Staging in EMS

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EPICMEDIC

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Lately there seems to be a lot of talk about staging for EMS calls. I always ask the question of is it necessary, but it seems everyone blindly stages without a real reason. For instance, a psych call at a nursing home seems a bit ridiculous to me. Or, staging for police on calls where "the calltaker thought they sounded angry or was using foul language". I am in no way saying to take unnecessary risks, but it seems that blind staging without reason is taking over. Please provide your thoughts and reasons behind your rationale.
 
Dispatch can request a stage, but in the end it's up to the crew. If PD is on scene, we tend to go in.
 
If dispatch requests that we stage then we will stage until police clear the scene. The crew doesn't have a choice on to stage or not to stage if dispatch requests it. The crew can also make a choice to stage on calls if dispatch doesn't tell us to.

Everything that the PD gets called out for we get staged automatically. If it's an unattened full arrest we stage until they clear the scene.

I honestly don't have a problem staging for any call, and would not argue with dispatch if we were requested to stage for a runny nose.
 
We sometimes stage. I know units that will go into shootings and stabbings before PD get there, as well as hear stories of crews who would be on the scene and leaving the scene with the shooting/stabbing victim as PD was pulling up.

me personally? If I get a report of a violent EDP, or an armed EDP with no PD on scene, I'm gonna stage until PD get there. stabbing and shootings, I'm probably going to wait until PD get there.

as for staging due to angry callers or foul language, ehhh, judgement call. I'd rather send 2 LEOs into an intense scene followed by the EMS personnel, because the LEOs can make sure everyone behaves, and take appropriate action in case they don't. I've been told by callers "just send the :censored::censored::censored::censored:ing ambulance, and stop asking me why" which usually gets an LEO response because I don't want anyone messing with my EMS crews as they are trying to do their job.

side note, situational awareness is a lost skill. knowing when not to get too far into a scene, knowing how to get out, knowing when to get out, are often forgotten traits. for example, I was dispatched to an armed suicidal juvie EDP running through the woods. Cops are chasing him, dispatch request we stage. my partner stays in the truck, I decide to wander up to see what is going on. a slow walk, I meet up with one of the cops, get a size up the situation, and when 5 cops dog pile on the kid to disarm him and take him into custody, all I'm doing is holding the flashlight so they can see what they are doing (since it was 2am). not getting directly involved, but being close enough to be aware of what is going on in case something goes wrong.

and I would never ever stage for a full arrest, unless there was a really good reason. sooner CPR/Defib is initiated the better the chance of survival.
 
At my station it's the units judgement call on if we stage. Dispatch will advise us that PD is enroute or on scene, but they wont tell us to stage or not to stage.

Every scene is potentially unstable. That's why they added SCENE SAFETY into EMT class. While some scenes you absolutely need to stage, for example something like a shooting or stabbing, some you need to use your judgement and decide for yourself.

If it's decided that we are entering a scene, we are smart about it. Make sure you have your ingress/egress, keep your eyes open, and travel together.
 
When dispatch tells us to stage, we stage until dispatch tells us the scene is secure. I guess you can consider all staging to be "blind" because until we're on scene, we don't have any idea what's really going on.
 
We generally only stage at the direction of PD, or if the address/caller is a known frequent flier that has given trouble before (I can name a couple addresses in our first due by memory, that we will not go into until PD is on scene). The only times I would say we absolutely stage are assaults/domestics in progress, things like that. We are often asked to stage for suspected ODs, but that is left to the discretion of the crew.
 
if we get called for a code 4 (staging) we wait until we are told to go in by PD. If its a while...we will call back in to see if we are still needed.
 
EPICMEDIC said:
Lately there seems to be a lot of talk about staging for EMS calls. I always ask the question of is it necessary, but it seems everyone blindly stages without a real reason. For instance, a psych call at a nursing home seems a bit ridiculous to me. Or, staging for police on calls where "the calltaker thought they sounded angry or was using foul language". I am in no way saying to take unnecessary risks, but it seems that blind staging without reason is taking over. Please provide your thoughts and reasons behind your rationale.
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Maybe you should stage a little more often there epicmedic... then we could avoid SOG's being written hahaha ;)
 
Linuss said:
Dispatch can request a stage, but in the end it's up to the crew. If PD is on scene, we tend to go in.
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Around here, if the dispatcher tells you to stage, and you don't, you better have a damn good reason ready when you walk back into the station and your chief greets you with two words: "Office. Now."

firefite said:
If dispatch requests that we stage then we will stage until police clear the scene. The crew doesn't have a choice on to stage or not to stage if dispatch requests it. The crew can also make a choice to stage on calls if dispatch doesn't tell us to.

