The Social Network & Community JUST for Firefighters
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
-
Permalink Reply by Celestiel Mccarty on
-
Well, here is my opinion on this............I am a Paramedic and a Captain at my fire department. In my 13 years in the "service" as you call it......I have seen a lot of medical people that I would like to smack in the mouth because of their "godly" attitude. However, I too have seen many more fireman that I would also like to smack in the mouth due to their tendencies as well. It is the piss poor attitute of the "fire vs ems" that we need to pull away from. In WV all fireman are also required to have First Aid and CPR therefore, they know what needs to be known about ABC's, which I may add is all that needs to be known when doing a primary assesment on anyone, medical or trauma.
The attitudes of the old vs new fire service SUCKS! It is this attitude that makes us unable to cooperate together. We need to work together for the greater good of the citizens, besides isn't the firemans first responsibility....hmmmm...i dont know.....to save lives...hello!!!!
Yes, I fully agree that EMS needs to stay out of the way on a fire scene of any type. But, we all need to realize that once the fire department brings them out, we as medics get busy, not the other way around. We all need to change our attitudes and views of each other and see that we are the closest thing to GOD on this planet, so we are all GODs hands. GET OVER IT. We do our best whether we are on ambulance that day or fire department, we are not god but we do our damnest to go that far. Loose the holier than thou attitude and work together. we can do both, yes again I am a fire officer and a paramedic and being a parmedic DOES NOT make me any less of a fireman.
-
Permalink Reply by Oldman on
-
Reading between the lines, I feel there are several issues. EMS is in charge of not only patient care, they are in charge of the patient, period. This applies to anything which may affect the patient, including extrication. Maybe the patient condition warranted a more rapid removal than would have been possible otherwise. Maybe by taking the roof off, would allow for the spinal alignment to remain straighter than laying them over and removing them from the side.
"finishing up on the dash roll", "cut the roof of the truck off when there was absolutely no need to."
This indicates to me that hydraulic tools were being used. What difference would it make if you take the roof off? Theres not an insurance company in existence today that will repair a vehicle when the tools are used, even just popping the door. As soon as the spreaders start on the vehicle, it's totaled plain and simple. So property conservation shouldn't be an issue.
It really sounds that we may have an communication issue along with, "this is my territory" issue. Which is what I was involved with many years ago.
I was involved with a similar situation between the EMS agency I was with, and the local fire department. They thought I was trying to tell them how to do their job when extrication was necessary. When the FD Chief and I had a heart to heart, we found out we were trying to accomplish the same thing but with a different mindset. All it took was some mutual training between the two agencies. The more we trained together, the better our understanding of each others tactics and methods got. In the end, even though we were two separate agencies, we developed an outstanding working relationship.
Sometimes all it takes is some discussion leaving the egos at the door, and the willingness to work together for a common goal, which is after all, the patient.
-
Permalink Reply by lutan1 on
-
I have looked at the file you have posted. In many of its cases I seen a lot of manipulation of the spine.
Celestiel, if this is in relation to the file I posted earlier, referencing this manual-
http://emergencytechnologies.com.au/vet.htm then I'd suggest that you reread it very carefully. There is zero twisiting of the spine in these techniques. The author has devoted over 20 years to researching spinal injuries and extraction techniques before writing this manual.
Feel free to contact him and discuss directly- I think you'll be surprised...
-
Permalink Reply by Asst. Chief Bigshow on
-
I'm from Georgia and the county I live in has 6 volunteer fire depts. and two paid city depts. Our depts are an all volunteer dept. and have been for over 25 yrs and carry and ISO rating of a 4-8b. Our EMA (emergency management agency) takes care of all extrications. The EMA personnel is all volunteer as well made up of volunteer firemen except for the director. However, everyone involved in the extrication is certified by the state. In Georgia, all EMS personnel are required as part of their training and licensing to be extrication certified. When we have a call that requires extrication the fire dept, and EMA are paged out as well as EMS of course. Our EMA director becomes the IC when he gets on scene. But EMS still controls the patient and patient care. However, we all, I repeat, WE ALL WORK TOGETHER-- EMS, EMA, FD. If EMS knows a better way to get the patient out with out causing more trauma due to the patients body size, position or condition then it is best to do it their way. After all, they are trained. No one person or dept. or agency trys to be an --what was it called--extrication god. It is what we call TEAM WORK. THEIR IS NO "I" IN TEAM. No matter how you look at it we are all Brother and Sisters on scene to accomplish one goal, and that is to get that patient out of entrapment and in to that ambulance and on to the hospital.
-
Permalink Reply by mike angle on
-
Well said lutan 1 in the past 20 yrs i have work many calls on both sides . Fire & ems and there are reasons for ems to stay back . However if there is a need for trauma intervention ems should be equiptment to be inside the vehicle to provide this care . The end result should be that patient care is not delayed because some fire department personnel has an ego . Don't take the last statement wrong we all know both ems and fire personnel that have a god like personna. And those of us whom have been here for a looooong time know that experiance and a level and cool head is always better than being a hot head and pissing people off. BOTTOM LINE WE MUST WORK TOGETHER.
