Rural Scene Times

[mobey]

Mobey, as I believe we've established, here, we are all using some varient of CUPS status to determine appropriate scene time. For those who don't know CUPS, that is Cardiac Arrest (or Critical), Unstable, Potentially Unstable, and Stable, which should be used to determine staying on scene to treat, or taking the show on the road, what I've been irreverently calling "Load and Go" versus "Stay and Play".

Neat! I have never seen this before.

Excluding trauma, I have 30min on scene times with almost all of these patients. But as this thread is reerring to, that is kind of a rural/remote thing, Stabilize prior to transport.

[Richard B the EMT]

Neat! I have never seen this before.

I think you might have, but using different wordings.

There is, also, scene times that get longer, such as extrications, where one removes a patient from a damaged vehicle, and disentanglements, where the pneumatic cutters and spreaders remove the damaged vehicle from the patient.

[melclin]

I just can't understand how you could get a scene time of 10 mins.

My scene times are routinely 30+ mins. When we're really moving that might peak under 20.

Anyone got any insight into how jobs are being run to achieve these 10min scene times?

[Richard B the EMT]

The shortest scene times I know of, are some of the "you called us for THIS?" walking patient calls, where the patient meets us at curbside.

[emtdennis]

"You called us for THIS?" YUP!!! I know what you mean. We got called for a pt who got hurt 2 weeks prior, and the injury site felt sore..... Got on his cell phone as soon as we got rolling to the hosp.

[mobey]

Shortest scene time I have seen was for a young lady who had "the shakes" a day after a night of drinking. I was on practicum, my partner opened the door to the house and saw her lying on the couch. He asks "are you the patient?" She answers "yup", he says "grab your shoes, lets go"

She stands up, puts her shoes on and walks to the rig. We start moving immediatly, and I barely have time to get vitals before we are at hospital.

Hilarious 5am call.

Not the way I choose to do things..... but a good experience for me as a student.

[island emt]

I just can't understand how you could get a scene time of 10 mins.

My scene times are routinely 30+ mins. When we're really moving that might peak under 20.

Anyone got any insight into how jobs are being run to achieve these 10min scene times?

We routinely have <10 min scene times. Unless you are working a code or resp distress/arrest needing immediate right now on scene care, why would you need more time.

Walk in say hi ask what caused you to call 911. Get a set of vitals and maybe give ASA & do 12 lead or neb tx prn. while partner gets the stairchair or stretcher ready to travel, total time 3-5 mins elapsed. Do you haul in all the equipment on the bus so you can do IV's and med tx on scene when you should be on the road heading to the hospital.

I prefer to be in my office where privacy and security are good and all the equipment is nearby .

PS: We have a minimum of 30 minute travel time to nearest hosp ER & an Hour plus to a trauma/ Cath lab center, so plenty of time inroute to do all the care we want and the Pt needs. If you work in the hood where the transport time is < 10 minutes then the culture that develops is to spend 30 minutes on scene so the medics can accomplish their tasks .

added PS

Edited June 28, 2012 by island emt

[Arctickat]

Mobey, as I believe we've established, here, we are all using some varient of CUPS status to determine appropriate scene time. For those who don't know CUPS, that is Cardiac Arrest (or Critical), Unstable, Potentially Unstable, and Stable, which should be used to determine staying on scene to treat, or taking the show on the road, what I've been irreverently calling "Load and Go" versus "Stay and Play".

We use the Canadian Triage and Acuity Scale. (CTAS)

http://caep.ca/resources/ctas

It uses a scale of 1 - 5.

[Richard B the EMT]

While not always attainable, it is do-able. With minimum 2 person crews, one asks the questions of patient and family, or bystanders, while the other actually does the vital signs.If ALS, slightly more to set up and run either 2 or 12 lead EKG.

I had one call where the family complained I was doing all the work, while my partner did the writing. I explained it was to save time, and the next day, the partner would do vitals while i did the writing. They accepted our logic.

We take turns at FDNY EMS, driving and teching. "Shotgun" writes, and continues care during transport, "Wheels" does vitals, and, of course. drives

[paramedicmike]

I just can't understand how you could get a scene time of 10 mins.

Why can't you understand this?

My scene times are routinely 30+ mins. When we're really moving that might peak under 20.

What do you spend all that time doing?

Anyone got any insight into how jobs are being run to achieve these 10min scene times?

Yes. First, however, I gotta know what you're doing in your 30 or more minutes on scene time.