Moral/Ethical Limits of Scene Safety

[18G]

Actually only "children" who are of reproductive maturity, which aren't really children.

A 3 or 4 year old? Contributes nothing.

A unique innocence and bond that a child brings into the world, the influence that has on adults which curtails behavior, and children who have saved their parents and others lives through having the intelligence to know how to recognize an emergency and call 911 is all just nothing?

You speak of children as if they are of absolute zero value. That's like not even human coming from any gender. Have a child of your own and you will see first hand the effect they have on you as a parent and in society.

Back on topic... it really comes down to training and experience. Fire/Rescue/EMS is about selfless service to risk ones life to save another. It's part of the deal. Losing our life while performing our duty is the reality of what we do. And that is why we train and train hard to be prepared and mitigate the inherent risks as much as possible.

A human life holds the highest level of value. Risk a lot, to save a lot is a core principle in this decision making. You can use the excuse of "me first" and standby while someone dies without even trying, or you can be trained to react and put ones self on the line for someone else. This is what is called selfless service. No it's not for everyone but I believe in going all the way and ask that you go all the way and do the same for my family and I as well.

 

[Aerin-Sol]

A unique innocence and bond that a child brings into the world, the influence that has on adults which curtails behavior, and children who have saved their parents and others lives through having the intelligence to know how to recognize an emergency and call 911 is all just nothing?

If all children are special because of these reasons, then how are they unique attributes?

A human life holds the highest level of value.

Except, apparently, for the lives of people in EMS, which should be cheerfully sacrificed for others.

You can use the excuse of "me first" and standby while someone dies without even trying, or you can be trained to react and put ones self on the line for someone else. This is what is called selfless service. No it's not for everyone but I believe in going all the way and ask that you go all the way and do the same for my family and I as well.

I don't know where you went through training, but the primary thing emphasized in mine was ensuring my own safety.

 

[steveshurtleff]

Except, apparently, for the lives of people in EMS, which should be cheerfully sacrificed for others.

Nobody said anything about EMS members being less valuable than others or that their lives should be "cheerfully sacrificed for others". Please refer to the first page and read the original post.

 

[18G]

If all children are special because of these reasons, then how are they unique attributes?

They are unique as a group or an age population in comparison to adults. I didn't think I needed to spell out the context of that statement.


I don't know where you went through training, but the primary thing emphasized in mine was ensuring my own safety.

I believe I specified that OUR safety does come first and qualified that with "relative safety" based on our job type, training, and experience. If your a firefighter and enter a burning building, are you violating what you been taught? Or are you being "safe" in entering that burning building as a result of your training, experience, protective gear, and system your working within? Even if your first on-scene in an ambulance you may still have structural firefighting gear, possibly even an SCBA, a hand light, and radio communication. How would a Paramedic utilizing these tools be considered careless if using good judgement at the same time?

To most people, entering a burning building is a very unsafe thing to do. But we are able to do it as safely as possible through training and experience. So going on what YOU have been taught we are supposed to let the occupants and building burn because it's an unsafe environment that could take our life? Since were never supposed to enter unsafe conditions no matter how well prepared?

It's our training, education, and protective gear that allow us to take "safe risks" while doing our job. Unfortunately, those "safe risks" can take our lives. But it is part of the job. If I pull up in my Medic unit to a car on fire I will try everything I can to get those occupants out. Is it safe to assume you will stand there and watch them burn since your training taught you to never put yourself at risk?


Except, apparently, for the lives of people in EMS, which should be cheerfully sacrificed for others.

Who ever said that? I never did. I said if based on your training and experience you feel comfortable in trying to rescue someone then go for it. And I also that if your not crossed trained and don't feel comfortable in attempting a rescue than don't. And no one should judge you for it.

...

 

[Aerin-Sol]

Nobody said anything about EMS members being less valuable than others or that their lives should be "cheerfully sacrificed for others". Please refer to the first page and read the original post.

Please read the post I was responding to.

If your a firefighter

If I was a firefighter I would be posting on a FF board, not posting on an EMS board and then typing 3 paragraphs about entering a burning building.

 

[steveshurtleff]

Please read the post I was responding to.

I did. Again, who said anything about cheerfully giving up your own life for another?

The topic of this thread is about the possible conditions under which you might disregard normal scene safety rules in order to provide care. If the patient is at the bottom of a 500' cliff, nobody is going to blindly jump. However, if there is a potentially injured child in a car that has been in a collision and FD/HR has not yet arrived, yet you believe you can get the kid out, would you not?

 

[nemedic]

Just thinking now. Kinda messed up. You shot my buddy, then I shot you. Now I have to treat you and my buddy.

But unless the buddy is obviously a DOA, and assuming no other people w/ injuries, I'd treat the buddy 1st every time.(and I will freely admit this would be the case on the civilian side).

And for the tango, my 1st line treatment would be high velocity lead injection therapy. Failing that, an accidental air embolus

 

[18G]

If I was a firefighter I would be posting on a FF board, not posting on an EMS board and then typing 3 paragraphs about entering a burning building.

I was using the FF example to try and make a point that if you have the training and experience than use that in the decision making. I was also trying to illustrate that the decision in the field isn't as easy as the one declared in the classroom and many other factors play apart in deciding to provide care/rescue in a hazardous situation. Pretty much all I was trying to say is there is no real answer to the question posed and its not cut and dry. A lot of variables come into play from one situation or provider to the next. My bad if it didn't come across that way.

