Ambulance stopped at border - Canada

[BossyCow]

Actually, from what I read, there is a system in place that was not followed. Much different than ignored. Border security is too serious to just assume that lights and sirens means a genuine emergency. There should have been a call made ahead of the ambulance and officials at the border to assure a safe crossing. Instead, taking the word of the driver just doesn't cut it these days. I'm sure the system has a better protocol than that.

I thought I read they had a police escort to the border.

 

[Rattletrap]

He didn't say he wasn't going to an emergency; he just implied he wasn't dispatched by 911. Not all emergency calls are dispatched by the municipality. Private ambulance companies also run emergency calls; they are called directly, not though 911.

Thank you.

The authority comes from a direct call to our dispatch center telling me someone is laying on the floor unresponsive with a head injury.

The rest of story involves the fact that a long term sheriff deputy. chased a blue and white type 2 ambulance saying that there was not an emergency in the county. He was backed up by a higher ranking long term sheriff deputy.

Problem.

They were informed who we were and we were responding to a direct call through our dispatch center and what/where it was. They said we were telling lies.

Most of the chase was on the interstate. State highway patrol was not informed.

Our phone number in big letters on side of truck. Not called.

They told the owner of company they thought that someone was joy riding in a truck belonging to the VFD that is in the town our station was in. Did I say long term deputies? Our truck blue and white type 2 truck and VFD truck orange and white type 3 truck. VFD has their name on truck, we have our name on truck.

 

[Flight-LP]

Again, you may need to notify county authorities if you are responding emergency in their territory. Since the nursing home failed to notify 911 for this emergency and instead called a private, the sheriff is correct in his assumption as to not knowing that an emergency existed. Regardless, they have every right to pull you over and inquire. Should you fail to stop, you will be held accountable. Communication is everything, remember you are not the 911 provider and are subject to some questioning. It happens all the time.

I do wonder why they would think that someone was "joy riding"..............

 

[Rattletrap]

Again, you may need to notify county authorities if you are responding emergency in their territory. Since the nursing home failed to notify 911 for this emergency and instead called a private, the sheriff is correct in his assumption as to not knowing that an emergency existed. Regardless, they have every right to pull you over and inquire. Should you fail to stop, you will be held accountable. Communication is everything, remember you are not the 911 provider and are subject to some questioning. It happens all the time.

I do wonder why they would think that someone was "joy riding"..............

Not trying to sound nasty but none of private companies talk to 911 unless they dispatch us. if there was question, our number is in big letters on side of truck. they could/should have called us. 911 around here does not want to be bothered with that either.

I also mentioned that state highway patrol was not notified. The deputies were acting outside their jurisdiction, per highway patrol. They did not know anything about it until I contacted them later in day. There was an investigation. I don't know outcome.

 

[jmaccauley]

I got ya. An emergency run, but the police couldn't verify it through 911.

 

[bstone]

Not being able to verify through 911 is extremely common. I work for a private ambulance service and we run l/s whenever the situation is an emergency. We alert the receiving hospital but we do not alert 911 as we are not part of their system.

In fact, I don't think we have a way to alert 911 other than calling 911 from our cell phones.

 

[VentMedic]

Not being able to verify through 911 is extremely common. I work for a private ambulance service and we run l/s whenever the situation is an emergency. We alert the receiving hospital but we do not alert 911 as we are not part of their system.

In fact, I don't think we have a way to alert 911 other than calling 911 from our cell phones.

It is required in many of our counties, especially in the cities, that the company's dispatcher alert the county 911 center. We have had a few accidents in the past between emergency vehicles meeting unpleasantly at intersections. Often you will hear the dispatcher advise of other emergency traffic in the area.

Occasionally a small hospital I am familiar with will send a patient by BLS transfer to the city for diagnostics not available at their facility. There have been times when the Sheriff's office calls the ambulance dispatch and the hospital for emergency run verification when they see the L/S on a private ambulance. The hospital will confirm BLS nonemergent transport. The S.O. will follow the ambulance until the dispatcher tells them to slow down and knock off the L/S. If the driver is reckless or speed is excessive, that ambulance will be pulled over. There will also be a report filed by the hospital and the S.O. for the county to review the call for justification of the ambulance crew's decision to run L/S. The hospital and sending doctor are very concerned about this since they think they released a stable patient to go by BLS on a long transport. There is much liability and responsibility to pass around when something goes wrong.

 

[JJR512]

It is required in many of our counties, especially in the cities, that the company's dispatcher alert the county 911 center. We have had a few accidents in the past between emergency vehicles meeting unpleasantly at intersections. Often you will hear the dispatcher advise of other emergency traffic in the area.

