Moral/Ethical Limits of Scene Safety

[EMTBHillbilly]

I'm a newbie here so please excuse my ignorance.
I'm just wondering why this forum was closed for 24 hours. It seemed as if there was a constructive discussion going on about EMS duty in rescue situations. Is a little disagreement on issues not allowed?
Just asking.

 

[ffemt8978]

I'm a newbie here so please excuse my ignorance.
I'm just wondering why this forum was closed for 24 hours. It seemed as if there was a constructive discussion going on about EMS duty in rescue situations. Is a little disagreement on issues not allowed?
Just asking.

Disagreement is allowed as long as it remains polite and civil. Since there were comments posted that can be construed as being impolite (Im glad I'm not on your ambulance), and it was starting to get off topic (military scene safety vs civilian), this thread was closed for 24 hours to allow for a cool off period and to allow it to get back on topic.

 

[MediMike]

(cough)SashaI'llridewithyouanytime(cough)

 

[DrParasite]

They appear to be using the excuse of "I'm just an EMT or a Paramedic, there is no way I could ever be expected to or actually safely carry out a rescue". Almost as if they are better than that which is really sad.

I don't believe anyone actually said that. what they said was "I'm just an EMT/Paramedic, if there is an unsafe scene, let those who are trained and equipped to mitigate said unsafe scene do so, before I let my untrained and unequipped attempt to get involved, where I have a high likelihood of not helping or even worse adding to the incident when I get hurt."

I don't want any of my coworkers get hurt because they tried to enter an unsafe scene and got burned. I also don't want to be the *** who does something equally stupid and tries to help said coworker get out of said unsafe situation (although I probably would).

I don't care if a dozen babies die, the nuns perish, the school kids don't make it, I know it sounds harsh to some people, but if you try to be a hero and do something stupid and end up getting hurt, you have not helped anyone, you have made the situation worse. You want to try to save everyone, more power to you.

if it's an unsafe scene (building collapse, active shooting, MVA with overturn and entrapment, electrocution, assault in progress, hazmat scene, you name it), I am going to let those who are trained and equipped to mitigate the situation do there job, and if it's still unsafe, bring the sick and injured out of the unsafe scene and to me, because I want to go home at the end of my shift.

 

[Sasha]

(cough)SashaI'llridewithyouanytime(cough)

Yay!!

Anyway, I asked for the thread to be unlocked because I had an "experience" that made me instantly think of this thread the night it was locked.

I was on shift, and my partner and I were lost. Our GPS was not being very friendly. We were in the ghetto of the ghetto. Scary in itself, but we made the best of it by playing spot the prostitute (I lost by one point.) but we were riding along and down an alley we see, one guy laying on the ground, and what looks like four people around him (there could of been more.. but they were black and it was dark. Yes, I understand that sounds racist but it's the truth, when you're black wearing black clothes you are difficult to see.) beating the crap out of him.

We did a U-Turn, and as we were coming upon that alley again we chirpped the siren like a cop would. They scattered like roaches, and the man on the ground didn't stir. Got on the phone, called 911, reported what we saw (leaving out the fact that we were in an ambulance.) my partner wanted to stop.

I told her flat out NO! We are two very unintimidating white girls. Don't know where they ran off too, if they're coming back and what they'd have on them when they came back. Could we have probably pulled up to the guy, jumped out and dragged him into the truck relatively quickly? Yes. Was I willing to risk the few minutes of exposure? No.

The man could be dead or dying for all I knew. He could have been the sweetest man just walking back from his job at the gas station and got jumped, or some hardened drug dealer. It's not my place to play judge, but there was no way I was taking that risk.

We did kind of maintain around the area until the cop got there to make sure SOMEONE got there, then we got on out of there.

 

[Sandog]

Not even the FD? They should never enter burning buildings? Never enter confined spaces with who knows what kind of atmosphere? Never enter rushing water? It is the FD's job to train and practice for these hazards. It is why they take the job and is their obligation!

Not even the PD? They should never pursue or approach an armed gunman? They should never engage in a firefight? Never taken down an assailant? They should turn and run?

Not even our armed forces? They should not do all that they do? They should not patrol roads with potential IEDs? Engage the enemy? All because they may get killed? They do what they do because it is part of the job!

There is an obligation and duty to act. It has absolutely nothing to do with fantasy, playing hero, or romanticizing. Fire/Rescue/EMS/Law Enforcement are dangerous jobs and you never know what situation you may find yourself in. That's why we train to be able to handle the situation and work through it.

A firefighter does not fight fire or search an apartment building engulfed in flames to be a hero. They do it because it is their job and obligation.

A cop doesn't pull his side arm and fire shots to be a hero. It is his/her job.

