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Respond to accidents with injuries or not

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  • Respond to accidents with injuries or not

    Are there other FD's (Career or Volunteer) that do not respond to accidents with injuries? My dept believes responding to these calls results in: 1. Run to many calls, 2.Not needed at the scene because EMS gets there first and if they need us they'll call, 3.Liability for putting another piece of equipment on the street. 4. Do not want to add additional training (First Aid).

    We do respond to confirmed accidents with entrapment with a Heavy Rescue and Eng.

    We respond to 1000 calls a year. The question should we be responding to accidents which would take us to 2500 calls per year. Any suggestions or opinions.

    Any yes, we are 100% Volunteer

  • #2
    First, some background on us. Ambulance and fire are separate services. Rescue is technically separate from the FD, but run by the FD (don't ask, even we have trouble figuring it out).
    For accidents with injuries only and confirmed NO entrapment, only an ambulance is dispatched. If there is confirmed entrapment, or if it's unknown, rescue is also paged.
    The ambulance may ask for rescue for manpower on the injury only calls, but it is up to them.
    We are trying to get the Borough and dispatch to page out an engine with the rescue, but right now we have to special call it.
    Most of us feel that at least the rescue should be on the highway for any accident, and the engine is a good idea for both visibility and having water on scene should the vehicle(s) catch fire.


    • #3
      Our department (combination career/volunteer) responds to all accidents with injuries, or unknown injuries. Most of our responses are non-emergency (code-2). Our EMS is provided by a third-party agency. We respond an engine equipped with EMS gear and an AED, a limited amount of stabilization equipment, and a small combination hydraulic tool. For any incidents with known unstable vehicles (rollovers, vehicle on its side, etc.) or entrapment, a rescue truck also responds. Nearly all our FF's have 1st aid training, and about 25% have EMT or higher certification. Our primary purposes in response are potential extrication and scene safety/hazard control - including downed wires, fluids on the roadway, scene lighting, fire control, undeployed airbags, and unstable vehicles (which may include vehicles still sitting on all 4 wheels). Our job is to make the scene as safe as possible for all concerned. Often the apparatus is positioned to provide a safe area in which to work - a 30,000 pound engine makes a decent safety barrier. We also provide limited EMS when we arrive ahead of our EMS service, and assist with patient care when they do arrive. We may assist police with traffic control, crowd control, measurements, and photography if needed. To address the four points posed by your department: 1. How many calls are too many? Do you limit your response to only fire incidents, or do you handle lock-ins/lock-outs, CO detectors, gas odors, downed wires, etc? 2. Is there a need for any of the services you are capable (and willing) to provide at these accidents? Many of the services we provide at an accident do not relate to EMS. You can always cancel your response if PD or EMS arrives and finds no hazards and needs no assistance. 3. Liability in terms of placing your apparatus in the street - you would have to elaborate on this. There is a liability attached to everything we do. Some laywers might find that you were negligent for not responding to an incident where your services were potentially needed. 4. As for first aid training, we have found that our department often benefits directly by having a minimum level of EMS training. This allows us to take care of our own when EMS is not on-scene with us. The public frequenly assumes that all FF's are trained in first aid (or higher). We often get "walk-ins" to our station in need of EMS care. We would be doing a disservice to our residents if we simply said "sit down and we'll call you an ambulance". If your only purpose in life is to respond to fires, you may be in for a rude awakening one of these days. The fire service is constantly changing, and is called upon more than ever to be an "all hazards, all risks" type of organization. Simply put, we are called to handle nearly everything save for obviously law-enforcement issues. Our business is definately "Lead, follow, or get out of the way". Stay safe.
      R.A. Ricciuti
      Mt. Lebanon Fire Department


      • #4
        Our SOP's call for the fire dept. to be paged along with ambulance for all injury accidents (if dispatch does this is a different topic for a different day). Rescue is run by the fire dept., but not all members are involved with this-more training, more calls, more time...however our ambulance squad also has members trained for extrication, and if the engine doesn't already have 4 firefighters that are qualified aboard they will jump in. The reasoning behind going to all injury accidents is similar to previous posts, traffic control, assisting EMS, and if the collision was bad enough to cause injury, who knows what happened to the vehicle that may cause a fire or other hazardous condition. We have 25 firefighters on our roster-all firefighters are trained for CPR & First Aid, approx. 5 are at First Responder level and 4 are at EMT-B.
        I don't get paid-the hours are terrible-but I'm doing what I enjoy, and that's good enough for me!


        • #5
          Whenever a medic is disptached to a call in our fire district, we always send something. So, even if there`s only a call for neck pain at an MVA scene, we`ll usually run the MVA response, engine and rescue, rather then just the rescue which is sent on normal EMS runs. First off, the accident must be significant, or the police would handle it themselves, and second dispatch screws things up so often, we can`t be sure the MVA will be as minor as they say...


          • #6
            A Posting from Forum Moderator Ron Moore

            The second edition of my Vehicle Rescue & Extrication book is due out in Spring 2002. In Chapter 4, I address what I feel are broad criteria for why an agency should or could be summoned to a vehicle crash. The fire and extrication sections reflect the competencies of NFPA Standard 1670, Vehicle Rescue section. Maybe this will provide some unbiased food for thought.
            * * * * * * * *
            Recommended Agency Roles

            Agencies that routinely work side by side at crashes should develop assigned responsibilities for each agency to fulfill at the scene. The following example illustrates how standardized operating procedures and responsibilities can be established.

            LAW ENFORCEMENT PERSONNEL (minimum two personnel)
            o Investigate the accident to determine its cause and whether there are any violations of the law

            o Establish and maintain traffic control and control of bystanders at the incident scene

            o Make arrangements for any additional resources that may be required

            o Preserve the scene for accident reconstruction and investigation teams.

