Stretcher to the House?

[mediccjh]

Police? What are those?

Now stop being a smartass before I have you arrested (again). 8)

[akroeze]

Question:

If you don't bring the stretcher in and you need it, what do you do? Do both you and your partner leave the person alone while you go get it? Does just your partner go? What if there are several stairs to get up to the door?

This is assuming it's just the two of you and no fire.

[vs-eh?]

Here is my take...

I'd say ummmm, 70% of patients are either ambulatory or walk to the stretcher with no/minimal assistance.

The other 30% are either stairchaired/scooped/walk a few steps/slid/fore and afted to the stretcher.

Whether or not we take in the stretcher is usually a combo of call details/distance to patient (i.e apartment)/presumed equip needed...

Either way it is extremely rare that I would take the stretcher directly into a residence first without doing an assessment. It usually just stays outside of the house/apartment until we decide what is going to happen. But if we are going to take in all the stuff, then the stretcher goes, simply for assumed patient acuity and more importantly a shorter time that you are carrying that shite.

[Medic253]

Well here is how it works where I am at depending on the call, If it’s a BLS call the box and maybe O2. For the ALS calls the full gamete box, O2, and the 12. Now as for the stretcher it stays’s inside the truck unless it is a nursing home call then it goes in with. Otherwise it will stay there until the cop or someone gets it. There is no need to take that in when there is much more to do yes in some situations; shootings, stabbings, some MVA’s where they are right there and all you do is scoop and run. So there is my opinion on how things are done.

[Eyegor]

Well, it looks like I'm going to have to stick up for the stretcher jocks.

In a former lifetime I worked ALS for a private that did both interfacility and 911. We were always a 2 man crew and usually a long way from the hospital. The stretcher always came in with us. At least to the door. If we were not in the truck in fifteen minutes then something was seriously wrong. Minimum scene time was our key. One trip to the truck vs. 2 or 3 = saved time.

Now days, my agency is a combination career/volunteer agency with career ALS 1st response. As a volunteer on the ambulance, the medic has almost always preceeded me to the scene and began his/her work up. Again, we take the stretcher with us (when appropiate) because we have a much better idea of what the scene entails.

BTW: When I am on the ambulance, once we get on scene my driver has two primary jobs. 1st. Position the ambulance in the best location. Driveway, roadway, whatever works best. 2nd: Plan a route to remove the patient from the location. Does furniture need to be moved? Is there a back door with easier access? etc.

When this topic started I flashed back Larry Hagman and the stretcher on the stairs from M,J and S. 8)

[Dustdevil]

Explain your response to #1, please.

Sure. The simple fact is that you just do not know about a great many dangers on your scene until you get there and find them. And a great many of the alleged dangers you assume were there because of the nature of the dispatch were never there to begin with. And the mere presence of police on a scene does not in any way assure your safety. Almost every time I have been attacked, including shootings, it has been with police on scene. If police on-scene was such a safety assuring factor, then we wouldn't see so many cops being shot and assaulted, would we? Use your heads.

This is yet another glaring example of both the naiveté of most medics, as well as the horrible inadequacy of EMS education that allows them to enter the field believing this crap. "Scene safety" is not just a phrase you verbalise in skills lab. It is a very real and very important concept that must be in the forefront of your mind at all times. Seems like every idiot coming out of school these days actually believes that as long as police are on scene, they are perfectly safe, and it's just crap. I'm not working with anybody who doesn't get that thought out of his or her head on day one.

And I'm not working with anybody who has to be told a third time to keep all ambo doors locked at all times either.

[Dustdevil]

We were always a 2 man crew and usually a long way from the hospital. The stretcher always came in with us. At least to the door. If we were not in the truck in fifteen minutes then something was seriously wrong. Minimum scene time was our key. One trip to the truck vs. 2 or 3 = saved time.

Doesn't matter. You still have to make a second trip to return equipment to the ambo. Unless you're piling your equipment on the cot with your patient, or trying to carry equipment and the patient simultaneously, which I as a manager would not allow for obvious safety reasons.

If you're carrying a patient, that is ALL you should be doing. You should not have bags slung over your shoulder that may shift and throw your balance off, or one hand full of equipment keeping you from having both hands on the stretcher at all times.

Carry equipment into patient.

