Rural MVC's

[6000medic]

I live in a rural area with a major interstate going thru our coverage area, the nearest Trauma facility is 42 miles away. Administrators want to put a stop to our local Volunteer Fire Dept. rolling with the EMT's due to the cost involved of extra personnel. There desire is to have us arrive on scene and call the Volunteer Fire Dept. if needed. Our service currently exist of one 24hr. truck and one Day Truck.

Please give your input to this topic, so that we can get Administrators to see (our) point of view.

[tniuqs]

I live in a rural area with a major interstate going thru our coverage area, the nearest Trauma facility is 42 miles away. Administrators want to put a stop to our local Volunteer Fire Dept. rolling with the EMT's due to the cost involved of extra personnel. There desire is to have us arrive on scene and call the Volunteer Fire Dept. if needed. Our service currently exist of one 24hr. truck and one Day Truck.

Please give your input to this topic, so that we can get Administrators to see (our) point of view.

So with a possibility of multiple patients, High way traffic Control and Safety extra manpower then the and possibility extrication .. just what are they expecting X men EMTs with swiss army extrication knives on your belts ?

Just an idea, go look at your own stats from say the last 3 years, and compare fire + medical responses perhaps a good place to start ?

Do the EMTs get called out to do Fire Standby coverage ?

cheers

[Diazepam618]

Well cost is cost, unless you guys can produce some extra dollars your going to have a dead zone on your highway.

[HERBIE1]

You need numbers to back up your position. Averages over a set period of time. How many patients are transported? How many were extrications? How many needed to be airlifted? Transport times? Outcomes of patients- could transport delays have contributed to M&M of the victims?

See if you can generate some stats to justify your claims. I agree that this is about a cost/benefit ratio, so you need to be able to justify that benefit to the powers that be.

Good luck.

[Timmy]

I agree, you need to collaborate some data and statistics on this matter and present it to the relevant people. Maybe you could look at some funding or grants? I know in Australia there are Road Accident Rescue grants for organisations who supply this service.

We have a similar situation where I live in regards to a rural area, covering highways and the major hospitals being some distance away. Fortantly in Australia all emergency services are government funded and so on. Paramedics, Fire, Rescue, Police and tow truck often dual respond to MVAs so all services arrive on scene within a similar time frame.

Being not fimilar with the level of care your EMTs provide, is there any ALS responding also? Being in a rural area with long transport times and the possibility of having a prolonged extraction time (especially if you having to call for rescue after you arrive) it may be a good idea to add this to your proposal (if it's not already in place?)

Also remind these people, if they cut the essential services and something goes wrong, guess who has to face the music? If they do cut the services make sure your local community are aware of it. You need to also include a strategic 'real life' situation in your proposal. Say you have an MVA down the highway with the travelling time of 30 minutes before any service is on scene, EMS or police arrive on scene to find patients are trapped and call for rescue, that's potentially an hour before you can even start extraction and pushing the time frame for timed critical care patients to reach the hospital. What if the car is on fire? Again, EMS and police will arrive and have to call for the fire service delaying access to the vehicle and endangering life. How can they guarantee scene safety? After all, who has the equipment and resources to deal with chemical/fuel spills, LPG leaks, disconnecting the battery ect which are all very real possibility's responders will face upon arrival.

Your already a volunteer service, cutting funding and possibly delaying road rescue and fire suppression services is not a proactive move, push to have all emergency services dual respond to MVAs.

[joesph]

Consider the cost of scene safety, big red firetrucks are easy to see and a lot of shit will deflect off it. No one likes to park cars at 2 a.m. but it is a necessary task and if no one is doing it the job will fall to you or the local law enforcement agency. Extrication is a big heavy job that requires a significant investment in tools and training maybe your administrator can pony that up.

[Richard B the EMT]

big red firetrucks are easy to see

Not all fire departments use red vehicles. I have seen white, and even black, fire company paint jobs, just around New York State. That is not mentioning that new checkerboard design I see on some of the ambulance manufacturer's print ads in JEMS.

[firemed665]

An engine company or other rescue vehicle should always accompany an EMS unit responding to a roadway call of ANY kind. You will find this in any IFSTA manual, your new EMT or Medic text book, and just about any major Fire or EMS publication out there. The reason for this is to provide scene safety and protect both the rescuers and the victims from traffic. By parking the transport vehicle ahead of the scene and a secondary vehicle behind to block and redirect traffic around the scene you provide a safe zone of operation on the roadway. It doesn't necessarily have to be a big red firetruck, for those that have angst for the FD, but it should be something visible. And as an extra perk, the guys on the FD units could probably give you a needed hand if it turns out to be a nasty call. The patients might appreciate being cut out of a mangled car quickly as well. As far as research on this goes, go to www.firefighterclosecalls.com, or research it on the web. And by the way, I'm pretty sure your local OSHA office and the company's insurance agent may not be to happy to hear this. I'm guessing that the brain stud that made this decision based on monetary costs hasn't provided you with your Federally mandated ANSI safety vests either. Sounds like a bad idea to me. Good luck!!

[Chief1C]

To add a note on scene safety. Every new ambulance and fire apparatus, under NFPA Standards, will need the safety chevrons on the rear. We just purchased a large rescue vehicle, and it wasn't even an option, it just had to be there. Red and yellow; our signature color scheme is red over white, has been for decades.

[rock_shoes]

I know all about the frustrations of MVC's in a rural setting. Just the other day I attended a high speed roll-over MVC (vehicle still on its roof). We where on scene waiting for fire/rescue for 30 minutes just so I could confirm the patient was deceased. It was impossible to even check for a carotid from the patient's side of the vehicle and I couldn't enter through the other side of the vehicle because the airbag hadn't deployed (No point risking serious injury for a patient who is likely dead). It's extremely frustrating to say the least. Our "paid on call" Fire/Rescue guys are usually fairly prompt but there is only one rescue in a small city surrounded by major highways. In our area the FRS is dispatched automatically whenever there are confirmed entrapments. Otherwise it is only at our request. The real key in these events is educating the public and getting them to actually stop so that entrapment can be confirmed ASAP.

Ed