Staging for PD

[LucidResq]

Had a call the other day - adult son can't get dad to answer phone. Adult son eventually goes over to dad's house and finds him completely unconscious, with snoring resps, and a suicide note. It seems he OD'd on some unknown medication/drug. Unknown time frame - could have been as long as 24-36 hours. Pt/dad was distraught over the recent death of his wife.

As per protocol, both EMS/FD and PD are dispatched. FD (ALS-equipped engine - all 4 on board are medics) decide to stage because PD hasn't made it yet. Dispatch politely reminds FD that this patient is an unconscious OD patient with poor respiratory status, with 1 cooperative family member on scene. No... they're staging.

WHY? This is the same dept that decided to waltz in without PD, on a physical DV, with suspect still on scene, for a simple eye injury.

Does your department have set-in-stone protocols requiring you to stage in certain situations or is it a call for you and your partner to make? I am a huge advocate for responder safety, but at what point do we lose our common sense?

 

[HotelCo]

Had a call the other day - adult son can't get dad to answer phone. Adult son eventually goes over to dad's house and finds him completely unconscious, with snoring resps, and a suicide note. It seems he OD'd on some unknown medication/drug. Unknown time frame - could have been as long as 24-36 hours. Pt/dad was distraught over the recent death of his wife.

As per protocol, both EMS/FD and PD are dispatched. FD (ALS-equipped engine - all 4 on board are medics) decide to stage because PD hasn't made it yet. Dispatch politely reminds FD that this patient is an unconscious OD patient with poor respiratory status, with 1 cooperative family member on scene. No... they're staging.

WHY? This is the same dept that decided to waltz in without PD, on a physical DV, with suspect still on scene, for a simple eye injury.

Does your department have set-in-stone protocols requiring you to stage in certain situations or is it a call for you and your partner to make? I am a huge advocate for responder safety, but at what point do we lose our common sense?

It's up to my partner and I, as it should be.

 

[DrParasite]

my department does have a policy, in writing. an unconcious overdose on meds would probably not warrant staging. an overdose on PCP probably would. if others are there, and could endanger the crews, than I won't blame the crews for staging, especially if they thought it could be an unsafe scene.

after all, just because dispatch says it's safe, doesn't mean dispatch is always right, because callers lie to dispatchers all the time.

 

[Shishkabob]

If ANYONE should have staged it should have been the ambulance, not the engine with 4 people...

 

[DesertMedic66]

my old station has a written policy for certain calls. and the fire crew can still decide to stage for other calls that is not within the policy. we have staged for pretty much all suicides because all the info we would get would be "attempted suicide at 2243 jonny street"

 

[lightsandsirens5]

It is mainly up to my partner and I based on what dispatch tells us. Unless we are ordered to stage by dispatch, then we stage whether we want to or not.

 

[LucidResq]

If ANYONE should have staged it should have been the ambulance, not the engine with 4 people...

The funny thing is, the ambulance folks got on scene soon after FD but before PD and decided to go in and then it seems like FD realized maybe we should go with them and followed.

I will always support people on the street making their safety their first priority, sometimes I'm just concerned that they sometimes don't pay full attention to the info we give them.... they just hear "suicide attempt by OD" and ignore that the pt is unconscious and in respiratory distress, or "eye injury" and ignore that the assailant that caused the injury is still on scene.

I'm also just curious if any agencies have written-in-stone protocols, because we really don't here - it's their own discretion.

 

[firetender]

If the FD understood its role as securing the scene until the judgment of a higher authority, then they did their job. If they were actually medics on-duty then they didn't. They deprived the patient of an immediate assessment which COULD have uncovered a potentially fatal condition, even after being made aware of the circumstances by dispatch.

 

[CAOX3]

We rely completely on information obtained by our dispatchers, their very good. Most of them are retired providers themselves so they can get a sense by talking with the person the possible hazards.

This isnt a situation where we would be advised to stage, been on many an overdose without the police, but I wasn't there and sometimes you just have to listen to your gut. I wouldn't question their decisions. Maybe something was off, didn't feel right, bad neighborhood or whatever.

I got no problem throwing up the stop sign if I feel something isnt right. My gut has saved me on more then one occasion

 

[nakenyon]

We don't have a written policy on staging. The state police who cover our territory general advise us to stage if they are enroute, but ultimately the decision is in our hands based on how we feel from information provided by dispatch. I generally stage for all suicide attempts where the patient used a weapon or is reported to be violent.

 

[sir.shocksalot]

Was this Aurora Fire? Regardless I have noticed a lot of issues everywhere regarding scene safety. Typically I will stage if dispatch recommends it since good dispatchers typically have a good feel for the scene before we do. If staging is not recommended I typically go in. Just because someone is suicidal it doesn't necessarily make them a threat to others.

As always if you walk on scene and feel unsafe, you can always leave.

 

[MEDIC802]

we have state protocols for staging however it is ultimately up to my partner and I, sometimes pd will advise us to stage and IF I have my gear and have another TEMS medic as my partner we may got to an unsecure scene depends upon dispatch info.