1. #51
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    Quote Originally Posted by FireMidget View Post
    I was just wondering what other's protocols were for this. I have asked a few different partners on few different instances (multiple agencies, including police, fire, and medical).

    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.

    What do you do?
    Unresponsive and not breathing? He's likely going to die even if you brought your gold-plated defib paddles with you that day. People in EMS have been letting their heads swell too much lately with code saves. If your area has super fast ALS first response, then maybe it's worth continuing to the call.

    Abandonment has nothing to do with this. It would only be considered abandonment if you assumed care of those patients in the MVA. Which realistically, you should. It is actually the law in some jurisdictions that an ambulance cannot bypass a person needing help, even enroute to another call.

    Edit: On second thought, if the MVA is going to require extrication, it makes no sense to stop and hang around waiting for the rescue company.
    Last edited by ActionGoose; 04-09-2009 at 04:19 PM.

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    Quote Originally Posted by ScareCrow57 View Post
    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.
    Your primary duty is not responding to the first emergency.

    Your primary duty is protecting the lives of civilians within your response area from whatever emergencies they get themselves into.
    "
    First come/first serve works fine when standing in line for concert tickets.

    In the world of emergency services, it just doesn't.

    I know you just like to argue to hear yourself speak. But on this issue, I am pretty sure you don't even subscribe to what you are saying. Using the phrase "found somethng else to do" to describe stopping at an unfolding emergency tells me that you are in this just to go round and round.

    Silly little man you are.

    Call he rest of us "unethical" if you will. That coming from YOU is a compliment.

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    Quote Originally Posted by ActionGoose View Post
    Unresponsive and not breathing? He's likely going to die even if you brought your gold-plated defib paddles with you that day. People in EMS have been letting their heads swell too much lately with code saves. If your area has super fast ALS first response, then maybe it's worth continuing to the call.

    Abandonment has nothing to do with this. It would only be considered abandonment if you assumed care of those patients in the MVA. Which realistically, you should. It is actually the law in some jurisdictions that an ambulance cannot bypass a person needing help, even enroute to another call.

    Edit: On second thought, if the MVA is going to require extrication, it makes no sense to stop and hang around waiting for the rescue company.

    Don't make any sense?? How about stop the bleeding or checking for injuries??? Maybe calming the folks down or holding a child whose Mother has just been killed???

    Another one with his head on backwards!!!



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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.
    This is how we do it too. MVA right in front of us? 90% of the time we keep going and call it in.

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    Quote Originally Posted by ActionGoose View Post
    Unresponsive and not breathing? He's likely going to die even if you brought your gold-plated defib paddles with you that day. People in EMS have been letting their heads swell too much lately with code saves. If your area has super fast ALS first response, then maybe it's worth continuing to the call.

    Abandonment has nothing to do with this. It would only be considered abandonment if you assumed care of those patients in the MVA. Which realistically, you should. It is actually the law in some jurisdictions that an ambulance cannot bypass a person needing help, even enroute to another call.

    Edit: On second thought, if the MVA is going to require extrication, it makes no sense to stop and hang around waiting for the rescue company.
    You are making the assumption that the person calling it in is giving good information. I have arrived ion several scenes where the patient was unresponsive, as he sits in his chair

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    Quote Originally Posted by CaptOldTimer View Post
    Don't make any sense?? How about stop the bleeding or checking for injuries??? Maybe calming the folks down or holding a child whose Mother has just been killed???

    Another one with his head on backwards!!!



    Extrication tools are carried on all apparatus from my department bucko!!
    Interesting thought. I was under the impression since we were responding to a medical emergency we were in the ambulance. If You are in a rescue and an Ambulance is responding then it makes sense to stop.

    My problem is with leaving the people who have requested assistance high and dry.

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    Quote Originally Posted by jakesdad View Post
    Your primary duty is not responding to the first emergency.

    Your primary duty is protecting the lives of civilians within your response area from whatever emergencies they get themselves into.
    "
    First come/first serve works fine when standing in line for concert tickets.

    In the world of emergency services, it just doesn't.

    I know you just like to argue to hear yourself speak. But on this issue, I am pretty sure you don't even subscribe to what you are saying. Using the phrase "found somethng else to do" to describe stopping at an unfolding emergency tells me that you are in this just to go round and round.

    Silly little man you are.

    Call he rest of us "unethical" if you will. That coming from YOU is a compliment.
    So do you always pick and choose? Your primary duty is protecting the lives of civilians within your response area from whatever emergencies they get themselves into. Since you have been sent to help someone shouldn't you do that? By not answering the call what does that say? What do you say to the family of the person who dies because you thought their emergency wasn't important enough? The car accident you stumbled on was far more important. We will just have to disagree on this. You were sent to help someone and decided to help someone else instead. Meanwhile, the people you were sent to help suffer.

