Who Makes the Call?

[jeepmedic]

First... when acting as First Responders, even the Fire Department is functioning as part of the Emergency Medical Services of your area... collectivly referred to as EMS (I keep on having to correct myself) You are correct, First Responders / QRS units can't transport... but they can initaite patient care FASTER than the ambulance crew can, and perhaps even obtain a refusal and recall the ambulance crew.

I agree that taking a fire engine on EVERY ambulance call doesn't make sense, but if the FD can beat the ambulance to the scene, they SHOULD be going. It also helps to justify a paid FD staff... because (anecdotaly) we've done a real good job at public education, and there are less fires, and less major fires than there were years ago.

Jon

Very well said.

 

[Mercy4Angels]

guess it depends on your town. here its the police (first responders), us (bls), medics (als), lifeflight (doctor or medic depending)

 

[TedDM4605]

Around here anyone First Resp, Police, Fire, etc can request air transport, but the final determination is made by the ambulance if they continue or get disregarded. The reasoning is fairly simple. The transporting medic is the one that will end up with the responsibility of transport and managing the pt during that time so they have the final say. Some other factors is we are notified (most of the time) which hospitals can and will accept various types of patients (diversion).

 

[94accord]

He who is on scene has the best understanding.

If Fire-ALS is on scene and they say they don't need a bird, then that is what goes unless there is something blatantly obvious they are missing.

This does sound like mistrust on the part of EMS-ALS and a pissing match between EMS-ALS and Fire-ALS

While I would agree that it may seem a little like a pissing match, one can not ignore that fact that fire trucks do NOT transport people... end of story. If the fire medic is there and is the ONLY one there, cool, let him/her make the call. However, I can not see any good reason for cancelling the birn in flight when the possibility just MIGHT exist that you may need that thing. As someone else said, always err on the side of helping the patient. Ultimatly, it should have been the ground medic that had the final say, and I am VERY surprised that a fire medic would have cancelled ANY additional equipment... last i checked, they like all the gear and help they can get. I have had a few run-in's with other private ems teams on the same accident, and its sad, but some people see it as a competition, and that is truly pathetic. Our job, our goal, and my personal desire, is to help the people that I can... that can not and will not get done if i am busy second guessing another tech on scene.


Just my 2cents.