What role does/should EMS play in rescue?

[firedoc5]

Much of the time we as EMS was Rescue. It was John Wayne time and we had to pony up. Actually I liked it. I think if anyone has the chance to take an ERT class, do it. At least have the knowledge and understanding of what is going on. If you can't/won't do it and there is somebody else, by all means stay back until the pt. is brought to you. But just think what you can do as a Medic while they are doing Rescue/ Extrication/ Extraction.

[Cookie]

This topic brings to mind the exact scenario that happened in our area Sunday night.

Bear with me please.

We do not do water rescue or recovery, we call in the experts. There are four search/rescue/recovery dive teams within 60 + miles of where we are located. We have had meetings and training with these dive teams as to what they want us to do and not do prior to their arrival etc.

Sunday night at a nearby borrow pit/ pond that is about 40 feet deep, and slopes gently away from the bank about 20 yards then takes a sharp drop down to the bottom. A young man age 16 who did not swim very well was out in the water early evening. The skies had been darkening for some time and swimmers continued in the water, a storm blew up and this young man got in an area where it sloped down and he panicked, he was seen one second and gone the next. Friends and family searched for ten minutes before they called 911. We arrived in a wind and rain storm from hell only to find people out in the water trying to search. Not good. We had dive teams on the way immediately. Problem was because of the storm and reported tornado on the ground not far from out location the weather caused delays in their deployment.

We did as we were trained to do, secured the area, got the family and friends isolated from onlookers, and available for the dive teams to interview, as to where and when he was last scene etc. We knew what we had and we also knew it was going to be a long night for all involved. There were about 60 personnel in all on scene. He was found in 21 feet of water 4 hours after disappearance he was just a couple months shy of his 17th birthday.

Now knowing what we were supposed to do, and most of us did that, we had a few individuals who went out into the water to search up to chest deep and in lightening and high winds and rain. Idiots. These same individuals were not at these training sessions and that is the first thing we were told, DON'T GO IN THE WATER TO SEARCH, it stirs things up and there is already one body in the water they do not need more, leave the search to the experts.

It was really one of the hardest calls we ever had. I was with the family the whole time, keeping them posted etc. and I was with the family and friends when they recovered the body and were informed of his death. They knew he had drowned, it was just our Medics and Doctor confirming this for the family. They were also told in the beginning what would be done after they recovered the body, to make an attempt at rescussication, unfortunately he was down too long and the water was too warm.

If you don't have the training and expertise, stand back and let the experts do it. You can take care of the patient afterwards, and don't put yourself in danger, your no good to anyone injured or dead.

[firedoc5]

My father was on a Rescue Squad on the IL River, 1970-72 and was on over 75 drownings in that area. He wasn't a diver but piloted the boats. Unfortunately most were recoveries. And I think I took too many water rescue classes that now I don't have any fun swimming. Always wanted to become a diver but never did, but was certified for dive surface support. One thing I learned was that if you are not a trained swimmer for a rescue, don't try it. Too many have tried and failed, sometimes loosing their own lives.

[Richard B the EMT]

Firedoc5 said

One thing I learned was that if you are not a trained swimmer for a rescue, don't try it. Too many have tried and failed, sometimes loosing their own lives.

Cookie said

If you don't have the training and expertise, stand back and let the experts do it. You can take care of the patient afterwards, and don't put yourself in danger, your no good to anyone injured or dead.

Both are saying from more direct contact than I have with water rescue, but restate in essence what I stated earlier in this string:

Don't do anything involving rescue that makes you need rescuing also.

[firedoc5]

Firedoc5 said

Cookie said

Both are saying from more direct contact than I have with water rescue, but restate in essence what I stated earlier in this string:

You know what they say about great minds....

[JET EMT]

Wow JPINFV , Did you have to take a [hypocritic] oath for your "job"? I hope you didn't break a nail or anything.

I am going through the joining process now, for our County Heavy Rescue Squad, one of the primary requirements that they have is that all members must be an EMT, which only makes sense because there is not much point in rescueing a victim of an MVC or other incident, if you can't help them when you get to them.

I was also a scout, Life Scout/O.A., aged out just prior to making Eagle.

[toutdoors]

I agree somewhat with Dust in the regards to learning something and doing it well, I don't think he was trying to draw a line in the sand and say that when said pt crosses the line, he will begin care and treatment. EMS belongs on rescue scenes, and should take an active role in the rescue. However, the EMS providers need to have an understanding of what is occurring during the rescue. If it is a vehicle accident, the EMS provider should be familiar with what types of evolutions might occur, such as a door removal, roof removal, dash displacement,yada yada yada. This is not to say that the EMS provider needs to be proficient at using the tools, just understand what can be done to extricate the pt.

In a rope rescue scenario, the EMS provider should be at a level trained to be able to be "put over the edge." In some areas this may involve extensive moutaineering climbing skills. In our area, it is grain elevators, or steep hillsides, which are pretty much earthen hills, not the rocky type. It is not that difficult to train the paramedics that are willing to participate from the private side how to rappel, and be on a belay. They basically are being lowered or lifted, while still transversing the hillside on their own two feet. This has worked quite well for us.

In regards to the really technical stuff, our USR team has paramedics trained in structure collapse and has received specialized training in how to treat for crush injuries and the like.

I think it pretty much boils down to what type of rescue a person is talking about, and that will determine how involved the EMS personnel on scene will become involved in pt contact while rescue is being performed. Some of what is considered technical rescue, is pretty basic, and not that dramatic. The most common scenario I can think of is an MVA. If a medic needs to be in the vehicle to intubate and BVM a pt as extrication is occurring, so be it. If I am working fire that day, I have no problem with it.

With that being said, you can't expect fire or rescue personnel to be very good at removing a pt from some sort of entrapment if they do not possess some minimum level of EMS training, which should be EMT at the very least. Even if private sector medical providers don't like fire EMS, we all need to work alongside one another to provide for the best possible pt outcome.

Don't forget the proper PPE for the scenario and ensuring everyone's safety, should go with out saying. However, if I don't say it, I am sure someone would point it out. Way to keep a fella on his toes.

[joesph]

Yes EMS should be trained in rescue. first for there safety second to expedite the safe removal of the patient from the hazard or entrapment. Now if you are going to train in these fields then you need to be equipped and and kept proficient at them. This can be cost prohibitive for the agency. Should EMT.s entangle themselves in the rescue or extrication all the time no. But being able to lend a hand or transfer between positions will definitely be helpful. Also being cross trained in fire, medical and rescue will make you a more desirable employee when looking for a job. I think a lot of the old timers are resistant to the all risk training approach is because then they would no longer be at the top of there field.