    You don't freelance on the fire ground, why you freelance in this case?

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    Our protocal states that at least one responding unit stop to check for injuries, and will then either treat the injuries as necessary, or continue on the scene if the MVA is minor. Naturally, if the unit commits to the accident, then another one is dispatched to the initial medical emergency, along with a closer engine company if the 2nd ambulance is coming from a distance.

    Our officers are empowered to make the decisions based on the the best interest of all of the patients involved.
    Last edited by BoxAlarm187; 04-09-2009 at 05:43 PM.
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    Quote Originally Posted by ScareCrow57 View Post
    You were sent to help someone and decided to help someone else instead.
    The fact that they called 911 seconds before the MVA occured makes the medical emergency more important?
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    I really don't see what the major arguement is here.

    If you are close enough to the MVA to possibly be a causal factor - you stop and get another unit en-route to the first call.

    If you 'happen upon it', the officer needs to do a few things - one inform dispatch and two, make a decision based on the information he has and your dept standing orders. Some times they will bypass the incident if its a simple fender-bender other times they may stop. To many variable not to allow some level of judgement to the personell on scene.

    For my dept - its easy. We stop with some of our units and others continue on. The ambulance goes to the more critical call with a 2nd ALS unit getting dispatched to the other call.

    Its not rocket science as our dept *is* capable of handling more than one call at a time.

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    Quote Originally Posted by ScareCrow57 View Post
    So do you always pick and choose? Your primary duty is protecting the lives of civilians within your response area from whatever emergencies they get themselves into. Since you have been sent to help someone shouldn't you do that? By not answering the call what does that say? What do you say to the family of the person who dies because you thought their emergency wasn't important enough? The car accident you stumbled on was far more important. We will just have to disagree on this. You were sent to help someone and decided to help someone else instead. Meanwhile, the people you were sent to help suffer.

    You don't freelance on the fire ground, why you freelance in this case?
    Disagree we will.

    But I am comfortable and confident in my decisions and are under absolutely no threat of litigation for stopping and helping in the event I have to pass one emergency to get to another.

    I know for a fact that by simply driving off, you cannot say the same thing, as that is the very legal definition of abandonment with regard to patient care.

    Which could help explain why almost every single person that actually does respond to emergencies operates under the same premise, and why virtually every system in which this is a regular occurence DEMANDS that their personell stop and assess the injured and ill who present themselves while they are responding to another run.

    We will chalk this one up to yet another topic you seemingly know nothing about yet have quite a bit to say.

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    Quote Originally Posted by BoxAlarm187 View Post
    The fact that they called 911 seconds before the MVA occured makes the medical emergency more important?
    Then the MVA should be right in front of the station and a second unit can respond to the MVA. What if you were a block away, would you abandon the first call to go to the other one?

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    Quote Originally Posted by ScareCrow57 View Post
    Then the MVA should be right in front of the station and a second unit can respond to the MVA. What if you were a block away, would you abandon the first call to go to the other one?
    I want a nickel for every time you've said, "what if." It gets really old. You're not provoking thought, you're alienating yourself.

    I'm done with this thread...
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    Quote Originally Posted by jakesdad View Post
    How can you be sued for abandonement if you haven't even made contact with the patient?
    If you are dispatched to a call, you have assumed responsibility for that call. If you disregard on that call, One could argue that you are abandoning it and the patient. You may be able to do so in an urban, or even a suburban, area where there are other units withing a reasonable response time, but that's not always the case in the rural areas.

    As Harve alluded to, this may even vary from state to state.

    However, as I mentioned, it was the opinion of the ambulance district's attorney. No offense, but I'll put my money on his opinion, unless you've passed the bar and are licensed in Missouri, and we don't know it.

    Quote Originally Posted by jakesdad View Post
    Furthermore, what would be the difference if you were involved in an accident while responding, or the apparatus had a mechanical failure and you couldnt respond? Neither of those two circumstances warrant a case of "abandonement", much the same way stopping to render aid to those who need it doesn't.
    You're going to equate dumping a call to handle another call with being involved in an emergency or having a mechanical failure? Come on.

    Quote Originally Posted by jakesdad View Post
    Each circumstance will be different and that is why you need to have competent, trained people making the important decisions on the fly.
    I won't argue with that. I believe I've said the same basic thing. There's no possible way to make a blanket statement or policy regarding such a thing, there's too many variables.

