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rescue EMT's
o.k. this one is just for my information. I was wondering how many EMT are involved in vech. extraction? I'm a member of the the fire/rescue squad but I am also a EMT with the ambulance squad of the same fire company., the thing is, the last vech. rescue class we had had a good turn out with more then 30 firefigthers from all over the county attending. but I was the only EMT in the group....so I was wondering if the EMT's in your company get involved in the hand on part of vech extraication or do you wait for the rescue squad to bring the patient to you? Like I said just wanted to get a feel for how it's done elsewhere.......
Replies to This Discussion
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Permalink Reply by Joe Stoltz on
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In our Department, some of the firefighters (myself included) are also EMTs, so we get involved right from the beginning. One EMT or CFR (if available) holds manual c-spine stabilization while a second is assessing vitals and directing the extrication.
By directing the extrication, I mean that the second EMT also observes the area around the patient and monitors the effects of tool work on the patient. Close communication with the rescue officer has to be maintained.
We also cover a small portion of a town that has its own ambulance service. For accidents in this territory the other ambulance EMTs wait for us to extricate the patient before they do their thing.
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Permalink Reply by Pablo J. de la Torre on
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O.K., what I'm hearing sounds just about right, in my department (fire side) you cannot go anywhere near any extracation before you have had at least the Vech. Rescue Operations leval and they prefer you to have taken the Vech. Rescue Tech course. PPE is a must, turn-out gear is the norm...as a firefighter and EMT I try to remember my place, I run with the EMS side one whole day a week (plus responded when I hear the need) but if the tones go out I respond as a FF, then if we have a full crew for the rig and EMS needs a EMT then I may fill in for them. What I find surprising is that you don't find more EMT's at these course, I would think that you (as EMT) would want to get as much training as you could in order to understand what is involved in Patient extracation and perhaps start your assestment before the CUT....Fire Department are all short handed now a days some times just don't have the manpower to hold c-spine while the vech is cut away....Now the other question I have is what type of rescue work do your EMT's get involved in?
Do they do any kind of rope rescue? Water rescue? Search and rescue? and should they?
Just thinking!!!
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Permalink Reply by Ben Waller on
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In my department, every firefghter must be a minimum of a state and National Registry EMT-B by the end of their first year, as a condition of employment. About 50% of our EMTs are basics, the other 50% are paramedics. All of our firefighters are trained at least to the operations level in extrication, rope rescue, and water rescue as well. We don't distinguish between fire and EMS - every firefighter we have does both.
In many areas of the country, the EMS department is actually responsible for extrication and rescue. This can be done either jointly with or instead of the fire department being the rescue provider.
Examples:
Pittsburgh EMS runs two heavy rescue squads and is responsible for "Medically-Directed Rescue" in the PGH area.
http://www.city.pittsburgh.pa.us/ems/html/rescue_division.html
Several Maryland EMS/Rescue companies provide primary EMS and Rescue services with the EMTs assigned to the rescues also being at least a FF1. These include the Bethesda-Chevy Chase and Wheaton Rescue Squads in Montgomery County and Community Rescue Service and Boonsboro EMS in Hagerstown/Washington County.
http://www.bccrs.org/
http://www.wvrs.org/
http://www.crs75.org/
There are numerous "4th service" rescue squads that provide primary rescue services with rescue EMTs, particularly in both Carolinas, Virginia, Georgia, and Tennessee. These squads may or may not also provide transport EMS.
http://www.kvers.net/
http://www.newtonconoverrescue.org/apparatus.htm
http://www.rescue1.org/
FDNY has started a Rescue EMT program in the special operations section of their EMS division. Some of these folks are featured on the cover shot of the May 2008 JEMS. Their training and operations are discussed in the accompanying article regarding the NY crane collapse incident. http://www.jems.com/news_and_articles/articles/JEMS/May_2008.html
There are lots of ways that EMTs can be involved in rescue, and a lot of them don't involve the requirement to be a firefighter. This is true for both volunteers and career EMTs.
