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  • Medic vs Rescue Co.

    Haven't we learned yet?! I am looking for an ear to bend. Last night we were called to a "Mutal Aid" rescue. We were dispatched 10 minutes after the local company. We arrived on location 2 minutes behind their first engine. As we were staging, we spoke to the locals Deputy Chief. He said to remove a door. OK, we started to set up to do that and then the medic said we need her out now. Both air bags deployed and she was conscious and alert. She also was collared(to my amazement) but no c-spine stabilization. He was the same "medic" who pulled a victim out of a head on without a collar and stabilization. (That victim is now a C4-C5.) We sat around the scene in amazement. We packed our equipment up and left the scene. What can we do. Is it in our right to say something? I know the "highest trained medical person" is in charge of patient care, but come on. This "medic" is know for yanking and running. When will it stop? Please let me know if anyone else runs into this and how to change it. Thank you for letting me bend your ears. Be safe.

  • #2
    king solomon could not come up with a answer to this situation.i have seen this problem from both sides.obviously this medic needs to be spoken to either by you or his bosses.higher medical authority does not mean he is in control of the entire scene.yes he may have control over pt. care but it is the duty of the IC who really has the ultimate control of the scene.i would like to know whatlocal protocols say about whose duties are at this type of call.i dont think its a matter of having ultimate control,we must still remember we do have a public to serve and egos should not get in the way of patient care.if you see this person doing care that is inappropriate to the pt you do have a moral as well as a professional duty to act on behalf of the victim.

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    • #3
      I am glad we run our rescue and EMS together here. I am afraid I could come to blows with a joker like this. In Ohio, the Fire Chief is "in charge" of an emergency. While patient care crosses that boundary at times, I wonder of the argument could be made that clearing the victim from the wrecked vehicle exceeds the desires of the paramedic to "grab-n-run"? The medic can advise and assist with this process, but the Chief Fire Officer would be responsible for mitigating the emergency (i.e. removing the victim from the vehicle).



      ------------------
      Richard Nester
      Orrville (OH) Fire Dept.

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      • #4
        Well being a medic and also having a lot of respect for my brothers. I let the rescue crew decide how to remove the patient from the wreckage. At our dept we have a medic on the rescue and on each engine that responds to an extrication. The IC has the overall command of the scene period. I do ultimately have patient care and advise the IC of patient status i.e.-do we need to get them out now because traumatic arrest etc... It sounds to me that this particular medic needs to either chill out or get some experience dealing with trauma.

        And yes I think someone needs to point out to this person that not every patient is a "load and go." He is going to cause someone their life some day.

        ------------------
        Fishers Fire Dept.
        FF/Medic
        Local 416

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        • #5
          I too am glad that both our rescue and ems are run together. If the "highest trained medical person" doesn't know about extrication, are they the "highest trained"??
          I know that in my department, the EMTs will generally listen to what the E.O. (extrication officer) says. If is safer for the patient to remove the doors first, then so be it.
          If that medic was on my service, he would not be for long. BAD PATIENT CARE!!!


          Chris Schultz
          Mountain Ambulance Service www.rescue70.org

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          • #6
            I have been in this type of situation before, but lucky for my community not guys like this. We do the extrication work and a private comp. does the ems stuff. In "The Great State of Texas" the IC is the trooper working the accident. We are in charge of scene safety and extrication. Since we cover such a vast area it has come to medics resorting to rapid extrication due to pt status. I have told my share of medics where to go for telling me how to do my job, but if they pull a pt from a car due to their status I don't question them. I have faith in their judgement and let them do their job. I hope I never meet this guy, because much like you, I would want to wear him out with a short stick!

            ------------------
            SERVING FOR PRIDE
            PROUD TO SERVE!

            [This message has been edited by JAMESBENNETT (edited 12-29-2000).]

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            • #7
              I just wanted to ad that as a Paramedic, one of the things that we or I should say, we should learn is how to take information from another person, and that includes critisism (sorry about the spelling, but I'm not perfect). You have every right to voice your concern or opinion about a patient, and patient care. We are a team. And I have had instances where I've wanted to do something and a EMT and even just a plain firefighter with no EMS training has said something to change my mind or thought. There are times to scoop and go, we all know that. As far as the Fire Chief being in charge Metal, its the same here. However, most of the Fire Chiefs around here have no Medical training and wouldn't get involved in the patient care boundary, especially on my scene. You do bring up a good issue however. The only other problem I have is if it is a known fact that he caused a paralysis, where is the QA/QI for the state, county, region, dept./agency, whatever. Why is this guys still on the street?