Establish patient contact, assessment, and care.

Partner returns unnecessary equipment to ambo and retrieves cot (or stair chair, or whatever)

Both crew carry patient -- with only necessary equipment (monitor, O[sub:a9fed5ca5c]2[/sub:a9fed5ca5c]) -- to ambo.

No extra trips involved. Patient is safer. You are safer.

And yeah, the vast majority of systems have firemonkeys to do all that for them anyhow.

[medik8]

Sure. The simple fact is that you just do not know about a great many dangers on your scene until you get there and find them. And a great many of the alleged dangers you assume were there because of the nature of the dispatch were never there to begin with. And the mere presence of police on a scene does not in any way assure your safety. Almost every time I have been attacked, including shootings, it has been with police on scene. If police on-scene was such a safety assuring factor, then we wouldn't see so many cops being shot and assaulted, would we? Use your heads.

This is yet another glaring example of both the naiveté of most medics, as well as the horrible inadequacy of EMS education that allows them to enter the field believing this crap. "Scene safety" is not just a phrase you verbalise in skills lab. It is a very real and very important concept that must be in the forefront of your mind at all times. Seems like every idiot coming out of school these days actually believes that as long as police are on scene, they are perfectly safe, and it's just crap. I'm not working with anybody who doesn't get that thought out of his or her head on day one.

And I'm not working with anybody who has to be told a third time to keep all ambo doors locked at all times either.

Now Dust...I DO agree with you that a cop does not necessarily make your scene safe. You are right....things can and do happen to them too. We have to take responsibility for ourselves....however, and correct me if I'm wrong, but I think possibly that we were all under the same impression and misunderstood possibly what you meant. I think that I, Nate and PRPG thought that you were trying to say that you should not wait for a police officer and basically just forget about it...bust on in and do your job. In essence, what I get from your post now is that you are just wanting to establish that the mentality of believing you are safe just because someone is there with a gun, is untrue. And I agree.... What we were trying to convey is that ....well...certainly you still have to be careful, but police presence with guns is a necessity. It's not a guarantee...but you sure do have a better chance of protection if SOMEONE is able to at least TRY to protect you. Thus...our questioning your reply to Nate.

Does all of that make sense? Whew....probably not the best worded post I have posted...LMAO...but I think I got my point across...

In summary....Don't rely on ANYONE to cover your ass. Do it yourself. Be careful out there. At least make sure you have police presence on a scene and it is secure as it can be. This doesn't prevent us from being hurt or killed...but at least it's something. No scene is ever fully secure, I believe. Things can fall...there can always be another shooter...hell, your patient can go postal on you! I have had more dangerous patients than bystanders or others. Just BE CAREFUL.... Don't be naive enough to believe that you are ever out of harm's way. All we can do is our best. Stay awake, alert...and use common sense and THEN some....

xoxoxoxo :wink:

Luv, 8

[Dustdevil]

The only point I was making was that the attitude Nate was conveying was, "I don't have to worry about scene safety, because I wait for police to arrive on scenes dispatched as potentially violent," and that is dangerously naive. There is SO much more to scene safety than the presence of police, yet Nate's statement seems to suggest he does not recognise that.

Not all domestic disputes are dispatched as such. Many of them are dispatched as difficulty breathing, injured person, chest pain, seizure, diabetic emergency, or the ubiquitous "unknown medical emergency." Not all people with guns, knives, meth labs, or psych conditions bother to tell the dispatcher. It's simply absurd for any medic to assume that any scene is ever safe based upon dispatch information or the presence of police.

[Nate]

The only point I was making was that the attitude Nate was conveying was, "I don't have to worry about scene safety, because I wait for police to arrive on scenes dispatched as potentially violent," and that is dangerously naive. There is SO much more to scene safety than the presence of police, yet Nate's statement seems to suggest he does not recognise that.

So you were reading into what I wrote instead of asking me to clarify it? :roll: Come on man, you should know me better then to believe that just because a cop is there that it is safe. I was posting in response to what someone else had posted about making a scene before PD arrived. We don't do that around here, we always wait for PD if the nature of the call could be violant.

Also, the doors at Bay Star lock, the doors at the other city service lack locks. That was an issue that was addressed when we ordered our new ambulances for the city I work in. :wink: