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    Default Protocol for "stumbling" upon a call when ernt to a call?

    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?
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    IMHO - And based soley on your scenario, an MVA with OBVIOUS injuries occurring right in front of you, you gotta stop! Especially if no other responder (PD,EMS) is on scene. Otherwise, it would be a complete abandonment of any form of the establishment of emergency services command and control. Besides, if it happened "right in frot of you", you re not only a witness, but your sirens (or driving) may have contributed to the MVA. Direct the dispatch of a "next due" to the first call. If someone else is already on-scene on the"new" call, then that may change things, where you can continue.
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    Quote Originally Posted by DFDCar1 View Post
    IMHO - And based soley on your scenario, an MVA with OBVIOUS injuries occurring right in front of you, you gotta stop! Especially if no other responder (PD,EMS) is on scene. Otherwise, it would be a complete abandonment of any form of the establishment of emergency services command and control. Besides, if it happened "right in frot of you", you re not only a witness, but your sirens (or driving) may have contributed to the MVA. Direct the dispatch of a "next due" to the first call. If someone else is already on-scene on the"new" call, then that may change things, where you can continue.
    I agree with DFDCar1. Dispatch another unit to the medical and take care of the incident where you are.
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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'll second Gonzo's motion.

    If nothing else, the APPEARENCE that you give if you don't stop is unnerving to any spectators. Remember, when you come around the corner and find something in front of you, only you know that this isn't what you're responding to, everyone else assumes you're coming for this incident. Blasting on by will likely result in a few complaints at least, and a full blown Media circus at worst.............
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    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.

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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.
    If the patient in the first medical is unconcious and not breathing 10 to 15 minutes into his "golden hour".. he's already gone.. clinical death occurs when the heart stops, biological death occurs within 4 to 6 minutes.

    "Hour of Power" sounds like religious programming on Daystar...
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    I've always understood it that if you're en route to a call, then you're dedicated to that call. If you're responding to a medical and come upon a wreck and stop there, you're flirting with abandonment of your initial call.

    If you're going to a fire alarm or something like that, I could see stopping, but not if you're going to something where one's safety/life may be at risk.

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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.
    Actually, in the world of triage, the patient that is uncon and not breathing gets the black tag - and then we would move on to hand out green/yellow/red ones to the people in the MVA that are still alive....
    "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 Catch22 View Post
    I've always understood it that if you're en route to a call, then you're dedicated to that call. If you're responding to a medical and come upon a wreck and stop there, you're flirting with abandonment of your initial call.

    If you're going to a fire alarm or something like that, I could see stopping, but not if you're going to something where one's safety/life may be at risk.
    That's our protocol. Now, we don't run ambulances, but once enroute to one call, you're dedicated to it unless disgregarded by dispatch or an officer, especially if you're in the first out apparatus.

    Secondary apparatus have a little more leeway.

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    Quote Originally Posted by Catch22 View Post
    If you're going to a fire alarm or something like that, I could see stopping, but not if you're going to something where one's safety/life may be at risk.
    Are you saying lives are not at stake for a fire alarm? Do you know why the fire alarm went off? Yes, I would say that over 95% of fire alarm calls are minor but it may be the real deal, you don't know take each alarm call as the real deal and do not endanger life.
    I have had an MVC occur in front of me going to a medical call. The incident involved a motorcyclist who went over the handlebars on a 4 lane road. I made the decision to stop, due to traffic conditions,(motorcyclist could have been run over) ambulance was in front of the accident and continued to med call. I did notify dispatch of the accident and had our next due apparatus respond to the medical call with ambulance and that we would need an ambulance at this location.
    Our Standard Operating policy states you will respond to the call dispatched to. Chief and my captain both agreed with my decision to stop and render aid, due to location, and cirumstance.

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    Quote Originally Posted by kjohn23 View Post
    Are you saying lives are not at stake for a fire alarm? Do you know why the fire alarm went off? Yes, I would say that over 95% of fire alarm calls are minor but it may be the real deal, you don't know take each alarm call as the real deal and do not endanger life.
    Forgive me if I forget not every department runs like ours. With most departments, multiple apparatus are responding to a fire alarm. If one apparatus stops their response for an incident that's confirmed, another can be sent in their place.

    If I'm first due on the alarm, I'm probably going to relay the MVA to another unit.

