In the house vs. In the ambulance

[PRPGfirerescuetech]

No matter what you do, never, never, NEVER! go into the house without your airway bag and oxygen.

....and your partner.

[Ace844]

Or ensuring a means for you and your parteners quick egress as needed...

[mediccjh]

Or ensuring a means for you and your parteners quick egress as needed...

That's why you always prop the stairchair in the door.

[FormerEMSLT297]

My specific questions are:

• 1. All things being equal, which is your preferred method of operation on an ALS medical run? Why?

2. Does your agency have an SOP covering this? If so, what is it?

3. Did your instructor or school ever tell you which way was the "right" way or the way you should do it?

4. Does everybody in your agency operate the same way, or does the controversy still divide the profession?

Qualifiers: I don't want to hear a bunch of "what ifs." This is not a trick question. It is a simple, straightforward question that does not require any reading into. Your scenario is a safe, uncomplicated medical (not trauma) scene in a well lit suburban home with the ambulance parked close by and fair weather. You are not being rushed by low staffing levels, danger, or a lack of support. And I am asking specifically about ALS intervention, not ABC's.

OK I will try to answer dustdevils exact questions:

1. all things being equal I prefer to do an assessment and any BLS, ALS in the house, get your O2, V/S, Baseline EKG and I.V, as well as first round set of medications, then package to patient and transport and we will contact med control either from the residence via phone or via radio while en route hospital for additional orders.

2. Our agency SOP's only address what equipment you must bring in to a call, not where to work, however if you get seen by a supervisor bringing a patient out of a house without ALS when the patient clearly needs it, s/he may question why you didn't do ALS prior to transport.

3. Medic school was a LONG, LONG, time ago but my instructors explained that they felt that getting the initial BLS and ALS treatment on board will usually provide a more rapid benefit to the patient, especially in the Resp. distress and cardiac pts.

4. a large large majority of medics in my former agency operate the same way, but some controversy still surrounds the question and at my new job in MD some medics will just V/S and O2 and EKG and do the IV and meds en route to the hosp.

I hope this answers the specific questions that you asked...

[tinman694]

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 love this...our '911' dispatchers cannot determine between a stumped toe and cardiac arrest

(I had a subject fallen call yesterday...subject was fallen all right...dead x 12 hours)

Walk 'em to the truck and get busy...

[Arachne]

I love this...our '911' dispatchers cannot determine between a stumped toe and cardiac arrest

(I had a subject fallen call yesterday...subject was fallen all right...dead x 12 hours)

My first code was like that...they sent a BLS truck for a fall, and we walked in to find grey skin, no pulse, no breathing. We're dispatched by a fire department that doesn't have real dispatchers - the firefighters rotate through dispatch. I guess it's too much work to ask, "Is he conscious?" or "Is he breathing?" when you can just say, "Yup, okay, we'll send someone over for a fall".