Extrication

[WolfmanHarris]

So for all the time we spend ragging on Fire when it comes to EMS, I was reading today about the issue on the other foot.

New South Wales Ambulance to Lose Extrication

I don't know a tonne about this specific situation but it did get me thinking and... I'm with Fire on this one. (Not that from my reading they were trying to steal this or anything; it didn't specify)

I don't think EMS has any more business doing rescue then Fire has doing medical. Seems self-evident too me, especially give all our discussions on fire and ems. Any other thoughts on this?

- Matt

[JET EMT]

My thoughts on this may be a little bias, as I am a member of a rescue squad, we are contracted as a first responder for MEDIC, which is the counties ALS/Transport service and they direct all EMS in the county, We are responsible for rescue and extrications and assisting with on scene BLS care. We are one of only three certified Heavy Rescue Units in the county and our duties include Extrication, High Angle Rescue, Swift Water Rescue, Search, Etc. Everyone on the squad is an EMT-B and must get certified as Rescue Tech. within 2 yrs of joining the squad. We do not do any transport, only on scene care.

I agree that primary medical care and transport should be left to the Paramedics, and Extrication and Rescue should be performed by properly trained RTs and/or Fire Rescue personel.

Thats my 2 cents for what its worth.

[Timmy]

I don’t live in NSW but I do agree, paramedics should not be rescue officers.

In my state of Victoria which borders NSW we have State Emergency Service who provide road accident rescue to rural areas and the Fire Brigade who cover metro areas. Ambulance Victoria which is the state paramedic service have nothing to do with rescue, only patient care. Some paramedics may volunteer with an SES team but they would only respond when there off duty and do not respond in a medical capacity.

This may be out of line but a lot of paramedics bang on about being understaffed, is it any wonder when you have paramedics responding in a non medical capacity?

[Dustdevil]

I don’t live in NSW but I do agree, paramedics should not be rescue officers.

I'll do you one better. Firemonkeys shouldn't be rescue officers either.

[Don1977]

Here fire and EMS do extrication, depends what area its in, I believe EMS should do extrication, there could be an unEMS trained person working on the extrication who has no idea what "hold C-spine" means.

Let the fire dept clean the road hazards up and "assist" with extrication and pt care if possible

[Timmy]

I would disagree Don, anyone can perform cervical spine stabilization. Hey you, come here, hold this still.

If you had paramedics with jaws of life and trying to figure out how to get them out of the car then who is looking after the patient?

When we have an MVA here the following happens:

-Police are dispatched for traffic control and accident investigation.

-State Emergency Service are dispatched for rescue/jaws of life/lighting ect

-Ambulance Victoria Paramedics are dispatched for patient care and transport.

-Country Fire Authority are dispatched for fire suppression standby and wash away.

It all works pretty well, everyone has a job and we work well as a team.

[WolfmanHarris]

If presented with an option of either cross-training paramedics in extrication or taking an underutilized Fire service and retraining and retasking them as a rescue service with Fire suppression being part of their repetoir I'm going to go with not doing anything that pulls the Paramedics away from patient care. You want to do rescue, do rescue. Awareness level training is useful for technical rescue, but what ALS skills are you going to be using with the jaws in your hand?

[Arizonaffcep]

As long as it (extrication, light/med/heavy) can reach the patient in a timely manner, who cares who does it as long as they have the qualifications? By that same token, I would say EMS would have a greater ability to handle extrication in areas that are not covered well by fire, either poorly staffed vollies or ill trained FT ff's. I think the most important aspect of this is, that the patient not get lost in the "who's flapping the roof" contest. If there are separate fire/EMS, EMS must play a role in extrication, even if it's only passive and focused on treating the patient while everyone else is extricating. This opinion does assume everyone involved has the correct PPE to do their respective jobs.

[Just Plain Ruff]

I am not issued PPE(bunker gear) so I'm not about to start cutting very very sharp metal with jsut a pair of ems pants on.

We have three really good extrication crews that help us out on calls and we like it that way.

My responsibility is for the patient. You have you and your partner on the ambulance - who of the 2 crew members are gonna pop the door or peel the roof. Or do you add a 3 man crew on a rescue truck that is run by the EMS Agency. Regardless, you need more than 2 people on scene to do it all.

[firedoc5]

I know it's different in a lot of areas, but for where I worked we did it all. Fire/Rescue/Medical/Haz Mat/, etc.

And we had to become certified in all those things within the first three years on the dept. Luckily I was already certified in all but the Haz Mat at the time.