# WWYD....



## DrParasite (Jan 1, 2023)

This situation occurred in my county, and I'm curious how you would have handled it

EMS is dispatched for a woman who cut her leg, and it is "bleeding really bad."  The location is a private residence, single wide home, in the rural part of the county.  The location is next door to a local FD station, staffed by at least 3 career FF/EMTs, however, they are not dispatched to the call due to dispatch criteria.

EMS arrives on the scene, and the crew is advised by the patient that she was stabbed by her boyfriend.  his current location is unknown. The only noticable bleeding is coming from her leg.

No additional information is provided

What's your next step?


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## DesertMedic66 (Jan 1, 2023)

A mix of #2 and #4. Have partner call for PD. If the bleeding is major then toss on a TQ and get her to the ambulance and start going to the ED. If the bleeding isn’t major then just get her to the ambulance. Contact the ED so they can stage security around the ED.


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## E tank (Jan 1, 2023)

2. Already on the scene and gonna leave anyway. Take the patient with you. The cops don't have to figure out who did it and they can question the victim anywhere. Advise police enroute.


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## IsraelEMS (Jan 4, 2023)

I agree with E Tank. Did she tell dispatch that it was an assult?


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## Tigger (Jan 4, 2023)

If we have the patient we are just going to leave. No sense waiting for the assailant to come back.


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## CCCSD (Jan 4, 2023)

Tigger said:


> If we have the patient we are just going to leave. No sense waiting for the assailant to come back.


But then you can double bill.


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## DrParasite (Jan 5, 2023)

IsraelEMS said:


> I agree with E Tank. Did she tell dispatch that it was an assult?


no... they dispatched it as a serious hemorrhage from the leg.

For the record, I'm in agreement with what everyone else is saying.


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## CCCSD (Jan 5, 2023)

I once went out on a lead poisoning call.

GSW L Chest.


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## Bullets (Jan 7, 2023)

If i have patient contact, literally drag her out if necessary and leave. Call PD as i do.


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## M3dicalR3dn3ck (Jan 7, 2023)

Where my 911 job is at, PD or Sheriff's Office should be and usually is already on scene in these cases, especially if our response time is more than 5 minutes (we're a city department but cover a good majority of the county, and only have two trucks). If for some reason we beat them on scene, we'll go ahead and transport. If boyfriend actually did stab her and has ill intent for us, well this is Oklahoma and we're legally allowed to defend ourselves with an appropriate level of force. That's assuming they don't get on scene while we're getting the bleeding controlled.


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## IsraelEMS (Sunday at 7:32 AM)

@M3dicalR3dn3ck PD comes to a call for bleeding even without report of assult?


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## ruralEMSgirl (Monday at 10:00 AM)

In agreement with a lot of what I'm writing here- some combination of #2 and #4 (as we all know- _stopping the bleed when we can is always priority #1_ in any type of significant trauma).

 I would also be pro-getting-this-PT-the-F-into-my-ambulance-and-off-scene and conducting all further assessment/intervention from the rig and enroute, as we can't be confident the original scene is safe. 

I would be very interested to hear more about the "dispatch criteria" in your service area which led to the very close-by crew not being sent, but (at least in my experience) there's not always a ton of info provided to us on the EMS side of things on how dispatch-y things work.


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## DrParasite (Monday at 11:50 AM)

ruralEMSgirl said:


> I would be very interested to hear more about the "dispatch criteria" in your service area which led to the very close-by crew not being sent, but (at least in my experience) there's not always a ton of info provided to us on the EMS side of things on how dispatch-y things work.


To be honest, I don't know.... the FD isn't sent on alpha calls (most times), and only sometimes on bravo calls, which is how this call was coded.  

I'm not a dispatcher, I'm not involved with this call, so I have 0 first hand knowledge of what occurred.  Personally, I'm would much rather EMS be able to handle the EMS call volume without needing the FD to stop the clock (that's an argument for another time), but I'm surprised the FD wasn't sent on this call.  However, I didn't take the 911 calls, so I don't know what the caller told the dispatcher, so I won't second guess them.  

In this case, it's likely there wasn't criteria to send them, instead of dispatch criteria to send them (but I'm just guessing on that one).


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## M3dicalR3dn3ck (Tuesday at 4:21 PM)

IsraelEMS said:


> @M3dicalR3dn3ck PD comes to a call for bleeding even without report of assult?


I should add more clarification, they don't show up for epistaxis or something simple like that. I'm going based off the "cut herself" as well as the bleeding. That said, we only know if it's reported as an assault when law enforcement requests us, so if we get dispatched at the same time as our law enforcement, all we'll know is the bleeding really bad part. Anything serious like that and our PD or SO will be on scene. Not a bad thing either because we can focus on patient care while they secure the scene and they'll even help us lift and load patients if there's no danger present to us. That said, our dispatch is county dispatch, and it's not comprised of particularly intelligent individuals


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## IsraelEMS (Thursday at 7:38 AM)

I understand. So we can always see if the call to us came from fire or police or if either was called by our dispatch based on the info from the caller. In fact I can see all other personel on a call (meaning who is in the BLS or ALS ambulance or the names of any first responders who might be coming before the ambulance getts there). In general, police only show up in the case of assult, traffic accident or if there is an odd or suspicious event unless we call them specifically. 

Fire only shows up to fire calls (fires, gas leaks, people trapped in places or if a door needs to be blown off to get to the pt).


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## M3dicalR3dn3ck (Yesterday at 9:47 PM)

@IsraelEMS one of our fire departments north of us is really awesome about showing up on everything, my only complaint is that they park really crappy. But they're competent for their level of care and they always get us a good assessment and history at the bare minimum, and usually have performed at least one intervention. They would have been on scene already in this situation as well and had the bleeding controlled by the time we got there (15-20 minute response time even running emergent), so all we'd have had to do is load the patient and go.


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