Extrication

[mstovall]

For the EMS services that do their own extrication, do you wait until fire is on scene to start cutting? Who is the safety officer? Where is your fire suppression? Is it just the two little fire extinguishers on the ambulance?

While I have no problem doing my own extrication, and sometimes prefer it as I know what benefits my patient better than a fir guy with no medical training, I do have a problem with doing it unsafely. We need to focus on one of our first duties as EMS, scene safety.

Michael

[firedoc5]

For the EMS services that do their own extrication, do you wait until fire is on scene to start cutting? Who is the safety officer? Where is your fire suppression? Is it just the two little fire extinguishers on the ambulance?

While I have no problem doing my own extrication, and sometimes prefer it as I know what benefits my patient better than a fir guy with no medical training, I do have a problem with doing it unsafely. We need to focus on one of our first duties as EMS, scene safety.

Michael

When I was working for a private ambulance serv., way back when, we didn't wait. Since I was the smallest, usually, I would dive into a vehicle with the pt., literally. I would do what assessment and treatment I could. We had all the extrication equipment as Rescue except the Jaws. Luckily we pretty much had the same ETA as Fire/Rescue. At least within 3-5 min. If we hadn't started to actually start extricating we'd at least be set up to start or at least knew what needed to be done by the time they got there. Many at that agency was ERT's or Extrication Specialist.

We helped with fire rescue too. Right along with the FD.

I know, kinda putting myself at risk too. But I was young and really wasn't too concerned about it myself back then. Many times I'd be inside with the pt. and they would just cut the vehicle away from around the two of us.

It wasn't until I got onto the FD full time did I actually think about it, and how inappropriate my actions were. I guess you could say I 'grew up'.

But even after getting on the FD and only ran in town calls, I was stuffed into a vehicle just as before when the extricating was going on. Back then at, 5'3" 119 lbs-125 lbs, I was able to get into a lot of tight spaces. Attics, crawlspaces, old coal shoots, vehicles, air ducts, you just about name it. I guess no wonder why my neck, back and legs are shot now.

[Chief1C]

Just my opinion, as all of our services fire/ems/pd seem to work so well together. May not work where you are, but it works fine here. I always felt that Rescue and EMS should go hand-in-hand, since there is usually a victim being rescued. Cross training to an extent, and the capability of working well together may be enough.

Clearly, you need more than a rescue tool on an ambulance, you'd need additional personnel other than what is on the ambulance. But it's my opinion that the better rescue and ems can work together, the safer the outcome for the patient. If they know a little first aid, they won't be man handling the victim. Likewise we won't be out with our chisels, hacksaw and wreck bar trying to get them out the way a tow service driver would have fifty years ago. Since it's more than just snipping metal with a pair of hydraulic shears; stabilization, fire suppression, hazards, etc..

[toutdoors]

In my area, the FD does the extrication, and the ambulance treats and transports. Bear in mind that all FF's are EMT's, so that at the very least, everyone on scene knows what C-spine immobilization means, and there is a good amount of common ground that we are all on. For the veteran medics, they know the difference between when a door just needs popping, and when everything needs to get moved. I am a firm believer in some amount of cross training. At least to the awareness levels. This way that brand new medic, who has never seen a fire engine, or rescue rig in person knows what the capabilities are of the extrication team, and what certain terms mean. ie, pop a door, or flap a roof. I also believe that anyone who is going to do extrication needs to be an EMT at a minimum. This only makes sense, well to me anyway. I mean really, if you are going to remove a bunch of mangled metal from around a patient, shouldn't you have a basic understanding of EMS? On the flip side of that coin; if you are going to treat and transport a patient that was entrapped in an MVC, shouldn't you have a understanding of what type of extrication evolutions would be of the best interest to your patient? I am not saying that all medics should be or need to be extrication techs, but they should have a basic understanding of how extrication is performed, and what evolutions will give them the best possible outcome for the pt.

Why should we have two different agencies working toward the same goal, but not know what the other agency is doing, or why. The more I read here, the more I realize that where I work, we must truly be blessed, because the relationship between fire and medics is really good. (Most of the time) Of course we have some individual personality issues at times, but that will happen. The professional relationship, and respect goes both ways for us around here, I truly feel fortunate.

[craig]

Guys

thanks for the insight that you have but you need a little back ground to understand the situation

The Ambulance service of NSW has been performing rescue for over 50 years.

they dont do it out of the back of an ambulance, they have specialised rescue units to carry out this work.

not all paramedics in nsw are trained in specialist rescue, it is a further optiona nd career path for paramedics

not all areas in nsw have ambulance rescue, and the fire brigade is only taking over in the metropolitan areas.

The problem is that the firebrigade do not have high angle/vertical rescue nor swift water or depts and trenches.. nor do they all do confind space rescue.

the paramedics that are on the rescue units have to maintain their rescue recertification as well as their medical certification.

if they are dispatched to a scene that requirs rescue, they back up and assist the ambulance paramedic already on scene. if required they then after the extrication can assist with the treatment of any injured persons. They do not transport the sick and injured....that is what the ambulance is for.

In times when the ambulance crews are tied up on cases, the rescue crew can respond to medical emergencies to treat the patient until an ambulance can be dispatched to attend for the transport...same as the first responder (single officer in the SUV).

ther was never any problem with the fire brigade doig rescue in nsw, however the ambulance service has a history of carrying out a important and needed task, and woithout any thought it has been taken away, and the public now has to wear the cost.

Stay safe

craig

[craig]

Oh

anf i forgot to say the the firebrigade in nsw do not have any of their fire fighters as EMT (at any level from Basic to Para)

however they do have a first aid certificate and can use an auto defib and O2

stay safe

craig

[Arizonaffcep]

What is the motivation for them taking over extrication operations? From the sounds of it...they don't have the qualifications...

[firedoc5]

Oh

anf i forgot to say the the firebrigade in nsw do not have any of their fire fighters as EMT (at any level from Basic to Para)

however they do have a first aid certificate and can use an auto defib and O2

stay safe

craig

I, personally, think that's not quite right. If they are going on extrications they should have more training than that. What if they beat EMS to a call where the patient is trapped and needs immediate care? Do they know how and when to move a patient if need to?

Early in my career we did have a few depts. that had no additional training and they learned real fast that they needed to improve, and they have.

We had a van flip off an "S" curve. We got there first luckily. When Fire/"Rescue" got there not a one came down the embankment to help out. Except for one. His mother was the driver. The others just stood at the top of the hill, one guy just holding a booster line nozzle. Drove us nuts.