Would you stop?

[tskstorm]

FDNY and NY policies, basically state you only need 1 EMT per patient.

MCI happens does your partner stay at your hip or do you work separately on different patients?

When there is a patient in back of the ambulance, how many EMT's are there? There is only 1 required.

So you can question the policy, but you certainly can not question the crew or their actions.

Saying what you would do or think should be done is irrelevant, if you choose to disregard a protocol/policy you would lose your certification. So for everyone here who has said they should not get out and start treatment would all lose your certifications, in NY, and thats that.

Anyways this thread is getting silly.

[whit72]

Ok I tried, I made my point and I was done with it. Well I thought I was done with it. Until someone made a comment about urban EMS. I worked a busy city truck for a long time, six thousand calls a year. I have since moved on to a rural truck, still around 10 calls a twenty-four, but thats quiet for me.

If this was a rural setting where the next ambulance was an hour or two away, I would have less of a problem with it. Being an urban system, with ambulances on every corner. I don't agree, notify dispatch carry on. You have hardly exhausted your resources with a hospital every mile I would assume that there are plenty of private ambulances to call if your backed up.

As far as the two scenarios flight brought up. If I could responsibly leave my asthma patient in the care of another crew sure. If there are no beds available thats tough to do. I guess you could leave them on your stretcher, as long as you have your equipment and respond to provide care until a transporting unit arrived. Sounds fair enough.

As far as the medical helo landing at the bus accident. I don't have any experience working a helicopter, but I am guessing if their flying the patient, their critical enough to need your total attention and landing at a bus engulfed in flames without hoses or extrication equipment would be a breech in care. Just my opinion. Can you even initiate care as helicopter personnel without being requested. I wouldn't think you would have the necessary equipment, and if your already occupied I would assume your equipment was already busy. Just a thought.

[medic001918]

Thats really what I'm going for...I haven't been in this type of situation but doubt I would have done much different. How many of us would be able to act with enough sense to secure a scene with an active shooter? How many of us would be able to be smart enough to exit the bus and find better coverage? I hope most of us...How many of us as paramedic students have been in active shooter calls? Hopefully not many, but dare I say this guy got a hell of a shift that day.

Thanks for addressing the question about your experience and the comments about your blind accusations about other people's experience on this forum. You've attacked our experience (or percieved lack of it) and have not outlined anything with regard to yours other than to say you don't have experience with an active shooter scene. While you might not have a lot of experience with shooting scene's, there are those people here who do have experience with them. These guy's did nothing to "secure the scene." They went to cover and retreated to safety. Congratulations to them...for doing their job. They still endangered a pediatric patient and their family needlessly. So I'll say that takes away their congratulations and makes them square with the house at best. I'd say even negative for needlessly endangering a patient...first by stopping, second by exposing the patient to an unknown situation that happened to turn violent.

Exiting the bus and finding better coverage, absolutely. Having to worry about my patient from another call, absolutely not. They would have gotten another ambulance dispatched to the scene. My obligation still lies to my patient that I'm already transporting.

Shane

NREMT-P

[whit72]

Tkstorm wrote:

Saying what you would do or think should be done is irrelevant, if you choose to disregard a protocol/policy you would lose your certification. So for everyone here who has said they should not get out and start treatment would all lose your certifications, in NY, and thats that.

Protocols and policies are written in controlled environments. I don't work in those same environments My patient is of my utmost concern. I am driven by their needs, if that means a protocol or policy is broken so be it, thats fine, you want to put me on the carpet for it, go ahead. As you progress in your career you will understand that not everything is black and white, sometimes rules policies, protocols get disregarded for the benefit of your patient. It happens.

[tskstorm]

Tkstorm wrote:

Saying what you would do or think should be done is irrelevant, if you choose to disregard a protocol/policy you would lose your certification. So for everyone here who has said they should not get out and start treatment would all lose your certifications, in NY, and thats that.

Protocols and policies are written in controlled environments. I don't work in those same environments My patient is of my utmost concern. I am driven by their needs, if that means a protocol or policy is broken so be it, thats fine, you want to put me on the carpet for it, go ahead. As you progress in your career you will understand that not everything is black and white, sometimes rules policies, protocols get disregarded for the benefit of your patient. It happens.

It has been asked for many times, please provide past precedent of this protocol getting disregarded in NY.

I'm fairly certain that if such past precedent existed the protocol/policy would no longer exist.

