Quick and Easy
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Shishkabob
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Keep going, but report to dispatch.
Otherwise it's abandonment.
Sadly, this will (pee) off the un-educated public, and it isn't my favorite choice, but that's how it is.
Otherwise it's abandonment.
Sadly, this will (pee) off the un-educated public, and it isn't my favorite choice, but that's how it is.
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I think there's a way to get around the abandonment issue, since there are two of you, but then you're split up and no one can be transported unless it's together, and it's a mess, and...
Anyway, I think that's a good call. Rescue 911 inspired.
sir.shocksalot
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If you stop and try and help out the accident this is what will happen (or at least this is what happens to me). Your partner jumps out and runs over and finds a critical patient that needs immediate treatment, as he runs back to the ambulance you notice your moderately sick patient's blood pressure has started to tank, now you have two critical patients and no transport. Thats why I don't stop at accidents when I'm transporting.
Yeah, that makes perfect sense. It's the right thing to do, just a PR nightmare.
Can't be helped though.
daedalus
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I encountered this dilemma a few times. I STOP the ambulance, stay in the cab, roll down the window and tell bystanders that I am transporting a patient, and that I have radioed for additional units to respond ASAP. I than continue on. Its just like stopping at a light, takes all of 10 seconds, and prevents you from looking like an *** while still not endangering your patient.
I have never had a hard time with this, and everytime (3) I have done this, they thank me and wave, and seemed to have gotten the picture.
I have never had a hard time with this, and everytime (3) I have done this, they thank me and wave, and seemed to have gotten the picture.
Good advice. Thanks.
EeyoreEMT
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This had always bothered me To Stop or Not to Stop
It was always one of my worst fears working in ems, if you have a pt- despite what their condition is, your first priority is to that pt, however, if the pt is stable and you can explain the circumstances, just like he said, slow down, explain you already have a pt and have radioed for help, but then if the other pt is critical and you and your partner separate, it can get very messy, especially when help is a ways off. Remember, once you make contact, you cannot leave until the same level of care or above has arrived.
My fear came true in 2006, We had a code 2 pt, it was a clear, dry, warm day and I was traveling about 50 mph behind a motorcycle probably about 5 carlengths. The next thing I knew, his front wheel locked up, throwing him in the middle of the road, the bike flipping over to the right end over end. I yelled for my partner to hold on and braked looked, thankfully nothing coming opposite direction, drove left of center around the driver. As I hit the brakes, I hit out strobes and lights on. I was so scared I was going to run over him. He kept rolling and flipping, not sure where he was going to land. Then everything stopped. His body was motionless in the road, no helmet. I yelled for my partner at the same time I grabbed the radio for help. I called in a motorcycle mva 1 injury unresponsive male, possible head injuries. My partner told me to get in back with the pt and he got out and checked the driver. By the time he got traffic stopped and got to him, he started coming around. The squad's eta was 3 min, by the time they got there the driver was standing, talking with blood all over his face from road rash and cuts. He left AMA and a sign off was done. I think my hands shook the next 10 miles.
It was always one of my worst fears working in ems, if you have a pt- despite what their condition is, your first priority is to that pt, however, if the pt is stable and you can explain the circumstances, just like he said, slow down, explain you already have a pt and have radioed for help, but then if the other pt is critical and you and your partner separate, it can get very messy, especially when help is a ways off. Remember, once you make contact, you cannot leave until the same level of care or above has arrived.
My fear came true in 2006, We had a code 2 pt, it was a clear, dry, warm day and I was traveling about 50 mph behind a motorcycle probably about 5 carlengths. The next thing I knew, his front wheel locked up, throwing him in the middle of the road, the bike flipping over to the right end over end. I yelled for my partner to hold on and braked looked, thankfully nothing coming opposite direction, drove left of center around the driver. As I hit the brakes, I hit out strobes and lights on. I was so scared I was going to run over him. He kept rolling and flipping, not sure where he was going to land. Then everything stopped. His body was motionless in the road, no helmet. I yelled for my partner at the same time I grabbed the radio for help. I called in a motorcycle mva 1 injury unresponsive male, possible head injuries. My partner told me to get in back with the pt and he got out and checked the driver. By the time he got traffic stopped and got to him, he started coming around. The squad's eta was 3 min, by the time they got there the driver was standing, talking with blood all over his face from road rash and cuts. He left AMA and a sign off was done. I think my hands shook the next 10 miles.
everyone always asks "what if somebody looks critical?"
