first units chosen, Laerdal HeartStart FR, were lightweight, analysed heart rhythms, decided whether a shock was needed and gave simple voice prompts and instructions.

The MFB continues to remain at the forefront of this technology using a new and ground breaking defibrillator data download and transfer system to store, record and transfer patient ECG and treatment information within minutes of receiving a request from a receiving hospital. All MFB primary appliances carry AED units, Oxygen Resuscitator, First Aid kits and other life support equipment necessary for the provision of the EMR role.

Pilot Program In early January 1998 after much negotiation from all stakeholders involved in the development and implementation of the EMR program, the then Victorian State Government through the Minister for Health, determined that a conjoint six month pilot be initiated. The primary objective of the pilot was to determine whether simultaneous dispatch of both MFB and MAS resources would lead to more rapid response times and therefore more rapid application of defibrillation for life threatening medical emergencies involving cardiac arrest.

The EMR First Responder pilot commenced in the MFB’s Southern Zone incorporating seven fire stations and nine appliances (Need to name the stations). Firefighters from the 13 surrounding stations also received First Responder training to ensure cover of the pilot fire stations when required. A total of 25 stations/22 appliances were involved in the initial pilot program.

Commencing on the 14 July 1998 the 6-month pilot was assessed and independently evaluated by Monash University Department of Epidemiology and Preventative Medicine utilising data collected for all cardiac arrest events attended. Initial data from the pilot study indicated that both response times and time for defibrillation were reduced in the pilot area. There was however, an insufficient number of cardiac arrest cases to draw significant medical conclusions. As a consequence, on the 8 February 2000, the EMR First Responder program rolled out across the whole MFD as an extended 12-month pilot. This roll-out incorporated all 46 fire stations, 58 primary fire appliances and over 1300 trained firefighters.

Following the success of the extended pilot period, the then Minister for Health (Hon John Thwaites) on the 11th October 2001 confirmed the EMR First Responder program as an ongoing role and part of the core function of the MFB.

The MFB EMR Program - What Happened When
1993: CFO Godfredson appoints initial EMS Project Team.

1994: The Victorian government’s Public Bodies Review Committee recommends that “the MFB extend it’s role to include Emergency Medical Response”.

1994: Following UFU rejection of EB package, CFO Godfredson ceases training programs.

1996: The MFB recommence consultation process with MAS, UFU and the Ambulance Union.

1996: The Australian Industrial Relations Commission handed down a decision including the introduction and trial of emergency medical response for firefighters.

1997: KPMG review recommends development of a “Public Safety Model” further supporting the proposal that the MFB undertake a medial first responder function.

1997: First Responder Steering Committee established by Victorian Government. Five subcommittees operating under steering committee included Training, Operations, Medical, PR/Media and Finance

1998: First Responder training program commences with MUCAPS

1998: The first pilot program, Emergency Medical Response First Responder began in July. This six-month program was an initiative of the Victorian Government’s Ministry of Human Services.

1999: Following the pilot program (which finished in January 1999), a Monash University review found that response times were reduced in the pilot area.

1999: Government announces decision to extend First Responder pilot for further 12 months to incorporate whole of MFD.

2000: An extended pilot program began on 8 February. This year-long program proved the benefits of firefighters working as first responders.

2000: 16 February - first defibrillation save by Firefighter EMR First Responders (P7A)

2001: The Victorian Government’s Minister of Health confirms Emergency Medical Response role as part of the MFB’s core function.

2005: The joint MFB/MAS Emergency Medical Response program achieves its 50th successful team resuscitation (July)

2007: Total successful team resuscitations to date: 91

Conclusion The EMR program has allowed the MFB to build stronger connections with other Victorian emergency service providers, the benefits of sharing resources, skills and experience has also become more and more obvious. The partnership formed between the MFB and the Metropolitan Ambulance Service has proved to be an especially rewarding one, ensuring that an optimum level of patient care is delivered with life saving results that demonstrate the benefits of shared responsibility in emergency situations.

Given that the ultimate aim of any emergency service is to save lives and protect the community, the EMR program has been an outstanding and successful achievement for the MFB and the City of Melbourne. Since its introduction the EMR program has initiated significant internal cultural change to the MFB. This change has not only been of benefit to the organisation internally, but more importantly it has helped to ensure the MFB provides a contemporary, relevant and life saving service to the community it serves, the people of Melbourne,

“ The introduction of the EMR program into the MFB has given our firefighters the skills, confidence, equipment and support not only to provide lifesaving medical assistance at EMR calls, but at all call types and emergency situations we attend on a day to day basis.” - Station Officer Allan Morton

See also

• Australasian Fire Authorities Council
• Country Fire Authority
• Country Fire Service
• New South Wales Fire Brigades

References

1. ^ ^{a b} http://www.mfb.vic.gov.au/default.asp?casid=569#act Taken from MFB website and accessed 22 May 2007, Originally from "Life Under The Bells" by Sally Wilde (ISBN 0 582 87023 2) published by Longman Cheshire in 1991 on the occasion of the centennial of the Board
2. ^ http://www.mfb.vic.gov.au/default.asp?casid=27 - Knowing the MFB (Zones and Maps)
3. ^ Our People : Metropolitan Fire & Emergency Service Board Annual Report 2005
4. ^ http://www.mfb.vic.gov.au/default.asp?casid=188 - Knowing the MFB (Stations)

External links

• Metropolitan Fire Brigade web site
• MFB Act
• Fire Services Museum of Victoria
• MFBWiki