In my theory both patients get care and treatment.

[Dustdevil]

A lot of the problem here is that EMS in NY just plain sucks. They're twenty years behind the rest of the country (which is twenty years behind the rest of the world), and they don't even know it. Consequently, they don't know what they don't know.

The rest of the country figured this all out two decades ago, but they're still blissfully ignorant of it in NYS.

[PRPGfirerescuetech]

It has been asked for many times, please provide past precedent of this protocol getting disregarded in NY.

I'm fairly certain that if such past precedent existed the protocol/policy would no longer exist.

In my theory[/font:171a8103fa] both patients get care and treatment.

Lets focus on this word.

Theory.

You think it should be this way.

Problem.

Thats not reality.

Reality: You have delayed care of the patient you are responsible for and currently transporting.

Thats bad. Thats reality.

[brentoli]

7 pages..

No one agrees.

Those for it are for it.

Those against it are against it.

[wrenEMT]

I live in indiana and work yes for a basic service. I was transporting a dialysis patient in the back of my ambulance when my partner saw a kid laying on the side of the road OBVIOUSLY INJURED.. we stopped and he got and checked on kid.. My patient was wondering what was going and after explanation he was wondering also if there was something wrong with the kid.. Well, we proceed to let our dispatch know that we are going to a bit late dropping off patient because of kid on side of road, with obvious injuries.

WE GOT OUR ASSES RIPPED RIGHT THEN AND THERE.. We were in his eyes "abandoning our patient" our dispatcher is also our boss just so you know. He said get an SOR we will send another crew after him and get on your way.. Mother had already called 911 and got the other ambulance company dispatched when we were leaving scene with SOR. Saw crew and kid not 15 min later pulling up in the ER with splint on.. Asked in the ER what happened with boy and found out it was a nice Tib Fib Fx. So needless to say I wasn't endangering my pt because I was in the back of the ambulance the whole time while my partner was assessing the kid. But I still got my ass chewed just a wee bit and told to never stop while I have a pt on board and to call for an ambulance while still en route to my destination. Hope that helped with shedding a little light on my experience end of things. Not dangerous situation.. but still I got my ass reemed for stopping for another patient.. Because even if we got patient in back of ambulance and brought him to the hospital I would have then 2 patients instead of just one and Yes I can handle that but apparently my bosses didn't think it wise to have one tech per 2 patients. aww well they are private company and they can deal with the ramifications.. I'm not losing my cert for their stupidity anytime soon..

I personally would have called for another crew in that case anyway because of the need for possible extraction, and any number of things that could have gone on in that scene other than the fact of the patient having a gun, which then endangered my other patient, my partner, and patients family and any number of other people around the scene like the people in the diner.. period.. the end

[medic001918]

WE GOT OUR ASSES RIPPED RIGHT THEN AND THERE.. We were in his eyes "abandoning our patient" our dispatcher is also our boss just so you know.

And guess what, in this case your boss was right!!! You have a patient in the back of your ambulance that you're transporting. It doesn't matter if you're going to dialysis or the ED. You have a patient, you're not in service at the time. You're committed to your assigned call. You should have gotten chewed for stopping. You also said that another service had been dispatched, was this call in your primary service area? All things to consider. As much as it sucks driving by someone with injuries, you have an obligation to complete the call you're on before getting involved in another one.

even if we got patient in back of ambulance and brought him to the hospital I would have then 2 patients instead of just one and Yes I can handle that but apparently my bosses didn't think it wise to have one tech per 2 patients. aww well they are private company and they can deal with the ramifications.. I'm not losing my cert for their stupidity anytime soon..

So now you would have been willing to transport this child the ED if I'm reading correctly? What do you do with your dialysis patient while completing the transfer of care and paperwork for the patient you decided to transport while already transporting one to a completely different facility? The patient that you were initially commited to, along with the receiving facility have to bear the burden of your decision to stop to help another patient. There are schedules that dialysis centers try to adhere to as best they can. Having a patient showing up late by the time it takes to complete a call is not needed. Any dispatcher should be managing resources to keep a unit available for a call. Someone else earlier in the thread mentioned that everyone can wait their time for an ambulance to respond. I don't disagree. Once you have a patient in your ambulance that you're transporting, you're commited. This is different from a scene with multiple patients that you are dispatched to and arrive to. You've already determined the resources for your patient, and you need to complete your call.

Shane

NREMT-P