The Social Network & Community JUST for Firefighters
EMS standby at structure fire.
We are a volunteer BLS service in a very small town. We are paged to standby at structure fires, which thankfully, we do not have too many. The fire department is also volunteer and I am also a firefighter.
Our protocols demand we obtain consent prior to initiating treatment (of course) and once we have started our assessment/treatment we expect to transport. The patient has the right to decline treatment/transport at any time. Pretty basic I assume.
My question: Do you do anything different when on standby for a fire? Do you follow all protocols, or can you (for example) give a firefighter a little shot of O2 at their request without doing a full workup and transport? As a firefighter we have O2 on our rescue vehicle for just such occasions. As an EMT I don't think I can give O2 unless doing a full assessment and transport. The black and white answer is of course to follow protocol, but is that the only answer? My thought is to direct the firefighters to the rescue vehicle, there are firefighters capable of running the O2. What is the RIGHT way to handle this?
Our protocols demand we obtain consent prior to initiating treatment (of course) and once we have started our assessment/treatment we expect to transport. The patient has the right to decline treatment/transport at any time. Pretty basic I assume.
My question: Do you do anything different when on standby for a fire? Do you follow all protocols, or can you (for example) give a firefighter a little shot of O2 at their request without doing a full workup and transport? As a firefighter we have O2 on our rescue vehicle for just such occasions. As an EMT I don't think I can give O2 unless doing a full assessment and transport. The black and white answer is of course to follow protocol, but is that the only answer? My thought is to direct the firefighters to the rescue vehicle, there are firefighters capable of running the O2. What is the RIGHT way to handle this?
Replies to This Discussion
-
Permalink Reply by anne potter on
-
Spanner thanks but I can tell you know I don't get bullied into too much... as far a judy she does not want to overhydrate her fireman????????.. We have guide lines for vitals and the fireman must fall in those guid lines before returning to scene... When I have done enough on the fire scene I am very thankful for the EMs that is there.. See I am on both ends.. been in both situations... Spanner your not wrong,nor are you right.. What it involves is good judgment from all....
-
Permalink Reply by Spanner 122 on
-
My only point Anne, is firefighters should never return to the scene after being treated, with anything other than a bandaid (or something similar to this). According to SOP's in my department and many others, if you need intervention, such as O2, or anything other than water and food, you are not to return to the scene to work. Period. In this case, yes I am right... well, not so much me, but the department's policies.
I agree, allow EMS to take vitals, they make the decisions as to how long you need to sit, if at all, but intervention means no more work. It's the only safe way to be.
We will most likely have to agree to disagree here, sadly, but I am of the opinion that you are wrong if you think firefighters should be taking any amount of O2 and then returning to work.
-
-
To gain a blood clog judy in that kind of time yet to see it.. Your heart is in the right place ,but stop trying to explain ... your better off just leaving it alone.. Book smart does not cut it here
-
-
lol... that's why when we have rehab set up we have at least two chiefs on scene, more than likely if there's going to be an issue there's at least three on scene because it's a bigger scene. You would be lucky to get past two bottles without going to rehab, some can swing it, but there's a slap on the wrist to follow. Chiefie keeps himself very close to the accountability board.
Nothing shakin' here... just my head!! hahahaa!!
-
-
I going to call it a draw .. Different thoughts on this is ok... I'm going to call it that I was right only because I pretty sure I am ,as for you thinking you are right.. call it a draw..lol
-
Permalink Reply by George on
-
Would it be possible to get a copy of that also. That is something we have talked about here and sounds like you have a good things started. If you dont mind you can send it to dyerfiretn@yahoo.com . Thanks
-
Permalink Reply by chele on
-
Thank you to everyone for your input! This has been very informative for me and I really apprechiate it. Ben, I especially apprechiate the effort you have put in to help me! Thanks!
-
Permalink Reply by FETC on
-
Ben,
In New Hampshire, EMT-I or P's administer IV's and D-50 to diabetic patient's in the field. If the patient chooses to sign-off no transport, we can not make them be transported to the hospital. Therefore your comments about physicians orders or written prescription is interesting.
We have actually had cases proven in court that we do not work for the medical control doctor in the ER. We work under the State of NH EMS protocols, which are adopted by the state government. These are our standing orders for which we follow, to include when to administer IV's, paramedic medications and whether we can or can't transport someone to a medical facility.
The fire department owns all of the ambulance equipment, medical supplies and medications... not the hospital.
-
Permalink Reply by Ben Waller on
-
We do the same thing in South Carolina, but we still have to do a run report.
Some of our protocols are standing orders, but we have to follow those exactly, and these are signed in advance by a physician.
Does your EMS system (either state and/or local) have a physician Medical Director?
Does he or she sign your EMS system's protocol document? If so, then it is defined as a prescription/order for the medications.
Even if you operate under state or local standing orders, I'm betting that they were signed off by a physician somewhere, at some time.
A state paramedic scope-of-practice document with standing orders doesn't trump the federal FDA and DEA regs.
And...if you're doing invasive ALS/ no transports without doing a report, I'm betting the right lawyer just hasn't discovered it yet.
I'd appreciate more information as well as clarification on the above - I'm not familiar with New Hampshire's system.
Thanks,
Ben
-
Permalink Reply by Christy on
-
I haven't read all the replies. We are a county EMS department. We respond to every call the fire dept. goes on. We have rehab on scene and are able to give IV fluids, if necessary, without transport. Easiest way to get around transports is to call the ER and request to release the pt. Usually the ER's are so busy that they are more than willing to sign off on AMA's that really don't require transport. Our county has a specific rehab protocol. If yours does not then maybe you should suggest that they add one.
-
-
Is this protocol based on what's easiest for the fire crew, what's easiest for the EMS crew, or what's best for the health of the firefighters. Sorry to be adamant about this, but if a firefighter needs IVs to rehydrate, it's hospital time. Oral rehydration is a different story.
-
-
It's not about what is easist. When you are in an area where it is very hot and humid sometimes they just need a bit of fluids. Not everyone needs to be seen at the ED. We are allowed to treat and release. As I stated...call and talk to the doc. As I stated in my previous post...docs are more than willing to give the ok when a person doesn't need to be transported. I didn't say they will give the ok when a person needs to see the doctor.
© 2024 Created by Firefighter Nation WebChief.
Powered by
