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    Quote Originally Posted by jakesdad View Post
    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.
    We don't just drive past, we call it in and help is dispatched.

    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.
    I don't drive the engine, so don't worry.

    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.
    And I told you that we are going to pass it and call it in unless there are some extraordinary circumstances.

    The fact remains, if immediate help is needed, you WOULD stop and help, which is exactly what I am saying.
    No we wouldn't. Immediate help is also needed on the call we were dispatched to. Thats where we go.

    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.
    We would most likely never stop in the first place - again, unless it was some extraordinary circumstance. And we could not continue on until we turn the pt. over to emt's - we can't take a refusal.

    Like I said, assignments can and have been changed - most commonly for fires - but it is an exception. Our rules are that you continue to your original run. You guys can do whatever you want, apparently. Thats fine too.
    Last edited by Whocares; 04-10-2009 at 01:12 PM.

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    Quote Originally Posted by jakesdad View Post
    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.
    To use your scenario "crafting", how can you justify stopping for whiplash and broken bones when you have a child unconscious and moments from death on your original run? I'm sure the little fella won't be bothered by the extended response and the family will understand that you had a car wreck you found that you thought was more important.

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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!!
    You carry extrication tools on your ambulances? That's really impressive. Ours are full of things like airway equipment, intravenous solutions, and a cardiac monitor. I suppose we could dump all that stuff out and replace it with cribbing and hydraulic tools, but I can't see how that would help on most medical calls.




    The vollie department i'm with has a GlasMaster and halligan under the drivers seat of their ambulance, but that's only because the bus often makes it to the scene ahead of the rescue or engine.

    How exactly is my head on backwards? If I am responding to a medical call as a paramedic, I should not be crawling in and out of wrecked vehicles. Thats the job of the rescue or engine company. Turnout gear and extrication gloves do a better job of protecting you from sharp metal than a fleece jacket and latex gloves.

    That is probably hypocritical of me to say, because I know that i've started IVs while hanging upside down in mangled cars. But if something were to happen (fire, vehicle slides down embankment), it would be completely my fault for not wearing proper PPE.

    Now lets get back to the argument at hand, shall we?

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    Quote Originally Posted by ScareCrow57 View Post
    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
    And we've all been dispatched to a "general illness" where the patient is a full arrest. You can only work with the information you're given. Thankfully most of our dispatchers are EMS personnel or at least EMD trained.

    A possible (and risky) exception to this is if you are sent to a familiar address of a patient who themselves (or their family) inflates their symptoms to try to get help faster. I can think of a certain residence off the top of my head, home to a man is non compliant with his seizure medication and seizes often. His wife likes to tell the dispatcher that he is not breathing, or choking on blood in order to "hurry us up".

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    Quote Originally Posted by ActionGoose View Post
    You carry extrication tools on your ambulances? That's really impressive. Ours are full of things like airway equipment, intravenous solutions, and a cardiac monitor. I suppose we could dump all that stuff out and replace it with cribbing and hydraulic tools, but I can't see how that would help on most medical calls.




    The vollie department i'm with has a GlasMaster and halligan under the drivers seat of their ambulance, but that's only because the bus often makes it to the scene ahead of the rescue or engine.

    How exactly is my head on backwards? If I am responding to a medical call as a paramedic, I should not be crawling in and out of wrecked vehicles. Thats the job of the rescue or engine company. Turnout gear and extrication gloves do a better job of protecting you from sharp metal than a fleece jacket and latex gloves.

    That is probably hypocritical of me to say, because I know that i've started IVs while hanging upside down in mangled cars. But if something were to happen (fire, vehicle slides down embankment), it would be completely my fault for not wearing proper PPE.

    Now lets get back to the argument at hand, shall we?

    We do not run ambulances! FIRE apparatus carry extrication tools, etc on all of them. Our members are EMT's or above!

    The ambulance is a third service which is an authority of the City!


    AGAIN Our SOG/SOP = if a company that is responding to a call and comes up on a MVA with injuries, people laying in the street and what appears to be entrapment, that OFFICER has the authority and the responsibility to STOP and see if anyone needs assistance. Should he made the decision to remain on this scene and provide care, then that Officer will notify the FAO of this fact and request the FAO to send another piece of apparatus in their place. On structure calls, usually hvae dispatched 4 to 6 pieces of fire apparatus are responding.

