Lightning Strike

[VentMonkey]

FF-EMT is still very much prevalent in a large portion of Central California.

What's your guys' magic MCI number? Ours is 5 or more patients. The OP's post wouldn't constitute an MCI in Kern County.

 

[CALEMT]

FF-EMT is still very much prevalent in a large portion of Central California.

What's your guys' magic MCI number? Ours is 5 or more patients. The OP's post wouldn't constitute an MCI in Kern County.

The county states 10 or more patients requiring transport OR if deemed necessary.

 

[DesertMedic66]

FF-EMT is still very much prevalent in a large portion of Central California.

What's your guys' magic MCI number? Ours is 5 or more patients. The OP's post wouldn't constitute an MCI in Kern County.

This for right now. However it seems to change every year. It goes from 5 or more patients or when the number of patients out numbers the providers on scene.

The county states 10 or more patients requiring transport OR if deemed necessary.

 

[Tigger]

If you are the only resource on scene, there is one patient. The other two have complaints but based on the (admittedly sketchy) info in the OP, it is very apparent that the other three need minimal if any medical attention immediately. That would leave you with an arrest patient that you have a very good chance of resuscitating. But no, we aren't going to do that because we only triage one way?

Jesus. Do the right thing.

 

[Summit]

Our regional protocol explicitly says: "Mass casualty incidents are not covered in detail by these guidelines" and "No protocol can anticipate every scenario and providers must use best judgment."

This one is just blowing my freakin' mind... let me paint darkly in a hypothetical AAR:

So when the IC gave an ignorant order that you correctly understood to mean, "Don't try to save your patient's life. Waste your effort!" you responded, "Well, that is what the protocol says to do... and you're the boss!"

Really?

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This is not solely an EMS problem. I'm also reminded of some RNs I worked with (and despised) who loved following policies so much that they'd follow them to the detriment of their patients even though a core tenet of nursing educational philosophy is to question harmful prerogatives. It was easier to disengage the brain and follow the policy.

Protocols cannot cover all eventualities and being an avowed slave to them falls somewhere between ignorance and ethical laziness. That is a much kinder description than I would apply to the system that demands/allows such mindsets.

"I'm sorry, I wouldn't advocate for my patient because I might get in trouble for it even though I'm 100% right and it could have saved a life," describes a systemic problem so deep and broad, the mind fairly boggles.

 

[StCEMT]

Realistically, I don't think it matters. At least here, I don't know any Capt or BC that wouldn't follow my lead on a medical scene with just 4 patients. No fire? No extrication? Cool, this is my area of knowledge and this is my suggestion on what to do. Done.

 

[johnrsemt]

MCI is not a set number and doesn't depend on where you work: Major City: LA, NYC, Chicago, Salt Lake, etc. MCI could be 3 patients if you are the first on scene with you and your partner; until you get help.
Where I work FT with 3 ambulance crews 4 days a week and 2 crews on weekends: with shuttle vans with 12 people in them, if we have an accident it would always be a MCI for us; Fire is right there with us, but 2nd and 3rd ambulance and more than 6 FF are 20 minutes away, (if we are lucky).
PT job has 2 or 3 crews on duty/on call. But 2 hours from closest hospital and 90+ minutes from help (40 minutes from helicopter help) makes life interesting: especially since we have 5 large hotels/casino's MCI is a real threat.

On the lightening strike scenario you need to be cautious when you are that far from help: My only lightening strike had 2 patients, and the one walking around confused but with good vital signs almost died where the one that wasn't breathing on his own, and bystanders were doing CPR when we got there did fine.
So if you and your partner start doing CPR on the pulseless/apneic patient who is going to watch the other 3 until help gets there?