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    As a company officer, the higher priority call is going to get my attention. If I'm going to an unresponsive and pass an accident, I'm going to use my professional judgment as to where my company is needed. Most times, I'd probably dispatch an additional company for the wreck and continue to the unresponsive.

    One night back when we ran only one staffed engine company, we were dispatched to a fall at an assisted living center. As we arrived on scene, they dispatched an infant not breathing. At least twice prior, "falls" at the assisted living center turned into cardiac arrests (one was a code save). So, the C/O felt we couldn't ignore either incident. Paging our volunteers would have resulted in a 7-10 minute delay as would calling for a mutual aid company from a neighboring town. So...

    We dropped one of our hosemen off at the assisted living facility with the AED and jump kit. We went enroute to the pediatric emergency, which required us to pass by our station on the way. We slowed down in front of the station, our other hoseman hopped out and followed us to the second call in our brush truck, which had a jump kit and AED.

    In the end, both patients were breathing and lived to see another day and the fire department handled both calls in a way that appeared seamless to those that needed us. The point of the story is that there are no black and white answers when discussing issues like this. Sometimes, you just have to make like Gunny Highway and improvise, adapt and overcome.

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    Quote Originally Posted by CaptainGonzo View Post
    So.. when I go to a call where the patient is as cold as ice,stiff as a 2X10 and has morbid lividity, I need a "medical professional" to tell me he's dead?.
    You don't know that until you examine the patient. It's just like responding to an automatic alarm. You have a mission and you need to complete your assigned mission.

    If you were not enroute, then the second incident would still have to wait for a unit to respond from the station anyway.

    You haven't answered though, what makes one emergency more important than the other?

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    Quote Originally Posted by ScareCrow57 View Post
    You don't know that until you examine the patient. It's just like responding to an automatic alarm. You have a mission and you need to complete your assigned mission.

    If you were not enroute, then the second incident would still have to wait for a unit to respond from the station anyway.

    You haven't answered though, what makes one emergency more important than the other?
    "Hour of Power"? "Mission"?

    Clearly you are not in the same fire service as the rest of us are?

    What makes one emergency more important than another? Easy...its severity and the resulting damage of NOT doing something to mitigate it.

    By your logic, you would have us believe that those in the same burning building should be rescued in the order they called 911.

    You can only deal with one emergency at a time, and if you have to go through one to get to the other, then it is encumbant upon you to stop and assess the severity of that emergency you are passing through and render the appropriate amount of care to minimize that emergency before moving on to the next.

    It happens routinely in emergency services without lawsuits and without fools mistaking an emergency run for a "mission".

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    Quote Originally Posted by ScareCrow57 View Post
    You don't know that until you examine the patient. It's just like responding to an automatic alarm. You have a mission and you need to complete your assigned mission.

    If you were not enroute, then the second incident would still have to wait for a unit to respond from the station anyway.

    You haven't answered though, what makes one emergency more important than the other?
    So by your line of thought, a smells and bells is more important than a MVA with injuries, in which you roll up on while responding to a bs call???
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    Originally Posted by moi
    So.. when I go to a call where the patient is as cold as ice,stiff as a 2X10 and has morbid lividity, I need a "medical professional" to tell me he's dead?.
    posted by strawbrain
    You don't know that until you examine the patient. It's just like responding to an automatic alarm. You have a mission and you need to complete your assigned mission.
    You suck at reading comprehension.

    How would I know if the patient was cold, stiff and had morbid lividity if I didn't examine the patient?
    Last edited by CaptainGonzo; 04-08-2009 at 11:36 PM. Reason: spelling correction
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    What DFDCar1, Gonz, and Harve said in the first 3 posts.

    Stop and assess, dispatch another unit to the original call.
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    I know this is kind of hijacking, but what do other people do when there are calls that are in between you and the station. Say your a volly who lives 5 miles from the station, you get a call thats enroute to the station. what do you do? Also assuming you dont have turnout gear with you.

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    Quote Originally Posted by scfire86 View Post
    Jake. Don't waste your time. You're dealing with idiotboy. He'll just keep throwing out "what if" scenarios all day long.

    This happened several times in my career. We stopped. While my crew was out securing and assessing the scene I would notify dispatch of our situation and they immediately dispatched the next closest unit.

    No one ever filed a lawsuit.
    You are a knot head. This entire thread is based on a "What if" Just when I though you couldn't get any dumber you go and prove me wrong.

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    Quote Originally Posted by CaptOldTimer View Post
    So by your line of thought, a smells and bells is more important than a MVA with injuries, in which you roll up on while responding to a bs call???
    How do you know it is a BS call until you arrive on scene and assess the situation? Ever arrived at a car fire to find out it is in the garage?

