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IC commad at MVC's

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  • j. schmidt
    replied
    I think that I have to give a little more back ground...................

    There is an Interstate hwy that runs thru both these towns. The two depts. are all volunteer, they do all the extrciation and EMS is sep. The one dept. that I belong has 13 EMT's. So when we go to MVC's we end up jumping into the EMS role alot, because the EMS squad is just not agressive enough and doesn't do extrication and has no training in this area. The standard respones is 2 rescues, 1 engine, and 2 squads other resouces are add as needed.

    Usually what ever chief gets there first regardless of who's town it is in takes charge. Someone posted something about ego? Well there right. Me being the highest medical person on sence relayed to the chief first to his face and then thru a Cap. that the engine co. was needed to enter the hwy. because I knew they had EMT's on board. ALS was recalled by me because they were not needed everything could be handle by BLS. The chief also did not relay this to dispatch. When the medics walked up I knew one of them and he asked what was going on? I told him that they were not needed and was sorry that the chief would not recall them. ALS made them selves ava. and went on there way. Finally he had the engine co. enter the hwy., but this caused a delay were pt. could have been geting backboarded and collar before the squads got there. Not to mention it was [email protected]#$% cold outside!

    I felt that a IC who has EMS background would have had this all taken care of by the time I got out of the back of the rescue. Instead care was delayed and I had to quickly triage the pt. and get care started by myself with and engine co. with emt's on it watching from the overpass for sometime.

    Ego being if you want to be THE BIG DOG at a MVC you'd better know what you are doing!!!!!!!!! My fire chief is and EMT and if he had gotten there first I know none of this cluster would have happened.

    Leave a comment:


  • old timer
    replied
    AMEN LADDERCAPP. I am sure each area of this country varies in how the Incident Command System and its struture are developed, as well as how the ego's of the members of each department are evolved.

    Truth is, as stated above by Laddercapp, the Incident Command system is a tool for the Fire-EMS-Rescue-Police Agencies to utilize. No where in any Command Class that I have had the pleasure of taking, is there a chapter that says YOU MUST DO THIS.

    We can go on forever on this, but it really doesn't matter where you are from and wether you are a volunteer or paid person, or from the biggest to smallest agency, if it works keep doing it, if its broke fix it.

    Communications, Hmm, pretty simple thing to do. Leave the ego's at the door and talk with your Mutual aid companies. Wonders never cease.

    Keep doing it for the right reasons!!!!!!

    Leave a comment:


  • jeffmarshall911
    replied
    Our town has separate Police, Fire and EMS departments that have a consistent history of working well together. We have the additional advantage of being dispatched by the same center.

    For MVAs, Sr. Fire Officer (Lt. or above) is IC regardless of background. EMS designates "Medical Command" and coordinates with IC for support and assistance.

    We use this structure at every MVA and it works well for us - we don't overcomplicate the obvious. Very simple to use for the 1 vehicle, 1 pt calls (typically Med Command is working on pt at the time) and scales well to multi-vehicle multi-pt calls.

    Leave a comment:


  • LadderCapp
    replied
    Now that we've danced around the issue, and deviated to another whole mess of issues with the Vollie, vs. Career rhetoric. Let's get down to the nuts and bolts of it. Does the IC of an MVA need to be medically qualified? The answer is a resounding NO. <br /> I am 20+ years in service, an emt of 18 years + with a strong love of ems. All that resume crap aside, the IC position has to do with deployment of your available resources, and assurance that you have enroute, or available resources to meet with whatever obstacles you have on scene. If I am in an IC position on the mentioned mva, every available medical person on scene would be on a pt. But the scenario you mentioned sounds more like dept. politics, and personal issues than it does fire and rescue priorities.<br /> The entire Incident Command System is what you make of it. It is merely an tool to assist in getting the job done. What one or two individuals do with it, or how the prioritize a specific incident is not a problem with the ICS, but the individual. IMHO

    Leave a comment:


  • Dan Wood
    replied
    I've been watching this debate since it was launched on 12/26 and I am glad to see that it seems to be taking a turn for the better!

    In my opinion, I think Lewiston2Capt, SFDchief and ALSfirefighter were all leading up to the same end result that was so well-stated by our friend from Australia . . . the need for good communication between the IC (whoever it may be)and all personnel operating at the scene of an incident. ALSfirefighter hit the nail on the head - we MUST overcome the ego issue to avoid micromanagement on any type of emergency scene we may be operating at.