    If the fire department’s services are not needed then that company will continue the response to the original incident.

    As others that have a lot of time in the fire service as I have, over 52 years, I am through with this petty bickering and am gone from this thread. You youngsters hash it out!


    Last edited by CaptOldTimer; 04-10-2009 at 03:03 PM.
    Stay Safe and Well Out There....

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    Posted by CaptainOdTimer
    As others that have a lot of time in the fire service as I have, over 52 years, I am through with this petty bickering and am gone from this thread. You youngsters hash it out!
    These "kids" are going to ruin this job....
    ‎"The education of a firefighter and the continued education of a firefighter is what makes "real" firefighters. Continuous skill development is the core of progressive firefighting. We learn by doing and doing it again and again, both on the training ground and the fireground."
    Lt. Ray McCormack, FDNY

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    Quote Originally Posted by CaptainGonzo View Post
    Posted by CaptainOdTimer

    These "kids" are going to ruin this job....
    Which "kids" are you speaking of?

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    And which "job" are you speaking of? Fire? EMS? Sword swallowing?

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    Quote Originally Posted by jakesdad View Post
    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.
    OK, let me be really clear about this. That opinion came from an ambulance district attorney, hired to protect the interests of that district, and was in reference to the operations of an ambulance district in Missouri. This is an attorney who has passed the bar exam and worked with a number of ambulance districts and companies in our area.

    No offense, but I'm willing to be he knows far more about operations of ambulances in Missouri than you do, no matter what you think you know about our legal system.

    Quote Originally Posted by jakesdad View Post
    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.
    Once again, what is your knowledge of Missouri laws?

    Quote Originally Posted by jakesdad View Post
    And who in the hell said anything about "dumping" one run for another?
    You do realize that where ever you're at isn't the center of the world, right? When you put a call to another unit for whatever reason, we call it "dumping" the call on them.

    Quote Originally Posted by jakesdad View Post
    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.
    And once again, there are other systems out there that run different than the one you're in. I know this is hard to realize, but please try.

    This is a situation that may involve fire or EMS. If a fire truck is providing first response to a medical call and stops at an accident, it's a bit different than if the ambulance does so. If the same happens in a more rural area, it's different than in an urban area. If the medical call is a chest pain, it's different than a lift assist.

    Quote Originally Posted by jakesdad View Post
    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.
    Have YOU dealt with this scenario in a courtroom, or even researched Missouri laws on this particular issue, or passed the Bar exam in the state of Missouri? If so, let me know so the next time I'm riding the box and encounter this situation I can do whatever you say is right. Otherwise, you're spouting off an opinion based on your experience in your locale, which I don't believe is anywhere near Missouri.

    There's a bit of a difference between you and I. I'm willing to acknowledge and accept that there are different aspects of this situation (fire vs EMS, type of call, etc.) and different laws for different states, whereas you are apparently convinced that everywhere is the same as where you are. That's a dangerous assumption to make when giving advise.

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    http://www.jems.com/news_and_article...andonment.html

    To prove abandonment, a plaintiff must show that a patient needs care — that a medical provider has entered into a relationship to provide care to that patient, and then either stops providing care or transfers care to a person of lesser training when the patient needs the higher level of training.
    If you consider making eye contact while driving by an accident victim to be entering a relationship to provide care, you are completely divorced from reality.

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    Quote Originally Posted by ActionGoose View Post
    http://www.jems.com/news_and_article...andonment.html



    If you consider making eye contact while driving by an accident victim to be entering a relationship to provide care, you are completely divorced from reality.
    And if you think that after making that eye contact and then proceeding to leave, and harm is done due to a delay in receiving care, YOU are divorced from reality.

    What exactly would your defense be in this case? I would love to hear it.

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    Quote Originally Posted by Catch22 View Post
    Once again, what is your knowledge of Missouri laws?

    You do realize that where ever you're at isn't the center of the world, right? When you put a call to another unit for whatever reason, we call it "dumping" the call on them.


    And once again, there are other systems out there that run different than the one you're in. I know this is hard to realize, but please try.

