Bad situation. What would you do?

[usalsfyre]

I'm glad you have bro. Cause I have not and I hope to God I don't run across something like this before I do make my decision.

The thought has tortured me on occasion and I guess I'll only get over that once I make a choice.

It wasn't easy. As you know I work full time for an agency with fairly liberal practice guidelines. However at my part-time job I first respond for "the other guys" in our region, who aren't. Many things I'm credentialed and allowed the freedom to do they're not. Not to mention I'm no better than a ECA in their eyes. So I had to make the decision. All I can do is advocate for the patient and offer up the best tool I have (my knowledge and experience) to the crew on scene. But you won't find me with a laryngoscope or scalpel in hand over there.

 

[Sasha]

Also, right or wrong, I've never bought in to the whole your life over your patients. Not fully at least. Risk-benefit analysis. Risk a little to save a little. Risk a lot to save a lot. If a fellow PD brother goes down in the hot or warm zone, I know that I will do whatever it takes to get him out. If a fellow firefighter goes down in a bad fire, I will make every attempt to get to him. If a patient is within arms reach in a fire that's threatening to flash, I'm going to exhaust all means to get her out. Again, right or wrong, that's just the way I'm wired.

All you will be doing is making two patients instead of one.

 

[STXmedic]

I disagree. Knowing when your in an untenable situation and acting to the best if your education while calling for backup is one of the traits of a professional. Going cowboy with a recip saw doesn't meet that criteria.

I don't think its cowboy. I think its doing your job. Its using what you have to get the job accomplished. We aren't working in an office. Part of the training I went through was to think out of the box as do what works. I'm not advocating taking a recip saw to everybody, I'm sure a situation like that would be a once in a couple hundred ff's careers.

 

[Handsome Robb]

So i have to ask. What is an ECA?

 

[usalsfyre]

Also, right or wrong, I've never bought in to the whole your life over your patients. Not fully at least. Risk-benefit analysis. Risk a little to save a little. Risk a lot to save a lot. If a fellow PD brother goes down in the hot or warm zone, I know that I will do whatever it takes to get him out. If a fellow firefighter goes down in a bad fire, I will make every attempt to get to him. If a patient is within arms reach in a fire that's threatening to flash, I'm going to exhaust all means to get her out. Again, right or wrong, that's just the way I'm wired.

All you have to do is look at the Worchester 6 to see why taking this philosophy does no good though. You HAVE to realize when a good outcome us unlikely. Otherwise you end up with a trail of bodies. It's one of the reasons we continue to have buildings fall on our heads and run out of air.

 

[STXmedic]

All you will be doing is making two patients instead of one.

Maybe. Or maybe I'll be giving her children their mother back. Or maybe I'll end up fine and the mother still dies. It's impossible to tell. All I know is that I've got equipment and training that the average civilian does not, in order to help them in their time of need. Emergency Services is what we get paid for, right?

 

[usalsfyre]

So i have to ask. What is an ECA?

Emergency Care Attendant. The Texas equivalent of a first responder.

 

[STXmedic]

All you have to do is look at the Worchester 6 to see why taking this philosophy does no good though. You HAVE to realize when a good outcome us unlikely. Otherwise you end up with a trail of bodies. It's one of the reasons we continue to have buildings fall on our heads and run out of air.

Agreed. If it's blatantly obvious that there is no chance for survival, there is not a lot to save, therefor there won't be a lot risked.

 

[Sasha]

Maybe. Or maybe I'll be giving her children their mother back. Or maybe I'll end up fine and the mother still dies. It's impossible to tell. All I know is that I've got equipment and training that the average civilian does not, in order to help them in their time of need. Emergency Services is what we get paid for, right?

I get paid to provide care within my scope of practice, and to go home every night.

I don't get paid to take away a daughter, aunt, and sister from my family.

 

[Shishkabob]

Also, right or wrong, I've never bought in to the whole your life over your patients.

There's a difference between taking a calculated risk, and putting a strangers life above your own.


I've straight up told my partner that if a car is on fire and the person burning alive, chances are I won't go near it. He said he would because he's been an FF for many years. I'm single, without kids, and he's legally married with 2 kids. To each his own.


However, a month ago, we went in to a somewhat unsecure scene with multiple machete attack victims, and found out later that the machete wielder was no more than 20 yards from us at one point.




But again, I would like to think I'd look at this like it was an MCI (which is was in this situation). Even if the person is still alive, they're a blacktag as working to save them would take needed resources away from others who could benefit.

 

[usalsfyre]

Agreed. If it's blatantly obvious that there is no chance for survival, there is not a lot to save, therefor there won't be a lot risked.

But you can't let citizen, LEO or FF status play into your decision making.

Just speaking as a guy who's burned way, way out on seeing dead "heros". It happened more so from HEMS, but every time I see someone die over this crap it twist my gut.

 

[SanDiegoEmt7]

Didnt mean for the post to sound accusatory. You never mentioned the use of extinguishers and all we can work with are the details given, and it's simply something that is always on my mind at car fires. Have one person go to the patient to attempt extraction, the other grab a fire extinguisher. Which can put out small fires and possibly by time.

I'll repeat unless I'm missing something, my armchairing is only as good as the details.

In the end you do what you can, sometimes situations develop so fast it's that nothing can be done. 3
Minutes is pretty short.

 

[firetender]

Sometimes you have to watch people die

Really, how long did it take for this whole scenario to play out?

I suspect two minutes at the most. By the time whoever came to the realization that it may be too late to do anything (especially spark a fire with a saw!) it would have already been too late and the appropriate thing to do would be to protect yourself.

In this case, I think I'd do a quick calculation of the odds. (Not good!)

Honestly, the thought that crossed my mind was that what I'd hope I'd have the courage to do is to get as close to the woman as I could (safely) and let her know, "We've got your kids, they're ALL RIGHT!"

...and then wish her well on her journey as I headed for cover.

 

[johnrsemt]

May just be me but no one has thought about cable to frame; to truck; Back up and yank car out from under truck. That may rip the patients hand off, but the crew can't be sued for it since they are trained in towing and pulling.

 

[STXmedic]

May just be me but no one has thought about cable to frame; to truck; Back up and yank car out from under truck. That may rip the patients hand off, but the crew can't be sued for it since they are trained in towing and pulling.

Lol nice, I like it! I don't know if they can't be sued, but it's definitely a plausible option (at least as plausible as field amputation!)

 

[mycrofft]

Agreed johnrsemt, and Linus, I respect that.

John, my old ex-Ranger partner would like your out of box thinking.

Linus, well put. No pusillany there.

I once climbed into a partly flattened rollover with gasoline spilled to hold C spine on the drunken occupant WITHOUT turnouts or a pumper standing by. I'm still conflicted (the accident was single car versus three cherry trees and a curb at speed) as to whether this was stupid; it was instinctive, and it worked, but I would never tell anyone else to do it.

 

[wadford]

You train to use an AED but the ambulance doesn't carry one? That's crazy! Does the ALS unit get there in 8 minutes? AEDs are absolutely an essential piece of equipment.

 

[Sasha]

Not according to state requirements.