A Paramedic does not attempt to rescue a person entrapped in an auto or attempt to pull someone from a house fire to be a hero. They do it because it's their job and obligation.

A Marine does not engage the enemy to be a hero. They do it because it is their duty and their job.

RISKING YOUR SELF IS AN OBLIGATION AND PART OF THE JOB. YOU DO IT SAFELY, NOT BLINDLY AND IGNORANTLY. SOMETIMES WE DON'T ALL MAKE IT HOME AND THAT PART SUCKS. BUT WE SACRIFICE BECAUSE OF OUR LOVE FOR OUR FELLOW MAN AND STRIVE SO THAT THEY CAN LIVE AND CONTINUE WITH A FUTURE. JUST AS WE WOULD EXPECT THE SAME IN RETURN. IF YOUR IN A SITUATION WHERE YOUR GONNA DIE UNLESS SOMEONE ELSE PUTS THEMSELVES IN EQUAL DANGER, ARE YOU OKAY WITH THEM STANDING BY WATCHING YOU DIE? OR ARE YOU GONNA BE HOPING THEY HAVE THE TRAINING TO GET YOU OUT OF WHATEVER SITUATION YOUR IN?

ITS NOT ABOUT BEING A HERO. ITS ABOUT TAKING THE TRAINING AND SKILLS YOU WORKED YOUR *** OFF TO ACHIEVE AND PUTTING THEM TO USE TO SAVE ANOTHER'S LIFE.

As FireTender basically said, it's a calculated risk based on all information available at the time. We can only hope when its all said and done that the math adds up and we end up okay.

Has the world really turned that selfish where we no longer can support someone giving their all to aid another human being? Where we no longer expect our emergency services providers to put themselves in harms way to save another's life? That we just want to stand back and watch?

I would never ask someone to put themselves in a situation they are not trained to handle and have NEVER advocated that in this thread. Bottom line... if your trained, experienced, and based on your calculations you can carry out a safe rescue in spite of extreme hazards than you decide what your gonna do. Just don't tell someone else that they are foolish or stupid for putting forth the effort and skill to save someone else when the decision is of sound judgement based or training and professional experience.

Well said, I love this post, you could not have said it better. If this post does not cause people to take pause, I do not think anything will. You put the A in articulation.

 

[Veneficus]

I would never ask someone to put themselves in a situation they are not trained to handle and have NEVER advocated that in this thread. Bottom line... if your trained, experienced, and based on your calculations you can carry out a safe rescue in spite of extreme hazards than you decide what your gonna do. Just don't tell someone else that they are foolish or stupid for putting forth the effort and skill to save someone else when the decision is of sound judgement based or training and professional experience.

That is the key phrase.

Those are the people who decide when to attempt to effect a rescue. Not the people who feel it is taking too long for them to arrive.

Rescue may be a part of EMS in your area, but it is not recognized as part of EMS according to the majority of EMS training standards. I think it should be, but my opinions don't change anything.

If you notice in this thread, I didn't elude to what my action or reaction would be, but i spoke about what I advocate others to do.

I don't want somebody to think it is ok to put themselves in danger that is beyond them. As I said, it is most often people who do not realize the dangers or don't know enough about it who get themselves injured or killed.

In my experience, the people who are trained and experienced don't ponder what they are going to do in such situations because they already know.

Furthermore I don't want people thinking that the purpose of the job is to get killed if need be. Getting killed is what happens when something goes wrong on the job. Be it fire, EMS, law enforcement, or the military.

"No :censored::censored::censored::censored::censored::censored::censored: ever won a war by dying for his country. He won it by making the other poor dumb :censored::censored::censored::censored::censored::censored::censored: die for his country.
---George S. Patton"

Though I think a variation of this was originally uttered by Napolean.

 

[mcdonl]

Question: If your not trained in rescue to some degree I would highly recommend you get the training. Answer: If I did, what good would it do? I don't have the equipment, or gear to carry out most rescues. I suppose I could help someone up that fell in a pothole...

My opinion, the good it would do would be to give you a better level of scene assessment. If you had proper training for instance on MVA's, you could determine if the scene was safe (At the FD level) and then make the determination if you could assist the patient while waiting for the patient to be freed from the vehicle. Not sure what state you are in, but in Maine all EMS training involves removing patients from vehicles and other tight places.

Our Intubation training require we tube patients in tight spaces as well.

So, the training does not mean you need to carry extrication tools but it would give you a new level of scene assessment that could benefit the patient. I know our safety is number one, but somewhere in the top ten is the patient...

 

[lampnyter]

In my class we learned extrication. If a person was in a car and the FD was there i would go in the car...

