Help me settle a debate

[mikeffd]

Me and my partner have been in argument for the last few days. I was wondering if some of you could lend your opinion.

We work on a native reservation in Northern Ontario. We were paged out sometime between 5-6am for a drug overdose. The only other info that I remember was that the patient was 37 and female. My partner insisted that we wait until the police cleared the scene before we went in. I felt comfortable going in without them. He contends that given the fact that we weren't familiar with the residence, as well as the time of day and the nature of the call (potential for hostility), it was unacceptable to enter before the police. I maintained that given the potential seriousness of the call, that decision was at the paramedic's discretion. In short, it's not a black and white, yes/no answer.

Your thoughts?

[Happiness]

I agree with your partner on this one. I live in a community that is small and even if I know the residence and it is a certain type of call I wait for the police. Where there are drugs there is normally violence. Always remember your safety ALWAYS comes first. If your partner didnt want to go in then you should respect that.

[Eydawn]

What did the residence look like? Previous runs there? Lots of OD turned violent calls on your reservation? How many people there when you got there? ETA on police?

It's never cut and dry, but this is way too devoid of detail to make a decision on. I agree, however, if your partner felt uncomfortable, you did the right thing by staying. Always listen to that little voice in your head... gut instinct can tell you so much.

And, speaking as that person who's just had "a hunch" before and been proven right, listen to the crazy partner unless they're hyper paranoid all the time. It sucks to have to stick yourself out there and say "no really, something's not right here" without an explanation, but boy does it suck if you keep quiet and something happens...

Wendy

CO EMT-B

[mikeffd]

What did the residence look like? Previous runs there? Lots of OD turned violent calls on your reservation? How many people there when you got there? ETA on police?

It's never cut and dry, but this is way too devoid of detail to make a decision on. I agree, however, if your partner felt uncomfortable, you did the right thing by staying. Always listen to that little voice in your head... gut instinct can tell you so much.

And, speaking as that person who's just had "a hunch" before and been proven right, listen to the crazy partner unless they're hyper paranoid all the time. It sucks to have to stick yourself out there and say "no really, something's not right here" without an explanation, but boy does it suck if you keep quiet and something happens...

Wendy

CO EMT-B

The residence looked delapidated and shabby (as all the homes here do). I've never been there before. The police showed up 10-15 minutes later.

I agree that safety comes first. Also, I absolutely respect my partner's concerns. I'd never dream of forcing them into a situation theyd be uncomfortable in. Simply put, he contends that given the circumstances and the info we had we simply shouldnt have gone without police.

[JakeEMTP]

I have to agree with the ladies Mikeffd. My safety is paramount, then my partner and then the patient. If either of us don't feel comfortable then we don't go in.

I don't know the area where you work (although I've probably been in the vicinity) but anytime there is the possibility of a criminal element involved, I like to wait for the cops. My main goal when I come to work is the ability to go home in one piece. I'm positive I/we have entered scenes where we should have waited for the law. But, the longer I do this, the more I realise it's not my emergency.

I remember a call we responded to for a GSW and waited for what we thought was an extended time for the Sheriffs Office to respond. My partner wanted to go in, but we staged an appropriate distance away until the scene was secured. We treated the pt. when the scene was as safe as it could be (no scene is truly safe), and transported routine traffic. Anyway, when taking to the Deputy later we were informed that the assailant was still in the house and was placed in custody. I know I rambled a bit, but we most likely would have been in danger if we had proceeded to the call PTA of the law. The decision to stay staged was a good one.

I'm no hero. I will treat me patients to the best of my ability whilst at work but at the end of the day, I just want to go home to my misses.

[Eydawn]

Looks like your partner's threshold for "I want the cops to clear it first" and yours differ. Nothing wrong with that, and nothing to say who's right or wrong... not worth fighting over. Did the patient die because you waited? Would you have died if there had been a coked out/meth'd out whacko hiding behind the door? All major unknowns in the game of EMS...

Wendy

CO EMT-B

[paramedicmike]

Simply put, he contends that given the circumstances and the info we had we simply shouldnt have gone without police.

And he is correct.

We can't save everyone all the time. We certainly can't save them if the scene blows up in our faces and we wind up hurt or dead from it.

[DFIB]

I would hate for some delusional junkie, just out of prison, or with warrants for his arrest, to wake up from a drug induced stupor to see two uniformed people bending over his main squeeze, "Hey, leave my chica alone!" Bang, Bang! The last patient the medics ever see, the last call they ever attend, the last breath they ever take.

Scene safety. Not an option.

Edited November 18, 2011 by DFIB

[rock_shoes]

Looks like your partner's threshold for "I want the cops to clear it first" and yours differ. Nothing wrong with that, and nothing to say who's right or wrong... not worth fighting over. Did the patient die because you waited? Would you have died if there had been a coked out/meth'd out whacko hiding behind the door? All major unknowns in the game of EMS...

Wendy

CO EMT-B

Incorrect. If instructed to allow police to clear a scene prior to entry you wait until police have cleared that scene prior to entering. In this case the OP was wrong and his partner was correct. As much as pre-hospital care has many grey areas this one is very black and white. If nothing else the OP's partner deserves kudos for standing his/her ground.

[Eydawn]

I disagree. Nowhere was it indicated to wait for police arrival based on the information given in this scenario. There's a distinct difference between the cops are also coming and dispatch instructions not to enter until a scene is clear. Sounds like his partner wanted police clearance, not that there were dispatch instructions to that effect. Unless there's standing orders for PD to clear every drug OD, there's definitely grey areas here.

It's a moot point anyway- it's the calls you never expect to be shitty that jump out and bite you in the ass... (elderly unwell, enter home, realize about 10 seconds into the living room that there's a pit bull sneaking out from behind the couch who looked PISSED that we're in there... that was a nice objective lesson in scene safety...)

I stand by what I said- sounds like there's a different threshhold for comfort here, partner wanted cops, other partner didn't feel it necessary, waited for cops anyway, everyone's alive, time to go home...

If you do notice, in my first post in this thread, I did say that you always err on the side of the little voice... whether it's in your head or your partner's head. Gut feelings can save your arse.

Wendy

CO EMT-B