Richard Serino started out as a volunteer on the Boston City Hospital Ambulance squad in the 1970s. In fact, Serino attended the first EMT class held in Massachusetts in 1973 and the first paramedic class in New England in 1978. Later, he became chief of the department of Boston EMS and held that position for 10 years. Now, he serves as FEMA's deputy administrator. Serino recently spoke exclusively to FIRE CHIEF about how EMS is an essential component of FEMA's response to large-scale incidents.
Based on your decades-long service, what trends have you witnessed in EMS — specifically in fire departments?
EMS has certainly grown. I started in the early '70s, when EMS consisted of a stretcher, an oxygen tank, a basic first-aid kit, and that was all you had. You went from using a Life Pack 4 — your older readers will remember it — which was a heavy piece of equipment used as an EKG machine. Now, we have Life Pack 12 and are doing 12-lead EKGs.
With EMS, you have to keep current because medicine changes. You have to keep up with medical changes throughout the years.
How have firefighters roles' changed over the years as the result of taking on EMS responsibilities?
It certainly has come a long way. I recall cops would say, when EMTs or paramedics would show up to a scene, that "you're not doctors, you don't need to be here in the street." Then they actually saw the difference it made in people's lives — it saved lives literally in front of their eyes. That really changed people's views, whether it was longtime police officers or firefighters who in the '70s didn't appreciate EMS. But it certainly has come full circle now, as most people see the value of EMS regardless of how it's provided throughout the country. It does save lives and is a staple in almost every community throughout the country.
How does EMS fit into FEMA's response strategies?
It translates into emergency management quite well. [EMTs] have seen the difference working as a team really makes. You cannot handle incidents alone. You have to go into it as a team, whether you are going in with EMS, with the police, with the fire department … but all working as a team. Also, figure out how you can incorporate the public. When you arrive on a scene, usually the public or witnesses are there first. You have to figure out how to incorporate them into the response effort, whether they provided life-saving care before an ambulance arrived or even asking them to help control a crowd. Give them roles at a scene, whether it's an accident, a shooting or a fire.
What does FEMA expect of fire departments when it comes to EMS?
Medical care is the absolute essential. The patient comes first. [Fire departments] should have a strong medical component and make sure they have the highest-trained paramedics in the area and work together with the medical community. It has to be an effort not just with EMS, not just fire, not just police … but working together is essential to having a good EMS.
What message does FEMA want to get out to fire chiefs?
Emergency management is about engaging the public. You look at the whole community, whether emergency management or EMS. Bring people together. Doing that will make the public more resilient and, at the same time, it will save lives.