Good luck.
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Permalink Reply by mike angle on
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I've been in ems for 17 yrs . The state in which i work has 16 hours of extrication built into the course . I have also went on to attend any and all extrication course that the fire academy in my state offer's
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Thank Ben,
Great info.
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Mike!
We also had some build in extrication class in our EMT course, but only covered what you call an intro to awareness....I'm like you, when ever I hear of an upcoming class I go for it....have rope rescue, vech. rescue at tech leval., and am signed up for trench and structural collapse classes.
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Permalink Reply by George on
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We are a small town volunteer fire department. Over the years we have tried to get to the point where when we roll up on a wreck we can handle it all but the transport. We have emts that are extrication trained. But we go by who is there on the scene. If we have enough firemen that are trained they do the extrication while we prepare for the medical. If not we either double duty or swap out as needed. We have had patients out and packaged by the time the ambulance arrives. They load take a set of vitals and roll. The extrication is done by anyone that is trained and certified. The other fireman either assist by bringing equipment asked for or standing by with a charged line.
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Permalink Reply by Lawrence W on
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I volunteer in a rural community fire department and as you can imagine, our manpower is sometimes at a premium. Our Ambulance is in the same house with all of our other equipment. There is no separate EMS Division. As a firefighter/EMT, your responsibility would be based on your assignment for the call. Not all firefighters in my area are EMTs. This is at the option of the individual.
Engine/Truck - Primary extrication/suppression duties. This is to include removal of the patient from the vehicle. If available, and it is safe to do so, an EMT on these apparatus would be assigned inside the vehicle for stabilization and monitoring of changing conditions. This would allow the Ambulance crew more time and flexibility to prepare for treatment and transport.
Ambulance - Responsible for primary patient care once the patient is removed. If there is an EMT on board who is properly trained in vehicle rescue and has the appropriate PPE, that provider would be able to take the interior patient care position as described above in the event there are no EMTs on board the Engine or Truck.
Oftentimes, we will have more than the base two providers on our ambulance, which makes having someone available for the interior vehicle position a bit more likely.
As with any scene, the IC is responsible for overall scene operations. In this situation, he or she would be answering to the interior EMT as if they were acting as an additional Safety Officer. The interior EMT would be able to stop any and all extrication activities if it was deemed detrimental to the patients safety.
I hope this helps...
Be Safe.
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Permalink Reply by tonya keene on
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as an emt-b for many years i was envolved in many vech. extracations and was a major part in them because i am a small person i am ussaully crawling in the vech. to hold traction on my patients. i have helped with several extracations and have taken several classes involving them to. but i have also noticed that most the people in those classes are firefighters and not emts but the way i look at it is that at least i have the knowlage to beable to do a proper extracation.
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Permalink Reply by Kenneth on
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Well the protocol for NYC is to let FDNY get them out then you can play with them. If I was a fire/rescue volunteer then i'd only get involved if they needed me in there. Too many hands just makes it a bad situation. also, FDNY has a ton of protocols that I don't wanna get mixed up into if anything happens to go south god forbid.
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Permalink Reply by Jeanine on
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In my department, you do it all. Everyone is trained the same, the firefighters attend our ems training and all of our EMT's are firefighters.....
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Permalink Reply by Jim on
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When our ambulance service belong to the County and we were mostly a BLS service we were heavily involved in the extrication process. Most of us were also members of the Volunteer FD so we had the training. Since being taken over by the hospital and becoming an ALS service the few of us that stuck around are still involved with the pt from arriving on scene until they are at the hospital. The Paramedics that came to work for us from larger cities will come up and ask if we need anything then go sit in the ambulance and wait for the pt. Personally, i want to get in the vehicle, see what I have for injuries, assure the pt that we are going to help them and treat them enroute. When the Para medics first arrived, there were some "discussions" about the wait for the pt attitude, but we have resolved most of those...LOL
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