EMS and ladder trucks

[NomadicMedic]

It would be next to impossible to list or even make policies for things we are not allowed to do. Waiting on scene while I can see a patient who has a broken hip on the other side of a sliding glass door and just doing nothing because the fire department isn't there is poor patient care IMPO. Same with a child locked inside a car on a 125 degree day. There is no policy that says I can or can't break the window but I'm not officially trained in how to break a window so what now? The fire department isn't always right around the corner and can easily take over 30 minutes to respond.

We actually have a written policy for us riding in on the airships that allows us to do so..

I have a boating accident in the river/lake and the only way to access them is by boat. There are other boaters there more than willing to give us a ride over but instead I am going to wait possibly close to an hour before the fire department gets there with their boat..

Same with drownings. The patient is still in the pool but I'm not a lifeguard and not trained in "water rescue" neither is PD or fire. So what do we do? Wait for a lifeguard to get on scene of this privately owned pool? Wait for them to float to the surface and fetch them with the pool net?

I judge the risks vs benefits for these types of situations and go from there. These are not just "what if" scenarios, these are actual calls that have happened. I've had the hip fracture call many many times.

So have I. I've forced a door. I've gone out on a boat. I've been dropped on to a ledge from a sheriff department helicopter. But, if I got hurt doing any of that, I wouldn't have been covered and you're damn sure there would be a policy against it the next day. Risk vs benefit is a decision we all make every day. Should I drive faster than the speed limit? I

If you do it and it's fine, you're a hero. If anything bad happens, you're the guy who got the "dont go on boats" policy written about them and hopefully they're not holding a fundraiser to help support your family. See what I'm saying?

 

[VentMonkey]

Yup, it attests to my hard and fast rule with any, and all trainees I've ever had:

"Don't be a memo."

 

[Jim37F]

Curious - is this SOP or is this just generally accepted wisdom?

generally accepted wisdom....as Vent posted above:

"Don't be a memo."

I'm sure if tomorrow I happen to cut myself on some piece of car bad enough to require going out of service and calling Supe and going to the company's occupational health/urgent care place, then there would almost assuredly be a memo out before the end of the week telling us not to touch cars lol

But if I can open a car door to get to a patient, I'd rather do that than stand there with my thumb up my 4th point of contact waiting for a firefighter to do the same thing....

 

[Tigger]

This post is the stuff that policies are made of.

It's all okay until it's NOT okay. First time a medic falls off an ATV, falls out of a pickup truck, gets injured making a forced entry or on the airship... it's all over. Trust me.

Saying "well, we've being doing it this way forever, nobody's ever said anything and nobody's gotten hurt" is not an acceptable defense. That's why risk management professionals get paid so much.

We have no policy yet are provided with PPE and backcountry bags. I'm not sure where that leaves us. If the agency is going to prepare us for such things, I expect that they understand the risks.

 

[NomadicMedic]

We have no policy yet are provided with PPE and backcountry bags. I'm not sure where that leaves us. If the agency is going to prepare us for such things, I expect that they understand the risks.

I know the little bit about your service that you've shared here. I'd be curious what their risk assessment was and what their policy is. Ask a boss what would happen if you were injured due to misadventure on a civilian vehicle or performing a skill that you have not been trained for. If they say they'll cover you, ask for that in writing. I'd bet the entire position would change.

 

[DrParasite]

Same with a child locked inside a car on a 125 degree day. There is no policy that says I can or can't break the window but I'm not officially trained in how to break a window so what now?

I'm assuming you are using the center punch that is in your agency provided toolbox right? because using personal tools (that are not explicitly permitted by company SOP) can get you in trouble if something goes wrong.

Same with drownings. The patient is still in the pool but I'm not a lifeguard and not trained in "water rescue" neither is PD or fire. So what do we do? Wait for a lifeguard to get on scene of this privately owned pool? Wait for them to float to the surface and fetch them with the pool net?

well, you do know that going into the water is usually the means of last resort, right? REACH – THROW – ROW - GO, that is the order of what trained professionals are trained to do when it comes to water rescue. but a body in the water (pool, lake etc), is usually a recovery, not a rescue. and if they are drowning (as in sinking and in the process of going under, while still concious), you know that they will pull you under and drown you to save yourself right? which is why going in after them in the mission of last resort.