    My department is totally volunteer. We are strictly a fire & rescue department and our first-due area is covered by a separate paid ambulance service. While I operate as the IC at mva's in our coverage area, I base our rescue activities on the needs of responding EMS units. This loose type of "unified command" only works for us because of good communication between the medics and my fire personnel.

    It seems (to me anyway) that the initial question posed by 10-75k was more a result of an IC with an ego than an IC with no medical background. Paid and volunteer alike - I think that many IC's would be well-served to take an occasional look at why they make the decisions they do. It is not always easy to admit, especially in front of your peers, that you do not have all the answers. As IC's, we need to constantly remember that we are all there for the same reason - to give the victim(s) the best service possible. It is not possible to do this while feeding an ego.

    Leave a comment:


  • truckie_ladderco_147
    replied
    Paid,vollie,who cares! Fire is fire and mva's are mva's.Um I keep forgetting that these cars are carrying gas and oil and lets see whatelse can you find in someones car?Or better yet how about a delivery truck.No need for the fd at a MVA?I think you better back up and do another walk around.Thats in my seriously humble opinion. [quote] <hr></blockquote>Fire lives it breathes and it hates(plus it doesnt care if you are paid or vollie when it burns you.so stay low. <img src="biggrin.gif" border="0"> )

    Leave a comment:


  • MetalMedic
    replied
    [quote]Originally posted by 10-75k:<br /><strong>MetalMedic:

    You seem like an intelligent person. I don't want to get into the paid/volunteer debate on this subject (I'll fight that battle some other time.) The subject matter on this topic it that the IC should have EMS training on MVC's. If it wasn't for EMS there would be no need for the fire dept. on MVC's. The person could just climb out the window. The thing that I guess I'm getting at is that the IC needs EMS training to understand pt care and what other resources might be needed. On this incident I told the IC what I needed and he looked at me with this blank stare.

    [ 12-28-2001: Message edited by: rmoore ]</strong><hr></blockquote>

    Intelligent person!!! <img src="biggrin.gif" border="0"> I am nothing special, just spent a lot of time the past 21 years observing how things are done by various agencies.

    I guess I cannot give you a better answer than I have. I was once involved with a town that would send EMS to MVAs and not send the Fire Dept. unless requested by EMS. I believe they still do this to this day on accidents that happen inside their city limits. I am not sure of that is a better answer than having an non-medically trained Fire Officer in charge of the scene.

    My guess is that if you wanted to require the OIC to be medically trained, it would take a change in your State's laws, and that would be impractical. So, that only leaves you with trying to develop a better working relationship with this person in the interest of better patient care. It won't happen overnight, but you won't get very far being confrontational with the "OIC" on the scene,,, the time to deal with such problems is before they happen.

    Good luck!

    Leave a comment:


  • lutan
    replied
    Let's see if I've got this correct....

    According to some people who have posted, I shouldn't be/can't be an IC at a rescue because I'm not medically trained? Or that I'm a vollie and not paid?

    CRAP! CRAP! CRAP!

    Over in Oz, we do it a little different- not to say we're correct and you're not, but....

    My dept. is a rescue dept and nothing more. We don't fight fires, we don't respond to medical incidents, etc. We rescue.

    We work along side ambulance depats. (All paid) and combination vollie and paid fire fighters. They do medical and fire related stuff respectively.

    At an MVA, each service/dept on scene has a dept. commander. The Police are the Incident Controllers. They have the final say on the scene itself. The fire dept look after all fire and safety related issues and the ambo's look after all medical/patient related stuff. We, as a rescue dept. perform the rescue. We perform that rescue after close consultation with the ambos, and in consultation with the firey's.

    We do it, we do it well. We're trained to do it.<br />We don't tell them how to treat a patient or how to fight a fire, and they don't tell us how to do our tasks.

    It all comes down to communication- with no communication, how can anyone perform a rescue of any sort. Regardless of what dept they are from and whether they are paid or volunteer. <img src="rolleyes.gif" border="0">

    And to really add fuel to the argument about paid vs volunteer- some could say that vols do it because they want to, paid staff do it because they have to.... <img src="biggrin.gif" border="0">

    Leave a comment:


  • ALSfirefighter
    replied
    SFD, excellent points. The EMS sector of incident command is often overlooked. What's even rarer, but seems to be growing, is the concept of unified command. There a lot of ego's that need to be overcome to accomplish that form of IC. However, in larger incidents it can be very successful. Many larger cities utilize this form of command. As far as requiring medical training to be an officer, hey, I never say no to more training. However, I don't feel that it is as necessary as firefighter26 states. Again, that is what sectors are for. Anything less in my opinion is micromanagement. <br />------------------------------------------------<br />The above is my opinion only and doesn't reflect that of any dept/agency I work for,deal with, or am a member of. <img src="biggrin.gif" border="0">

