Two Vehicle MVC

[Ridryder 911]

I hope I did not read that you were going to flag a female responsive to stimulus... this is how Paramedics get on the front page of the paper.. flagging someone that is not dead... love to be the plaintiffs attorney! You have 3 ALS truck which should = 6 medics.. 6 patients. Not all the patients are critical and can be doubled up.

Be safe,

R/R 911

[PRPGfirerescuetech]

Sorry i didnt read all the replies until after my post, but it gave me some better ideas. I just don't know about the sheet and moving on thing, how many of you would be able to put a sheet over a 20 and a 3 year old trauma patient. I don't care how critical they are, 3 trucks and 6 patients there shouldn't be a reason to leave two pediatric patients (20 isnt really pedi but still), but i just wouldn't leave them for dead.

Dead is dead regardless of age. /Injuries not campatable with life remains just that regardless of emotion.

[JCicco345]

I know dead is dead, but patients with falling vitals are not dead. Like ryder said and i think i stated before 3 als trucks for 6 patients, there shouldn't be any patients that cannot be treated. So just because the patient has falling vitals means you should take care of a patient with bilateral ankle pain first and just leave the critical patient there to die ??? Good to know if i ever see you pulling up i'll make sure i complain of ankle pain.

[PRPGfirerescuetech]

I know dead is dead, but patients with falling vitals are not dead. Like ryder said and i think i stated before 3 als trucks for 6 patients, there shouldn't be any patients that cannot be treated. So just because the patient has falling vitals means you should take care of a patient with bilateral ankle pain first and just leave the critical patient there to die ??? Good to know if i ever see you pulling up i'll make sure i complain of ankle pain.

Lets remember, 3 ALS trucks doesnt mean 6 medics in many systems, it means three medics.

Under the guise of three medics, patient #1 and patient #2 are dead.

If three als units means 6 medics, I could see the arguement you make.

[JCicco345]

Good point, in my system 3 als trucks = 6 medics, if not you'd atleast have 3 als and 3 bls, so the medics can take pt 1 and pt 2 and let the bls handle the ankle pain, and 1 or 2 other bls pt's. All i'm saying is there are ways to treat all 6 patients, and you do not, i'll say it again DO NOT leave a patient that is living for dead, maybe in a serious mci (plane, train, serious bus crash) but this isnt even really an MCI. MCI by definition is more than what you can handle, 3 trucks can handle 6 patients. Pt 1 needs extrication, so your probably going to end up with the birdie for that one anyways, pt 2 is critical and you take her and take one of the bls patients, and buh-bye, transport. Then you have 4 patients with two trucks, load up a bls and als patient, and your second als truck is gone. down to 2 patients and 1 truck, now that truck has to stand-by with the extrication and if the bird is coming wait for that too, so you leave your ankle pain patient on scene with you and have fire or your partner, who ever is availble start treating them. Then once you have either loaded pt 1 up or got the bird to take them then you throw the bls pt into your truck and there you go. Now you have zero patients, all patients transport to a hospital and hopefully all got there alive, thats really all you can ask for. You don't have people standing by on scene wondering why there is a seriously injuried 20 y/o driver with a seriously injuried 3 y/o in the back, and your medics are looking at possible ankle fx's. Try explaining that to your boss when that makes the news, i'd love to hear your reasoning.

[PRPGfirerescuetech]

You raise a good point. this call does not fit the standards of an MCI.

That being said, im going to partially step away from my previous statement.

this call, while not a definable MCI, still does severely extend your resources. Looking at it from this perspective, one could extrapolate several things.

Patient #1, #2, #4, and #6 are ALS patients.

Patient #3, and #5 are BLS patients.

The incident mitigation is profoundly different based on the level of response, as well as proximity to a trauma center.

Under a limited MIC system, with three responding paramedic's, and three responding EMT's....heres my thoughts.

1st in: Triage all patients, determine needs as such.

Direct request 4 Air medical units to the scene

Identify patient one, and patient two, as the most critical ALS, and patients four, and six as severe, but not critical ALS.

Assign Medic one, EMT one, and Medic two to these two patients.

Assign EMT two, Medic three, and EMT three to patients 3, 4, 5, 6.

Arrival of the first in Air unit, handoff patient #2.

Medic two to assist with patients 3, 4, 5, 6

Arrival Air two, handoff....patient 6?

Arrival air three, handoff...patient #4.

Load Medic unit three with patient 5, Medic 3 and EMT three ground transport.

Load Medic unit # two with patient # 3, Medic #2, EMT #2 ground transport.

Arrival air four, load patient #1 whenever applicable extraction from vehicle is complete.

Obviously, if #1 is extricated earlier in the scenario, then the next arriving air unit would assume that patient.

My apologies, It can be done, although rather tight with this scenario.

Wow that was too much thinking. Im off for a nap...

Regards,

PRPG

[Sassafras]

Lets remember, 3 ALS trucks doesnt mean 6 medics in many systems, it means three medics.

Under the guise of three medics, patient #1 and patient #2 are dead.

If three als units means 6 medics, I could see the arguement you make.

I respectfully disagree. Even if there are only 3 medics, there is still adequate personnel available to treat and transport every patient. Broken ankles can wait.

*Ask for the helicopter. If they're unavailable, have dispatch send a fourth unit. I want fire/rescue working to extricate patient #1. Transport as soon as she's freed.

*The first patient I want to send out is the 3 year old in the backseat of the Civic, but if patient 6 is ready to go first then so be it. Pts. 3 and 5 can be placed in FSP and secured to the bench seat on any unit (as a 2nd pt.) and transported. BLS is capable of providing medical care to these patients (obviously, I would have someone drive us in). Worst case scenario (meaning 3 medics, 3 EMTs) this is 4 patients off of the scene already. The helicopter/4th unit gets one of the priority patients (preferably pt. 2 goes via air) and the other (3rd) unit gets pt. 4.

Obviously, I'm working under the guise of having plenty of available resources. I understand that this is not always the case. In any case, there is no way in hell I'm leaving pt. 2 on scene with a blanket over her. My medical director would have my patch before the unit was even cleaned.

[PRPGfirerescuetech]

Please read post above yours. That is the post where I agreed with you.

Regards,

PRPG

[Sassafras]

Please read post above yours. That is the post where I agreed with you.

Regards,

PRPG

Oh, sorry! I guess this is why it's a good idea to read the *entire* thread first.

[Mikeyg]

patient one is high priority but wouldnt you also radio for more help? Especially considering theres 6 patients and 2 of them are just babies.