On my department a lot of our calls are medical calls and we've got 15-20 fireman that are medical trained for this reason and the ambulance will call use when they need assistance. But we get quite a few fireman that show up that are not trained at all, they might have cpr but thats it. Nobody seems to care about this that we've got untrained people trying to help out at medical calls. My question is, is this even legal and what would happen if it would ever go to court and what can be done to try to stop it. I just dont want a lawsuit and the other fireman are like it'll never happen, maybe I'm over reacting here I dont know.
We have a Problem like that with one of our neighboring fire companies.. Im also on the ambulance service.. This fire department lets thier JUNIORS go to EMS calls. I totally disagree with this issue.. They are not even old enough to be doing firematic things...WTH... It has been discussed but nothing is ever done.. UGH..
You've done all you can if you bring it to the attention of an officer. If nothing happens and you are paid, tell the union. If nothing happens and you are a volly, bring it up at a meeting. I can see maybe an officer and/or the driver not being trained, but the driver should stay with the rig and the officer should just co-ordinate between his crew and EMS. I have the same problem with vol. RIT companys going to RIT calls with only one or two RIT guys surrounded by non-rit guys. In both situations, who knows that they are not trained? Nobody, until they mess up and someone gets hurt, dies or sues.
Permalink Reply by FETC on October 6, 2008 at 11:50am
First, you should be happy they are showing up to help. Nothing stinks worse than going to a call and needing more help. If what they are doing is only helping the trained EMS Providers, than you are OK. If they are trying to be Johnny Gage before EMS arrives well then you have a problem.
They can do many things on the scene, getting the truck ready for transport, traffic control, assist with carrying the patient, or your tools / equipment, etc. They can do pretty much anything asked to do under the direction of the person having patient care to include CPR with a code or driving the rig to the hospital while the certified people perform patient care.
If you have some who are trying to do EMS care, then you must steer them to a first responder or EMT class. I do not see this problem in my department as everybody is crossed trained to the Firefighter 2 / EMT-Intermediate Level.
T.J. What is the issue with a non-ems trained person using the jaws? The use of extrication tools has absolutely not direct link to patient care. When performing these extrications there should be an EMT under the blanket with the victim with patient care. Many big city fire departments who run heavy rescues may or may not be an EMT.
Also, if you are a fire-based EMS service, when the fire department is toned out to respond for a medical call, do you have an issue with a Fire Officer being in charge of the incident, even though a paramedic is providing patient care?
Do NOT count on the "good samaritan" laws here.....they may protect the individuals......perhaps not....and they are DEFINATELY not a safety net for the department sending non-trained personnel to a medical. I agree that you should bring these issues up asap. its just a matter of department responsibility here in my opinion.
Around here the Fire Officer is NOT in charge of a medical incident once the paramedics arrive. Its not his/her forte' unless there is an extrication or fire aspect to the call. even then he is in charge only of the fire or extrication aspect....the highest ranking medical personnel on scene is in charge of all patients aspects in that case as well......Check it out on NIMS....i believe its the SOP they mandate
Permalink Reply by T.J. on October 6, 2008 at 12:30pm
Yes our non-medical try to be Johny Gage and they wont take a ems class and if they do they dont keep up on their credits and its lost, I've got no problem with firefighters using the jaws, thats fine with me, and I guess I have a slight problem with Fire Officers who are not medical running a "just medical call at a residence". They really have nothing to do with the call and for them to be blat'en orders and have no medical training, I feel that is wrong. If they want to come and keep their mouth shut and help if we need them then thats great. But it doesnt work that way.
Permalink Reply by FETC on October 6, 2008 at 2:20pm
OK before Swat kicks down my door, we are a fulltime fire-based EMS service, we are ALL medically trained to EMT-I or P level including the Fire Officer's. If I say jump and your my medic, it is how high sir. Not, I am the paramedic and this is what we are going to do... I am not a Hazmat Specialist but I am the Incident Commander at Haz Mat Incidents... it's called using resources and research from many personnel to make educated decisions.
