Ped major trauma - Houston FD delayed EMS response?

Farmer2DO said:
You're right. What DO you know about parenting? Precious little, apparently. I'm curious where you get off saying that bad parenting is to blame.

Kids are unpredictable, and sometimes, despite the most vigilant parents, kids get somewhere they're not supposed to be. I would imagine this mother is just completely torn up, and second guessing herself as it is. You coming in here and throwing your opinion around that this is the parent's fault is ignorant and insulting. As a parent I do everything in my power to keep my children safe, and there have been several near misses, and there was nothing I was doing wrong. By the grace of God, they haven't been seriously hurt.

Do us a favor and keep your self righteous, obnoxious opinions to yourself.
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Maybe the fact she ran over her kid. Good parents don't run them over.

If the kid was outside she should have been with someone to keep her out of the drive. She's 4 years old for god sakes. Whenever ANYONE is coming in or out of the driveway and my nephew is outside we have him by the hand so he doesn't dart in the way and get hit.

It's called common sense.

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abckidsmom said:
Please make sure you use birth control. This year alone, I can think of three episodes where my kids did not die through the grace of God alone. Going through life being able to control it is exhausting, and impossible.

Could you stop your kid from getting kicked in the chest by a horse? Choking on a hot dog? Falling out of a tree?

Life is really dangerous. 100% fatal, in the end.
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Wow Dana I'm shocked at you.

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My take on this, I have no problem with a fire truck being dispatched first to assess if an ambulance is needed. Let's stop pretending that every patient needs an ambulance. How would the mother feel if the ambulance took 15 minutes because they were tied up with a sprained ankle or someone with a sore throat?

I think its great they are trying to keep ambulances free by first sending someone to assess if its needed.

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Two thoughts...

1)Anyone who insist on the "BLS before ALS" mantra has never played with a knackered airway, treated a desating, tired asthma patient or seen a closed tension pneumothorax.

2)Parenting, especially multiple kids, changes one's perspective. Previously, I would have been right there with the "bad parent" crowd. Now? "Holy crap I see how that could happen". Babysitting may give some insight, but not a comprehensive view. At some point, your guard will slip, no matter how good of a parent you are simply from the 24/7 nature of the job. Like Dana, I can recall times God had to have been looking after my kids. It happens. Unfortunately it had a horrible outcome in this case.
 
Let's also stop pretending that this is because they are trying to manage their resources. This is because there aren't enough ambulances on the streets to handle the call volume. You can't expect to get it right all the time when you're only using telephone triage. Many of my Delta and Charlie jobs get transported BLS, and many of my Alpha and Bravo jobs get transported ALS. Stop cutting corners and put the ambulances on the street. People need to realize that if they want the ambulance there when they call 911, it's going to cost someone money. The answer is to make people financially accountable, not limit the availability of ambulances.

I don't have a problem with the firetruck response; I DO have a problem with waiting to get a firetruck on scene before deciding if they need an ambulance. People are going to have bad outcomes with this policy. This is a band aid for an issue that amounts to a limb amputation. Put the trucks on the road needed to cover the calls. Whoever approved this policy should be considered to be part of this child's death.

As for Abckidsmom, I agree with her comments. It's OK for Fast65 to unilaterally declare that it's the parents fault, but he gets offended when she speaks her mind. Cuts both ways.
 
To say that he should use birth control because he believes the parent is at fault for the death is ridiculous.

Let's face it, the death was preventable. It is not the same as a child choking or gettin kicked by a horse.

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Sasha said:
Maybe the fact she ran over her kid. Good parents don't run them over.

If the kid was outside she should have been with someone to keep her out of the drive. She's 4 years old for god sakes. Whenever ANYONE is coming in or out of the driveway and my nephew is outside we have him by the hand so he doesn't dart in the way and get hit.

It's called common sense.

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Sasha said:
Wow Dana I'm shocked at you.

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I guess I wasn't communicating exactly well. I just have had several friends who lost children through freak accidents and of course, retrospectively they were always preventable.

And childless people who make sweeping statements about bad parenting really push my buttons.

In this case, the girl could have slipped out of the house without her knowing, the girl could have been hiding behind the car without the mom knowing she was outside, and so on. Constant vigilance wears out, it really does, even for good parents. When you know a kid, and you think you know what they're thinking, it gets a little too easy sometimes to think they are going to do what you tell them to do, or to think they are going to keep doing whatever predictable thing they are currently doing.

Things happen. Sadly, I've never heard of a neglectful parent runnign over a kid with the car, only loving ones who made a tragic mistake.
 
Sasha said:
To say that he should use birth control because he believes the parent is at fault for the death is ridiculous.

Let's face it, the death was preventable. It is not the same as a child choking or gettin kicked by a horse.

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I said that in a moment of agitated snarkiness because people who believe they have the world under control are gonna have the rug jerked out from under them the minute they hear that baby cry for the first time and realize that they are really at the mercy of any random thing that comes next. Control is a big fat illusion, and parents who believe they can protect their kids from every danger are often stressed out beyond words.
 
