Ok so I know I am new at this.. but last week I went back to Ohio and had a chance to do some ride time with a local ambulace who does 911 for the city.. In the 2 days I was with them we had 1 911 call.. It was sat morning.. came out as a norepsosive Diabetic.. we get there and this guy is a mess.. he is 400 pounds so we call for back up.. he is in and out of resp arrest.. to find his blood sugar to be 217. It took our back up 10 min to get there.. we did everything we could due to his side and to conditions.. we get him in the back of the truck and he goes in to cardiac arrest.. I start CPR. we lost his IV, they tried to tube him and got it in his belly.. we worked him for at least 10 min in his drive way.. took into the ER and the pronoced him.. my thing is this I thought all fire deparments responded.. I guess not.. but if they would have my guy might have died in the ER and not on the truck we wouldn't have had to wait for back up just for lifting help... so that was my first ever call too.. just kinda wanting some feedback on all this.. thanks
Permalink Reply by T.J. on January 1, 2009 at 1:28pm
You should've called for them right away when you got dispatched. The FD is not just going to come if they're not called. Plus with that type of call and being the man was over weight makes it totally different and any ambulance service would've had problems too. I feel the family or patient or at fault for these types of calls, when they call 911 they should tell them to call for manpower and tell them their 400 pounds. They know 10 people dont come with the ambulance 3 at the most.
I live in a small town however they always send at a minimum an engine and ambulance on every call no matter what the call is, a house fire or such they will send 2 engines, a ladder and the ambulance, one doesn't go without the other and if the ambulance was at the hospital they will send 2 engines and call for another ambulance mutual aid from a neighboring town. There are at least 4 people at every call along with the LT on duty so that makes 5. I guess every town/ county is different. Sorry your call didn't end up the way we would have liked it. I'm sure you know you did your best. Wishing you a Happy New Year.
Permalink Reply by FETC on January 1, 2009 at 1:45pm
Sorry to hear your first call was a bad one to base how EMS works. Things to remember are you did everything you could for the patient, unfortunately though the "diabetic issue" masked a true cardiac emergency.
We respond with a 3 person FD Based Ambulance. We do not respond with an engine unless it is coded as Delta or Echo Level call via the enhanced 911 call coding system. Which is not Breathing or Cardiac Arrest. So we would intially responded with just an ambulance if the patient was BREATHING. If the call came in NOT BREATHING diabetic emergency, then the (3) personnel would be (7) on scene.
Permalink Reply by Alan on January 1, 2009 at 2:07pm
In our fire district, we have a vol ambulance that handles all our ambulance runs. If they are out on another run and the call is serious enough that would be life threatening, then we will be hit out for a medical assist. If the ambulance arrives on scene and they need manpower assist, then they will hit us out. We had this happen a couple of weeks ago and and we responded and helped them load the patient. It was basically the same type call, the patient was close to 400 lb diabetic and had fell and injured his ankle. But each fire district has different and has different agreements with their ambulance service.
T.J. your giving the public way too much credit. Most civilians don't know how fire or EMS operate, they go by what they see on TV. It is frustrating. Also, if the call taker has a little snap and either follows the prompts or asks the right questions, a diabetic unresponsive should already be upgraded to a manpower response with additional units be they fire or another ambulance..
Not wanting to dissect your call too much, there was something else (cardiac, CVA) going on with your patient. 217 is not that high to be causing unresponsiveness. Sounds to me that you could have had 3 people, or 20 people and it wouldn't have made much of a difference.
There are two rules in EMS.
#1. People die
#2. Paramedics cannot change rule #1
This will happen again. It just goes with the territory. You do what you can and move on.
Depending on where you were, Ohio is not unique, you may not have a combination fire/EMS department. If you were with a third party EMS service or private EMS service, they would have to request fire most likely. Even at a fire department that runs both, extra manpower would have been needed. As soon as I see someone that big, extra help is called no matter what. I can always send them home if not needed. We also have a cot that can handle a lot more weight, along with ramps and a haul system for loading and unloading. We have aslo had to use the tech rescue team on occassion for the big un's if they are upstairs. Sometimes, you have to get creative to transport them. Just remember all fires eventually go out, all bleeding eventually stops and all people eventaully die. Sometimes, there is nothing you can do to change that.