              ---------------------------------------
              The above is my opinion only, it does not reflect that of any dept./agency I work for, deal with, or am a member of.

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              • #8
                Over here in Australia we have similar or worse problems.

                Overall in charge of any accident is the Police. The fire dept is in charge of fire safety, the ambulance service is in charge of patient care, and the resuce provider is in charge of the rescue.

                As an IC of a rescue dept, I liase closely with the ambulance regarding time critical, injuries, etc. They tell me their preferred method for removal of the causlty, I then tell them the ways we can achieve that.....

                Can become confusing as a lot of the Ambulance crews are not trained in what a rescue dept can do for them, nor do they fully understand the capabilities of the equipment or the crews.

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                • #9
                  I think it's time to bring this medic's actions to their medical director's attention. It seems as though patient care is not optimum here, and that needs to be addressed.

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                  • #10
                    To be breif, this medic needs an attitude adjustment and a refresher lesson in EMT skills! but hey what do i know?!

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                    • #11
                      This "medic" needs some refreshing in the area of Standards of Care. We(I'm a Paramedic) work closely with the FD IC on any scene. We are the medical control and IC is in charge of scene. They and any other who believes an unsafe act is/or is about to occur are encouraged to bring it to the attention of the IC or PM squadleader on the scene. Load and Go's are almost never a one person decision, as the outcome of the pt relies heavily on the actions of the "team" that chooses a rapid extrication.
                      www.nsfire.org

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                      • #12
                        The "medic" (this one sounds like someone we can do without) needs to be reeducated. If the rescue team cannot or willnot talk to him, then you have to meet with his supervisor and open up some communication and education.

                        Like many, I worked from fire to rescue to ems and finally medic. If a patient is stable and it makes it less strenous and less hazardous to pry a door to move the patient, then do it. I do not want to be injured or see anyone injured trying to manhandle a patient from a car because I don't want to wait the few minutes to have the metal moved.

                        The one thing to consider, was there truly a need to tool the vehicle? I have seen tools out and extrication being done when there was an easier way to remove the patient. If the vehicle truly should have been tooled to facilitate a smooth removal, then complain.

                        Don

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                        • #13
                          in prior experience this person sounds to have an ego or control problem. it would probaly be in best intrest to contact medical control or board of directors because this person is probably beyond any field personal talking to or lecture, as far as if the situation ever arises again do what you need to get the job done right ;] and you will get the support from the rest of your team members.

                          Comment


                          • #14
                            Some true to heart medic will know limitations. They at times realize that they are a bit dull in their BLS skills. The medics that realize this are the most pleasant to work with. I envy the departments that run the BLS and/or ALS with the rescue company. But if it becomes a liabilty issue I personally would say to a medic lets step back and take a breath before I would stand there and allow a patient to become paralized for poor judgement. If that doesn't work then as someone else had said that a word needs to be taken up with the Medical Director of that ALS division. If you are there and you have even the remote contact with a patient you can also be named in a potential law suite for their error. COVER YOUR ***!!!! That is the way it has to be today.

                            ------------------
                            David DeCant
                            Firefighter/NREMT-B
                            Barrington, New Jersey
                            Career or volunteer we are all brothers. Just feel good for the good you do for others.

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                            • #15
                              In Englich

                              It is incredible to see that in coutry that it marks the injured protocols of attention of they badly present/display cases of handling of patients by the SME.
                              Of course that badly the handling occurs by some people and this it does not indicate that all laboren in the same way.
                              In my city, we did not count on a Regulating Medic, the service of rescues belongs totally to the Firemen, and the attention of injured is of the service of ambulances of the municipality.

                              Being a small city the paramedicos and the Firemen we know ourselves and the desiciones of each one are respected. The injured one
                              " belongs " to the rescue team while it is catched and it is responsability of Bombero-paramedico until it is released.

                              en Español.

                              Es increible ver que en un pais que marca los protocolos de atencion de lesionados se presenten casos de mal manejo de pacientes por los SME. Por supuesto que el mal manejo se da por algunas personas y esto no indica que todos laboren de la misma manera.

                              En mi ciudad, no contamos con un Medico Regulador, el servicio de rescates pertenece totalmente a los Bomberos, y la atención de lesionados es del servicio de ambulancias del municipio.

                              Por ser un una ciudad pequeña los paramedicos y los Bomberos nos conocemos y se respetan las desiciones de cada uno. El lesionado "pertenece" al equipo de rescates mientras se encuentra atrapado y es responzabilidad del Bombero-paramedico hasta que sea liberado.

                              Zapopan Jalisco Mexico.

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