Fatal Ambulance Accident under Investigation in Utah

[Kiwiology]

Priority 1 responses here are determined by MPDS with C, D or E calls automatically being a P1; requests by crews for Intensive Care Paramedic backup (R50) are automatically a P1 unless requested to be normal road speed (P2) by the crew who are on scene but this is rare.

Returning P1 is entirely at the discretion of the crew who are on scene.

I assume "SR" means symptom relief?

[jonas salk]

For awhile there was a push from management (well the QA Sup) at my local service for Code 4 return on all CTAS 2 patients. The crews fought and fought, resisted and refused and eventually it was dropped with the BS CYA remark of: "fine but you could wear it as a result."

Where I work there's no policy at all. Code 4 return is entirely crews discretion and I've never had anyone question it. As a service, culturally we very rarely transport Code 4. CTAS 1, STEMI's and CVA's and non-STEMI ischemic CP's are usually it.

Code 4 response is at our discretion to but we tend to error on following dispatch since we've all been burned before. My last call of my last shift was a possible UTI, Code 4 due to drowsy. Arrived to find Pt GCS 5 x24 hrs, per-arrest. She was DNR but by moving quick and getting her in she was able to get BIPAP before she arrested and did end up being weaned and survived fr at least a few days. Extreme case certainly but I prefer arriving in a timely manner just to be sure.

I also had a big disagreement with a colleague on transporting active labour Code 4. I refuse in the case of uncomplicated labour. If we need to deliver we need to deliver but it's not worth the risk. He expressed not wanting to deliver in the Ambulance as justification. I pointed to the almost regular cases of unassisted home and side of the road births and that even contractions 2mins apart may be hours from delivery.

Things have changed with your service from when I was there, unless there is a cultural divide between the north and south with code 4 returns.

[BillKaneEMT]

If they're transporting a patient that they should be able to treat and stabilise competently given their training and scope, then there shouldn't be any reason for them to use L/S. If the patient requires further treatment beyond what the medic is capable of providing to stabilise the patient, then L/S are warranted.

I think this a perfect expression of what every policy for ambulance services should be. I'm going to show this to my boss and it'll probably be printed out and put on a poster at the base. Well said.