So let's say you are the paramedic and the only one of scene. You have one or even two patients and they need your godly services immediately and there is no other EMT or Intermediate on the scene who can give it, what you are saying is you are in command of patient and the incident. (Huh) sorry but something is gonna suffer either patient care or incident command. See, I ask my paramedic what he needs and I as the Incident Commander get him the resources he requests but I NEVER work for him.
A medical call in my city with our fire-based EMS service, has a incident commander who is a Fire Officer. When we run out of busses and the private comes to the scene to transport the Incident Commander from the engine company is in Command of the incident (I don't care if you are a doctor on the private bus) you are a resource in which the incident commander requested.
NIMS, blah... they calls tankers, tenders and most of the country calls them TANKERS!
This could be an authority having jurisdiction issue, in my State, the RSA states the Senior Fire Official is in charge of the incident. If it is a motor vehicle accident on a roadway, the RSA states the Senior Fire Official and the Senior Law Enforcement Officer will be in equal control of the incident using Unified Command. This is from seeing other states having Fire Officer's arrested by law enforcment from closing a roadway and the PD didn't like it.
Permalink Reply by T.J. on October 6, 2008 at 2:35pm
OK, I can see where your coming from here, and it sounds like it works great for you, also here in Michigan the Fire Officer or who ever is in charge of a scene has control over any other agency including law.
umm....ok......nowhere did i say that i call all the shots and people work for me....nor did i say that i somehow run the show and nobody else matters......the original question to start the post was NON-medical FF running medical calls....and that is excactly what i responded to.....if you have medical people on your department and they establish IC...well then run with it.....i was refering to non medical trained IC trying to call the shots.....sorry for the confusion on my part
I have 11 Years as a EMT-P and Firefighter 1 & 2...im a bit more than just a "resource requested by IC"....im just telling you the SOP here. I have a GREAT respect and relationship with the first responders when im in the medic role, and an equally great respect and relationship with the medics when i am not in the ALS role.
I said the medics have total authority of patient care........nothing else but that....Incident command may be transferred multiple times as higher ranking personnel arrive.....im just saying that for the aspect of patient care, the paramedic is the authority on that situation as it relates to patient care....
....no worries....i wont be kicking down your door anytime soon.....i have an Incident Commander to do that for me!.........IM KIDDING!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Sorry...perhaps i came off wrong in my initial responses....just explaining how we work around here is all and was responding to the initial question as asked......sorry for the confusion there..
Permalink Reply by FETC on October 6, 2008 at 3:16pm
All is good, but I was referring to your first reply:
"Around here the Fire Officer is NOT in charge of a medical incident once the paramedics arrive."
Its not his/her forte' unless there is an extrication or fire aspect to the call. even then he is in charge only of the fire or extrication aspect....the highest ranking medical personnel on scene is in charge of all patients aspects in that case as well......Check it out on NIMS....i believe its the SOP they mandate
sorry...i see the confustion.....the incident is definately the Fire Officers at all times......the patient is the direct control of the highest ranking medical on scene..........
If the incident is a chest pain, abdominal pain, etc etc.........id let the medics call the plays...
if the incident is a fire, extrication, rescue, etc etc.........im followin my trusty firefighter allll the way!!
Bottom line.....our private EMS and Fire departments work GREAT together around here!!!! Makes the job that much easier ...and fun!
I will only say that, if there is a problem with personnel showing up at medical calls who are not trained to deliver specific medical care and if medical personnel are showing up and allowing personnel who are not trained to deliver medical care to deliver medical care and if the medical director isn't stepping in and stopping it or the fire department through their board of trustees is not stopping it, due to liability issues that will go well beyond their insurance coverage, then I have to say that it is a LEADERSHIP issue, plain and simple.
Cowboys, hot dogs, loose cannons, free lancers or whackers; call them whatever you want, but they are a menace to themselves, the patients and their services. Keep them as far away from medical calls as possible. You cannot afford them.
IMHO.
TCSS.
Art