Code 3 with a doctor on board!?

[911emt911]

I have read some of the topics posted about how running lights and sirens is almost useless in most situations. Not sure if every city has the neonatal units designed for newborns only or not. Our hospital has an ambulance that comes roughly 100 miles away regularly to take these transfers out to a bigger city. There is a doctor that I know of, and three others that come on these transfers. A doctor, paramedic, nurse, and driver. They drive emergency down here to pick the babies up and emergency back ofcourse. With THREE highly trained medical personnel, including a D-O-C-T-O-R, is this legitimate, (running code 3)? I mean, you treat/asses them 'almost' the same way. Just wondering what you all might think about this, im not saying it's wright or wrong, just thought it was a little weird, given the fact it is a big unit with nothing but neonatal equipment on it and 3 Medical personnel.

Happy Holidays to you all!

[WestSideBorderPatrol]

I think that each and every call is different and there cannot/shouldn't be a set way of doing things such as running Code 3. Especially with neonates, while there is a high level of care that is on board, that will only get you so far. Sometimes the one thing they need is to be at the receiving facility before their time runs out.

[akroeze]

so they are a doctor, so what?

If they don't have the equipment they need what good are they? In other words, yes it can be justified (ignoring for now the argument as to if L&S is justified ever)

[VentMedic]

That is truly the exception to the practice for Neo Transport teams. The good Neonatal teams are trained to travel long distances with the sickest of the sick. We do not allow our team to run Code 3 to or from any hospital. Since the Neo doctors at our facility are in communication with the doctor at the other facility, things can be done prior to the team's arrival by the staff there. It's not like the baby is waiting on the curb with no healthcare workers by its side. Yes they need specialized care, but if the ambulance gets in an accident, the baby's chances are greatly reduced to nothing.

Time is best saved on paper work and having priority to different transport modes that the hospital does not own such as a fixed wing aircraft. If the helicopter we own is out, we have plan B. If we have to go to the airport to make a connection, no code 3. The neonatal team consists of RN and RRT. If we take our ambulance, the driver is an EMT who is also a staff member of the hospital. All the equipment we need goes everywhere with us.

If we have an ambulance meeting our helicopter on a Specialty Transport in another town, we do not want a L/S response. We may notifiy the ambulance service at least 1 hour in advance. Yet, on approach, we'll look down and see the fools "running" for the airport. We will shut down completely to unload. It is rare for a specialty transport that we will load or unload with anything still moving on the helicopter. There is time to get to us calmly. We just hate to see people "rushing" up to us. Bad mistakes can be made quickly.

If the weather does not permit flight, some transports may be 6 hours one way. Some flights may be to South America or the islands. There is little we can do by saving a few minutes. We do not stress the truck, crew, other people on the road and especially not the baby with Code 3. Also, if there is any chance of the parents following, we will try our best to discourage that or drive unbelievably carefull. Around 10 years ago, many of you may have heard about the mother and father being killed at an intersection while attempting to follow the ambulance that was traveling at a normal pace and then "lit up" to go through a busy intersection. The baby lived but was parentless. That set an example for the industry.

I would say that team needs to re-evaluate their skills and expertise. Neo/Peds teams have huge conferences at a national and international level with same for all modes of transportation being a big issue.

The only time we take an M.D. on board anywhere is for training purposes only for a resident. Then, they look, don't touch and sit quietly. The other rare occasion might be for an ECMO candidate and the attending goes. His/Her presence may be more for family information and various consents that will be needed.

It is really disgusting to hear about teams like this. It sounds like this may not be a dedicated team but something that gets thrown together at the last minute. So no, you may not have 3 "highly trained Neo professionals" on board but some "I'll go! Pick me please!" volunteers. The other reason and possibly one of the very few situations to consider L/S is when you have medical incompetence in back with the patient.

[DwayneEMTP]

You know Vent, you are a gift to the City.

Your answers are so thorough, intelligent and educational. You often seem to intuit the unasked portions of a poster's questions...Pretty cool.

Your kind of like a Dustdevil with girl parts and none of the rough edges...

Thanks for the time you spend teaching us here.

Dwayne

[Ridryder 911]

I find it strange that any neonatal would run "hot", especially returning. Research has demonstrated that time is not the element. Even the existence of neonatal flight teams are questioned due to as Vent described the infant is treated at the hospital.

R/r 911

[akroeze]

Well said Vent! You have managed to sway my position on this issue, I retract my previous statement except for my frustration over the idea that "They're doctors! They can do ANYTHING!!!!1111oneone"

[CBEMT]

I've transported both neonate and pedi teams, both of whom consisted of a doctor and nurse, and an RT prn. The neo team seemed to have Respiratory most of the time though.

Since we were a private, we had to do what the team told us, including l/s decisions. But, if they didn't say anything up front, I didn't ask and did it my way. After a little while, the nurses started working with me instead of dictating. Besides, by that time I had figured out what needed a quick trip and who didn't. Post cardiac arrest, 30-minute run during morning rush? Sure. Stable new onset IDDM at 9pm? Nah.

The neonate teams in particular seemed to have an affinity for the flashy stuff; I mean they really did NOT want to spend any length of time on the road, which to me simply spoke of their discomfort with anything outside of their bright spacious NICU. But in general, both teams would commonly say, "We want the lights, but just to get through the red lights." :roll: Basically if the truck wasn't moving for any "extended" period of time they started asking questions.

[911emt911]

So basically what you all are saying is that the lights and sirens are really not needed? I kinda feel the same way you all do.

[p3medic]

Your kind of like a Dustdevil with girl parts and none of the rough edges...

Dwayne

I think I just wet my pants. That is just hilarious!!!