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EMS Trying to get involved in extrication.
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???
Replies to This Discussion
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Permalink Reply by lutan1 on
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Very different! Not sure I agree with it....
We'd be strung up if we didn't take guidnace from EMS- as I said in my original post, they tell us how they want to get the patient out based on a clinical decision (ie: out side of car, out rear, out front, etc) and we give them the options- we can take a roof off, flap a roof, etc, etc. They have the final say unless there's a safety reason or a particular way is impractical due to equipment, space, environment, etc, etc
Does that make sense?
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Permalink Reply by PFC Harmon on
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In my department the EMS lets us handle extrication, we are trained and certified in it. Also alot of us are EMTs or Paramedics and work for the ambulance service. If for some reason the EMS crew wants us to cut a vehicle a certain way they will got to the IC and tell them and he will decide if we need to change out tactics.
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Permalink Reply by Phil on
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I agree with about everyone on this forum. However, A good firefighter knows a little bit about EMS. A good firefighter should relay medical information... IE who is breathing, who is not, are there scared kids?.. elderly, drunk, or who is hurt the worst. It should be the fire officer on the scene to delegate who checks the patients, relays the information to EMS, who should be well out of the way, because unless they are part of the fire department, they typically dont have proper PPE and dont know the dangers of a MVA. Then the EMS command says ok, person A should come out first, and person B next...etc..... Its up to the fire department to clear the way for the medics to get in and further evaluate, after the access is cleared for the best possible egrees, and the saftey hazards have been reduced.
My issue is around here EMTS and medics show up at a MVA... while they might pass over a general illness at the nursing home. They all think they are gods, and they all think that there is glory at an MVA.... for some reason I will never find out. Now there is a bit of glory... i guess but they dont get recognized... perhaps its like the rich kid driving a hummer with a small penis.......... over compensation and wanting to be noticed?....
leave the fire service to the service and leave the medical to the medics..... but we have to work together to keep everyone safe.
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Permalink Reply by Joe Stoltz on
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Let me expand a bit on our operation. Suppose we have a crash with a single occupant, the driver. We put a member (preferably an EMT) in the back seat, to begin and maintain c-spine stabilization. A second EMT in the front seat (or wherever) will begin assessment of the patient's vital signs; baseline pulse, resps, BP and LOC are noted to begin trend analysis. All members are in full firefighting PPE although we often doff our helmets when inside the vehicle.
Meanwhile the extrication crew has set up the tools and begun their work. Although this operation is under the control of the extrication officer, that officer and the EMTs inside confer as to the best way to remove the patient. If any tool work disturbs the patient the EMT calls a halt, and work halts.
The people inside explain everything to the patient, i.e. the loud pops or noises as the car is being opened up. They are under the covering blanket too while glass is being removed, again to reassure and assess the patient.
I just can't imagine rival fire and EMS agencies working together like this without some heartburn flaring up. I say again, it is very important for these agencies to train together to come up with a workable system that everyone can support.
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I did download this and skimmed through it. Very interesting indeed. I will make sure we try some of these techniques next time we get some cars to practice with.
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Permalink Reply by Ben Waller on
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John,
I'm curious as to why you would make that statement.
I think that EMS should advise the extrication team about what the best extrication techiques might be, based on what the patient's needs are. Those needs are different at every extrication.
If EMS can't make recommendations to the "crew with experience" doing the extrication, my experience tells me that the extrication crew might be tripping over an ego or turf problem.
In my experience, EMS systems that run extrication do some of the best-quality extrication around, because their techniques are based on a) size-up and b) what is best for the patient.
Extrication should be about the patient, not about fire/rescue or EMS egos or turf wars.
There are several EMS systems that operate Heavy Rescue units and are the primary rescue agency in their areas, and the ones linked below are all pretty good ones'
http://www.crs75.org/
http://www.bccrs.org/
http://www.wvrs.org/
http://www.city.pittsburgh.pa.us/ems/html/rescue_division.html
I'm not familiar with the fire-rescue and EMS systems where you work, but the above offer some excellent evidence that EMS should not only be involved in extrication, but in some places they're responsible for it.
Ben
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Permalink Reply by Heather on
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Yes we have a medic in our county and is on our department and tries to over ride our cheif and do things that should not be done.
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Permalink Reply by KARL on
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We don't have that problem around here. Most of the time the EMS crew will let us do our jobs and they will assist in getting us what we need off the truck and work very well with us.
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Amen brother! You've just said what I've been trying to say in multiple posts!!!!
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Permalink Reply by Spanner 122 on
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We will work with EMS to determine the best way to get the pt out of the vehicle at times... but in most cases, we pop the door and take the person out, unless there is some extreme damage to either the vehicle or the pt. Seeing as there are times there are neck and back injuries and very little damage to the car, we certainly wouldn't start cutting the car apart. The last time this happened, we simply helped EMS with the KED and got the pt out. It always depends on the situation... if you're cutting anyway and have the time to make it as easy a removal as possible, why not? more experience cutting, right?
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Permalink Reply by Celestiel Mccarty on
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I work in a Rural County in West Virginia. Most of our EMS personnel is also firefighters. The way we operate here may be a little different than others but here is how we do it. If we have any type of MVA with or without entrapment, the EMS personnel is to stay at their ambulance until the scene is deamed safe by the fire department working the accident. The only exception is if a fire officer puts an EMT/Paramedic in the car to begin treatment while we are working on the vehicle. I have personally made EMS leave the car until we get the patient out. We train our members in backboarding and loading of the patient. Therefore, we bring the patient to them. The scene belongs to the fire department until it is other wise deamed safe for personnel (EMS). If the EMS personnel gets hurt or killed on the scene of an accident then the fire department is ultimately responsible. The FD is responsible for the overall scene safety, safety of members, patients, and bystanders. At the point of the call where extrication is going on EMS is considered a bystander and is a tool for the FD to use when it is safe and needed, until then we have first responders, EMT and Paramedics on our department that can do patient care until the patient is removed from the accident.
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I have looked at the file you have posted. In many of its cases I seen a lot of manipulation of the spine. It seems to me before anyone goes with the techniques (most of them) in this brochure they need someone to really come in and teach a good extrication class, that covers the old and new vehicle technologies. I am a fire and ems instructor and there are only two cases that I have used with my department that was shown, in 13 years..hmmmmmmm We have very quick extrication times, patient access to medical care and low to none injuries to fireman and/or patients due to extrication techniques. As I can recall, no patient has ever been injured or further injured due to extrication, and only a couple of scratches to fireman. I too am a Paramedic and I would NEVER interfere with the FD in any extrication that they were doing. Maybe I am just fortunate to have a fire department and EMS that knows what the hell they are doing!
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