Smitster_911

The fire dept is on a very slippery slope. If someone calls 911, the conventional wisdom is that they want to go to the hospital, and you'll never be in any trouble by taking them there.

You don't say which state you're in, so I can't speak to the legalities of your question, other than to advise you to only perform any treatment that is equal to your level of training. Even when off duty. Being 'certified' means that you do not have 'Good Samaritan' immunity, ie, you know better. So if you work outside the First Responder level, you can be successfully sued. Although, if there are no protocols, nor is the first responder level recognized, you may be OK. What you need to do is speak with the legal department of the 'local health services agency' that trained you. Good luck.

While asking what type of MD is a good start, I think you'll find, that, probably in most states, an MD that begins care is REQUIRED to accompany the patient to the hospital! If one asks to help after you're on scene, and have begun patient care, and you allow it, he/she also will need to go with the pt.

All right folks, Have all our backs here received a sufficient stabbing? When did this board become a place for everyone to show everyone else: 1. How much better you are than anyone else, and, 2. How much dumber everyone is than you? Why can't we just have a group hug and help each other out without having, first, to tear each other down? Everybody, well, most everybody, well, some of us here, are just trying to learn from, teach, or support others when they have questions or concerns. Nobody knows all, and everybody can learn from anybody. Now, let's just look at the facts of this case as presented (and I'm certainly no authority on anything. I've only been in EMS 16 years-out 2- and am, at least, smart enough to know that I still don't know squat, and have a great deal yet to learn). Here is the original post in it's entirety, verbatim: Let's take a look at the information that was given to us, which is what I based my response on: 1. A Mustang (small) was 'T-Boned' on an interstate (speed limit at least 55 MPH) by a semi (big, and always wins against small) and that one of the people in said Mustang was pinned. 2. No other condition of pinned pt was given (until after extrication). 3. Second pt walked to truck and was found in it-presumably seated (and if so, this is the pt that should have gotten the KED). 4. Pt was extricated from car (a time no one other than the pt should be in the car barring exceptional circumstances). 5. Would the application of the KED have changed the parameters of the extrication (Fire really hates that!)? Given the limited information available, I could only draw conclusions based on the condition of the car. While I agree that the pt should be treated based on clinical observation, and the cars condition should only be used as supplemental information, unfortunately, in this scenario, the cars condition is all that was known, so that's all I could base my treatment options on. A lot of responses had to do with the pt going to a level I trauma center, and that is what I would also have suggested. A protocol (maybe yours?) that says transport to a level I is appropriate in a case like this (if that's what your region requires), doesn't it follow that a patient be expeditiously removed from a car from which he had to be extricated? I understand that protocols are just guidelines, and deviations must be well documented as to why the change, since I keep leaving my X-Ray eyes and MRI glasses at home (I never seem to be able to find them!) if there's any question at all I'll just go with the local standard of care. In the hospital, they may have the luxury of ruling things out, but in the field, we have to rule things in to make sure all our i's are dotted, and t's crossed. Treating the pt is paramount, but in a forum like this, the ideal situation doesn't always exist so improvisations must be made-as in real life. As one of my Captains used to say: "Life, like EMS, is fluid and dynamic in nature and subject to change without notice." While I learned many moons ago that I can't change the world alone, if we work together, WE can. Working together is the key.

I was taught that a KED is used on a seated, stable pt. Given that he was pinned and required extrication, that, IMHO, says that the mechanism of injury is there to classify this person as potentially unstable-rapid extrcation therefore, is warranted, and the KED should be forgone and a long board used.