# Pt access on frozen lake



## zappa26 (Sep 22, 2009)

It's the middle of winter in Minnesota, and all the lakes are frozen.  You are dispatched at 2pm on a Sunday afternoon to a report of a 12yo female who rolled an ATV on the lake and is "awake but won't move".  Patient is in the middle of the lake, so instead of dispatching you to the family's residence, you are sent to the beach / public access boat ramp.  Patient's father meets you at the boat ramp on another ATV.  He informs you that the ice is thick enough to drive on.  Distance from the ramp to where the girl is located is about a quarter mile, and there's also about six inches of snow on top of the ice.

Do you trust the dad and drive the ambulance onto the lake?  If not, how do you access patient?  Do you call anyone for backup?

It's a true story, I'll tell what happened later.


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## Dominion (Sep 22, 2009)

I'm not from an area where ice forms that thick so here is my answer.

I do not drive on the ice and wait on a team specially trained in that kind of rescue to retrieve the patient for us.  I would have them enroute before we even left the bay.


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## Seaglass (Sep 22, 2009)

Ice has only gotten thick enough for an ATV maybe once or twice within my lifetime. I've heard that a local department has a vehicle designed for going on out on uncertain ice, although I've never actually seen it. At any rate, I'd call them and wait. 

Answer only changes if the ice has been professionally evaluated that day, as some parks have done with frozen lakes in the past. Even then, I'm not taking something as big as an ambulance. I'd get a backboard, some extra blankets, a few firefighters to help carry, and walk. No thanks to trying to get the cot through six inches of snow.


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## 8jimi8 (Sep 22, 2009)

hopefully your service stocks a drysuit.  If i had to improvise, i'd say get a sled and a few firefighters, everyone spread out and move carefully.


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## Epi-do (Sep 22, 2009)

First of all, there is no way I am driving my ambulance onto that ice.  Secondly, I am part of the water rescue team, so we would put a couple people into mustang suits and send them out to the patient to evaluate her and bring her back to the docks for EMS to take over.


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## wvditchdoc (Sep 22, 2009)

zappa26 said:


> Do you trust the dad and drive the ambulance onto the lake? If not, how do you access patient? Do you call anyone for backup?


 
Not only no, but &^&*(*% no! Regardless of the shape of the young lady, you won't do her any good should you, your crew, and all you equipment become victims as well. 

Call the specialists to do their jobs and bring her to you. 

Just my $0.02......


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## Mountain Res-Q (Sep 22, 2009)

Epi-do said:


> First of all, there is no way I am driving my ambulance onto that ice.  Secondly, I am part of the water rescue team, so we would put a couple people into mustang suits and send them out to the patient to evaluate her and bring her back to the docks for EMS to take over.



Plus One...

Somehow driving an ambo onto ice based on a distraught fathers advice doesn't seem like a smart idea...  

Because the pt.is less than a mile away from the paved road, this would be classified (at least in my area) as an "extended reach medical", meaning that SAR is not required, and you (on ambo or fire) may "hike" it in and take care of business...  However, you may want to request that the agncy having jurisdiction over Water/Ice Rescue Locally be on standby.  Also, may Fire, Forest Service, and/or Rescue Agencies that operate in these areas have snowmobiles and rescue sleds, so contact them and use them.  i.e. in my area all Water Rescue goes through SAR and there are two agencies that have snowmobiles as part of their arsenal: SAR and one Vollie FD that operates at 5,500 feet.  Hopefully Dispatch put those various resources into motion from the word go, as we all know that the initial report is never as it really is...


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## dragonjbynight (Sep 22, 2009)

Coming from the heart of maine, and seeing ice 2-4 feet thick, I would still agree with the H*&* no.. Most rural areas such as this would have a sled (snowmobile) or four wheeler available to the department. If not, It is a walking scenario. grab a board, gear and move....its hard walking but not impossible.....

Could you imagine the headlines, Ambulance and crew sunk after driving on thin ice...


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## firecoins (Sep 22, 2009)

call experts.  I don't drive my ambulance off the beaten path.


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## zappa26 (Sep 22, 2009)

It happened this winter (before I had any EMS experience/interest) to my sister at my dad's house.

They called for police and fire backup.  One of the medics took some equipment with him and rode on the back of my dad's ATV back to my sister.  His assessment found possibility of spinal injury due to mechanism and inability to move legs.  When a police car arrived, the other medic took the rest of the equipment (along with a backboard) in the back of the cop car, and then drove that out onto the ice.  That worked fine because all the lakes in Minnesota at the time had been cleared for cars, small trucks, and ice fishing houses.

They boarded her and started an IV for what I think was pain management, and then put her on the board across the back seat of the cop car and drove back to the public access where the ambulance was waiting.  She ended up with just a pelvic fracture and some bruises, a pretty bad concussion but no spinal injury, and made a full recovery in a matter of weeks.

I just wanted to see how you all would have handled it.


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## Barney_Fife (Sep 22, 2009)

We have this Oceanid Ice Sled thing that you slide onto the ice, with an opening in the front. Throw a rope to the person, the pull them into said opening, and onto the craft, then ppl on shore pull you in. Works for water rescue too, but the main purpose is ice.


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## Medic One (Sep 23, 2009)

Call the FD or a what ever your special rescue team is called.

I would not venture out there just because of the potential risk of you and your partner.

He would be too excited for you to ride on someones ATV he would be hauling butt to try and help you save HIS daughter/frined. And first rule scene safety.  His excitement is unsafe for you to ride with some stranger with no helmet/protective gear....well.... unless he has candy!!

No seriously you need to be professional and explain the reasons why you can not go with him to get the injuried person. As far as a lawsuit I think it would get thrown out if you were sued over it...You are EMS not trained in ICE Rescue and as long as you called for the FD or trained personell you should have not problem.


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## MRE (Sep 23, 2009)

We regularly have ice over a foot thick, which is enough to safely support an ambulance.  However I would not drive it onto the ice, because there is always a chance that there will be thin spots in the ice due to rocks just under the water line, springs and currents in the lake and people cutting blocks out of the ice.  It isn't worth the risk to the ambulance to put it on the ice.

In this case, my service would bring in the ATV and our rescue sled.  Our engines carry chain saws and ice augers for getting through ice for draft sites, so I would have a test hole cut near the shore to check the thickness and quality of the ice, and then determine if we can get to the patient or if an ice/water rescue team needs to be called in.  

FYI on ice quality; smooth clear ice with no bubbles is the strongest.  It will usually look black from above.  Cloudy, grey, white or rough ice has a lot of air in it, and is much weaker than the clear stuff.


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