My question is: "so what?"
What can one person do for a critical pt?
Are you going to pull the monitor off the patient you have already on it? How many squads drive around with 2 working monitors?
You just created your very own MCI. More patients than you can handle now everyone is getting lesser care.
When all the new responders show up are you going to be boxed in? What happens to your patient?
What if you have multiple new patients at the scene?
What are you going to do when somebody rear-ends your vehicle with your partner and patient inside?
What is your partner going to do when you get hurt?
Realize you may be harming patients. When responders show up, your report may bias them. More assessments are better assessments. If you showed up and I was already on scene telling you "nobody looks that bad" (especially if we work together, or worse, I am your medic instructor) How thorough is your assessment going to be? (which truthfully you will never have to worry about as I will not be on your scene unless it is my family or friends' place and my assessment will be ongoing, because I am more interested in them than I am in you.)
I know this issue always seems to creep up on rural providers and new people. On my first day. (a long time ago) I was told: "don't get a $3000 light bar on your $2000 car. Don't carry around anything more advanced than some bandages and water, less equipment options gives you less chances to do someting wrong. Be a knowledgable bystander, not an off duty firefighter. (or whatever your position) when the calvary arrive give them a quick report and get out of there or make sure that the OIC has assigned you something specific." (aka knows you are there and exactly what you are doing)
If you are already in a squad, the primary function of the radio is to call for help. I never thought about the idea of stopping and explaining you already have a patient. I like that idea and will pass it on.
Moreover, why aren't instructors covering this in class?
My question is: "so what?"
What can one person do for a critical pt?
Are you going to pull the monitor off the patient you have already on it? How many squads drive around with 2 working monitors?
You just created your very own MCI. More patients than you can handle now everyone is getting lesser care.
When all the new responders show up are you going to be boxed in? What happens to your patient?
What if you have multiple new patients at the scene?
What are you going to do when somebody rear-ends your vehicle with your partner and patient inside?
What is your partner going to do when you get hurt?
Realize you may be harming patients. When responders show up, your report may bias them. More assessments are better assessments. If you showed up and I was already on scene telling you "nobody looks that bad" (especially if we work together, or worse, I am your medic instructor) How thorough is your assessment going to be? (which truthfully you will never have to worry about as I will not be on your scene unless it is my family or friends' place and my assessment will be ongoing, because I am more interested in them than I am in you.)
I know this issue always seems to creep up on rural providers and new people. On my first day. (a long time ago) I was told: "don't get a $3000 light bar on your $2000 car. Don't carry around anything more advanced than some bandages and water, less equipment options gives you less chances to do someting wrong. Be a knowledgable bystander, not an off duty firefighter. (or whatever your position) when the calvary arrive give them a quick report and get out of there or make sure that the OIC has assigned you something specific." (aka knows you are there and exactly what you are doing)
If you are already in a squad, the primary function of the radio is to call for help. I never thought about the idea of stopping and explaining you already have a patient. I like that idea and will pass it on.
Moreover, why aren't instructors covering this in class?
medic417
The Truth Provider
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Ok here is a rural boys way of handling. We stop. We have no other ambulance closer than an hour away. We start treatment. If it is only one or two more patients we load them in and continue down the highway. No big deal. Why are so many convinced they can only have one patient?
BossyCow
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Not always. Us rural girls know that our patient and our responsibility is to the pt in the rig. The one on whom we have begun patient care. To start care and transport on a pt and then to stop is going to put you in a huge nightmare of accountability.