    Leave a comment:


  • SFDchief
    replied
    [quote] Now as far as the IC with medical training again this would be a good thing. Wouldn't he have a duty to act since he is the only highest medically training person on scene at the time? Would that be abuse, neglect or abandedment on or of the patient? I guess he could pass command to the officer or highest senior member of the first due in rescue co. <hr></blockquote>

    Knighthawk, just to clarify, if I'm the IC of a job and there is a medic there although I'm the highest ranking officer I am not the highest medically trained person. A medic has more medical training as an emt. The highest medically trained person should be involved with patient care. If there's an officer that's an emt and a firefighter/emt they both have the same level of medical training regardless of their rank. As I stated before, a non-medically trained officer should not made medical desicions with out consulting ems command. Let me correct myself, NO INCIDENT COMMANDER should make medical desisions without first cnsulting ems command.

    If I am the first on the scene of an mva I will size up the scene as a whole and then if nothing else assess the patient(s) injuries as the state says I must do as an emt. If another emt (or medic) arrives I will then pass patient care over to them. Until the arrival of another emt (or medic) the next highest ranking officer (or senior firefighter) will be IC.

    In my opinion the IC does not neccesarally have to be the highest ranking officer.

    Leave a comment:


  • firenresq77
    replied
    I think SFDchief said it best. EMS isn't the only thing to worry about at an MVC. That is why there is an Incident Command SYSTEM. THe IC is there to run the whole scene, and must rely on the medically trained people to provide patient care and to advise what other resources they need.

    And yes, I am an EMT......

    Leave a comment:


  • Knighthawk
    replied
    The mutual aid buses sound like a good idea. Now this will be a hypo. situation. The mutual aid bus get toned 3 times and no response. This isnt't going to be slam on the Vol. service just to promote the paid service so PLEASE DO NOT TAKE IT THAT WAY! You know you have a paid bus from two separate Vol. organizations. The first is 1 town south and the other is 2 towns north. You can't just call for the paid buses because the mutual aid plan between the bus squads doesn't have them listed until the fourth or fifth alarm.<br />Thats 3 tones for your bus squad and they make out on the 3rd tone, 3 tones for mutual aid bus squad for which the co. you run the call with and your 1 EMT has to complete the crew, 3 tones for the bus squad of the town that's on your immediate border (Just down the road say maybe a mile) no response. By the time you get to the paid bus squad you could very well be within the 30-45 min. mark. The wrecker has come to remove the car now. Where do you put the three other patients to keep them out of the elements? Like I said this is just a hypo. situation.<br /> Now as far as the IC with medical training again this would be a good thing. Wouldn't he have a duty to act since he is the only highest medically training person on scene at the time? Would that be abuse, neglect or abandedment on or of the patient? I guess he could pass command to the officer or highest senior member of the first due in rescue co. If I am wrong please let me know and don't just blast me.

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  • dmsmith
    replied
    1 EMT, 5 Patients.....

    Why not call for some mutual aid ambulances?

    Leave a comment:


  • firefighter26
    replied
    I can't expain everything everwhere else, but I can tell you how things work at my department.

    In order to even be considered to be an officer you need to have medical training. My thoughts are, how else are you going to be able to command something you have no experience with? Here, I know that each and every one of my officers have done the tour and know their stuff. It makes a big difference at these kind of calls because they can automatically see what needs to be done and make sure we have the what we need to do it.

    I do agree that officers should be subjected to some type of medical training, even if it is just basic. Besides, you never know when it might be needed anyway, not just for command desicions.

    Leave a comment:


  • SFDchief
    replied
    In my opinion, I, as a medically trained individual and dept. chief, find it hard to run a mva and worry about patient care at the same time. Isn't that what the Incident Command System is for?.

    While patient care is an essential part of an mva the IC should also be concerned with overall scene safety, including but not limited to extrication (if needed), staging, traffic control, hazardious materials (fluid containment). Maybe it's more appropriate calling the incident commander, the incident coordinator.

    I would get any information needed about patient condition from ems command. Even though, as previously stated, I am medically trained, I would never second guess the condition of the patient when there is another emt treating the patient. I've seen too many chief officers, both medically trained as well as non-medicaly trained, sizing up a patient from several feet away when there is someone already in direct contact of the patient. Second guessing is a good way of getting yourself into trouble.

    Just my 2 cents

    [ 12-27-2001: Message edited by: SFDchief ]</p>

    Leave a comment:

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