Everything that the PD gets called out for we get staged automatically. If it's an unattened full arrest we stage until they clear the scene.

I honestly don't have a problem staging for any call, and would not argue with dispatch if we were requested to stage for a runny nose.
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In the urban area where I work, we stage for all calls that are violent (shooting, stabbing, injured from assault), all psych calls where there either is an attempt, or suicidal/homicidal ideations, and all unknown emergencies/911-hangups.

Out in the rural area, we stage for all of the above plus more. Any uncertain situations, any addresses that have been flagged for previous violent behavior, and any addresses that have been flagged for domestic violence, violence towards public safety, heavy drug usage, the list goes on. The reason for this is that we cover 190 square miles, which is a third of the county. The 3rd shift has only 2 deputies on for the entirety of the county, so if we need someone, it can be 45 minutes or greater before we get someone there to assist. Likewise, sometimes they'll have us stage at the firehouse, "in-service" so as not to tie us up while PD is responding in case a second run comes in. Mutual aid is also at least 30 minutes out and there is no reason to tie up a unit waiting for PD when there is another run over the hill...
 
I'm not saying to go in on a shooting in the projects when the cops aren't there yet. Safety is still paramount, but staging on a full arrest? Think about the odds that's some kind of trap vs the odds that you're delaying care to that patient? You ever seen a cop do CPR? I think not. Everything in life involves risk, and if you're not willing to take some to help real people, get out of EMS and let the big boys do the hard work.
 
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We don't stage at all. I don't think the dispatchers in my system know what that means. Hell, we're lucky to get the local sheriff to respond. We go in ready to take the patient down in those situations. We don't have the time to wait around for PD in the country.
 
savingparamedics said:
We don't stage at all. I don't think the dispatchers in my system know what that means. Hell, we're lucky to get the local sheriff to respond. We go in ready to take the patient down in those situations. We don't have the time to wait around for PD in the country.
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Yeah, that works real well...
http://www.emtlife.com/showthread.php?t=11109

As far as the comment, "We don't have the time to wait around for PD in the country.", would you rather wait for PD to secure your scene, or spend the rest of your life waiting for the coroner to come pick up you and your crew?
 
Just like an aeromedical flight; two to go, one for no. If we both think, "what the heck, let's go for it," we do. If either of us has any reservations, we stage.

Most of the time, it seems that the dispatcher tells units to stage just because they think they're supposed to always say that. Just another one of those useless radio lingo terms that creeps into the culture and never goes away. If you ask the dispatcher who advised us to stage, they lock up in confusion. Nobody told us to stage to begin with.
 
AJ Hidell said:
Just like an aeromedical flight; two to go, one for no. If we both think, "what the heck, let's go for it," we do. If either of us has any reservations, we stage.
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That's what we do here as well...any responding crew member can say, "hey, I think we should stage" and we do.
 
Addicted2Narcan said:
You ever seen a cop do CPR? I think not.
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I know I am just feeding the many named troll. But Yes I have. On just about every code we have around here. The day they didnt assist in some way or initiate if they arrived first would be the day they are most likely looking for a new job.
 
Addicted2Narcan said:
I'm not saying to go in on a shooting in the projects when the cops aren't there yet. Safety is still paramount, but staging on a full arrest? Think about the odds that's some kind of trap vs the odds that you're delaying care to that patient? You ever seen a cop do CPR? I think not. Everything in life involves risk, and if you're not willing to take some to help real people, get out of EMS and let the big boys do the hard work.
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And then let the smart ones come work the code on the big boys when they get themselves killed for not staging when told to do so.
 
Addicted2Narcan said:
I'm not saying to go in on a shooting in the projects when the cops aren't there yet. Safety is still paramount, but staging on a full arrest? Think about the odds that's some kind of trap vs the odds that you're delaying care to that patient?
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Once you have a little experience you'll learn that the odds are just as good that any shooter is going to bolt to avoid capture way before you get there. That's why you leave your sirens on until you're stepping out. Give them plenty of warning to run, so they don't feel trapped by your presence.

And we see plenty of cops doing CPR in my area. You need better cops.
 
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