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    Quote Originally Posted by CaptainGonzo View Post
    Originally Posted by moi


    posted by strawbrain


    You suck at reading comprehension.

    How would I know if the patient was cold, stiff and had morbid lividity if I didn't examine the patient?
    Then that means you didn't stop at the accident, but went straight to your first assignment.

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    Quote Originally Posted by jakesdad View Post
    "Hour of Power"? "Mission"?

    Clearly you are not in the same fire service as the rest of us are?

    What makes one emergency more important than another? Easy...its severity and the resulting damage of NOT doing something to mitigate it.

    By your logic, you would have us believe that those in the same burning building should be rescued in the order they called 911.

    You can only deal with one emergency at a time, and if you have to go through one to get to the other, then it is encumbant upon you to stop and assess the severity of that emergency you are passing through and render the appropriate amount of care to minimize that emergency before moving on to the next.

    It happens routinely in emergency services without lawsuits and without fools mistaking an emergency run for a "mission".
    So you are saying that the incident closer to the station takes priority over the incident farther out.

    Here is my issue. You have been dispatched to an emergency, and the people at that emergency are expecting you to arrive quickly. I believe most places are looking at 5 to 10 minute response time. So you abandon the people who called for help first. , while the second emergency hasn't even asked for help yet? That is really putting the screws to the people who had the first emergency situation. From what you guys have told me, they are all emergencies until we prove other wise.

    I still say that in all fairness to both parties you continue on to your original call and request another response to the second emergency. Just because someone lives farther from the station doesn't mean that should get diminished service.You simply tell the people at the accident you are your way to another call and that help is coming. Reasonable people will understand.

    What is more important? A heart attack, A stroke, a cut, a broken bone, a head injury? How much time do you have to treat these things? How about a structure fire with entrapment vs a car accident?

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    Quote Originally Posted by ScareCrow57 View Post
    Then that means you didn't stop at the accident, but went straight to your first assignment.
    Your three working brain cells are overheating again... and we all know what happens when brain straw overheats.
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    Quote Originally Posted by zackman1801 View Post
    I know this is kind of hijacking, but what do other people do when there are calls that are in between you and the station. Say your a volly who lives 5 miles from the station, you get a call thats enroute to the station. what do you do? Also assuming you dont have turnout gear with you.

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    Quote Originally Posted by ScareCrow57 View Post
    And how do you know that the patient at the medical emergency is not still alive? Did you or someone else examine him?
    Yes, you did:

    Quote Originally Posted by ScareCrow57 View Post
    The first call is for a "lets say man down, aka uncon not breathing". In the world of triage he would get top priority.
    Don't give me a scenario and then change it because you don't like my answer. Are you even an EMS provider? If you do then you obviously need a lesson on how EMS really runs:

    It has to be treated like a first in first out system. Changing priorities willy nilly is just unacceptable and crazy.
    So if I get dispatched to the "grandpa fell out of bed again" and then I get the "I have dialysis today and don't have a ride t othe hospital" then I am stuck on those calls in that order? What if YOU call 911 while I am enroute because your dad just had a heart attack? Since he is the 3rd caller he will just have to wait until I am done picking up someones grandfather from the floor and giving someone a ride to dialysis. Sure, both of those calls are a lot lower PRIORITY than your dads heart attack, but they called 911 first and thats the only thing that counts.

    You remind me of the guy that sits in the waiting room in the ER with a rash on his butt who complaints that all the guys with heart attacks and strokes get to go into the ER before him, even though you got here first.

    So what makes one emergency a higher priority than the other emergency. Just because one emergency is closer to the station does not give it a higher priority. Yo can bet your first born that If I find out my ambulance stopped to help someone else before me I will sue the pants off of them. I called for help first and you were being sent to help me. I'm sorry for the other peoples problem, but they have to wait their turn. Their emergency is no more important than my emergency.
    The prime example of the ME generation ladies and gentlemen. I don't care your baby is dead, I puked first and I called 911 first, so this ambulance is mine. He reminds me of the jerks who push you away from the Taxi because "they saw it first".

    How do you know it is a BS call until you arrive on scene and assess the situation? Ever arrived at a car fire to find out it is in the garage?
    Ever arrive to a "random example of a call" and find out the patient is dead? I can pull a worst case scenario out of me ***** for any type of call that you want.

    A car on fire would not really be a BS call to begin with, so that example is just stupid.