Its the same as if you are on a call and a second call comes in. Who do you treat, who do you go to? You deal with the call you are on. The second call is not your call but a call for which you are unavailable.
Our protocol to stop, assess the scene from the rig as best we could and radio to dispatch basic information about the scene. If we have additional personnel available to leave on scene, we will, otherwise its treated like a normal doubled up call that we didn't drive past. We would call for mutual aid from an adjoining agency if that was the only resource available.
Us rural girls know that we are not all things to all people and that there are limits to what we can do in every situation. I am so not going to stack patients up in the back of my rig like cordwood.
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Outbac1
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We stop all the time if we have a noncritica pt on. We check to see what is needed and would do what we could while waiting for another truck to arrive. If our pt is critical we drive by and call it in.
What's a code 2 pt?
What's a code 2 pt?
Outbac1
Forum Asst. Chief
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" Quote Bossey Cow Its the same as if you are on a call and a second call comes in. Who do you treat, who do you go to? You deal with the call you are on. The second call is not your call but a call for which you are unavailable. "
Here if our first call is a lift assist and a SOB call comes in and we are the closest truck to the second more serious call we will be diverted. As long as we did not arrive on scene for the first call.
Here if our first call is a lift assist and a SOB call comes in and we are the closest truck to the second more serious call we will be diverted. As long as we did not arrive on scene for the first call.
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BossyCow
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So what happens when you are out checking the pts on the ground and the pt in your rig crumps. I've had too many non-critical pts go south without warning to be comfortable leaving one in the back of my rig while I go play trauma investigation.
Your responsibility is to the pt in your rig, period. I'd double check your protocols and your agency liability insurance policy. You don't want to find out you assumed incorrectly while on the witness stand.
medic417
The Truth Provider
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But see thats the difference in your protocol compared to mine. We do request our mutual aid but we either treat and transport or we treat and wait for mutual aid. Sucks for the first patient if they have to wait very long.
I got to spend some time working with the rural boys.(We even had hanging stretchers from the ceiling of the squad because transporting 3 on longboards, 2 critical or sometimes 4-5 patients sitting was not unheard of) I have noticed that in places where you have to stop and/or transport multiple patients at a time because there is no help coming, nobody ever asks if they should stop. It is normal. But I can say definitively it is not ideal. It is particularly a problem when transporting antagonistic parties. Patient confidentiality is a nightmare; everyone knows everyone as it is. Equipment (like monitors) is always in short supply. With 1 basic driving and a medic in the back there is often a shortage of hands too. 3 man squads would have been a big help.
Plus I have noticed my rural brethren are less likely to sue me for something. A lot less. They understand when you live rural it comes with certain drawbacks, especially those who are many generations rural. They are sincerely thankful somebody showed up at all and I have never heard one ask “What took so long?”
It is not all roses though, they are way too concerned about modesty and when they are constantly trying to cover patients I am trying to uncover it can get a little maddening. I am also not sure what the use of a “sick rag” is either. People on both sides of the pond also like to hear about my experiences with supremacist “compounds” though those stories didn’t seem so funny at the time. I guess I don’t like to be in a situation where everyone has a firearm except me.
medic417
The Truth Provider
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Backboarded we can carry 4 adults plus a child or two. We can hang two. One on squad bench. One on cot. And kids on floor. Not idea but you do what you have to do. I have had 6 medical patients all unrelated in the patient compartment all the way to the hospital. These are just what you deal with in the frontier.
I bet that makes your company nuts doing the paper work with all the billing adjustments for multiple patients.
Are there seat belts/restraints for all passengers including the EMS providers?
Granted you do what you have to at times but I wouldn't advise doing it just because you can squeeze everybody into the ambulance.
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medic417
The Truth Provider
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Yup. Thankfully thats not the norm. Not safe for us. And billing is a challenge.
BossyCow
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No mutual aid?
I've hung cots and packed the ambulance with patients from the same MVA but to stop and attempt to run two calls at once just sounds horrendous on many many levels.