Occasionally a small hospital I am familiar with will send a patient by BLS transfer to the city for diagnostics not available at their facility. There have been times when the Sheriff's office calls the ambulance dispatch and the hospital for emergency run verification when they see the L/S on a private ambulance. The hospital will confirm BLS nonemergent transport. The S.O. will follow the ambulance until the dispatcher tells them to slow down and knock off the L/S. If the driver is reckless or speed is excessive, that ambulance will be pulled over. There will also be a report filed by the hospital and the S.O. for the county to review the call for justification of the ambulance crew's decision to run L/S. The hospital and sending doctor are very concerned about this since they think they released a stable patient to go by BLS on a long transport. There is much liability and responsibility to pass around when something goes wrong.

What happens around here (the Greater Baltimore Metropolitan Area, Maryland, USA) is that the private ambulance companies do not allow BLS crews to run L/S without authorization from a supervisor in the company. If a police officer decides to check on a L/S-running ambo, he/she calls the phone number on the ambo and checks with the company. I guess they do that because they know there's no point in checking through the 911 system because they know we don't report to them, but in the arrangement you describe, it does make sense.

Police officers don't usually check up on ambos running L/S, not around here, anyway. If they do, it's more likely to be for a Type 2 ambo (vanbulance) because they (the cops) know that no FDs use those, only private companies.

Personally, I don't really like the concept that someone on a BLS private ambo has to call his/her supervisor for permission to run L/S. I understand the justification--some private ambulance employees can be a little gung-ho and would step up to L/S more often if they could, for the thrill--but when you have a true emergency, it can be difficult to find the time to make that phone call.

 

[VentMedic]

Personally, I don't really like the concept that someone on a BLS private ambo has to call his/her supervisor for permission to run L/S. I understand the justification--some private ambulance employees can be a little gung-ho and would step up to L/S more often if they could, for the thrill--but when you have a true emergency, it can be difficult to find the time to make that phone call.

For some areas it greatly reduced using L/S just to get the truck back in service faster by the ambulance service. A company running its coverage thin due to economics should be addressed some place other than the streets.

Again, a review may be needed in regards to the facility sending the patient also. Did they request the appropriate level of care or was that patient beyond the scope of BLS and needed more monitoring? Safety measures are there to protect the EMT and Paramedic as well as the general public.

 

[Asclepius]

My thought is if they can't trust the EMT to make the determination for transport then they need to reevaulte their staff. Although, I can't think of a good reason for BLS to be transporting L/S unless they are responding to the scene, moving towards an ALS intercept, or are in a BLS zone around the hospital. I don't think a qualified EMT should need to seek permission to act in the best interest of the patient.

I also do not agree, generally, with the concept of blowing someone in just to get back in service, with very few exceptions. I understand that the system becomes taxed and sometimes it is necessary, but that should happen very infrequently. I've only seen it done a handful of times in all my years.

 

[jmaccauley]

I guess my thought was this: Why is BLS responding to an emergency? Why not have 911 called, unless it's not that critical and the NH just wanted an ambulance to transport. The problem, from law enforcement's poit of view, is that there are stolen ambulances and there are legitimate EMT's who like the lights and siren just because they have them. Whenever I see an ambulance driving at mach 1, I call and ask where they are going because I might very well be called next. As discussed in another thread, someone's crisis is not always our emergency.

 

[jmaccauley]

I thought I read they had a police escort to the border.

Obviously, the police turned them over to the border escorts without telling them anything about the emergency. A phone call might have saved everyone some unneeded agravation.

 

[JJR512]

I guess my thought was this: Why is BLS responding to an emergency? Why not have 911 called, unless it's not that critical and the NH just wanted an ambulance to transport.

The problem is that not all nursing homes are staffed by skilled nurses who care about their patients and can determine when there is a true emergency. Or the staff may not be quite as bad as that, but having so many patients to tend to, they might not be able to pay as much attention to one particular patient as might be needed; so, you might have a situation where a patient has a minor emergency that doesn't warrant calling 911, so they call a private company, but meanwhile, while the private company is on its way, the patient gets worse gradually, which is not noticed by staff.