    On all other calls I would go with statistics. An MVA in front of me, statisticly speaking, always means that there is an MVA in front of me. Passing past a house that is burning, statisticly speaking, always means that there is a house that is on fire. An automatic alarm, statisticly speaking, is always bull. I'm going with the odds here.

    Here is my issue. You have been dispatched to an emergency, and the people at that emergency are expecting you to arrive quickly. I believe most places are looking at 5 to 10 minute response time. So you abandon the people who called for help first. , while the second emergency hasn't even asked for help yet?
    Now I just have visions of you hanging out the side of the truck yelling at the people in the wreck: "Sorry, should have called 911." If you drive past a burning house do you stay outside until someone calls 911 and you get toned out?

    What if a cop is enroute to a burglary alarm going off at a business, and he passed a woman getting raped on the street? I mean look at her, sure the guy is on top of her raping her, and there is even 2 more guys waiting for her turn! But hey, she has not even called 911 yet, and besides, I am going to another call that dialed 911 first. Let the next cop handle it.....

    EDITED TO ADD:

    Besides, what makes her getting raped a higher priority than this emergency. ALL 911 calls should be answered in the order they are recieved.
    Last edited by MarcusKspn; 04-09-2009 at 07:09 AM.
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    Quote Originally Posted by ScareCrow57 View Post
    OK, but what about that hour of power thing. The first caller is 10 to 15 minutes in to their hour. Do you delay the response to the first caller by another 5 or 10 minutes. The first call is for a "lets say man down, aka uncon not breathing". In the world of triage he would get top priority.

    I would in this situation stop to tell the people on the scene of the second incident that you are enroute to another medical emergency and that help has been dispatched to their emergency.

    WTF are you talking about?
    The GOLDEN HOUR (NOT golden shower) applies to trauma, NOT medicals.

    Like the good Chief stated, brain death begins at 4-6 minutes.

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    Quote Originally Posted by ScareCrow57 View Post
    So you are saying that the incident closer to the station takes priority over the incident farther out.

    Here is my issue. You have been dispatched to an emergency, and the people at that emergency are expecting you to arrive quickly. I believe most places are looking at 5 to 10 minute response time. So you abandon the people who called for help first. , while the second emergency hasn't even asked for help yet? That is really putting the screws to the people who had the first emergency situation. From what you guys have told me, they are all emergencies until we prove other wise.

    I still say that in all fairness to both parties you continue on to your original call and request another response to the second emergency. Just because someone lives farther from the station doesn't mean that should get diminished service.You simply tell the people at the accident you are your way to another call and that help is coming. Reasonable people will understand.

    What is more important? A heart attack, A stroke, a cut, a broken bone, a head injury? How much time do you have to treat these things? How about a structure fire with entrapment vs a car accident?

    So the person lying in the steet bleeding, or the family members of loved ones injured in an accident will be "reasonable and understanding" as you drive off....but the person that called first can't be "reasonable" when any delay is explained by the first apparatus stopping to render aid to someone in need they came across along the way?

    You consistently craft scenarios specifically to fit whatever absurd argument you are trying to put forth, yet you can never fully account for holes in your logic or inconsistencies in your thought process.

    Why is it that the people in the accident would be reasonable after being told to "wait their turn" while you drive away with the tools and personell to help them but YOU would "sue the pants off" if you had to wait a few extra minutes for YOUR help to arrive?

    Probably best to leave this discussion to those that have actually responded to emergencies, because based on your posts and use of made up terminology I firmly believe your only knowledge of firefighting is coming from books and TV.

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    Slightly off point here, but in Alberta, only Drs can actually declare a casualty"dead". Only exception is in case of decapitation. This is actually law here. When the Dr declares a casualty "dead" this is the time of death on the certificate.
    As far as the discussion, I would go with most here and stop and at least assess the MVA situation, AFTER advising dispatch of the situation.

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    Quote Originally Posted by MarcusKspn View Post
    Don't give me a scenario and then change it because you don't like my answer. Are you even an EMS provider? If you do then you obviously need a lesson on how EMS really runs:
    Yes we are an EMS provider. I didn't change the scenario at all. I have seen many an "unconscious, passed out on the floor, not breathing" walking around. You assume they are alive until you prove otherwise.

    [/quote]So if I get dispatched to the "grandpa fell out of bed again" and then I get the "I have dialysis today and don't have a ride t othe hospital" then I am stuck on those calls in that order? What if YOU call 911 while I am enroute because your dad just had a heart attack? Since he is the 3rd caller he will just have to wait until I am done picking up someones grandfather from the floor and giving someone a ride to dialysis. Sure, both of those calls are a lot lower PRIORITY than your dads heart attack, but they called 911 first and thats the only thing that counts.