 

[crazycajun]

I would reccomend anyone to attend some sort of extracation class if you are a 911 EMS provider. Even if you never plan to use it you never know what you might emcounter. I refresh yearly with the local FD eventhough I am not a fire fighter. It helps.

 

[18G]

Yay!!

Anyway, I asked for the thread to be unlocked because I had an "experience" that made me instantly think of this thread the night it was locked.

I was on shift, and my partner and I were lost. Our GPS was not being very friendly. We were in the ghetto of the ghetto. Scary in itself, but we made the best of it by playing spot the prostitute (I lost by one point.) but we were riding along and down an alley we see, one guy laying on the ground, and what looks like four people around him (there could of been more.. but they were black and it was dark. Yes, I understand that sounds racist but it's the truth, when you're black wearing black clothes you are difficult to see.) beating the crap out of him.

We did a U-Turn, and as we were coming upon that alley again we chirpped the siren like a cop would. They scattered like roaches, and the man on the ground didn't stir. Got on the phone, called 911, reported what we saw (leaving out the fact that we were in an ambulance.) my partner wanted to stop.

I told her flat out NO! We are two very unintimidating white girls. Don't know where they ran off too, if they're coming back and what they'd have on them when they came back. Could we have probably pulled up to the guy, jumped out and dragged him into the truck relatively quickly? Yes. Was I willing to risk the few minutes of exposure? No.

The man could be dead or dying for all I knew. He could have been the sweetest man just walking back from his job at the gas station and got jumped, or some hardened drug dealer. It's not my place to play judge, but there was no way I was taking that risk.

We did kind of maintain around the area until the cop got there to make sure SOMEONE got there, then we got on out of there.

A very smart move indeed. No EMS crew should put themselves in that situation. No one is sayng every unsafe or potentially unsafe situation go throw yourself into it. Even if I were a cop off-duty working as a Medic I wouldn't have got out and helped that guy.

The rule is to NOT put yourself into an unsafe situation. The topic focuses on those rare situations where your faced with a critical decision where you may safely rescue someone as an exception under less than ideal circumstances.

 

[HotelCo]

And that is a personal choice that you nor anyone else should be judged for as long as you did not breach your duty to act.

At the end of the day we all go to bed with the choices we have made that affect our lives and the lives of others.

Seems like you're doing an awful lot of judging...

They appear to be using the excuse of "I'm just an EMT or a Paramedic, there is no way I could ever be expected to or actually safely carry out a rescue". Almost as if they are better than that which is really sad.

Who said they're better than that. From what I've read, people are saying that they won't put themselves in an unsafe situation, especially since they don't have the training to be in that situation, safely.

And yes, EMS does have responsibility to access patients and provide care in rescue situations. The patient may not have time to wait to be brought to you.

I don't have the training to do so safely. I'll wait the 4-7 minutes it takes for a suburban department to get on scene (and since our response time is longer than theirs, I'd venture to say that they'll be there before us).

Put yourself in that patients position and think what you would want and expect from that EMT or Paramedic on the scene to assist you. Would you want delayed care by 20,30,40mins all because of a crappy attitude?

I wouldn't want someone else getting killed because they were trying to help me, no. What good does a dead paramedic do?

If you don't want to work in the field and be exposed to hazards of rescue situations maybe the hospital ED is a better place to work.

Or, I could let those training in extrication, extricate...

(cough)SashaI'llridewithyouanytime(cough)

This

I don't believe anyone actually said that. what they said was "I'm just an EMT/Paramedic, if there is an unsafe scene, let those who are trained and equipped to mitigate said unsafe scene do so, before I let my untrained and unequipped attempt to get involved, where I have a high likelihood of not helping or even worse adding to the incident when I get hurt."

I don't want any of my coworkers get hurt because they tried to enter an unsafe scene and got burned. I also don't want to be the *** who does something equally stupid and tries to help said coworker get out of said unsafe situation (although I probably would).

I don't care if a dozen babies die, the nuns perish, the school kids don't make it, I know it sounds harsh to some people, but if you try to be a hero and do something stupid and end up getting hurt, you have not helped anyone, you have made the situation worse. You want to try to save everyone, more power to you.

if it's an unsafe scene (building collapse, active shooting, MVA with overturn and entrapment, electrocution, assault in progress, hazmat scene, you name it), I am going to let those who are trained and equipped to mitigate the situation do there job, and if it's still unsafe, bring the sick and injured out of the unsafe scene and to me, because I want to go home at the end of my shift.

This.

Not even the FD? They should never enter burning buildings? Never enter confined spaces with who knows what kind of atmosphere? Never enter rushing water? It is the FD's job to train and practice for these hazards. It is why they take the job and is their obligation!

They're trained to do so, I'm not.