    Have YOU dealt with this scenario in a courtroom, or even researched Missouri laws on this particular issue, or passed the Bar exam in the state of Missouri? If so, let me know so the next time I'm riding the box and encounter this situation I can do whatever you say is right. Otherwise, you're spouting off an opinion based on your experience in your locale, which I don't believe is anywhere near Missouri.

    There's a bit of a difference between you and I. I'm willing to acknowledge and accept that there are different aspects of this situation (fire vs EMS, type of call, etc.) and different laws for different states, whereas you are apparently convinced that everywhere is the same as where you are. That's a dangerous assumption to make when giving advise.
    If you are so familiar with Missouri law regarding abandonment, then please enlighten me as to what is states with regard to this.

    It is highly unlikely that you would ever face litigation regarding this topic, but I assure you that the person you are at most risk with is the one you have actually made it to, which for the sake of this discussion is the one you come across while enroute to the first caller one.

    The person you never make it to CANNOT make a case for abandonment in the event trained personell stop to assist those in need directly in front of them while responding to the original caller.

    Leaving the scene where someone was critically injured or ill and that delay in their care results in harm to them is justification for abandonment, even in Missouri.
    Last edited by jakesdad; 04-10-2009 at 06:00 PM.

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    Quote Originally Posted by Engine58 View Post
    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.
    It is simple. You were dispatched to help someone in need to save or life or protect their property. The second you pull out the door it is your emergency and you have told the world (at least around here, when we department we say XXX enroute to location of emergency). So jumping on another call without very good justification is dereliction of duty. You ignore the emergency you were sent to in favor of one that is somewhere else.

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    Quote Originally Posted by tbonetrexler View Post
    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.
    Exactly. There is no freelancing. If you are on a high priority (which I hope the uncon not breathing is) then move on.

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    Quote Originally Posted by hwoods View Post
    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........
    Excellent post and well said. Kudos to you my friend

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    4 paid members (1-3 paramedics) daytime at Central Station plus volunteer ride-outs. 1 (2 shifts paramedic/1 shift basic) paid member evening 5AM-5PM plus volunteer ride-outs. Parish paramedic EMS transport unit housed at our Central Station. 6 volunteer-only stations.

    Generally heavy rescue EMS response vehicle daytime and evenings if more than 2 in the house. Light rescue if less than 2. All primary vehicles have jumpkits and 02. Heavy and light rescue equipped as ALS first response units.

    Volunteers (several paramedics on the roster) respond directly to scene for EMS calls. Everyone has a portable and daytime personnel check responding and from where.


    If that situation happened in our fire district ....

    Assuming the fire department response unit has not left the central station with the parish EMS unit behind it, which is unusual...

    The fire department response unit (light or heavy rescue) would stop at the wreck. The parish EMS unit would continue to the original call. We would have volunteers continue to the original call until we knew the exact nature. If it was determined to be minor or something the parish EMS crew could handle alone by either the first arriving volunteer or the medic crew, the volunteers would be diverted to the wreck.

    The parish EMS unit would never be deviated from the original run, no matter how badly injured the victims at the wreck were. That is parish EMS protocol. The wreck would get the next closest parish unit, which is 8-20 minutes away, depending on where it is. Next one after that is 20-25 minutes out.

    If we were traveling together, which is far more common, the fire department unit would stop at the wreck and the ambo would continue to the original call. Only exception to that may be if the original call is a code or some type of rescue requiring the rescue apparatus. In that case, both units would continue and responding volunteers in that area would be diverted to the wreck.The closest rescue engine would be picked up by a volunteer and taken to the scene of the wreck.

    We have protocols for if we have members out in the district with utility or command trucks running errands or tasks at the satellite stations .... but that would only confuse matters.

    Under LA law, you can't abandon someone you have not made physical contact with.
    Last edited by LaFireEducator; 04-10-2009 at 08:25 PM.

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    Quote Originally Posted by ScareCrow57 View Post
    It is simple. You were dispatched to help someone in need to save or life or protect their property. The second you pull out the door it is your emergency and you have told the world (at least around here, when we department we say XXX enroute to location of emergency). So jumping on another call without very good justification is dereliction of duty. You ignore the emergency you were sent to in favor of one that is somewhere else.
    As usual...you are in over your head.

