Rescue Response-Qualifications needed

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upstateemt

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I apologize in advance if this is lengthy, it takes a bit to explain the situation I am questioning. I would also appreciate this not turning into a paid vs vollie debate, I know there are strong feelings on all sides.

I am a EMT-CC and Rescue Captain of a small Volunteer Fire Company in NY We are so small infact that I am one of only two EMT's in town. I also am a member of the Ambulance (also volunteer) that responds to the Rescue calls. I cover 7 shifts a month at the Ambulance as a bunker because I live 10 miles away and cannot respond in a timely fashion from home.

One reason I cover shifts at the Ambulance is because the Rescue Squad I am Captain of has less than 20 calls a year and I felt it was important to be proactive in maintianing my skills.

There is a serious diagreement in my Fire Company about responding to Rescue calls when there is no EMT available. As Rescue Captian I feel that if an EMT is not available to respond to a call the Rescue Truck should not move unless they are directed by the Ambualnce to respond for lifting assistance and even then they should not arrive on scene until the Ambulance does.

We have a couple of people on the Rescue who were certified EMT-B's at one time (and by all counts good ones) but have been expired for 5-10 years. We also have a couple of people with no medical training that want to respond to Rescue calls. These people feel that it is appropriate for them to respond without an EMT and initiate care.

My Ambulance EMS Chief does not feel untrained and/or uncertified people should be responding to calls and that I am correct in telling them that the Rescue Truck should not move without an EMT either enroute to the scene or on board. He has said that if there is a Rescue call and an EMT is not available the Rescue should stage away from the scene until the Ambulance has arrived and proceed into the scene with the Ambulance.

I am being accused by my Fire Company of "not caring" for people and the belief is that the unqualified individuals will be protected by the "Good Samaritan" laws. These people do not even have CPR training.......

I am very concerned about this situation and am ready to resign both my position as Rescue Captain and my membership in the Fire Company. I feel it is a quality of care issue as well as a legal issue. If I resigned from the Fire Company. I would then be responding to calls in my community as an Ambulance person and not a Rescue person.

Can anyone comment on the situation?
 
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I think that if they want to go and play on medical calls... they need medical training.

Red Cross/AHA First Aid and CPR would probably be fine... but they should have some certification as a CYA thing.

Get an instructor to come in and do it on a drill night.
 
2 things to start.

First, all of your members aren't required to be first responders? Thats a minimum for us if a person is going to go on calls.

second, what kind of services does your rescue truck provide? It sounds like you are using it for medical. My dept's rescue truck is designed for supporting extrication and major fire/MCI calls with lights, power, compressed air, extra SCBAs and tanks, and radios.

One example I will share with you happened yesterday.


Tones went off in my town for a 1 month old child having a seisure. No EMT's were immediately available, but a first responder FF arrived at the station (we usually have one of them drive the ambulance for us). Fire chief decided to have the first responder roll the ambulance to the scene and also called for a unit from the next town over. While our ambulance was en route, 2 of our EMT's called in from the next town (where they were at their non ems jobs) and said they were responding to the scene.

- Our ambulance with first responder arrives on scene, does initial check of PT
- Mutual aid ambulance arrives on scene, takes over care (we kept them as primary)
- Chief arrives on scene
- Our EMT's arrive on scene
- PT stabilized and transported in mutual aid ambulance


The rationale for this was that, given the response times of the 2 EMTs and the mutual aid ambulance, the chief would rather have a first responder at the scene with an ambulance than to have nobody for an additional 10 min. Of course he couldn't act as an EMT and certainly could not transport the PT, but he could only help the situation, and perform CPR/RB etc if necessary (it was not).

My point is that in some situations (rural especially) sometimes it may be appropreate to do things that a full time and fully staffed service might not. Of course you said that the members that they wanted to take the rescue truck are not even CPR certified. That is just unresponsible on their part and that of the service. They should not be allowed on a medical scene without being at least first responders.
 
