EMS Staging

[commlt163]

Some of our Medics have asked me the question, "Why do you even dispatch us on violent incidents before PD has cleared the scene?"

Our current practice is to dispatch the Medic immediately to every incident and provide them with as much information as we can. They use their judgement on how/if to stage.

I would like to hear what other EMS agencies do. Does anyone postpone dispatching EMS until after the scene has been secured by law enforcement?

Thanks.

 

[socoemt]

On my prehospital ridealong (Colorado Springs) for my basic class we were dispatched to a domestic dispute and staged outside of the apartment complex. Sat there for an hour before getting cancelled. Good times were had by no one.

 

[Medic Tim]

Where I was/am in Maine we are dispatched along with police and it is our discretion on how when where why to stage. Where I work in Canada we have certain calls where we automatically stage and others we can if we wish. We are sent the same time as police but respond cold and stage out of sight of the location. We usually willow follow police in unless we believe there to be a weapon. There are times in some of our rural areas where police can be an hour or more away. Most times we are cancelled by police or the pt ends up going with them to hospital after an assessment.

 

[Chimpie]

... Our current practice is to dispatch the Medic immediately to every incident and provide them with as much information as we can. They use their judgement on how/if to stage. ...

This is another one of those "depends on where you live and how EMS is staffed" type of things.

Up north, there are only a few ambulances on shift at a time (private agency), so a response may be 10+ minutes till they arrive on scene. Plus they are dispatched from a completely separate facility than police/fire, so it may take an extra few minutes before an ambulance is even dispatched in the first place.

Here locally, EMS is ran by the county which has many more ambulances. The time it takes them to get to the scene is usually much, much shorter.

... Where I work in Canada we have certain calls where we automatically stage and others we can if we wish. We are sent the same time as police but respond cold and stage out of sight of the location. ....

I've always thought this should be more common, again, depending on how the local area is covered.

 

[VCEMT]

This is how I see it. We are dispatched so that, there is a dedicated unit on the call. Otherwise, after they have cleared the scene, there are no rigs available or there is a critical pt. that requires immediate transport. If they dispatch us after the scene is clear, the closest unit may be across town or further. I'm paid either way. Part of the job, don't like it. Quit, you won't be missed.

 

[Veneficus]

I was once dispatched to an incident that was so close to the station I informed the dispatcher we would stage at the station.

Never got any grief from it.

While there are several good points here that I think are reasonable, there is also the issue of "time of call" to "time of dispatch" to "time on scene."

Aside from that, scenes are dynamic. You could have cops clear a scene 10 times and still something could happen.

 

[Anjel]

We are dispatched with PD so when the scene is clear we are right there. And it won't take another 5-8minute to arrive on scene.

Deciding to stage isn't up to the crew entirely. We are told to stage by dispatch, and they will let us know when to go.

 

[NomadicMedic]

It seems like we're often told to stage on calls that would not require staging. For example, on every overdose or "police action", we're usually advised to stage.

However, when reading the CAD notes it may be obvious that the overdose is a 16-year-old who took 20 Benadryl or the police action is a 20-year-old female who was struck by her boyfriend who's no longer on scene. In those instances, even though we're advised to stage we usually don't.

In the instance of an unstable situation, where the dispatcher will tell us there's a violent person, weapons involved... we respond cold and usually stage far enough away that we can't be seen from the residence. We are then advised to come in when the police have cleared the scene.

Situations are fluid, most of the medics here use their discretion on whether to stage or not. Not saying that we have a bunch of cowboys, but any situation can turn violent. It doesn't matter if it's dispatched as "stage for this call" or not.

 

[shfd739]

Staging for us is based on call type and what's going on.

Violent call such as shooting, stabbing, assault etc. we respond and the crew picks where they want to wait while law enforcement goes on in and checks the scene. Everyone is a little different with their comfort level as to how far away they wait.

Overdoses or when the assailant has left we are told to stage but some use their discretion on waiting or not. Or they wait super close.