-
Permalink Reply by Anthony Hann on
-
Just to clarify the comments relating to the techniques in the link sent in by Lutan that they cause manipulation of the spine ..... The manual shows a range of techniques based on a range of patient positions and situation. The manual teaches principles of each patient removal are simple: 1. Maintain Spine alignment and 2. minimise body twisting. So the Rescuer is able to use the manual as a reference based on the position of the patient, and limitations at the scene (time criticality vs rescue/no rescue available). Using these principles, the person sitting in the drivers seat would be extricated in-line out the back window (with significantly less manipulation than a side door extrication), but the side door extrication also shown, but not taught as a first choice (as it stated in the manual). In a ute, the vertical lift is the first option, but the manual shows other techniques based on needs at the scene (opposite side window where doors are jammed, patient is time critical, and rescue is not available). Simply, the manual needs to be read fully or misinterpretations can be made. The techniques in the manual are well tested and have generally become the standard of teaching over hear.
Anthony Hann
Author - Vehicle Extraction Techniques
-
Permalink Reply by fireman1049 on
-
Dustin,
i hate to be the bearer of bad news, but EMS calls the shots when extrication is involved...
i didnt see any mention of what type of accident this was.. was it a roll-over, head-on collision with an object, or a T-Bone? the accident type dictates how u remove the patient from the car?
second, there was no mention as to weather the patient hit the winshield an had head trauma...
was there any intrussion into the drivers compartment?
did the person go down an under the dash or up an over the dash?
injuries to the patient dictate what will be the safest way to remove the patient..
perhaps u should talk with the EMS crews to get some insight as to what they look for at an MVA as far as extrication is concerned...
Ladies an Gentlemen, did i miss anything or overlook a little information to help him out?
-
-
Hi Fireman 1049, just in regards to the comment that the accident type dictated how u remove the patient, It think this needs expanding as it is more complicated than this. The desicion is first based on patient positioning to maintain spinal alignment and minize body twisting so as to not exacerbate any injuries (as this is what it is all about). Once this is decided, the time criticality of the patient needs to be considered to determine time available for the extrication. Then if safe to do so, and without delays that may affect patient outcome, Rescue makes vehicle cuts to achieve the access to and egress of the patient to maintain spinal alignment and minize body twisting. Damage to the vehicle will ofcourse impact on cuts and the egress of the patient based on difficutly to achieve the cuts and scene safety.
Too often cuts are made in isolation to having a true goal - the patient. Making a desicion of cuts based on the way the vehicle is damaged alone, fails to take into account the patient and their care (the primary goal of vehicle rescue).
-
Permalink Reply by Ben Waller on
-
...and when the patient dies because of that policy, the resulting lawsuit will be difficult to win and the judgement impossible to pay for without bankrupting your department. You're leaving medical decisions including the level of care the patient needs to the fire officer to non EMTs???
You're also denying EMS access to the patient until packaged while people who are not EMTs apply the spinal immobilization? That's a very unsound policy and practice on both medical and legal grounds.
It would be much better to train and equip the EMS personnel to work the wreck jointly with the fire department extrication team. Good equipment, good joint procedures, and working together for the patient's benefit is the answer, not denying medical care to people based on a non-medical opinion.
The FD being responsible for overall scene safety doesn't give the FD the right to deny medical care to entrapped patients.
-
Permalink Reply by Tony P on
-
I'm a firefighter. Here, that usually means just that - I'm a firefighter. Some Brigades are Road Rescue trained and equipped - mine isn't. My training and experience for an MVA where there are injuries and entrapment is that the paramedics are in charge - they are the ones who suggest which way they would like a patient removed. Then it's up to the extrication crew to do their utmost to get things happening the way the paramedics asked. That's how we're taught.
As Lutan said, here the Police are in overall control; if there's fire we are in control until the fie is out. If there are injuries the Paramedics are in control, until patients are stabilised/extracted. The extraction crew are in charge of extraction procedures. Then it all falls back on the Police. Sometimes there are ego problems, not often. We all know who is in charge of what. We all work together.
We (the volunteer firies) tend to outnumber everyone else, so are used to fetching things for the rescue guys, holding saline bags for the ambos, abusing idiot motorists for the cops (oops, did I say that?) - I mean directing traffic under the control of the police... Things like that. As long as we're of use most of us don't mind what we're asked to do.
I've seen people saying things like 'most of our FF's are paramedics". Now that would be a rarity here! Unless a paramedic wants to be a volunteer FF as well. Career FF's also paramedics? I've never heard of one being dual qualified. With paramedic training being (please correct me if I'm wrong Anthony) a three year full time Bachelors Degree, plus clinical training, it just doesn't seem to be much of an option! Our system is that firefighters are firefighters, medics are medics - two different services. There are some firefighters who are trained as medical 1st responders. That's as far as it goes - and in my book that's too far. If we need FF's to respond to medical cases because they can get there quicker than an ambulance, then we need more ambulances and paramedics!
-
Permalink Reply by Peter Lupkowski on
-
Or is it really EMS based fire supression? I am an Asst Chief in charge of EMS for a small dept. I raz my Chief at every opportunity about my higher call volume and significant budget. Plus EMS brings in money to support the cause. But, we're all in this together. I can't attack a fire with a rescue or ambulance and he can't haul patients in our engines or trucks. We make a great team. He is command and I respect that, but if there is a patient issue we work together to solve the problem.
© 2024 Created by Firefighter Nation WebChief.
Powered by
