# Keep Mutual Aid Responding, Or Cancel Them?



## MedicTom (Jun 18, 2009)

This isn't a medical scenario, but a call response scenario.

A call came in at approx 0640hrs.  I proceeded through our normal dispatch procedure.  After 3 tone outs with no response from a driver I had mutual aid sent.  The closest mutual aid ambulance was 21 miles away.  I waited about 5 more minutes in the ambulance in case a driver showed up.  No response so I let dispatch know our ambulance service was standing down and letting mutual aid handle it.

As I got out of the rig inside the base the base phone was ringing.  I answered it and it was a driver.  He was a 1/2mile-1mile behind the mutual aid ambulance, still 15 miles from the scene and still in another ambulance district.  He's not an EMT, but he is a fire chief for a local dept and has red lights on his vehicle.  He said he'd respond and I could take the ambulance to the scene and 1st respond until he got there.  I got the location of the mutual aid rig, and the driver's POV location.  I told him that I did NOT feel comfortable having him respond from outside the ambulance district, 15 miles away, while behind the mutual aid ambulance.   I said that the mutual aid ambulance should take the call.  His voice appeared agitated as he hung up the phone.

My Reasoning

#1) I don't feel comfortable taking an ambulance to a scene by myself when a driver is coming from more than 5 miles away from the scene.

#2)  I don't believe an ambulance service should delay care so personnel from outside our district (IE at least 11 miles away from the scene) can respond to make a full crew

#3) If I had canceled mutual aid and he'd gotten into an accident, but I was on scene by myself w/ an ambulance I'd be SOL and delaying transport even longer.  (Not to mention being investigated by the state for why I responded by myself.)

#4) If I'd kept mutual aid responding, and had him respond also to make a full crew for us, it's pretty bad PR to send an ambulance home that has just responded 21 miles mutual aid only to be turned around and sent home.

So, what are your thoughts?


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## akflightmedic (Jun 18, 2009)

I think you made a reasonable and logical decision and wish there were more like you.

Good job!


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## Tincanfireman (Jun 18, 2009)

MedicTom said:


> So, what are your thoughts?


 
You made the right decision.


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## Shishkabob (Jun 18, 2009)

Why must you have a driver?  Are not all employees qualified to drive, or some insurance thing?



What was the call toned out as?  If it was a possible CA, you could have cost someone their life by deciding not to go, and having the pt wait ~10 minutes.  Always take the call in to consideration, and without you stating what the call was in your post, can't really give you a clear answer. 

 I don't see much wrong with first responding, given the proper situation.


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## MedicTom (Jun 18, 2009)

Linus, It's a volunteer service that employs 1 paid person from 1700-0800hrs Weds-Mon.  I was alone.


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## Shishkabob (Jun 18, 2009)

So, what was the call for?


EDIT-- Dont get me wrong, if you dont feel comfortable doing something then that's one thing.


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## djmedic913 (Jun 18, 2009)

In my opinion...for whatever that is worth...you made the correct call...

The responding chief was most likely agitated...he was a cheif and you made a decision instead of him...and on top of that it was a smart decision...Fire Chiefs hate that...lol


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## Mountain Res-Q (Jun 18, 2009)

Assuming it wasn't an multi victim call requiring additional responders and transporting units, IMHO, you made the right call.  You can not respond with one, because how can you treat and drive to a hospital?  So you called MA.  By the time you had the personnel to respond, MA was ahead of you; why put three code vehicles on the road when all that is needed is one?  Despite what some mihgt say, I know of no agency that would condone an ambo responding to a call with only one person.  In fact in CA, last time I checked, you must have at least one person certified to drive and one attendant certified to treat.

I would have done as you did, although it probably would have killed me to turf my call to another agency when I was ready and willing; but you had no choice on the MA, and to respond afterwards could have been a bad idea for the reasons you listed.  What sucks is the fact that you didn't get a better response to the page from your people.  That is a downside to volunteer; we all have lives and can't be garunteed to respond unless there is some sort of on-call rotation that garuntees that you have one attendant and one driver.  Thank God for MA Contracts sometimes, eh...


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## DV_EMT (Jun 18, 2009)

well... you made the right decision

however, if you had shown up you could have started initial vitals and history. 

My opinion is that the more hands the better. Here, Fire is usually first on scene to do a scene size up and take initial vitals... then AMR or any other ambulance does a second scene size up, treatment, and transport. If you had shown up and it was a MCI then you woulda been up a creek until they showed up. you coulda triaged it, but someone could have claimed negligence.

So... pro's vs. con's. You did the right thing for the given set of information!


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## Flight-LP (Jun 18, 2009)

Good decision made on your part!


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## MedicTom (Jun 18, 2009)

I don't feel the complaint is necessary in the description of events the call. It was not a multi-person call.  I will say if another agency (ie-fire) had run rescue I probably would have gone; but where the call was, that fire district does not run rescue.  I truly would have been alone on the scene b/c not even law enforcement was dispatched.  I'm not comfortable being completely ALONE at a scene for 10-20 minutes waiting for someone else to show up.