Not even the PD? They should never pursue or approach an armed gunman? They should never engage in a firefight? Never taken down an assailant? They should turn and run?

They're trained to do so, I'm not.

Not even our armed forces? They should not do all that they do? They should not patrol roads with potential IEDs? Engage the enemy? All because they may get killed? They do what they do because it is part of the job!

Where in my employment contract does it state: "I am prepared to give my life..." (taken from Article I of the US Armed Forces Code of Conduct)? It doesn't, and it doesn't say it in yours.

There is an obligation and duty to act. It has absolutely nothing to do with fantasy, playing hero, or romanticizing. Fire/Rescue/EMS/Law Enforcement are dangerous jobs and you never know what situation you may find yourself in. That's why we train to be able to handle the situation and work through it.

I must have missed the day that we trained to remove someone from a collapsed building.

A firefighter does not fight fire or search an apartment building engulfed in flames to be a hero. They do it because it is their job and obligation.

A cop doesn't pull his side arm and fire shots to be a hero. It is his/her job.

This seems like further babbling (I can think of no better word) continued from above, which I've answered.

A Paramedic does not attempt to rescue a person entrapped in an auto or attempt to pull someone from a house fire to be a hero. They do it because it's their job and obligation.

What EMS-only departments do you know that go into burning buildings?

A Marine does not engage the enemy to be a hero. They do it because it is their duty and their job.

And because they'll be killed if the enemy engages them first, and lands some rounds on target. How am I going to die if I don't enter a house fire?

RISKING YOUR SELF IS AN OBLIGATION AND PART OF THE JOB.

No, it's not.

YOU DO IT SAFELY, NOT BLINDLY AND IGNORANTLY. SOMETIMES WE DON'T ALL MAKE IT HOME AND THAT PART SUCKS. BUT WE SACRIFICE BECAUSE OF OUR LOVE FOR OUR FELLOW MAN AND STRIVE SO THAT THEY CAN LIVE AND CONTINUE WITH A FUTURE.

Rambling...

JUST AS WE WOULD EXPECT THE SAME IN RETURN. IF YOUR IN A SITUATION WHERE YOUR GONNA DIE UNLESS SOMEONE ELSE PUTS THEMSELVES IN EQUAL DANGER, ARE YOU OKAY WITH THEM STANDING BY WATCHING YOU DIE? OR ARE YOU GONNA BE HOPING THEY HAVE THE TRAINING TO GET YOU OUT OF WHATEVER SITUATION YOUR IN?

If they have the training, and equipment, how is that equal danger?

If I'm laying in a pool of water, with a downed power line in it, do I expect the paramedic to jump in and pull me out? No...

ITS NOT ABOUT BEING A HERO. ITS ABOUT TAKING THE TRAINING AND SKILLS YOU WORKED YOUR *** OFF TO ACHIEVE AND PUTTING THEM TO USE TO SAVE ANOTHER'S LIFE.

Rule #1: I go home at the end of the night.
Rule #2: Nothing interferes with Rule #1.

I would reccomend anyone to attend some sort of extracation class if you are a 911 EMS provider. Even if you never plan to use it you never know what you might emcounter. I refresh yearly with the local FD eventhough I am not a fire fighter. It helps.

Get the local community college to put me through their course, free of charge, and I'll be glad to learn...

 

[Sandog]

HotelCo, I think 18G stated his argument succinctly and with respect to the readers. I did not see his post as being judgmental at all as he did mention that the actions one decide to take is a personal call and one that that person will have to live with. I do not see any of what 18G had to say as ramblings and find that comment to be uncalled for as 18G has remained courteous throughout this post. I have not chimed in on this post as I am not able to express myself as well as 18G does, but I am in agreement with his philosophy and thus I am speaking now to give 18G my support.

 

[crazycajun]

Most FD's will let you train with them for free. Atleast for basic extraction courses.

 

[Sasha]

Most FD's will let you train with them for free. Atleast for basic extraction courses.

Really? not here.

 

[Sasha]

The rule is to NOT put yourself into an unsafe situation. The topic focuses on those rare situations where your faced with a critical decision where you may safely rescue someone as an exception under less than ideal circumstances.

And how did that not fit the situation? we could have pulled up and dragged him into the truck, it might have been safely executed, just like you taking your extraordinary risk might be safely executed.

I agree with everything that Hotel Co said. I especially second the "If it was me, I'd be ticked someone risked their life for me".

I wouldn't want to be the reason someone got injured or killed. If it ever comes down to safely waiting for the resources to rescue me, or playing cowboy and doing it unsafely, wait for the resources for me.

 

[Veneficus]

Get the local community college to put me through their course, free of charge, and I'll be glad to learn...

And paid for your time.

It is only right.