In the house vs. In the ambulance

[Dustdevil]

I don't ever feel safe on a scene unless I'm in my truck.

Did you know that the great majority of medics killed in the line of duty are killed in their trucks?

Food for thought. :wink:

[Guest]

We like to work the pt on scene, stabilizing them before transport, much like everyone else has stated.Once on the rig, the medic will start a line if needed or en route if the pt is high priority ( read L & S ). I always enter a home with the appropriate bag, O2, and stretcher if we have received the correct info from the EMD. :roll:

[Nate]

Did you know that the great majority of medics killed in the line of duty are killed in their trucks?

Food for thought. :wink:

I mean when it is parked.

[FVFD441]

As a rule I try to limit the time for the seriously ill to 10 minutes in the house. I feel that 10 minutes gives me time to

figure out whats going on and get on the road. I can always do more in the medic then in the house. But when working a code

I do one round of ACLS, Get an airway, IV, and BUST them before going to the truck.

[medicnow911]

Bring the gear in , in case it's needed immediately but the ultimate goal is to get them to the truck. Our medical control keeps a close watch on our "on scene" times. We don't "stay and play" too often

[paramedic_lives_here]

Medicnow, our company also has strict guidelines but often we are delayed do to extrication anyway!

Sometimes patients need treatment right away and dont have time to wait until the truck.

How many would agree that the cowboy days are over? Quality patient care versus fast driving and throw them on the stretcher and go?

[Dustdevil]

Our medical control keeps a close watch on our "on scene" times. We don't "stay and play" too often

Doesn't sound like a very progressive medical control. Better medical controls will be more concerned with the patient getting the care they need at the earliest possible time than with how long it takes to get them to the hospital. The point of ALS EMS is to take the hospital to the patient. And if the patient immediately requires something we have within our capability, any overriding concern for scene time is grossly misplaced.

[Dustdevil]

How many would agree that the cowboy days are over? Quality patient care versus fast driving and throw them on the stretcher and go?

Do not hijack topics. Discussions should remain focused on the original poster's intended topic. If a separate topic or concern arises during the course of discussion, post that topic or concern in a new topic rather than sidetracking the original discussion.

[combatmedic91a10]

I find it hard to accurately answer the "narrow" options of the poll.

My honest answer is that it depends on the situation. All of your prearrival preparation is done with information provided by the dispatcher -- so you begin to think, hmmm....this patient sounds sick, I'll take all the stuff or maybe, hmmmm smells like ca-ca, bring in the stair chair and lets get to the truck........

I think this entirely depends on exactly what type of patient you find yourself encountering. Does the patient need definitive care right then and there, or is your patient stable enough to be loaded to the truck? Decisions are actually made right then and there.

Where I work, we have guidelines (just like any ol EMT) that say to make our transport decision early (stay and play vs. load and go) but you kinda need to assess your patient first.

So I think the poll question should have a third option: "I assess my scene and patient and then decide where I am going to work."

Just my opinion

91a10

[medicnow911]

sorry, didn't mean to offend. Our med control" guidlines" give us 20 minutes on scene time. You can document in the report why you needed longer. extrication, large patient, whatever. There are, unfortunately, some people who will abuse it. There are probably even some medics, I can honestly say, I don't think CAN start an IV enroute. You are not going to be "tagged"by med control for a few minutes, but people who regularly take 30 minutes or longer are going to be questioned unless a legitimate reason can be documented. Our service area averages from 1 mile to 40 miles to the nearest hospital. I haven't had a problem staying within range of 20 min on scene time and we are an all ALS service with MFR non transport Fire Depts. My pt's don't just get thrown in my rig and treated with Diesel. They get all appropriate care and treatment.