first unit in is the last unit out

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spimx

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Say you are the first unit on scene with 3-4 patients mostly non-critical; should you be the last unit to leave the scene or can you just go ahead and load and transport the most critical patient as long as there is a fire officer on scene?
 
Has everyone heard this idea and does anyone know where it came from, I don't see this idea in NIMS
 
spimx said:
Say you are the first unit on scene with 3-4 patients mostly non-critical; should you be the last unit to leave the scene or can you just go ahead and load and transport the most critical patient as long as there is a fire officer on scene?
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You should transport all four, thus ensuring you are both First and Last.
 
It is a common practice that the first ambulance may assume a medical group supervisor role which accounts for triage/treatment/transportation. This may mean you end up transporting the last few greens once everyone else is gone. But that’s pretty system specific, if Fire is IC and also providing patient care, then you might be transporting first.
 
that's the big question... is the fire officer a medical provider providing patient care?

many years ago I was second due to an MVA in the next town over. the first arrive ambulance had a critical patient (pediatric passenger who was struck in the head by an unsecured spare tire, or something like that), so the ambulance gave me a poor status update (I think they said two non-criticals) and left for the trauma center. Us and the 3rd due ambulance showed up, only found LEO on scene tried to figure out what was going on, and each took a patient to the trauma center (theirs was a trauma, ours was not).

Was it right? you decide....
 
Depends on call, system design and patient. Nothing at all wrong with the first in unit transporting while the follow-ons manage minor stuff.
 
The first in should take the most critical patient and transport whenever they’re ready to go, as long as other trucks have arrived.
 
Our station (one of three in our agency) has a volunteer fire response that isn't exactly EMT certified. That said, we have the BC located at our station, so in the instance where there is a definite critical and all other patients are greengreengreen, we'd have our supervisor take IC and then either treat/refuse or call other ambulances. We otherwise would stay on scene and let the next ambulance transport while we maintain IC, assuming multiple critical patients.

We've discussed the chance (as rare as it would be) for my partner and I to be confronted with multiple patients and feel compelled to transport one immediately... and we've agreed that we would be making the smart choice to transport one (at least, if not both) before someone else can take IC from us. It hasn't happened yet. And really, it's unlikely.
 
Just send the Greens home. No need to transport. They can go to Doc in the Box if they need any treatment.
 
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