As an EMS provider, we are tasked with some rescue responsibilities (actually less than what we should be) and it is our job many times to make patient access and provide care throughout the extrication process whether it be a MVC, high/low angle rescue, confined space rescue, etc. How are we supposed to do this if we use the "scene safety card" and not subject ourselves to some risks? With more training and skills drills comes risk reduction. I would highly recommend all EMS providers to be cross trained in basic rescue techniques.

Also, many EMS providers do have fire/rescue backgrounds so I was trying to be inclusive of all possibilities. If your also a FF on a Medic unit, do you only play Medic for the day or do you do what your trained to do? For most I think it would be do what your trained to do. And even if not trained as a FF I would still say play it safe and err on the side of caution but give it your best effort and at least make the attempt.

Those looking to eliminate all risks and never go above and beyond the basic duty should probably look for a new job.

That's just my opinion.

 

[steveshurtleff]

I was also trying to illustrate that the decision in the field isn't as easy as the one declared in the classroom and many other factors play apart in deciding to provide care/rescue in a hazardous situation.

That's what I meant by possibly not being able to answer without actually being in the situation. It's like asking someone what they would do if they were aboard a plane that was about to crash. Until you're there, the question can't be accurately answered, but my question was still hypothetical (Do you think you'd disregard the guidelines?).

 

[Sasha]

Those looking to eliminate all risks and never go above and beyond the basic duty should probably look for a new job.

Sorry I don't see anywhere in my job description that says I have to take stupid and extraordinary risk to save lives of the already sick/injured.

This isn't the military, I didn't get into this job with the expectation of laying down my life for something else.

 

[18G]

Sorry I don't see anywhere in my job description that says I have to take stupid and extraordinary risk to save lives of the already sick/injured..

We agree mostly Sasha. I don't feel EMS should take "stupid" risks either. But risks based on odds of a successful execution which are based on training and experience I think we should take if were risking a lot to save a lot. If we don't who will?

Is 911 no longer the number to call for rescue teams who are trained and willing to give their all to people in dangerous situations? If so I never got that memo.

 

[Sasha]

Not me.

I'm not risking my life to save someone if that risk puts me in more than just the "normal" danger.

 

[18G]

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.

 

[Veneficus]

I think we should take if were risking a lot to save a lot. If we don't who will?

I would like to share with you a quote:

"A risk is a chance you take; if it fails you can recover. A gamble is a chance taken; if it fails, recovery is impossible."
---Erwin Rommel

"If we don't who will?"

I don't think anyone is obligated to.

The romantic ideas of what various emergency services do or are have very little basis in reality.

A flag and a wreath do not feed your family. A gravestone does not comfort them in their times of need.

Even when providers are lucky enough to survive, their lives and families are destroyed from their disability. In a few years even your coworkers will not remember you. Do you think any member of society is going to look out for the financial well being of you or your family after a failed attempt at heroism?

The evidence all points that they don't.

I hate to be the one to point this out, but it is this kind of romantic thinkking that gets people injured and killed needlessly. It should not be advocated.

Just as you will never find a fool who believes himself deficent, you will never find a would be hero who thinks they will fail because the situation is beyond them either.

 

[Sasha]

Maybe your choices at work affect your life, but I don't take work home with me.

 

[Gecko24]

This one time I knocked a German Shepherd out with a mag light. Ahhh good times. Gotta do what you gotta do.

 

[steveshurtleff]

But risks based on odds of a successful execution which are based on training and experience I think we should take if were risking a lot to save a lot. If we don't who will?

I agree completely. The training is what prepares us to face that situation and possible increased risk rationally rather than foolishly, and yes, different positions obviously carry different training. Like I said, if I believe I can get that child out of danger, I might do so. But do I believe I can get the child out of a car that's already on fire? Well, no, I don't. That would be suicide.

 

[firetender]

I'm not risking my life to save someone if that risk puts me in more than just the "normal" danger.

The way it happens is you're in the middle of a situation, you see an opening, you assess your risks and take action if all your computations come up go.

And then, out of nowhere (in your view anyway) BOOM! you're dead.

It doesn't matter what you missed or how you calculated or what actually occurred, behind you will be legions of medics saying to themselves and each other either you deserve a Purple Heart or you got what you deserved; a Darwin Award nomination!

My point is, once you figure out you're within the range of "just the 'normal' danger" it is the Unseen that determines your future or absence of one thereof.

Not me.

You are not in a job where that applies. You are a lightning rod for the twisted Gods. It's all about doing your best with the odds, and what you can live with.

 

[DrParasite]

Seemed appropriate

http://www.ems1.com/safety/articles/998633-UK-medics-told-they-must-risk-their-lives/

http://www.9news.com/news/story.aspx?storyid=162817&catid=339

and

http://www.wlbt.com/Global/story.asp?S=13191657

I'm reminded of a Rescue 77 episode (anyone else remember that show?) where there was an active shooting at the school. so with everyone pinned down by gun fire, the three paramedics donned bullet proof vests, kept their heads down and ran to help the injured students who had been shot.

Me personally? i don't want to get shot. I don't want to get hurt. I want to go home in the same condition I started my shift in. Violent EDP in a house stabbing nuns? wait till PD secures the violent person using the training and tools they have, and then I will help out the injured. Domestic in progress, where one party is beating the other with their 1 years old son? wait till PD secures the violent person using the training and tools they have, and then I will help out the injured.

Without the proper tools, PPE, and training, it isn't brave to enter an unsafe scene to make a rescue, it's foolish and stupid. an unsafe scene is an unsafe scene, regardless of who the victim is. Let those with the proper tools, PPE and training make the scene safe, and then do what you are trained to do

 

[18G]

"If we don't who will?"

I don't think anyone is obligated to.

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.