    Quote Originally Posted by jakesdad View Post
    But you would be hard pressed to make a legal case, much less a case in the court of public opinion as to why, after you HAVE established contact with the ill or injured, that you simply left them to wait for someone else while you continue to respond to someone whom you HAVE NOT made contact with.

    That IS abandonment. Urban or rural, your geography doesn't alter that.
    I would venture to say you're right. That's why we didn't make contact with any patients in the incident I cited.

    Fortunately, when I'm working the FD (either career or vollie), we're in a first responder mode and there's an ambulance en route as well. If I was on the bus, I'd have to think seriously about the situation before making a decision.

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    I have been reading this thread and some of your post are ridiculous. You can't have abandonment unless you initiate care and then terminate care or transfer care to a less trained or less competent person. So for you to say you can get charged with abandonment is ridiculous. You never initiated care and whoever said they would have to wait for you to get there from the firehouse if you had not had drove by is so true. And for the guy who said alarms are just bull are you f***ing serious. Just a little example one of the department that is close to ours got a alarm sounding at 6:30 a.m. Got on the scene Fairly soon after with nothing showing within 10 min of being on scene they ordered up a full assignment because fire started rolling out the roof. So next time you get a alarm and you are thinking oh this is going to be bull**** think again cause it might just be that time that you are not ready and it is the real thing and it causes someone their life.

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    Quote Originally Posted by jtucker1384 View Post
    I have been reading this thread and some of your post are ridiculous. You can't have abandonment unless you initiate care and then terminate care or transfer care to a less trained or less competent person. So for you to say you can get charged with abandonment is ridiculous. You never initiated care and whoever said they would have to wait for you to get there from the firehouse if you had not had drove by is so true.
    I'm curious, are you an attorney? Or are you willing to bet your livelihood on the notion being "ridiculous"?

    As I stated, the opinion I gave came from an attorney. In this sue-happy society full of liberal judges and juries who are willing to hand out million-dollar awards for people who burn themselves with coffee because it didn't have a warning on the cup, I'll believe the guy who's passed the bar.

    If you've got some case law or an opinion from an attorney, I might give your opinion some credit. However, I believe Harve is the only other one that's cited anything regarding a law or legal opinion, that being the law of the state he works in (seems like someone else may have, too, but I'm not taking the time to look right now). While there may be any number of states who have similar laws, don't be naive enough to believe they all have the same laws.

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    Post And........

    Catch, You are correct, I stated our position here in Maryland, as established by the Laws of our State. Let me note that we are more fortunate than some other States in the we have Laws to protect us from "Ambulance Chasing Lawyers". For anyone to be allowed to file a suit against my department, I must first be found to have been Grossly Negligent. I'm NOT a Lawyer, (I did stay at a Holiday Inn last night) but my years as the Legislative Committee Chairman for our State Fire Chief's Association has provided a lot of insight into how these laws are written, and yes, I've been in on creating some of them. We are lucky, and very pleased with our relationships with our Legislators (well, 95% of them) and it is shown time after time when we have a law passed (or blocked, as the case may be) that bolsters our position. It is a hard sell here, if you're going after a Firefighter. I'm not saying that we can't be sued, nor should we be immune beyond a reasonable point, but the Frivilous stuff just doesn't have a chance of making it to a Judge......

    And I went back and reviewed a few things again, and as I stated earlier, Here in Md. you cannot be charged with abandonment UNLESS you are physically present with the victim, initiate care, and then leave before turning the victim over to someone of equal or higher certification........
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    Quote Originally Posted by hwoods View Post
    And I went back and reviewed a few things again, and as I stated earlier, Here in Md. you cannot be charged with abandonment UNLESS you are physically present with the victim, initiate care, and then leave before turning the victim over to someone of equal or higher certification........

    I believe this is the same law in NJ also. I find it ridiculous how someone can be charged with abandonment when you werent on scene to abandon them in the first place, how is that so?? I dont know why this is such a big argument...its obvious here that everywhere is different and some laws make more sense than others... I'm sorry but if I'm responding to a call and either come across and witness a serious MVA right in front of me. I'm stopping and sending another unit to the other call. I understand that the other call has the priority due to it being dispatched first but how would you feel if you were involved in a serious accident and were injured and an ambulance or firetruck stopped looked at you and then kept driving? I'm not talking about fender benders either thats a whole other story...I'm talking about air bags deployed and its obvious its a pretty serious MVA.
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    Quote Originally Posted by Catch22 View Post
    If you are dispatched to a call, you have assumed responsibility for that call. If you disregard on that call, One could argue that you are abandoning it and the patient. You may be able to do so in an urban, or even a suburban, area where there are other units withing a reasonable response time, but that's not always the case in the rural areas.