We actually have a written policy for us riding in on the airships that allows us to do so..

good, so your company is aware of what is happening, so if something bad does happen, you have it in writing that your company approved your actions.

We have no policy yet are provided with PPE and backcountry bags. I'm not sure where that leaves us. If the agency is going to prepare us for such things, I expect that they understand the risks.

If your company provides you with the proper PPE and equipment, and your using their equipment, I'm pretty sure you can say with relative certainty that they understand the risks, and want you to use said equipment.

I've forced a door. I've gone out on a boat. I've been dropped on to a ledge from a sheriff department helicopter. But, if I got hurt doing any of that, I wouldn't have been covered and you're damn sure there would be a policy against it the next day. Risk vs benefit is a decision we all make every day. Should I drive faster than the speed limit? I

Me too. I've bent certain rules, and did stuff that I probably wasn't supposed to do, because it was in the best interest of the patient, or it gave me a better idea of what we were dealing with (being first in to an underground construction accident comes to mind). Had the #2 guy in my agency leave his office and show up unexpectedly on that one too.....

If you do it and it's fine, you're a hero.

If anything bad happens, you're the guy who got the "dont go on boats" policy written about them and hopefully they're not holding a fundraiser to help support your family

That's exactly what will happen. you do well, "great job." it goes downhill, and people outside of your department see what is happening, risk management gets involved, maybe even a rep from the workman's company (if they are paying for injuries), and before you know it, you have a policy written with your name on it.

Sadly a lot of bosses will tell you "sure, do what you have to do," until you ask so if i get hurt, will the department cover me? so can you put that in writing, just in case?

 

[DesertMedic66]

I'm assuming you are using the center punch that is in your agency provided toolbox right? because using personal tools (that are not explicitly permitted by company SOP) can get you in trouble if something goes wrong.well, you do know that going into the water is usually the means of last resort, right? REACH – THROW – ROW - GO, that is the order of what trained professionals are trained to do when it comes to water rescue. but a body in the water (pool, lake etc), is usually a recovery, not a rescue. and if they are drowning (as in sinking and in the process of going under, while still concious), you know that they will pull you under and drown you to save yourself right? which is why going in after them in the mission of last resort.
good, so your company is aware of what is happening, so if something bad does happen, you have it in writing that your company approved your actions.
If your company provides you with the proper PPE and equipment, and your using their equipment, I'm pretty sure you can say with relative certainty that they understand the risks, and want you to use said equipment.
Me too. I've bent certain rules, and did stuff that I probably wasn't supposed to do, because it was in the best interest of the patient, or it gave me a better idea of what we were dealing with (being first in to an underground construction accident comes to mind). Had the #2 guy in my agency leave his office and show up unexpectedly on that one too.....
That's exactly what will happen. you do well, "great job." it goes downhill, and people outside of your department see what is happening, risk management gets involved, maybe even a rep from the workman's company (if they are paying for injuries), and before you know it, you have a policy written with your name on it.

Sadly a lot of bosses will tell you "sure, do what you have to do," until you ask so if i get hurt, will the department cover me? so can you put that in writing, just in case?

Our agency has punch tools however they are usually hidden on the unit.

Yes I am aware of the water rescue stuff. When I was a Boy Scout we were actually trained and practiced water rescues from pools.

A body in a pool does not mean recovery. Recovery, at least around here, means the patient is already dead and no life saving measures will be taken.

 

[DrParasite]

I think you are still confusing the issue here... You having the training (from Boy Scouts) is great, but is it in your job description to get into the water to pull a body out of the water?

Using the same logic you are using, I happen to be a trained firefighter. I went to the fire academy and everything. So if I pull up to a house fire with a report of people trapped and i'm on the ambulance, should I be kicking in the front door to try to search for any victims? And should I suffer any injuries, do you think my company would (and should have to) cover me? After all, entering burning buildings isn't in my job description, as I don't have the proper PPE to do that job.

Does your ambulance have a PFD, or water rescue flotation device? Just like your hidden center punch, if they are agency supplied, then you should feel free to use the equipment they provide to you, because there is a reasonable expectation of use. If not, then if something goes wrong, and the person doesn't survive, was it due to you performing the rescue improperly?

If you do it and it's fine, you're a hero. If anything bad happens, you're the guy who got the "dont go on boats" policy written about them and hopefully they're not holding a fundraiser to help support your family. See what I'm saying?

What he said.