Stay and play / scoop and scoot

[Richard B the EMT]

A general rule I have been taught to follow is, for either trauma or medical calls, if the ALS time of arrival is more than the transport time to the nearest appropriate Emergency Department, scoop and run, treat the patient(s) to the best of your ability.

If ALS can intercept on your way, OK, let them aboard, and let them do what they have to do.

If ALS complains, they are fools.

[emt322632]

Getting cancelled because the BLS bus decided to take the 5 minute trip to the hospital instead of waiting 10-15 minutes for me to get there doesn't hurt my feelings any. You did right by this patient.

I know of too many basic providers that will wait for ALS to show up, just because they panic. One group actually waited on scene with a woman in resp. distress (accessory muscle use, audible wheezes, SpO2 92% on 15lpm) had her all loaded up in the back of the truck, waited 10 minutes for me to get there...but they had the neb all set up for me

[speedygodzilla]

You did exactly what you should of. When I read the first posting those were the exact actions I was thinking. Not quite sure what ALS is thinking? :roll:

[rock_shoes]

Given the circumstances I would have done exactly the same thing. The ALS crew filing the complaint need to have there heads examined.

[FireMedic65]

Given I don't know the scope of practice you folks use over there, it's hard to judge what I would do. From what you said, you did good work.

Bus people are ok... leave them sit in the bus... if it's stable of course. Transport the shocky pt immediatly, don't wait for ALS. Maybe pop in 2 iv's bolus with fluids... *can the emt-b transport that?* if so, do that. You are the highest trained on scene... you are in control.. you can't really leave. Everyone else is ok... forcus on the entrapped patient.. or not given on MOI.... but that's just me

aaron

[BEorP]

Given I don't know the scope of practice you folks use over there, it's hard to judge what I would do. From what you said, you did good work.

Bus people are ok... leave them sit in the bus... if it's stable of course. Transport the shocky pt immediatly, don't wait for ALS. Maybe pop in 2 iv's bolus with fluids... *can the emt-b transport that?* if so, do that. You are the highest trained on scene... you are in control.. you can't really leave. Everyone else is ok... forcus on the entrapped patient.. or not given on MOI.... but that's just me

aaron

Well that "just you" wanting to "forcus" on the entrapped patient would not be following the rules of triage. In addition, they are dead from trauma anyway so the chance of them coming back is very close to zero even if they were the only patient and got full ACLS and weren't trapped.

[FireMedic65]

learn how to read... yea.. big whoop... i made a typo... lets get all bitchy about it. i said once you had the shocky pt transported, get that entrapped patient out..... so next time you decide to bash what i have to say, read what i said first

[WendyT]

Actually Aaron, you didnt make any typo's, people cant read between the lines.

As for the dead girl, she died on contact, that's really sad and such a young age too.

WITHOUT PREJUDICE:

I dont know if it's me or not but I think you guys get a little hyper, Ya need to calm down and BREATHE, paper bags work best. :wink:

[KSEMT122]

You did the right thing. The ALS crew should have a complaint filed against them for taking too long. The Patient trapped in the vehicle is dead. Walking wounded's can wait. You helped save this woman's life. You should feel darn good about it. Those 2 Large Bore IV's of NS may not have kept her BP from falling, but I'll bet dimes to dollars that it helped slow it down. I would start them en route, which I'm sure you did.

[Richard B the EMT]

I am probably putting my famous "New York 'Spin'" on this, but, State protocol, far as I know, if in a car crash, there is even one dead, all others from the incident get immobilized, and everyone, except for the DOA, goes to a trauma center.