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  1. #41
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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.


  2. #42
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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.

  3. #43
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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.

  4. #44
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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.

  5. #45
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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.

  6. #46
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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 10:14 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.

  8. #48
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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.

  9. #49
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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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  10. #50
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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.

  11. #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.

  12. #52
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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.

  13. #53
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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.

  17. #57
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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?

  18. #58
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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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  19. #59
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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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