 

[Bullets]

Staging is a fluid thing, we only stage on violent crimes, such as assault victims ect. (not counting police standbys). We will park the truck a bit away outside the cops perimeter. I will leave my partner at the truck and approach on foot with a bag and reeves and make contact with the OIC who is usually outside. I will then confer with PD if we can do a rapid extraction via reeves or walk or we have to wait to bring the truck up and treat inside

 

[CentralCalEMT]

Unless it is a shooting, stabbing or assault with the suspect still on scene, we are usually given the discretion on whether to stage or not. My partner and I will discuss it on the way to the call and we only go in if both of us feel it is safe for us to do. Like others have said, it is fluid and depends on the circumstances. If we get a man down call in the Walmart parking lot at 1500 then no, we are not going to stage. However when we get the man down call at 0300 in a dark back alley in an area known for gang activity, then we will probably wait for the sheriff and follow them on scene.

If it is something like a shooting/stabbing/domestic then we will wait out of sight and either wait for dispatch to clear us or monitor PD on our portable and enter when we hear them say that EMS is clear to enter.

I am very big on scene safety, however, I am definitely not a fan of staging when it is unnecessary. In some areas, EMS crews seem to fear their own shadow. Where I used to work we were told by dispatch to stage for an unconscious 13 year old who took her mom's sleeping pills and both parents were on scene because it was an "overdose" and we stage on ALL overdoses no matter the circumstances. The end result is we waited for 15 minutes for PD (given that info it was a low priority call for them) and the patient had delayed care. I think that the crew should have as much info as possible and use their discretion weighing risk versus reward.

 

[DesertMedic66]

We are dispatched with PD so when the scene is clear we are right there. And it won't take another 5-8minute to arrive on scene.

Deciding to stage isn't up to the crew entirely. We are told to stage by dispatch, and they will let us know when to go.

Same here.

I've had a shooting go down across the street from where we were posting (didn't hear any gun shots). When dispatch gave us the call and told us to stage we were going away from where it happened fast. Went a couple of blocks down and staged until PD cleared it.

 

[leoemt]

It would depend on how your system is ran. Here it is rare for EMS to stage for most incidents. The police clear the scene usually by the time EMS arrives. If EMS is first on scene it is at their discretion on whether to stage or not.

When I was a cop we knew when EMS was arriving and staging. We worked hard to clear them as soon as possible. However, some calls requires a lengthy staging. For example, on SWAT call outs we would stage an ambulance for the duration of the call which could be hours. We also typically had a fire engine staged as well.

that is just how our system ran. Worked for us.

 

[DrParasite]

Some of our Medics have asked me the question, "Why do you even dispatch us on violent incidents before PD has cleared the scene?"

Per management's decree, we will not send an EMS unit on violent BLS calls. This includes Violent EDPs, Assaults in progress, domestics in progress, armed EDPs, and stuff like that. It is noted in the CAD that a call was received, and PD was advised to call us when they get a unit on scene and the scene has been secured. The reason for this is quite simple: An ambulance might get there in 10 minutes, and a cop will get there in an hour. Why should I have an ambulance waiting an hour until the cops show up, when they could be used elsewhere (if they are needed at all, more often than not PD handles the scene and there is no need for EMS)?

That all being said, units are directed to stage at ALS criteria calls: stabbings and shootings, unconscious assault victims (or any call where the person is reportedly unconscious due to a potential scene safety threat). PD categorizes these as high priority calls, so they will get there quicker than for the BLS calls.

 

[Shepard]

We're dispatched for a staging event as soon as the SO requests medical. We go code 2 to stage. Where we stage is at our discretion and then we're advised when SO clears us.

 

[Handsome Robb]

Our dispatch generally tells us whether or not to stage. Sometimes they leave it up to us. We are usually dispatched at the same time PD receives the call or shortly thereafter.

Per policy if it's a priority call we are supposed to run RLS to stage but common sense definitely comes into play.

You can generally tell the severity of a violent crime by how quickly we get cleared to enter.

 

[jeepdude911]

I've run calls in SoCal ( San Bernardino County) and NorCal ( San Francisco), and the main similarity between them is that they want EMS close by so that when PD gets a code 4, EMS can be in within 1 minute.