    As Harve alluded to, this may even vary from state to state.

    However, as I mentioned, it was the opinion of the ambulance district's attorney. No offense, but I'll put my money on his opinion, unless you've passed the bar and are licensed in Missouri, and we don't know it.

    You're going to equate dumping a call to handle another call with being involved in an emergency or having a mechanical failure? Come on.

    First of all...you should probably shed yourself from the notion that because someone is an attorney that they are all knowing and have all the answers. I am pretty sure that for every lying scumbag defendant that ever stepped into a courtroom, there was an "attorney" right beside him trying to help his client walk. Think OJ Simpson for example.

    What case law did your attorney cite for you to substantiate that claim? What litigation has been brought forward in regards to that claim? I am guessing he has never in his life been involved with such a case, so he is simply giving his opinion.

    But in actuality, abandonment is clealry defined in just about every state in this country and the person who is actually being abandoned is the one you are waving off in front of your ambulance or apparatus, not the one you haven't even made it to yet.

    And who in the hell said anything about "dumping" one run for another?

    Nobody said they would stop responding to a call for help to grab a bite to eat or take a nap...this is about what you do when you come across ill and injured people while enroute to another run and therefore HAVE made contact with them because they have presented themselves right in front of you.

    Again....in places where this ROUTINELY happens, it is not an issue. And those who actually deal with this scenario in real life know the difference between abandonment and being rerouted.

    But go with the advice of someone who has NEVER dealt with this scenario legally or otherwise. I hope his advice is as solid as you think it is.

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    Quote Originally Posted by jakesdad View Post
    .

    Again....in places where this ROUTINELY happens, it is not an issue. And those who actually deal with this scenario in real life know the difference between abandonment and being rerouted.

    But go with the advice of someone who has NEVER dealt with this scenario legally or otherwise. I hope his advice is as solid as you think it is.
    We ROUTINELY drive past other runs. How many cars have you seen rear ended because they stopped on the green to let you pass and the car behind didn't. You switch runs for this every time? That really has to screw up you alarm office - switching everyones runs around. Do you do this on the way to a fire call as well?

    That said, there is some leeway. An engine on the way to a medical will always divert for fire, or maybe even the MVA if it's something special, but usually we drive past.
    Last edited by Whocares; 04-10-2009 at 09:09 AM.

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    Quote Originally Posted by ScareCrow57 View Post
    You haven't answered though, what makes one emergency more important than the other?
    Sorry if someone has already replied with this, but this is why Priority Medical Dispatch exists. The answers to the questions the call taker asks dictates the level of response. Omega - Echo, echo being the highest. The same can exist for the fire side. Thus, yes, one emergency can be more important than another. I have rerouted numerous times, either at the order of the dispatch center, or while en route, a higher priority call was dispatched, so we responded to that call, and left the lower priority call to the next due unit (coming from a combination station, next due unit usually has to wait for a volunteer driver).

    As for the original topic, I have come across accidents twice in 2 years. One we stopped at because it was an obvious PI, advised dispatch to send the third due to the original call (we were the second due unit). The other time we saw a car get rear ended in the southbound lanes as we were going northbound. We could not easily stop, so we advised dispatch to notify PD to investigate.
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    Quote Originally Posted by Whocares View Post
    We ROUTINELY drive past other runs. How many cars have you seen rear ended because they stopped on the green to let you pass and the car behind didn't. You switch runs for this every time? That really has to screw up you alarm office - switching everyones runs around. Do you do this on the way to a fire call as well?

    That said, there is some leeway. An engine on the way to a medical will always divert for fire, or maybe even the MVA if it's something special, but usually we drive past.
    Who is talking about minor rear-end accidents?

    Craft 100 different scenarios to suit your argument. It makes no difference to me.

    The fact is, if you leave the injured and ill and they are harmed because you left, that IS abandonment.

    On your way to a car fire...are you really going to just drive past an overturned vehicle? On the way to a report of smoke, are you really going to swerve to avoid an unconscious child in the street and then keep going?

    Use your head, if no care is needed, continue on. But if you come across a serious accident with injured people, or an unconscious man lying in the street, something tells me that even YOU aren't going to just drive past it. It's called triage. And it is done all the time.

    It isn't a difficult concept.