I don't understand what the issue is here. It will take about 5 minutes to get the patient packaged on a backboard, and possibly get an IV or two started. Plenty of time for the firefighters to do that by the time thats done, the ambulance is pulling up get a turnover from the FF and is on their way within 2 or 3 minutes.

The issue seems to be about what took so long to get to the trauma center. It took "8 minutes, 30 seconds " for the unit to arrive, which means it took about 51 minutes and 30 seconds to get on their way and to a trauma center. Something more is up with this story, it's not unit allocation. Especially if it's an ALS engine.
 
Sasha said:
To say that he should use birth control because he believes the parent is at fault for the death is ridiculous.

Let's face it, the death was preventable. It is not the same as a child choking or gettin kicked by a horse.

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Exactly, I was NOT offended because she voiced her opinion, I WAS offended that her opinion implied I wasn't responsible enough to procreate. Again, if that's not what you're implying, I apologize.

I realize that accidents happen, and kids are unpredictable, but TO ME, this is a preventable death.
 
And getting rear-ended in the ambulance is preventable per CEVO. Hindsight is 20/20.

I hate to say this...but until you've been in those shoes, it's darn hard to Monday morning QB.
 
abckidsmom said:
I said that in a moment of agitated snarkiness because people who believe they have the world under control are gonna have the rug jerked out from under them the minute they hear that baby cry for the first time and realize that they are really at the mercy of any random thing that comes next. Control is a big fat illusion, and parents who believe they can protect their kids from every danger are often stressed out beyond words.
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With that explanation I can see where you're coming from, and that does give me some insight into how difficult parenting can be. I don't want to give the impression that I believe children can be prevented from being injured, I know that's not the case and I know that I don't have the world under control. However, I do think that certain things are preventable, and this was one of those things in my opinion.

It seems to me that we're all just gonna have to agree to disagree on this topic.
 
fast65 said:
With that explanation I can see where you're coming from, and that does give me some insight into how difficult parenting can be. I don't want to give the impression that I believe children can be prevented from being injured, I know that's not the case and I know that I don't have the world under control. However, I do think that certain things are preventable, and this was one of those things in my opinion.

It seems to me that we're all just gonna have to agree to disagree on this topic.
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Sure thing. I can agree to disagree.
 
exodus said:
I don't understand what the issue is here. It will take about 5 minutes to get the patient packaged on a backboard, and possibly get an IV or two started. Plenty of time for the firefighters to do that by the time thats done, the ambulance is pulling up get a turnover from the FF and is on their way within 2 or 3 minutes.

The issue seems to be about what took so long to get to the trauma center. It took "8 minutes, 30 seconds " for the unit to arrive, which means it took about 51 minutes and 30 seconds to get on their way and to a trauma center. Something more is up with this story, it's not unit allocation. Especially if it's an ALS engine.
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I agree that we probably don't know all of the details.

But to argue that it's OK to wait until you get on scene to decide if you need an ambulance, and that it's good patient care to sit there in the meantime and start IVs is just plain wrong. IVs get started while enroute to the hospital. Starting an IV is a low priority unless the patient is peri-arrest. Getting an IV will not save a life, and doing it on scene is delaying care. There is some research out there that is saying that trauma patients that get intubated and/or have fluid challeneges in the field have higher mortality rates.

Bottom line, trauma patients need to get in the ambulance and go to the hospital, preferrable a trauma center, if possible. Anything else is just increasing the body count.
 
fast65 said:
Exactly, I was NOT offended because she voiced her opinion, I WAS offended that her opinion implied I wasn't responsible enough to procreate. Again, if that's not what you're implying, I apologize.

I realize that accidents happen, and kids are unpredictable, but TO ME, this is a preventable death.
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That's how I read it as well.:ph34r:
 
Farmer2DO said:
I agree that we probably don't know all of the details.

But to argue that it's OK to wait until you get on scene to decide if you need an ambulance, and that it's good patient care to sit there in the meantime and start IVs is just plain wrong. IVs get started while enroute to the hospital. Starting an IV is a low priority unless the patient is peri-arrest. Getting an IV will not save a life, and doing it on scene is delaying care. There is some research out there that is saying that trauma patients that get intubated and/or have fluid challeneges in the field have higher mortality rates.

Bottom line, trauma patients need to get in the ambulance and go to the hospital, preferrable a trauma center, if possible. Anything else is just increasing the body count.
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You forgot the other treatment I mentioned. The one that will actually take about 4-5 minutes to complete from start to finish. The IV only takes 30 seconds.
 
An IV may only take 30 seconds in an experienced, proficient provider with someone helping him by setting up the equipment. Again, research is showing that many paramedic FFs lost their edge and are not as sharp as the medics who are transporting every day. So I would say that estimate is VERY optimistic.

The fact remains: we don't delay transport for IVs.
 
I just spoke to a good friend that now works for HFD. He said the councilman is actually correct concerning dispatch policy. However it has been this way for quite a while. Fire is dispatched behind HPD and a decision for ambulance transport is made upon arrival unless fire is on another call then either a medic unit or ambulance will respond.
 
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