Does It Get Any Dumber Than This

[Richard B the EMT]

2 EMTs on one truck and 2 Paramedics on another

And what is wrong with that type system? FDNY EMS Command, and before them, the NYC Health and Hospitals Corporation EMS, has been using it from before I even became an EMT in 1973.

If you work from previously established call types, the medical director(s) have already assigned both priorities, and response patterns (BLS only, ALS only, or both). HHC EMS, and then FDNY EMS, used, and are using at least 50 call types, from ARREST (Pri 1) to MECHF (Pri 8) (MECHF is an ambulance down "mechanical" with a flat tire).

As I think I already have posited, getting back on topic, having one agency check out the conditions to determine the need for another is an outdated policy, even when it originally was implimented.

However, nothing is absolute. If there is an arrangement that in certain circumstances there might be danger to responding EMS crews, such as reports of shots fired, let the LEOs check out the scene first, but have the ambulance "staging" from a safe location close to the actual scene, until the LEOs say it's relatively safe to have the EMS crew enter. I also realize this may not be either everyone's policy, or even workable in some situations.

[Kiwiology]

And what is wrong with that type system? FDNY EMS Command, and before them, the NYC Health and Hospitals Corporation EMS, has been using it from before I even became an EMT in 1973.

With the utmost respect to your decades of experience mate, this type of mix and match system is not good for business especially when one considers the horrendous disparity between 120 hours (EMT) and 1,200 hours* of education (Paramedic)

*give or take, except in Texas where 625 hours is acceptable

[hatelilpeepees]

I have to agree with Richard, there is no one-size fits all EMS/Fire System for every community. For all we know, every firefighter on the engine is a seasoned Paramedic, and as indicated by others, the response time was better than most urban systems.

At the end of the day, this is an "I feel guilty about killing my baby, so I need to blame someone else for it". As with many citizens, this parent probably feels that if the patient would have made it to the ER in 10 minutes, "House" would have been on-duty and performed a life saving miracle.

Traumatic arrest is traumatic arrest and it really does not matter when the ambulance arrives, especially when it is a child squished by vehicle (or at least 99% of the time I should say).

Had a similar call here, young med student blows his brains out (literally almost all brain matter splattered on ceiling and wall - GSW through mouth); EMS called the patient dead at scene, family sued because they did not try to save him.

[JakeEMTP]

HLPP, I went back and read the article again and again, missed the part where it was a traumatic arrest. I didn't read anywhere in the article where the pt. was a traumatic arrest. The article states she was pronounced at the hospital, an hour after the call began, For a city as big as Houston, that is unacceptable. An hour to get the pt. to a hospital? Total F'up by the FD and their idiotic dispatch system.

Frankly, your callous attitude towards pt. care scares me.

[HERBIE1]

HLPP, I went back and read the article again and again, missed the part where it was a traumatic arrest. I didn't read anywhere in the article where the pt. was a traumatic arrest. The article states she was pronounced at the hospital, an hour after the call began, For a city as big as Houston, that is unacceptable. An hour to get the pt. to a hospital? Total F'up by the FD and their idiotic dispatch system.

Frankly, your callous attitude towards pt. care scares me.

I'm not sure what you are referring to, but I agree with HLPP here at least about the survival rates for traumatic arrests in the field being essentially zero.

Maybe that system is required to work traumatic arrests, which means the patient was not pronounced until the ER, but was in full arrest the entire time. We are also required to transport traumatic arrests- unless they meet certain criteria, or it's declared a crime scene by the police.

Do I agree that an hour is far too long? Of course.

[paramedicmike]

The article did say a helicopter was requested. It did not say it was actually used. But I don't know a flight service that will actually fly a trauma code even if it's a kid.

That being said, there are an awful lot of questions left unanswered by this article. One thing I think we can agree on, though, is that even though one system may not work everywhere, it's pretty stupid to send a firetruck when an ambulance is needed.

[DwayneEMTP]

...We are also required to transport traumatic arrests- unless they meet certain criteria, or it's declared a crime scene by the police...

Not taking a shot, though I'm not sure how to phrase this without it sounding that way..

You have a protocol that states that the legal possibilities on the scene mandate the medical decisions made my the crew? You might work a trauma arrest from the scene of an accident, but not if there are bullet holes in the window?

Maybe I misunderstand. As you stated, working trauma arrests has fallen out of vogue due to all of the pesky science shit, but I found this curious.

Dwayne

[craig]

Had a similar call here, young med student blows his brains out (literally almost all brain matter splattered on ceiling and wall - GSW through mouth); EMS called the patient dead at scene, family sued because they did not try to save him.

and that goes to show the world how stuffed up America is with the litigation and blame someone else state they have gotten themselve into...........

[hatelilpeepees]

HLPP,  I went back and read the article again and again, missed the part where it was a traumatic arrest. I didn't read anywhere in the article where the pt. was a traumatic arrest.  The article states she was pronounced at the hospital, an hour after the call began,  For a city as big as Houston, that is unacceptable.  An hour to get the pt. to a hospital? Total F'up by the FD and their idiotic dispatch system.

Frankly, your callous attitude towards pt. care scares me.

Its not an attitude, it is scientific fact, I am sorry if I came across as callous, but traumatic arrests rarely survive for the obvious reasons.And most helicopter services in our area will fly a pediatric arrest, just not adults. You are correct though, the article does not state the child was in arrest upon the arrival of fire/ems.

Edited November 8, 2011 by hatelilpeepees

[paramedicmike]

I'm not sure it matters all that much if the child was in arrest upon the FD's arrival or not. The question here is a logistical one: Is it appropriate to send a fire truck to an ambulance call? The answer is a resounding "NO!".

Do we really think that this mother was on the phone with a lazy, "Yeah... I might've run over my kid with the car. Can you send someone out when they have a minute?"? Or was she on the phone hysterically crying, "OMG! IJUSTRANOVERMYBABY!COMEQUICK!!!!!"?

What on earth would make it appropriate to send a fire truck over an ambulance?