    You remind me of the guy that sits in the waiting room in the ER with a rash on his butt who complaints that all the guys with heart attacks and strokes get to go into the ER before him, even though you got here first.[/quote]

    Now who is changing the scenario. Realize, you aren't the only rig in the town. We don't do call jumping around here. If we are enroute to a call for help we go to the one we were dispatched too. Next call for help goes to the next rig in line.

    The prime example of the ME generation ladies and gentlemen. I don't care your baby is dead, I puked first and I called 911 first, so this ambulance is mine. He reminds me of the jerks who push you away from the Taxi because "they saw it first".
    Not at all. You have have been dispatched to attend to an emergency, you need to do that job. When a second emergency comes up you dispatch a second rig to the second emergency. I am the person who complains when I'm waiting to get my arm stitched up and the person who came in after me gets stitched up first. I don't put up with line jumpers.

    Ever arrive to a "random example of a call" and find out the patient is dead? I can pull a worst case scenario out of me ***** for any type of call that you want.
    Yup. And I have also been dispatched to chimney fires to find out it is a structure fire. But you exactly make my point here. You cannot abandon the first call until you have done the evaluation.

    A car on fire would not really be a BS call to begin with, so that example is just stupid.
    Disagree. A car fire in a field would take a lower priority than an MVA with injuries. By the time you get the call that the car is on fire it is totaled. All you will save is anything surrounding the car. Which as I have stated, you don't know what you have until you get there.

    On all other calls I would go with statistics. An MVA in front of me, statisticly speaking, always means that there is an MVA in front of me. Passing past a house that is burning, statisticly speaking, always means that there is a house that is on fire. An automatic alarm, statisticly speaking, is always bull. I'm going with the odds here.
    So that means that you are giving priority based on location and not incident. The person who lives farther away is not as important? Good for you.

    Now I just have visions of you hanging out the side of the truck yelling at the people in the wreck: "Sorry, should have called 911." If you drive past a burning house do you stay outside until someone calls 911 and you get toned out?

    What if a cop is enroute to a burglary alarm going off at a business, and he passed a woman getting raped on the street? I mean look at her, sure the guy is on top of her raping her, and there is even 2 more guys waiting for her turn! But hey, she has not even called 911 yet, and besides, I am going to another call that dialed 911 first. Let the next cop handle it.....

    EDITED TO ADD:

    Besides, what makes her getting raped a higher priority than this emergency. ALL 911 calls should be answered in the order they are recieved.

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    Slightly off point here, but in Alberta, only Drs can actually declare a casualty"dead". Only exception is in case of decapitation. This is actually law here. When the Dr declares a casualty "dead" this is the time of death on the certificate.
    As far as the discussion, I would go with most here and stop and at least assess the MVA situation, AFTER advising dispatch of the situation.

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    Quote Originally Posted by jakesdad View Post
    So the person lying in the steet bleeding, or the family members of loved ones injured in an accident will be "reasonable and understanding" as you drive off....but the person that called first can't be "reasonable" when any delay is explained by the first apparatus stopping to render aid to someone in need they came across along the way?

    You consistently craft scenarios specifically to fit whatever absurd argument you are trying to put forth, yet you can never fully account for holes in your logic or inconsistencies in your thought process.

    Why is it that the people in the accident would be reasonable after being told to "wait their turn" while you drive away with the tools and personell to help them but YOU would "sue the pants off" if you had to wait a few extra minutes for YOUR help to arrive?

    Probably best to leave this discussion to those that have actually responded to emergencies, because based on your posts and use of made up terminology I firmly believe your only knowledge of firefighting is coming from books and TV.
    You are setting yourself up for failure. Emergency A is 10 miles out. You come upon a second emergency 7 miles out. Stop there and call for a second rig. Second Rig comes upon another emergency and stops there, calling for a third rig. Meanwhile, the original emergency is totally ignored. Emergency is not setting there bad mouthing the useless service because no one ever shows or it takes them 95 minutes to show up.

    FYI, This is not my scenario. I am not crafting new scenarios. To refresh your memory.
    Originally posted by FireMidget
    Assume you are dispatched and enrt to a call (lets say man down, aka uncon not breathing). You go enrt. While enrt to loc an MVA occurs infront of you. You are going code at this time. You can tell injuries in the MVA. It has not been toned out at this time.
    You will note there is no mention of anyone puking, grandpa falling out of bed, or any of the other silly things that have been put out there. It is for an unconscious, not breathing; which anyone who has ever run a call knows that it doesn't mean the patient is not breathing or even dead. But if no one shows to help him in a timely manner, he will be.

