Would you stop?

[tniuqs]

You let your dispatcher tell you where to go.

Easy enough?

Wendy

CO EMT-B

Does your dispatcher issue you with Blinders or in RaceMedics last statement allow for input from the road, that worked very well for Acadian during Katrina, because the dispatcher was blind as a bat.

[brentoli]

See a theme here? You go where dispatch tells you to go (be nice, Brent) and follow protocols. You don't self activate unless there's a major communication screwup, you're totally free of other obligation, and you let someone (dispatch?) know where you're going and why.

Thanks, ruin my night too.

[Lone Star]

I fail to see why this topic seems to be so difficult to understand. Speaking from my own protocols, and only my protocols, the whole concept is easy enough to understand.

I realize that other geographical areas may do things differently.

Since the revival of this thread, I've noticed alot of 'back and forth' mud slinging....each side defending how it 'should be'.

Since the only available information is from a news article, how else can we discuss this on any other information?

Whether your views support the actions of the crew that stopped at the fender bender, or you don't, either way you're basing your support or condemnation on the same news article.....why cast aspersions to one side, for doing exactly what the other side is doing?

I know that MY protocols clearly state that if you have a patient on board and are transporting them, you're 'out of service' to any and all other calls until the completion of the call, which includes a 'proper' transfer of care (verbal and written reports complete).

If you're 'empty', then you are subject to local laws that apply about having to stop for accidents (providing you're not running to a priority 1 call [emergent call]).

If you're enroute to a priority 2 (no dawdling on your way to the call), or priority 3 (lowest priority ...usually BLS transfer), and you witness an accident, or are flagged down by Law Enforcement....you stop, notify the dispatch center and follow their directions, PRIOR to making patient contact.

I don't know about other counties/states and their protocols, nor do I really care what they are (I dont have to play under those rules).

I hate to say it, but watching this thread go back and forth, with this "I'm right, because I said so" mentality isn't productive to the entire topic.

[JPINFV]

[devils advocate]

Greatest good for the most amount of people would, ironically, be that hospital discharge. By discharging a patient, you open up a room in a hospital that could/would be filled by an emergency room patient. This opens up a bed in the emergency room that would be filled from a patient in the waiting room or a patient from an EMS unit. Stopping at an accident scene where there may or may not be a patient that you can do anything for [see personal anecdote below] prior to the arrival of the 911 units can end up with a ripple delay through the rest of the EMS system. [/devils advocate]

[personal anecdote: After being dispatched for a call at my old company [non-911 call], my unit ended up rolling up on a car that had hit a middle concrete barrier [like a Jersey barrier] and ended up on it's side. 3 patients [15 year old student driver, mom, and a year old baby in a car seat] and none of them seriously injured. It sucked sitting there for 5 minutes for the fire department to arrive to extricate them because there really wasn't any way to get into the car. The fire department ended up holding us on scene until extrication was complete in case everyone wanted to be transported, though]

[emt982002]

What if it was your mother or father that was involved in an accident and you had a stable patient on board? Would those of you who say do not stop, stop or go right on my your parents and call it into dispatch?

DK

[Kaisu]

What if it was your mother or father that was involved in an accident and you had a stable patient on board? Would those of you who say do not stop, stop or go right on my your parents and call it into dispatch?

DK

Do you think that you would be able to provide professional, competent care to someone that close to you?

[Dustdevil]

Are you suggesting that a 9 month old LIFE has more importance than an adult or are you just biased towards a this smaller person ?

Bias towards the patient you are already loaded with and committed to is a no-brainer, regardless of age. You're trying to take this off on an irrelevant tangent.

please note: Febrile siezures are "in most cases" are self limiting and medical based evidence suggests that very few have long term damage

Please note that nowhere in the article is it stated that the seizure was febrile in origin. Not all seizures are febrile seizures. The fact is that this crew had absolutely zero way of determining the etiology of the seizures, and therefore zero way of knowing the severity of the child's condition.

And if you want to continue to play this silly numbers game, remember that there is a statistically greater chance that a seizure patient is unstable than the chances of an MVA victim having critical injuries.

Any way you look at it, mathematically, legally, ethically, logically, medically, or even by FDNYs own policies, these guys were wrong.

[vs-eh?]

This thread is still going?

I just want to be clear on the "stopping is wrong" people's opinion.

You are an ALS crew that just picked up a 30 year old businessman, who is a baby and called 911 because he slipped and fell on the ice. He cannot weight bare and is put on your stretcher. His left ankle is pretty banged up, maybe query fracture, but he is tolerating things well with a splint and some ice. As you take your leisurely drive through the city, discussing the finer points of investment banking, a rapping comes upon your window pane...

You - "Hark! Thou hast startled me citizen!"

Citizen - "Ya ambulance man, someone collapsed over there..."

On the sidewalk, 20 meters away you see chest compressions being performed on a middle aged female.

Do you:

A) Tell the citizen that you have a patient and that you will call your dispatch and an ambulance (quite possibly BLS) will be around ASAP (perhaps 10 mins). Don't worry the fire department might be there in 4 minutes, may continue doing what your doing, but will not be transporting and generally will aid via the stare of life (kidding guys).

or

Tell your partner that it looks like somebody may have arrested on the sidewalk. Call dispatch and ask for fire and another unit. Get your defib and drug bag and walk the 20 meters to the patient (who is in cardiac arrest btw) and leave your partner with Johnny Kneepain in the back. Fire arrives in 4 minutes (the boys are good) and assist you with CPR. A PCP (BLS) ambulance ends up arriving in 8 minutes. You direct one of the paramedics to the back of your unit, and your partner swaps with her. You package up your patient (following a ROSC on the street, cause your wicked awesome), switch off patients with the PCP crew and take your ummmmm significantly more acute patient to the hospital.

Think that doesn't happen? I assure you it does...

Again as long as your initial patient does,

1) not require acute intervention with EMS or in hospital.

2) not remain by themselves in the ambulance with a provider that cannot adequately respond to their needs.

It is not cut and dry.

EDIT - I just realized something. We have the luxury of a pretty seamless hand off of patients because we are municipal and the only 911 EMS service for the city (or on the rarity of a neighboring municipal service). Could this entire issue of "stopping" be more a facet in the US of:

1) Money

2) The possibility of loosing money, especially if another service comes to render care

3) The lack of continuity of care should you hand off your patient, especially when another service (for profit) comes to back you up on the above call

[medibrat]

Thank you, VS, I have been away too long and apparently cannot effectively articulate what may actually happen or has already happened in real life. Again, thank you.

Brat :angel8:

[Lone Star]

What if it was your mother or father that was involved in an accident and you had a stable patient on board? Would those of you who say do not stop, stop or go right on my your parents and call it into dispatch?

DK

If I'm reading this correctly, it's my my parents in the accident that I'm passing with a patient on board. Would I stop, or call it in to dispatch?

Since the law is quite clear on this whole issue, I don't have the choice to make. It's called into dispatch, regardless of how much I may want to stop and deal with my parents who may be injured. Either I follow protocols, or I lose my license.....it's that simple. There is no room for 'modified interpretation' of protocols. They are set forth for a reason. End of story.