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sigh........................ these people don't even have CPR certification much less be certified as first responders. Our Rescue is Medical we carry the basics and an AED. Technically according to our PAD Application (AED) a minimum of CPR is required to use the AED. That requirement is not even met.

The First Responder suggestion is good though, perhaps I could get our expired EMT's to certify as First Responders if nothing else.
 
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upstateemt said:
does.

We have a couple of people on the Rescue who were certified EMT-B's at one time (and by all counts good ones) but have been expired for 5-10 years. We also have a couple of people with no medical training that want to respond to Rescue calls. These people feel that it is appropriate for them to respond without an EMT and initiate care.

My Ambulance EMS Chief does not feel untrained and/or uncertified people should be responding to calls and that I am correct in telling them that the Rescue Truck should not move without an EMT either enroute to the scene or on board. He has said that if there is a Rescue call and an EMT is not available the Rescue should stage away from the scene until the Ambulance has arrived and proceed into the scene with the Ambulance.

I am being accused by my Fire Company of "not caring" for people and the belief is that the unqualified individuals will be protected by the "Good Samaritan" laws. These people do not even have CPR training.......

I am very concerned about this situation and am ready to resign both my position as Rescue Captain and my membership in the Fire Company. I feel it is a quality of care issue as well as a legal issue. If I resigned from the Fire Company. I would then be responding to calls in my community as an Ambulance person and not a Rescue person.

Can anyone comment on the situation?
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Yes, your community needs to do some things immediately!

First contact your State EMS office, and see what the requirements are. Second, contact your city attorney and local insurance coverage. They will need them.

It is called "duty to act" and no matter if paid, volly, subscription what ever; one is judged equally. This means if you hang out your shingle, you must respond adequately or nothing at all (but refer to one that can). Sorry, this is heading for disaster.

Bringing an EMS unit without properly trained individuals is a time bomb awaiting for a several million dollar litigation. Yes, you will loose... easily.

As well, the "The Good Samaritan Act has never been for rescuers or EMS personnel. It is only good for common laymen or EMT's off duty acting as a common laymen. It cannot be used for departments providing coverage. Sorry, there is no coverage for being a good ole boy and being ignorant.

I suggest calling your State Fire Service education division and State EMS and allow them to give some "knowledgeable advice".

Good luck, it sounds like you will need it.

R/r 911
 
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Thank you ! I do plan on having a discussion this week with out County EMS Coordinator. I am being cautious about contacting "officials" as I would like the opportunity to resolve this internally before raising alot of red flags and having this become a public issue.

These (and other) opinions are very helpful in maintaining my determination to improve the situation and try to provide an appropriate level of care to the community. Some members are trying to make me feel I am being overly rigid.
 
CPR and First Aid are essential bare minimums. As far as the opinion that you don't care if you aren't willing to give a half as:censored:sed response that's not worth commenting on.

You aren't helping if you can't do something. The definition of someone who shows up but is unable to act in an emergency is spectator, even if you are riding in a cool red vehicle with lights and radios and sirens and stuff.
 
Here, all ambulance serivce is provided bya fully paid EMS service, for which I work full time. The local FD's, 99% of which are all vollies, require that you be a minimum of a FR to respond to calls. If you aren't a first responder, you don't go to medical calls. The only exception is if EMS asks for lift assistance or it's an MVA, then for obvious reasons FD responds all personnel available. As my FD medical director I don't let non certified people touch patient's unless it's to help lift the backboard/stretcher/etc.
 
Sometimes you pay a price to live where you do. That price may include waiting 30 minutes or so for a properly staffed and equipped ambulance to arrive. Do peoples conditions worsen or perhaps they die while waiting? Yes it happens, part of the price to live where you do.

To arrive on scene and not be trained to do medical aid is as Bossy said being a spectator. To show up as a member of a Dept. is to imply that you can do something.To attempt to do something you are not trained to do is to invite a lawsuit on your self and Dept. There is a reason there are a lot of rich lawyers in the states.

I believe you are right to insist on properly trained responders.