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    Following this post, I'm done here. It has become painfully obvious that to a minority of posters, the answer to whatever the question may be is that FIRE COMES FIRST. Never mind who is in need of help, FIRE is always more important than human life. None of you with this attitude would last a week here. The answer to the origional post is clear, to me anyway. USE COMMON SENSE. You MUST make a judgement call, that's the way life (and Death) is and you have to deal with it. In FIFTY ONE YEARS I have NEVER been dictated to by a Dispatcher. Given information on every call, Yes. But the decision on what to do with that information is mine, and I am responsible to use that information to provide the best outcome from the incident for all concerned. If I find something enroute, it's my call on which incident gets my help. Dispatch absolutely needs to know what is going on as soon as possible, and they must have input into resolving the unscheduled interruption to a call in progress, but only the ranking person on the street can make the call on which takes precedence. Operating a Fire/Rescue/EMS Organization isn't Rocket Science, but it takes Thick Skin and a Backbone.
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    Quote Originally Posted by jakesdad View Post
    Who is talking about minor rear-end accidents?
    Me. Why not talk about a fairly common occurance? How do you know they are minor? There can be significant injuries from a rear end collision.

    Craft 100 different scenarios to suit your argument. It makes no difference to me.
    I didn't "craft" 100 to suit my needs. I brought up the most common MVA that I have encountered enroute to a call. I guess you could bring up a thousand exotic scenarios to contradict our sop's, but why not just use a realistic one.

    The fact is, if you leave the injured and ill and they are harmed because you left, that IS abandonment.
    The fact is that where I work we are committed to the call we are dispatched to. It can and does change, but only in rare instances.

    On your way to a car fire...are you really going to just drive past an overturned vehicle? On the way to a report of smoke, are you really going to swerve to avoid an unconscious child in the street and then keep going?
    Yes on one, no on two. Talk about "crafting" scenarios... If Godzilla stepped on a car right in front of us I suppose we would stop too. How many times have been enroute and had to swerve around an unconcious child laying in the middle of the street? Although, if we are on a fire run, driving to a reported fire, how are we going to know it is an unconcious child and not a pile of rags or a bag of garbage?

    Use your head, if no care is needed, continue on. But if you come across a serious accident with injured people, or an unconscious man lying in the street, something tells me that even YOU aren't going to just drive past it. It's called triage. And it is done all the time.
    I don't know if care is needed or not, because we're driving to a call where help has been requested. I don't know where you work, but there are men passed out all around us quite commonly. Use your head...we dont stop for every homeless passed out drunk we pass - although you said lying in the street - crafting a scenario where we have to stop because he's obstructing the road. Our sop's are that we continue to our assigned run. As I stated before there are exceptions, but they are rare.

    It isn't a difficult concept.
    No, it's not. I have no trouble understanding how your department runs. It is you that has trouble understanding any system but yours.

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    Quote Originally Posted by Whocares View Post
    Me. Why not talk about a fairly common occurance? How do you know they are minor? There can be significant injuries from a rear end collision.

    I didn't "craft" 100 to suit my needs. I brought up the most common MVA that I have encountered enroute to a call. I guess you could bring up a thousand exotic scenarios to contradict our sop's, but why not just use a realistic one.

    The fact is that where I work we are committed to the call we are dispatched to. It can and does change, but only in rare instances.

    Yes on one, no on two. Talk about "crafting" scenarios... If Godzilla stepped on a car right in front of us I suppose we would stop too. How many times have been enroute and had to swerve around an unconcious child laying in the middle of the street? Although, if we are on a fire run, driving to a reported fire, how are we going to know it is an unconcious child and not a pile of rags or a bag of garbage?

    I don't know if care is needed or not, because we're driving to a call where help has been requested. I don't know where you work, but there are men passed out all around us quite commonly. Use your head...we dont stop for every homeless passed out drunk we pass - although you said lying in the street - crafting a scenario where we have to stop because he's obstructing the road. Our sop's are that we continue to our assigned run. As I stated before there are exceptions, but they are rare.

    No, it's not. I have no trouble understanding how your department runs. It is you that has trouble understanding any system but yours.
    So if a rear-end collision CAN result in serious injuries, you are making my point for me in that you are wrong for simply just driving past it without checking to see if immediate help is needed.

    And if you cant discern between an unconscious child in the street and a "bag of garbage", you have no business driving a car much less fire apparatus.

    This whole topic is about what you do when you come across an unfolding emergency while enroute to another one, one that you must pass through to get to the original caller. Which is the exact reason I used the example of an unconscious in the street in front of you. You have no choice but to come across it, and therefore are obligated to do SOMETHING.

    The fact remains, if immediate help is needed, you WOULD stop and help, which is exactly what I am saying.

    Obviously if no help is needed, you are going to continue on. But if someone isn't breathing, or is trapped in a car and seriously injured, I know you aren't just going to drive away.

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