I was recently called to a particular nursing home for a patient whose chief complaint, according to the staff, was "general lethargy and decreased appetite". (Another common nursing home patient complaint like that is "failure to thrive".) Anyway, I get there and do an assessment; pt. has recently (according to staff) altered mental status and is unable to communicate, and a BP of 72/38. Here's someone that clearly should have been at the hospital already, and probably could have been there quite a bit earlier had they called 911. But the staff based their decision to call us on factors other than BP, which at the last regular twice-daily check was 100/50. So either they weren't monitoring the BP more frequently because it wasn't a problem at the last regular check, or nobody cared enough, or knew enough... Anyway, we didn't run that one L/S, nor request an ALS rendezvous, because that NH happens to be next door to the hospital, so no point.

I'm sure it's the same all over, but some of the nursing homes around here are really quite deplorable, and it's amazing people ever get out of them alive.

 

[Rattletrap]

The problem is that not all nursing homes are staffed by skilled nurses who care about their patients and can determine when there is a true emergency. Or the staff may not be quite as bad as that, but having so many patients to tend to, they might not be able to pay as much attention to one particular patient as might be needed; so, you might have a situation where a patient has a minor emergency that doesn't warrant calling 911, so they call a private company, but meanwhile, while the private company is on its way, the patient gets worse gradually, which is not noticed by staff.

I was recently called to a particular nursing home for a patient whose chief complaint, according to the staff, was "general lethargy and decreased appetite". (Another common nursing home patient complaint like that is "failure to thrive".) Anyway, I get there and do an assessment; pt. has recently (according to staff) altered mental status and is unable to communicate, and a BP of 72/38. Here's someone that clearly should have been at the hospital already, and probably could have been there quite a bit earlier had they called 911. But the staff based their decision to call us on factors other than BP, which at the last regular twice-daily check was 100/50. So either they weren't monitoring the BP more frequently because it wasn't a problem at the last regular check, or nobody cared enough, or knew enough... Anyway, we didn't run that one L/S, nor request an ALS rendezvous, because that NH happens to be next door to the hospital, so no point.

I'm sure it's the same all over, but some of the nursing homes around here are really quite deplorable, and it's amazing people ever get out of them alive.

These decisions are in most cases not made by the staff. They must contact the pt doctor and wait for a call back. The doctor then decides what they want done after waiting several hrs to call back on info he has been given.

 

[JJR512]

Well that explains why I take so many NH patients to the hospital, patients who have fallen and hit their head or possible fractured something, and have to tell the ED staff why I'm just bringing the patient there now when the fall happened "last night" or "two days ago".

 

[Rattletrap]

Bingo

message must be 10 letters

 

[VentMedic]

I'm sure it's the same all over, but some of the nursing homes around here are really quite deplorable, and it's amazing people ever get out of them alive.

An RN at a NH has got to be one of the worst possible jobs an RN could have. Yet, many RNs love geriatric medicine and think they can make a difference. Soon, they find out that they are in a system that is just not reasonable medicine and good nurses get fried both mentally and legally. The more they care, the more they take the hits.

One RN may be responsible for easily 30 or more patients with very few unlicensed staff to assist. They must follow orders by doctors that may not see the patient for weeks if that. They do not have access to ACLS medications or even a code cart in most cases. If they start an IV they are regulated by the state and the facilty as to what meds they can run. Even the basic meds come from an outside pharmacy in only the amounts that have been ordered for each patient. Just to give an emergent Albuterol treatment, the RN may have to "borrow" from another patient.

If the RN bypasses the doctor calling protocol to get help faster and calls 911 ALS for a "fever" even though the RN recognizes the signs of sepsis, he/she may get a scolding from the ALS crew for calling them for a fever. "That's BLS".

If the RN jumps through all the hoops including being put in the waiting line for a BLS truck, the BLS crew sees a very unstable patient and again the RN is going to get chewed by the crew and by the ED. And yes, the ED may file a formal complaint. So, the RN will again have to justify his/her actions again in a system that can not be easily changed due to all the local, state and Federal guidelines in place to "protect the patient".

 

[JJR512]

I believe the only difference they can really make is in the attitude of their patients. If the nurse comes into the system knowing and understanding that, and is resigned to it, and puts a smile on and is pleasant with her charges, that can really make a positive impact on the patients. But one who is frustrated with the system, or just tired and burned out, and comes in with a scowl and an uncaring attitude is just going to make her patients sad and lonely.

It takes a really strong constitution of character to make that kind of a positive difference in the face of a system like this.

 

[emtwacker710]

this aggravates me...it does, there should be no reason for stopping that ambulance (or if you read the article the fire truck also) seriously it is not a matter of national security, if the US or Canada wanted to attack each other they would think of better ways than fire and EMS, lol anyways that cop that stopped them is very lucky that the pt. survived..or else he would be in some deep s*it