How far away is a fully staffed ambulance?
 
Your community suffers from your system. I may have a radical opinion here but you need to have anyone responding to a medical call trained up to first responder state certification with a BLS CPR/AED certification. Active and current with constant continuing medical education. This to me would be BARE MINIMUM. I would like to see all EMT crews with a paramedic in their somewhere.
 
upstateemt said:
I apologize in advance if this is lengthy, it takes a bit to explain the situation I am questioning. I would also appreciate this not turning into a paid vs vollie debate, I know there are strong feelings on all sides.

I am a EMT-CC and Rescue Captain of a small Volunteer Fire Company in NY We are so small infact that I am one of only two EMT's in town. I also am a member of the Ambulance (also volunteer) that responds to the Rescue calls. I cover 7 shifts a month at the Ambulance as a bunker because I live 10 miles away and cannot respond in a timely fashion from home.

One reason I cover shifts at the Ambulance is because the Rescue Squad I am Captain of has less than 20 calls a year and I felt it was important to be proactive in maintianing my skills.

There is a serious diagreement in my Fire Company about responding to Rescue calls when there is no EMT available. As Rescue Captian I feel that if an EMT is not available to respond to a call the Rescue Truck should not move unless they are directed by the Ambualnce to respond for lifting assistance and even then they should not arrive on scene until the Ambulance does.

We have a couple of people on the Rescue who were certified EMT-B's at one time (and by all counts good ones) but have been expired for 5-10 years. We also have a couple of people with no medical training that want to respond to Rescue calls. These people feel that it is appropriate for them to respond without an EMT and initiate care.

My Ambulance EMS Chief does not feel untrained and/or uncertified people should be responding to calls and that I am correct in telling them that the Rescue Truck should not move without an EMT either enroute to the scene or on board. He has said that if there is a Rescue call and an EMT is not available the Rescue should stage away from the scene until the Ambulance has arrived and proceed into the scene with the Ambulance.

I am being accused by my Fire Company of "not caring" for people and the belief is that the unqualified individuals will be protected by the "Good Samaritan" laws. These people do not even have CPR training.......

I am very concerned about this situation and am ready to resign both my position as Rescue Captain and my membership in the Fire Company. I feel it is a quality of care issue as well as a legal issue. If I resigned from the Fire Company. I would then be responding to calls in my community as an Ambulance person and not a Rescue person.

Can anyone comment on the situation?
Click to expand...

I am glad you are asking for comments instead of opinions. For you, I, and everyone else hear know all too well that opinions are like buttholes. Everyone's got one, and most of them stink. Not to mention that they are about as productive as mammary glands on male swine.

That being said, Rid is definitely correct. Prudency dictates that it would be wise for you to research your state's rules and regulations, and you should adhere to your state's rules and regulations as well.

Everyone can offer one opinion or another, and it would mean precisely squat when compared to your state saying what you have no choice but to do regardless of whether you want to or not. Some of your folks might say, "We haven't gotten in trouble for this, yet." And they would be right. The operative word is "yet". You will. You could fight it, but you will lose.

Call your state EMS office. Ask for their help. They want you to do the right thing.

Good luck.
 
You are absolutely correct. What they are doing violates every law that governs us, the State requires a minimum of First Responder. Unfortunately, like many small Departments that have existed for many years, some folks feel they are "above" the rules and regulations. It is the "greater good" mentality that says (in their view) " it may be wrong but I'm helping".

I am mostly looking for a sense of what the "real world" does and so far have not found a single person or department that supports the concept of responding with uncertified people.
 
upstateemt said:
I am mostly looking for a sense of what the "real world" does and so far have not found a single person or department that supports the concept of responding with uncertified people.
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Nor, should you. Sorry, the but the "good of the community" requires that these individuals need to know and be responsible for what they are doing. Alike I described, I much rather go down as a martyr and report them, causing changes than to be associated with them and be involved in litigation (it will occur). The community will appreciate it later and yes you will doing much more positive than you realize.

Good luck,

R/r 911
 
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