whos on scene?????

[suziquzi99]

I have a question. I have no motivation towards how this goes, just curious I guess. I also don't know how it goes except where i live soo..... ff usually on scene first and then ems takes over but there seems to be some rivalry b/c the first responder team for the ff doesn't want to give in to the ems. Hmm... Like I said, I don't have a take but I would like to know what you guys think.

 

[PrincessAnika]

transporting unit crew chief assumes pt responsibility and care when they get there. on scene, non-transporting ems, transfers pt care WITH REPORT GIVEN, same as if to the ED. if the first response/QRS team has a problem with the incoming crew or provider, that needs to be dealt with off-scene. if its a matter where providers disagree on treatment needed....keep it away from the pt but don't let anyone do anything that is going to harm the pt.

 

[CAOX3]

Depends on the level of provider.

Highest level of provider assumes responsibility of the patient transporting or not.

 

[reaper]

I have a question. I have no motivation towards how this goes, just curious I guess. I also don't know how it goes except where i live soo..... ff usually on scene first and then ems takes over but there seems to be some rivalry b/c the first responder team for the ff doesn't want to give in to the ems. Hmm... Like I said, I don't have a take but I would like to know what you guys think.

Suzi,

Where are you seeing this? I have never seen a scene in the area where FD is reluctant to turn over care to EMS. Since most FF's in the area have little to no medical training, they are more then happy when EMS shows up. Just curious as to where you are seeing this happen? You can PM me, if you wish to answer in private.

 

[Akulahawk]

Out here in Sacramento, (and IIRC Santa Clara County as well) there is a specific transition of care protocol from non-transport to transport medics. Most patients can have care transferred from one medic to another without issue. Critical patients and certain specified patient types can not be handed-off to a transport medic. In those instances, the non-transport medic retains patient care and responsibility. That medic must also accompany the patient to the hospital. The Fire Captains don't like that much because if their medic has to accompany the patient, their apparatus must go out of service and follow the ambulance to the ED to pick up the medic...

Patients that are that bad off where the non-transport medic can't hand-off the patient just doesn't happen that often down here. Why? Usually the transport and non-transport medics arrive on scene at the same time and transport makes patient contact first...

 

[Shishkabob]

Highest level provider is in charge.


If both first responders and transport are same level, then the transporting truck is in charge.

 

[feldy]

ive never seen this problem...most if not all FFs in my area have their EMT-B and are first on scene often. As soon as a transporting crew arrives or ALS unit arrives in the suv then they hand over care and offer assistance until the pt is put into the back of the truck.

 

[Sandog]

Since most FF's in the area have little to no medical training

In San Diego most FF have an EMT-B rating, but I agree with your point.

 

[JPINFV]

If Who is on scene, then They is in charge of patient care.

 

[esmcdowell]

Is it a question of who's scene it is, or whose patient? patients belong to the person with the highest training who is able to transport. Scene would still belong to the FD, unless they handed command off to EMS personnel. In most NIMS/ICS stuff however, IC has to be only IC, not an operational unit.

 

[JPINFV]

On a medical call with one patient, the scene and the patient is one and the same. You don't need a dedicated NIMS command system for every call.

 

[Aidey]

How is this for complicated? First agency on scene is in charge of the scene. First paramedic on scene is in charge of the patient. The first agency may NOT be the agency the paramedic is with (as in when a BLS fire crew is first on scene). If the first paramedic on scene is a fire dept paramedic they have two options, turn over care to the transport medic or not turn over care and ride in. The transport medic can accept the patient, or refuse to accept the patient, forcing the first on scene paramedic to ride in.

 

[JPINFV]

How is this for complicated?

Interdepartmental politics...

 

[mcdonl]

Well, we get Fire/Rescue calls and we get rescue calls. We do not roll an engine every-time Mr. Smith has SOB... So, if we are sending a fire company then it is a fire/rescue call. First on scene is IC (Again, assuming it is a Fire/Rescue call... MVA or something....) and when the transport unit get's there care is transferred to that unit. I cannot say that it always does, but it typically does.