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    Quote Originally Posted by CaptainGonzo View Post
    I agree with DFDCar1. Dispatch another unit to the medical and take care of the incident where you are.

    I brought this topic up at work, as it is somewhat of an interesting topic, and a great question for would be company officers.

    Department policy here is to notify the alarm bureau of the incident, and then continue the response to the original run.
    Now, that isn't to say that you can't use discretion in the decision. Officers in the past have deviated from that policy, and have not been disciplined, because they were able to adequately defend their logic.

    It has happened here, in which a company was dispatched to an EMS run only to encounter a building fire while en-route. The officer made the decision to stop for the fire and have the alarm bureau dispatch a different company to the first assignment.

    The officer had to justify their decision, and the logic that went into it, but so what. That is what company officers get paid to do, good, bad or otherwise.
    I'm sure most departments have some sort of written policy covering this, hopefully those policies allow for some decision making in the field.
    Last edited by jasper45; 04-09-2009 at 11:14 AM.

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    Quote Originally Posted by jasper45 View Post
    I brought this topic up at work, as it is somewhat of an interesting topic, and a great question for would be company officers.

    Department policy here is to notify the alarm bureau of the incident, and then continue the response to the original run.
    Now, that isn't to say that you can't use discretion in the decision. Officers in the past have deviated from that policy, and have not been disciplined, because they were able to adequately defend their logic.

    It has happened here, in which a company was dispatched to an EMS run only to encounter a building fire while en-route. The officer made the decision to stop for the fire and have the alarm bureau dispatch a different company to the first assignment.

    The officer had to justify their decision, and the logic that went into it, but so what. That is what company officers get paid to do, good, bad or otherwise.
    I'm sure most departments have some sort of written policy covering this, hopefully those policies allow for some decision making in the field.
    Excellent post, I think this says it best.

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    Quote Originally Posted by ScareCrow57 View Post
    So that means that you are giving priority based on location and not incident. The person who lives farther away is not as important? Good for you.
    As per standard protocol for you on here, you have once again entirely missed the point.

    Having to pass through an emergency to get to another one IS abandonment.

    It is not abandonment if you never get to it.

    Those who actually do this in real life understand this concept.

    Those who like to think they know everything about everything despite a considerable lack of real world experience sadly do not understand this concept.

    There is no "line". That is not the way the system works, and if that is how you operate under your system, you are doing it wrong.

    Triage is done by dispatchers routinely. Triage is performed by units in the field routinely.

    If contact is made by responding personell with the ill or injured while enroute to another emergency, they have to stop and at the minimum assess the severity of that emergency and if it is deemed that care is necessary and harm will be done by not rendering that care, they are legally obligated to provide that care.

    You don't have to agree with it. But you have absolutely no defense if you leave an emergency you are at to attend to one you are not at and harm results from you leaving.

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    Quote Originally Posted by BLSboy View Post

    WTF are you talking about?
    The GOLDEN HOUR (NOT golden shower) applies to trauma, NOT medicals.

    Like the good Chief stated, brain death begins at 4-6 minutes.

    Jesus, who the hell let you out of the window lickers area?
    Not to split hairs, but there is a "Golden Hour" for stroke patients to receive TPA treatments...they are most effective if given in the first hour after onset of stroke symptoms. At least that is what is being pushed by local hospitals for our county EMS crews.

    But you are correct, the golden hour is traditionally a trauma term and stroke patients are the only case of a golden hour applying to medical patients.

    Back to our regularly scheduled programming...
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    Quote Originally Posted by jakesdad View Post
    As per standard protocol for you on here, you have once again entirely missed the point.

    Having to pass through an emergency to get to another one IS abandonment.

    It is not abandonment if you never get to it.

    Those who actually do this in real life understand this concept.

    Those who like to think they know everything about everything despite a considerable lack of real world experience sadly do not understand this concept.

    There is no "line". That is not the way the system works, and if that is how you operate under your system, you are doing it wrong.

    Triage is done by dispatchers routinely. Triage is performed by units in the field routinely.

    If contact is made by responding personell with the ill or injured while enroute to another emergency, they have to stop and at the minimum assess the severity of that emergency and if it is deemed that care is necessary and harm will be done by not rendering that care, they are legally obligated to provide that care.

    You don't have to agree with it. But you have absolutely no defense if you leave an emergency you are at to attend to one you are not at and harm results from you leaving.
    I see. So the person who is having a stroke or heart attack and called for assistance gets to wait longer because you found something else to do?

    Like I said. You stop and explain you enrout to another emergency and more responders will be there to help them. Ignoring your primary duty of responding to the first emergency is just wrong and unethical.

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