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## Mountain Res-Q (Jun 18, 2009)

MedicTom said:


> I don't feel the complaint is necessary in the description of events the call. It was not a multi-person call.  I will say if another agency (ie-fire) had run rescue I probably would have gone; but where the call was, that fire district does not run rescue.  I truly would have been alone on the scene b/c not even law enforcement was dispatched.  I'm not comfortable being completely ALONE at a scene for 10-20 minutes waiting for someone else to show up.



Seems like you used you brain in reasoning this thing out logically.  No one in their right mind can fault you for your intelligent response.  B)


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## Small_Town_EMT (Jul 21, 2009)

I think you made the right decision.  You never want to put your neck on the line by saying you have it covered, and then have everything fall through.  Never leave the shed unless you have enough crew members ON AMBULANCE to cover the call.  If other crew members show up on scene after you get there all the better!


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## Hal9000 (Jul 21, 2009)

Interesting.  A full crew is basically part of my rig check.    I'd let the closest medical unit with a full crew take the call, so, in this case, that wasn't you.  

Anyway, like scuba diving, I benefit from having a buddy to cover my back.  Responding in an ambulance with only one person sounds like a way to end up giving a very awkward explanation, unless you operate fly cars? 

I'd say you made the right call.  Staffing only one person is a bit bizarre.


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## VFFforpeople (Jul 24, 2009)

MedicTom said:


> This isn't a medical scenario, but a call response scenario.
> 
> A call came in at approx 0640hrs.  I proceeded through our normal dispatch procedure.  After 3 tone outs with no response from a driver I had mutual aid sent.  The closest mutual aid ambulance was 21 miles away.  I waited about 5 more minutes in the ambulance in case a driver showed up.  No response so I let dispatch know our ambulance service was standing down and letting mutual aid handle it.
> 
> ...



Good call, I agree you made the right choice. The only thing I would have done different. (coming from a fire stand point). I would have had him come and had a double respond, never know how the call will go and what can happen, what is mutal aid got in a wreck? or for some reason someone on their crew went down? Just some extra ways to look at it. Again good logic and call.


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## Fireguy (Jul 26, 2009)

I used to run with a very rural BLS service that ran into that same kind of thing alot.  Being that we were so small we had trouble finding volunteers and most of them who did step up to the plate worked during the day.  Usually, if we couldn't make crew the members who were there would respond to the scene by POV to assist the mutial aid. Even if someone didnt feel safe going by themselves they would show up via POV after the other BLS or the ALS arrived on scene.  The mutial aid really did appriciate that.     Although you made the right decision by not taking the rig by yourself, esp. since the driver was further than the mutial aid.


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## MendoEMT (Jul 27, 2009)

Okay, maybe I'm not fully understanding the scenario.....

You didn't _want_ to go because you didn't _feel comfortable_ going by yourself?  I know that you need someone to attend and someone to drive, but c'mon!  Unless it was a violent scene, why would you not feel comfortable, and why couldn't you make it to the scene so that you could at least provide a little care while waiting for the other rig?  Again, I'm trying not to be too hasty in passing judgement, but what's preventing you from going there even though your partner isn't there?


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## mycrofft (Jul 27, 2009)

*Maybe that discomfort was realizing yojur rig was basically out of service?*

Better for the spare chief to respond to your 20 so that your rig was available in case more help was needed, or another emergency came in.
One man ambulance runs are trouble, ties up a vehicle which will not be utilized to its full potential, and what if something happens to the guy you are supposed to "mate up with" (just a figure of speech, folks!)?


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## MendoEMT (Jul 27, 2009)

Yeah, but if we're talking really rural here, the chances of another call coming in are slim, and if that happened just let MA deal with it and let your partner keep coming to you in their own vehicle.


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## Fireguy (Jul 28, 2009)

MendoEMT said:


> Unless it was a violent scene, why would you not feel comfortable


   You never know what to expect until you get there. Also keep in mind that the dispatcher only knows what he/she is told via phone. Ealier this year a volunteer EMT was shot after responding to a call for chest pains. 
http://watertowndailytimes.com/article/20090201/NEWS03/302019939/-1/NEWS


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## HotelCo (Jul 28, 2009)

Why not call for mutual aid when you realized you didn't have a driver? If the driver showed up and the mutal aid was still farther away than your location, have dispatch cancel them.


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## Fireguy (Jul 28, 2009)

HotelCo said:


> Why not call for mutual aid when you realized you didn't have a driver?


 The original poster stated they had  mutial aid dispatched after three tone outs.  Being from a rural 100% volunteer service I understand it usually takes about three dispatches to realize if you will have crew or not.  This is because volunteers can live up to ten miles out from the station. Additionally we have a few FFs who dont like running EMS but will drive if they hear an EMT is there but none of the usual drivers are showing up.


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