            FIRE DEPARTMENT ENGINE COMPANIES (minimum four personnel)

            o Establish and maintain scene safety by control of safety hazards including but not limited to the following:

            o Blocking of incident scene to create safe work area around crashed vehicles

            o Fire extinguishment or fire prevention

            o Fuel and fuel system spill or leak control

            o Perform vehicle safety surveys

            o Control and disabling of vehicle electrical system

            o Scanning for airbags

            o Vehicle stabilization

            o Assist law enforcement agencies

            o Locate all actual or potential patients

            o Provide emergency medical service at minimum BLS level

            o Assist EMS personnel as requested and assigned

            o Preserve crash scene for accident reconstruction and investigation teams

            EMERGENCY MEDICAL SERVICES (minimum two personnel)
            o Establish and maintain patient contact throughout incident

            o Evaluate condition of patients

            o Prioritize and administer necessary medical care

            o Assess need for disentanglement activities to free trapped patient

            o Advise rescue personnel of interior entrapment conditions

            o Properly package injured patients

            o Assist in extrication of patients from damaged vehicles

            o Transport patient to medical facility

            VEHICLE RESCUE and EXTRICATION PERSONNEL (minimum four personnel)
            o Establish Incident Command

            o Implement necessary safety measures on damaged vehicles to prevent further injuries to patients or operating personnel

            o Perform vehicle stabilization

            o Provide initial and sustained patient access

            o Disentangle patients

            o Extricate patients from damaged vehicles

            o Assist EMS personnel as necessary
            Ron Moore, Forum Moderator


            • #7
              We are a volunteer dept. and have fire and ems together. If there is an accident and an ambulance is dispatched then we roll and engine also that is also our rescue truck. We do this because one it may be worse than they were told. Second, there could be fire possible from leaking fluids. Plus, there is also the possiblity of a Haz mat spill with gas or diesel. There is a dept. close to us that rolls only an ems unit to accidents and it has gotten them in trouble before. If there is someone trapped that extra time that you are already in route will be a life saver. Remember the Golden Hour. It also includes your travel time. If rescue is not needed then you can always turn it around once ems or and officer gets on scene.


              • #8
                Wow, somebody runs vehicle accidents just like us! We do not go unless there is entrapment, fire, fuel spill, etc. Our PD has a very good response time, and they can get on scene within 2-3 minutes. Also EMS is another agency (career). They respond with a 2 person BLS and ALS responds with 2, or sometimes 3 ALS guys. We are also 100% volunteer and run about 1000 calls a year. We would add a good 1500 alarms per year if we went to all car wrecks. And we are not needed on scene very often. We run possibly 1 or 2 car accidents per month now, and when we get one, we treat it very seriously, since some sort of confirmed info was received. Even now, most times when we arrive on scene, EMS has the patient loaded and sometimes enroute to the hospital before we even show up. Only with entrapment is the patient not loaded up. I know this is not the norm for most, but it works for us. If we ran a half dozen accidents a day, plus all the alarm malfunctions we have anyway, our days as a quality fire department would be numbered. Our normal entrapment response is 2 Hurst tool equipped engines and the heavy rescue.


                • #9
                  Besides calls of confirmed entrapment, we always send out the rescue to accidents where the situation isn't clear, on the highways, or at major damage on the scene.

                  Besides all that, rescue is sent out to clean up oil and debris from accidents either with or without injury.


                  • #10
                    In our dept.we do respont to them even if they say it might be minor,because we had entrapped patient`s and the ambulance had to notify the fire dept.And the station was 2 street blocks away from the scene,the time the fire engine got there 20 mins had already gone by.and how many times didn`t you get the right info about a scene.I can`t speak for your conditions but in South Africa we sometimes get mva`s with 2 cars the one is a mini bus taxi with 16+ patient`s and then it`s good practise to help your medical crew.But I think it is up to department for themselves.Maybe have a small pick up with rapid intervention rescue tools to start the extrication,till back up can get there.The initial cost might be high but on the end it might save the cost of an engine.co.


                    • #11
                      As a volunteer department in a primarily rural area, sending an engine and a rescue truck along with a 1st responder ems crew has saved our bacon more than once. If the call is 10 to 15 minutes away from the station (they never seem to be real close) then the extrication crews or additional manpower would take an additional 10 to 15 minutes to arrive on scene. If we have all our resources en route at the same time, we can always cancel if not needed. This may be an inconvenience to us (not) but your patients will fare much better.

                      We once had a call where there were two vehicles in an accident. P.D. had cancelled the extra units but we were close so continued. We got out of the truck and soon discovered two more vehicles over the roadbank that the officer had not seen from his position on the road. Not his fault, but one person doing a site 360 was not enough. What he saw didn't look like too much so he cancelled us. If our SOP said not to roll with everything, an additional 10 minutes would have passed for the critical patients in the ditch.

                      Roll with more than enough. You can always turn around.


                      • #12
                        We have a dept that runs fire and EMS together. Our company has a rescue squad that responds to handle extrication. We also have an ambulance that we run on first due accidents. I know that in many departmeents, the rescue and EMS is separate from the FD, but at least an engine should respond. You often have hazards involved and there is always the possibility of fire. I was taught that an engine with a chargedline should be standing by at accidents. We may not always practice it, but there is always an engine until we determine they are not needed. Also, as far as making for more calls, that is what we are here for. We run over 2000 calls on our squad every year, and we still have an ambo, and truck. I know that as a rural department, you may have less people and longer response times, but if the service is needed than we must provide it. Remember we are trying to protect our communities.

                        Just my thoughts, sorry if you disagree.


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