Doing your own thing in EMS

[letmesleep]

We have all heard of freelancing in EMS before. I was just wanting to get some input on where you may have seen it happen, or have you gotten caught up in it, due to somebody else's bad judgement? Big situation (like WTC) or small (the county fair) doesn't really matter, having a system in place and following direction from command keeps things under control and utilizes resources appropriately, and without waste. Agree or disagree? What can be done (on a scene) when it occurs to stop it, and how can you (as an organization and a provider) learn from it? Every area/ region/ district is going to have their own system to some degree, so what happens when medics/ cops/ FF deviate from the system?

Thoughts?

[Christopher.Collins]

Im not quite sure how to answer your question... but I think the occasional freelance is ok provided the freelancer isnt stupid. The department I got started in, as with most (but not all) do not permit the use of personal emergency lights and POVs (aside from line officers) on highways in Connecticut. I have broken both of these protocols once and in another jurisdiction no less. But when your stuck in gridlocked traffic during evening rush on I-95 for close 4 minutes finally to come across a mangled trailer blocking the left breakdown lane... and a 25-30' boat crossing both travel lanes, with traffic barley sneaking by in the right breakdown, what is one to do? Several people were running around and 2 or 3 cars pulled over. I blocked both lanes (as if it was nessecarry with the boat there) put my LEDs and hazzards on, called 911 and started patient assesments (no injuries the trailer just ripped off the tow vehicle and people just stopped to gawk at it). Wondering if Id catch sh*t from the state police I waited for them before taking off. They, if anything, were greatfull I stopped... I wound up taking controll of traffic for a while because fire/ems wasnt cancled by them.

[flight-lp]

There are organizational operating policies in place for a reason. Like them or not, someone smarter and with more forethought than you and I has established them for the best interests of all parties involved. I can tell you first hand that freelancing will result in chaos. The level is directly proportionate to the level of the incident at hand.

During Hurricane Rita, a few dumba$$e$ decided to do their own thing in the Beaumont area. The result was not evacuating the largest hospital in East Texas until after the storm blew in. There was no command and control from local EMS agencies or the hospital administration. It took an outside EMS agency to come in with their tactical team to restore order and complete the mission. Many lost their jobs after that one and some were criminally prosecuted.......................

So to sum it up, follow your established procedures. If your agency says no to unneeded whacker lights, then don't buy them or use them. On duty EMS has a mission, let them do it. If they want your help, let them come to you. Otherwise you are more of a hinderance than help in many cases. Playing adrenaline junkie on your off time is just plain dumb, especially if you are knowingly violating your departments policy. Personally, I would have fired your a$$.

[Richard B the EMT]

When the World Trade Center collapsed, a lot of nearby "upstate" 9-1-1 service providers filled their ambulances up with supplies, and headed "South" (or west from Nassau and Suffolk counties), either directly to the scene, or to staging areas quickly set up at Shea Stadium. A good number of these services had "Mutual Aid" policies established with their neighboring services, so if one service had more calls than they could handle, the next one over would answer the call.

The problem was, too many services left their areas, and nobody was left to handle any calls at all. They all felt that their neighboring service would "pick up the slack," but the neighboring service was parked next to them at Shea.

I don't have any information available, but due to all these "upstate" services self dispatching, or freelancing, to New York City, I have vague, but undocumented, memories that several people in these areas died, as there was no ambulances available in the county (counties) at all.

Much closer to home, (like a half mile), when American Airlines Flight 587 crashed into my neighborhood, there were at least 2 Volunteer ambulances from 2 counties away. (I won't identify the agencies, as I still have friends in both of them)

Seeing how so many agencies were, in essence, deserting their post to go to the "Big One", leaving their Primary Area(s) of Responsibility uncovered, New York State Department of Health came up with a new plan, which I will attempt to recreate or paraphrase here.

If a Multiple Casualty Incident happens in one ambulance service provider's area, a neighboring service may not respond in, unless requested in by either the first area's agency, under pre-existing Mutual Aid agreements, or by the State Office of Emergency Management (OEM). Before the second agency can respond, they must secure sufficient coverage for their own area, to handle their usual call volume, before they can respond to the out of area MCI.

Here's the teeth of the enforcement: Any agency that self-dispatches a unit, uninvited, to an out of area call, or fail to provide proper coverage in their home area, BOTH the agency, AND the individual crew members, are getting a $10,000.00 Fine!