If you're by yourself?

[Bieber]

Like everyone said, in a situation where there are more patients than responders, spinal considerations go out the window. In a situation where it's just you and one patient, you might consider having the patient self-splint (i.e. "just stare straight forward and don't move, sir/ma'am"). People are not typically going to do things which cause pain or aggravate their injuries (I have yet to have to tell someone with a broken arm/leg to not to move their limb in such a way that worsens the fracture/creates other injuries).

[paramedicmike]

What TomP and Dwayne said. That basically sums everything up.

[Arctickat]

Can a mod fix the title of this thread? It just hurts to look at it when it pops up in my new messages list.

[ems94]

Sorry artic lol. Law enforcement around here don't just treat first redponders like dirt, they treat our emts and medics the same...they think just because they wear a badge they're better than us....when we have a multiple car collision they are more worried about prosecuting for DUI than helping us

And thanks for your words of wisdom...I'm new to ems and haven't had been on many calls...matter of fact never been by myself for more than 5 minutes....but I know soon 4 out of our 6 respomders are going on vacation and I just wanted to prepare myself

[Just Plain Ruff]

Sorry artic lol. Law enforcement around here don't just treat first redponders like dirt, they treat our emts and medics the same...they think just because they wear a badge they're better than us....when we have a multiple car collision they are more worried about prosecuting for DUI than helping us

And thanks for your words of wisdom...I'm new to ems and haven't had been on many calls...matter of fact never been by myself for more than 5 minutes....but I know soon 4 out of our 6 respomders are going on vacation and I just wanted to prepare myself

Your law enforcement will play a different toon when one of their own get's hurt and needs you guys.

But like Dwayne said, if law enforcement treats you guys like dirt, there has to be a underlying reason for that and that's something that you might want to look into and think about fixing.

[Secouriste]

We have a saying here which goes: "The ground is the best backboard." Which means if you have a casualty on the ground with suspicion of spinal injury, don't be too fast in immobilizing and rather focus on a good assessment (except of course in case of bad weather, hostile environment...).

But as it was said before, if you have more casualties than you can treat, we're in a complete different approach of the rescue action.

In France the first crew on a scene with several casualties will have to do the triage. We have a color code:

- Green: for anyone who can walk or limp. Those casualties are asked to join a gathering point.

- Red: for anyone who needs an emergency gesture performed: stop a bleeding / put on the lateral safety position.

- Black: for VSA casualties

- Yellow: for everything else.

Of course, the reinforcements all called as soon as the high number of casualties is established. This will trigger a special response plan and cause dozen of ambulances + mobile hospital to respond.

As soon as the first crew has finished the triage and as the other ambulances show up, the casualties will be treated in this order:

Red > Yellow > Green > Black

CPR will be performed only if there are sufficient EMTs on the scene.

But even if this plan works out well, let's face it, being the first crew on a "big" scene is very very stressful and demands huge focus on the real priorities.

If anyone has ever experienced such thing it could be interesting to hear it (I've had full-sized simulations but that's it).

[Arctickat]

Sorry artic lol.

No worries, I can understand how much of a PITA it is to use your cell phone to write a post.

[DFIB]

Dwayne is pretty much spot on. In a MCI if I am the only provider on the scene I recruit any bystanders I can and pass out gloves as needed. I treat the patients where they are so C-spine immobilization is usually a non issue at this point.

Our police are pretty much useless in helping in patient care so I rarely recur to them for help. I instruct the bystanders to help me watch patents breathing, mental status and help stop bleeding.

I don't get hung up on a single patient because when I finish the triage round I revisit the patients to monitor for changes and if additional quick interventions are needed. Also I go back to give the newly recruited team a pep talk and make sure they know that they are not on their own and I am available for help. I tell police where I need my ambulance staging area. I continue to make the rounds and prepare my patient priority list. Here, I usually have to exert some authority with LE to keep them from loading patients in the back of their pick up trucks for transport. This part really stinks. I know I used the pronoun I a lot but then I am alone right?

I do hope this helps organize your thoughts.

I like to use start triage. It is simple and fast.

Edited December 3, 2012 by DFIB

[ems94]

Thank you all once again for your great words....I know the question was pretty much common sense....but I guess I needed a little push in the right direction....I've only been with the city for a little bit, but i've already learned a lot from things y'all have posted on my topics and others as well. Looking forward to more to come.

[DFIB]

Thank you all once again for your great words....I know the question was pretty much common sense....but I guess I needed a little push in the right direction....I've only been with the city for a little bit, but i've already learned a lot from things y'all have posted on my topics and others as well. Looking forward to more to come.

Just an additional thought. I am trying to move our department toward less immobilization under a pretty simple guideline.

No pain + no deformity + no distracting injury = no immobilization

I have a fight ahead, but what the heck, I have nothing better to do!