We had 2 extrication calls this past monday and this past wednesday on both of thse scenes the ems crews keep trying to act like extrications gods. the accident on wednesday we had another fd respond mutual aid with us and we pretty much had the pt out except just finishing up on the dash roll. well the paramedics start running around telling this other dept to go cut the roof of the truck off when there was absolutely no need to. this dept is a county dept and is full of unexperienced guys who just want to do something so they just do wat neone will tell them.. but we got control of the situation before things got out of hnd and people started cutting things they shouldnt of...but neway does neone else have this problem???

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Not that I am really saying anything new, but it sounds like you need to fully understand and follow your Departments SOP's with relation to MVA's. Many others have suggested joint training efforts with said EMS agency and that is also a great idea. I personally don't have any of these issues at my FD because we have fire based EMS so we perform the rescue and transport, but I'll not bore you with the particulars because chances are they don't apply to your department. As far as who's in charge of a scene, I would suggest speaking with someone who is familiar with the laws regarding such incidents in your area. Everyone on scene wants to help, and if you take and make the time to know the capabilities and shortfalls of the people you run with; co-workers, mutual aid agencies, PD, then everyone can learn their roles on a scene. Otherwise, a scene can quickly turn into a Fire vs EMS, Police vs Fire, mines bigger than yours... take your pick. Bottom line is crew safety and pt care and that can suffer quickly when there is no cooperation.
We let the EMS people direct patient care...but they realize that we are much better than they are in extrication so they let us run that part of the show...it is called cooperation.....I wish more Departments would try it....it really can work wonders.....Paul
The problem with just following your department's SOPs is that other departments might not follow them...or understand them...or even know what they are.

Joint SOPs/SOGs are a lot better - they're worked out between all of the stakeholders in advance and everyone has a vested interest in the joint SOPs/SOGs and working together.
I can't agree more and that is why you get to know and train with your surrounding departments.
I see both sides to this discussion. I am a Paramedic/Firefighter that works for a paid city fire department and I also work for a paid county EMS service. As a firefighter, I am the extrication technician. I train and keep up with the lastest extrication techniques. So I know how to remove someone from a twisted heap of a car. On the other hand, I also work as a Paramedic and have been there when I didn't like the way the car was coming apart and wanted to try something else for the patient. You have to remember, we are looking at an overall picture of the patient's injuries and their position. I absolutely agree with pulling the roof, that makes for quicker access to the patient. Which would allow me to immobilize the c-spine, control an airway, start IVs, and do a better assessment of the patient. I gaurantee that if a Paramedic asked another crew to take the roof off, they were doing so because they felt like they needed to get to the patient. They knew you guys were doing the job you needed to be doing, but felt like it would be beneficial to the morbidity of the patient if they started to intervene on the injuries. Remember, most medical systems give 10 minutes to extricate a patient before you start losing ground due the injuries that the patient may have sustained.
Don't take it personally if this happens again. And it never hurts to ask the Paramedic what they are thinking. The greatest tool we have is communication when dealing with bad situations!
We have an excellent relationship with our County EMS. We run anywhere from 4 to 10 MVA's a month. Most of them not serious with no extrication needed, but every once and a while, we get a real bad one. The extrication is a joint process with both us and EMS working the scene. If any type of pt. immobilization is needed, its usually a FF inside the car doing it; just because we are the ones wearing all the PPE. However, a medic is close by making sure the pt. is doing ok and trying to provide whatever care they can practice safely at that point. You can bet that if one of those medics tells us to cut the roof for them, were gona cut it. They are ultimatly responsible for that pt's life.

I think the reason we work so well together is because we train together whenever possible. You can bet that we practice cutting a car up, county EMS is there not only for our safety but to practice pulling RESCUE RANDY out along side us. They bring their rig down to our station quite often so our FF's can go over it, study it, learn where everything is and how to use it. Maybe your dept. should try something like this if possible.

Oh... one more thing... can you please learn how to spell before your next post.
This sounds light a turf war. There are many different systems in this country, so no one way of doing things is going to be the catch all. I will make this statement though (It's not my call, and it's not your call, (IT"s OUR CALL AND WE BETTER GET TO WORKING TOGETHER SO THE OUTCOME IS BEST FOR THE VICTIM) This turf war about who is best needs to end and everyone needs to work together, sometimes it sounds like we are going back a hundred years or so when the Volunteer Depts. used to let the house burn down while they fought over whos turf it was.
on my dept we have a good relationship with ems they do their job and we do ours on a accident scene they will help us with priority that is about it
Why would EMS want to get involved in extrication?



Well, because in some places, they're responsible for it?
Hey Dustin,

What is you incident hierarchy?

Down here the cops are in charge of the security, investigation of the incident and crowd control. EMS's responsibility is the sick or injured. The Fire Department is responsible for the safety of the scene and the mitigation of the incident. This includes extrication. Most of the time the two agencies work in unison to remove the patient from the situation. There responsibilities do overlap but the incident commander (Capt., LT. or Sr. FF) has the final say. On one occasion we asked the law enforcement officer to assist us with an overzealous EMT.

I guess my point is that the IC is the IC. Unless the pt was going to die and needed immediate extrication with out regard to additional injuries the IC should put them in their place.....away from the tools and the men or women that are using them. Its for there on safety and typically the EMS does not have the proper PPE to be that close in.
Very well put Texas, we here also work in the same manor.
Texas,

Look up at the photos of the EMS rescue specialists working the extrication tools, please.
They're doing that because the IC "put them in their place"...which was working the extrication tools.

Ben

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