    The "good justification" is the emergency unfolding directly in front of you, and your deriliction of duty comes from leaving those people you HAVE made contact with for someone you HAVE NOT. Leaving the scene in which you are passing through, and therefore ON can result in abandonment. Notifiying your dispatcher that you have stopped to render aid to someone who IS IN NEED OF IT and WILL SUFFER FURTHER HARM FROM YOU LEAVING and having them send another unit to the first caller does not result in abandonment of the first caller.

    It is unfortunate that they must wait longer, but it is not illegal, and in fact, is the accepted practice in most agencies.

    I don't expect you to understand this concept on any level whatsoever. But how many more times does it need to be pointed out to you?

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    It is f*cking hysterical watching those who attempted to defend not sending anyone to automatic fire alarms, now claim that we must pass an obvious emergency to respond to that alarm.

    There are far too many variables to answer this question with any certainty, so those who attempt to claim "always and never" in either direction are dillusional and dont live in the real world.
    Proud East Coast Traditionalist.

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    Situation discussed was an EMS call, not a fire alarm.

    Different set of protocols completely and I really don't want to have to type them.

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    But but but but what it you were on your way to an automatic alarm, and then there was an MVA in front of you, and THEN there was a brush fire on your right and a plane crash on your left?!!?!?!?!?

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    That's an easy one goose ..

    If I was in the engine, I'd go to the alarm.
    If I was in the brush truck, I'd handle the brush fire.
    If I was in the heavy rescue, I'd work the wreck.
    And if I was in the pretend-ARFF rig I'd deal with the plane crash.

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    Quote Originally Posted by ScareCrow57 View Post
    It is simple. You were dispatched to help someone in need to save or life or protect their property. The second you pull out the door it is your emergency and you have told the world (at least around here, when we department we say XXX enroute to location of emergency). So jumping on another call without very good justification is dereliction of duty. You ignore the emergency you were sent to in favor of one that is somewhere else.
    I'm sorry that you think people in a wreck dying in front of you are not a good justification.....
    "They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety." -- Benjamin Franklin

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    Quote Originally Posted by jakesdad View Post
    As usual...you are in over your head.

    The "good justification" is the emergency unfolding directly in front of you, and your deriliction of duty comes from leaving those people you HAVE made contact with for someone you HAVE NOT. Leaving the scene in which you are passing through, and therefore ON can result in abandonment. Notifiying your dispatcher that you have stopped to render aid to someone who IS IN NEED OF IT and WILL SUFFER FURTHER HARM FROM YOU LEAVING and having them send another unit to the first caller does not result in abandonment of the first caller.

    It is unfortunate that they must wait longer, but it is not illegal, and in fact, is the accepted practice in most agencies.

    I don't expect you to understand this concept on any level whatsoever. But how many more times does it need to be pointed out to you?
    So a fender bender with minor injuries is more important than a life threatening heart attack or stroke? I hope I never have to count on you for help.

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    Quote Originally Posted by nyckftbl View Post
    It is f*cking hysterical watching those who attempted to defend not sending anyone to automatic fire alarms, now claim that we must pass an obvious emergency to respond to that alarm.

    There are far too many variables to answer this question with any certainty, so those who attempt to claim "always and never" in either direction are dillusional and dont live in the real world.
    Actually the original "what if" scenario was for responding to an unconscious not breathing and coming upon an MVA. A couple of points here.

    1. We don’t have much info about the MVA. Most MVAs have minor or no injuries, and one can easily look and see how bad the MVA is.

    2. We all know that a report of “unconscious not breathing” doesn’t necessarily mean that is the case.

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    Quote Originally Posted by MarcusKspn View Post
    I'm sorry that you think people in a wreck dying in front of you are not a good justification.....
    Except that rarely are MVAs fatal. Strokes and heart attacks are. I’m sorry that you think people in a minor accident take precedent over someone who may be dying.

    But this points out an important issue. It is cut and dried.

    I know some people think that first come first serve is a bad way to do business. But think about this for a minute. If you arrive in an ambulance with a patient who is dying, that hospital will commit its resources to saving the first person. If a second one arrives and there is no one to help them, they have to wait. Hence FIFO.

    So if you are responding to a life threatening situation and come upon another life threatening situation you have two choices. Allow the first emergency you were assigned to wait 10 minutes instead of 5, while responding immediacy to the second incident. Or be fair and have both scenes wait 5 minutes, thus providing equal and fair treatment to both emergencies.

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