How Active Are You On Scene During Rescue Operations?

[Christopher.Collins]

Ok first and foremost I DO NOT want to see this become a bash ALS/BLS/Fire/Volly/Paid thread... that is not what Im trying to get at here! This includes (personal) opinions such as fire should only hump hose and thats that, only we should provide patient care, unless your service actually has thoes kind of SOPs and SOGs stating as such. You can provide opinions, just dont use them to bash any form of service.

I am curious as to how active in rescue operations (of any type) you are or are allowed to be when your on the ambulance or medic intercept vehicle? I havnt done a poll before so appologies in advanced if it dosnt help... just post your response instead. For instance... do you jump right into an MVA extrication and provide whatever care you can, even if its just c-spine maintinence? Are you even allowed to do such things (per protocol, SOPs and SOGs)? I am not curious about just MVAs however... anything else like con-space, rope rescue... etc will suffice as well.

Most ambulance companies I have worked with have a good working relationship with the fire departments so in terms of that MVA I try to get right in. Regardless of any related SOPs and SOGs however I personally will only do so if I have the propper PPE. The last time I participated in an extrication without PPE my favorate sweater was covered in blood and I took a facefull of glass as well as a knock to the head. Im a little smarter now :wink: As far as other rescue operations its mostly just stay in the warm or cold zones or treoge untill fire extricates. We dont usually carry any specific equipment aside from turnout gear.

In terms of fire departments... all but one I have been a member of have fire based ambulances. Thus we had turnout gear and rescue equipment and any rescue operation was a part of our job.

Overall I do what I can (within reason) to stay with my patient. I am fairly aggressive in terms of I do not like to stand around and wait. I know of some services were EMS pretty much stays in the ambulance or even in the way untill requested. I also feel that its easier to provide care to a patient if you have been with them most of the time. If they are concious and alert it eliminates a need on their part to constantly repeat themselves as new people come to their aid. I find at times it forms kind of a bond if they are comfortable with you... none of this, "hi Im EMT Bob Ill be here untill we get you out..." Then later on "hi Im EMT Fred Ill be with you untill we get to the hospital." Too much confusion for the patient. If I cant participate in patient care from the begining I wont just sit in the ambulance like some others... Ill at least find someone who can keep me up to date on my patient and if Im lucky someone who knows the patient.

[Christopher.Collins]

Forgot to add... in Westerly, Rhode Island their rescue company is ambulance based. Fire does strictly fight fires... EMS does the rest.

[spenac]

Fire :boxing: EMS. :twisted:

We are active in that we are in the cars while we wait forever for fire to show up to cut up the car. We provide all medical care, fire provides equipment and manpower.

[reaper]

We deal with pt care in the car, while FD extricates.

For other rescues, we all share them. If it is a High angle rescue and the pt is injured, then I am usually the first one down to them. While I provide care, FD will set up for retrieval.

We happen to have a great county ERT team involving EMS,FD,and SO. We have different specialized teams and they will be called out as needed.

[Fox800]

We are expected to be at the patient's side in the vehicle, providing ALS assessment/care as needed. The fire department will also have an "inside firefighter" who's job is to support you while you are both in the car with the patient. We are issued wildland turnouts (wish they were structural gear), helmets, goggles, work gloves, and firefighting boots. At the scene of an entrapment, we are expected to be in the vehicle with the patient assuming that the scene is safe enough to permit this. As far as high angle/low angle/conspace/water rescue goes, we have specially trained Rescue Paramedics who carry rope rescue and water rescue equipment on their units. They will run the show as far as getting to the patient, stabilizing them, and working with the FDs to extricate the pt. Basically, our service has the capabilities to deliver ALS care to the patient in virtually any rescue environment (including HAZMAT).

[Just Plain Ruff]

I am always in the car with the patient unless I'm the 2nd paramedic(not primary care giver).

As for any other type rescue - I have no specialized experience or training to be of any good on a high angle, confined space or swiftwater rescue.

I will get in the confined space with the patient if asked but mostly I wait for the fire department to get the patient to me.

I have had one high angle rescue and I was terrified all the way down. But the patient required bagging so It was me or no-one. I think I had to re-evaluate my will and last testament after that one.

I don't have any problem in confined spaces nor in caves but I do not like heights nor do I like swiftwater - as a matter of fact I will not go in to swift water without 10 ropes and 5 life jackets and a Scuba tank and regulator is how much I dislike swiftwater.

If you are not trained to do it, then DO NOT DO IT>

[crazyemt5150]

Here In bakersfield we don't have any turnouts what so ever. If the pt is pinned in. Either the medic or I will get in the car to help with pt care, or a firefighter will get in to hold c-spine. If we do get in the car and they need to extricate, fire is normally pretty nice and will drape a jacket over us. I really believe we need turnouts for rescues, but that is just me

[rock_shoes]

Company policy allows us to participate in rescue operations to the scope of our training. If for example a patient requires rope rescue, and the attending paramedic is so trained, then that paramedic may participate to the level of his/her training. From what I've seen so far it's been a very workable policy that allows our members to function to the full scope of their knowledge not just what falls under a paramedic license.

[sirduke]

Our service runs two ambulances and a rescue truck, which has a complete extrication tool kit on it, everyone is required to attend training in extrication upon being hired and we are constantly having refresher courses.

That being said, unless I am assigned to the rescue unit, I am in the car with the patient. Or, I am playing attendant to whoever is in the vehicle with the patient, playing step and fetch-it. But usually, I'm the one in the vehicle.

I know all the volly bashers out there will hate to hear this, but we don't have a paid fire service in our county, and our volunteers are great, they train their asses off, and it shows on scene. They have a extrication team who 99% of the time rolls when we do, assist us in extrication, and them boys is GOOD.

I guess I would have to say that I am very active during the extrication, unless of course it is obvious death, in which case having determined that, I move out of the way and await the coroner.

[firedoc5]

Almost everyone I worked with were cross-trained, so everyone got in on it. When I was with a private ambulance service we did a lot more than your run-of-the mill services. We were extrication specialists, ERT's, etc. and did Fire/Rescue along side the volunteer and paid FD's.

When I got on full time with a paid FD, all that experience carried over. By that time I was already a Medic, ERT, FF II, HazMat, and others.

I felt privileged to have been able to do that.