    Quote Originally Posted by kjohn23 View Post
    I have had an MVC occur in front of me going to a medical call. The incident involved a motorcyclist who went over the handlebars on a 4 lane road. I made the decision to stop, due to traffic conditions,(motorcyclist could have been run over) ambulance was in front of the accident and continued to med call. I did notify dispatch of the accident and had our next due apparatus respond to the medical call with ambulance and that we would need an ambulance at this location.
    In this case, you have an ambulance you know is ahead of you and would arrive at, or before, the time you would have. That's a bit different than where I work, where the ambulance may already be there, or they may be 20 minutes behind.

    Quote Originally Posted by kjohn23 View Post
    Our Standard Operating policy states you will respond to the call dispatched to. Chief and my captain both agreed with my decision to stop and render aid, due to location, and cirumstance.
    Most of what a decision like this would be based on is based on circumstances. Unless I know there's another unit closer, or an ambulance en route that's going to arrive in an adequate time, I'm going to advice dispatch of the MVA and continue to the call I'm dispatched to. If the BC wants to divert me to the MVA, that's his decision.

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    Quote Originally Posted by Catch22 View Post
    I've always understood it that if you're en route to a call, then you're dedicated to that call. If you're responding to a medical and come upon a wreck and stop there, you're flirting with abandonment of your initial call.

    Here, by Law, you can't be charged with abandoning something that you don't have custody of. True, an EMS Field provider may not "Abandon" a Patient, but, the provider must first actually make contact with the patient in order to assume responsibility for the Patient. "Abandonment" caused by the responding unit changing from one emergency to another, PRIOR TO assuming responsibility for the first patient can't happen since it doesn't exist.
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    Quote Originally Posted by DFDCar1 View Post
    Direct the dispatch of a "next due" to the first call...
    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'm not the posting police, but I think that's what he was saying in there actually.
    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.
    This is why you are relagated to armchair quarterbacking. So much more going on than a clear black and white.

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    Quote Originally Posted by CaptainGonzo View Post
    If the patient in the first medical is unconcious and not breathing 10 to 15 minutes into his "golden hour".. he's already gone.. clinical death occurs when the heart stops, biological death occurs within 4 to 6 minutes.

    "Hour of Power" sounds like religious programming on Daystar...
    True, when declared by a medical professional. Frantic wife calls in and says her husband is unconscious and not breathing. Perhaps he is breathing, just very shallow. People who are experiencing a medical emergency for a loved one don't always use the right terms. We have had several choking and not breathing calls only to find it they were choking and breathing.

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    Quote Originally Posted by MarcusKspn View Post
    Actually, in the world of triage, the patient that is uncon and not breathing gets the black tag - and then we would move on to hand out green/yellow/red ones to the people in the MVA that are still alive....
    And how do you know that the patient at the medical emergency is not still alive? Did you or someone else examine him?

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    This actually happens alot in where I work EMS. This actually happened the other day...En route to an abdominal pain at a local elementary school 2 blocks away happen to come up to a 2 car MVA blocking 3 out of 4 lanes of the roadway going north and south. We stopped and had possible injuries so we sent another BLS unit to the job a few blocks away. If there wasnt any injuries I would of continued on to the original job...simple as that...
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    Quote Originally Posted by kjohn23 View Post
    Are you saying lives are not at stake for a fire alarm? Do you know why the fire alarm went off? Yes, I would say that over 95% of fire alarm calls are minor but it may be the real deal, you don't know take each alarm call as the real deal and do not endanger life.
    I have had an MVC occur in front of me going to a medical call. The incident involved a motorcyclist who went over the handlebars on a 4 lane road. I made the decision to stop, due to traffic conditions,(motorcyclist could have been run over) ambulance was in front of the accident and continued to med call. I did notify dispatch of the accident and had our next due apparatus respond to the medical call with ambulance and that we would need an ambulance at this location.
    Our Standard Operating policy states you will respond to the call dispatched to. Chief and my captain both agreed with my decision to stop and render aid, due to location, and cirumstance.

    Good point. If you have multiple units responding that would change things. One unit stops the other continues on. However, if you are the only responding unit you should notify the folks at the accident that additional help is on the way. And continue on. Free lancing would really screw up any controls and procedures that were in place. If it was your loved one who you had called for help for and you found out the ambulance went elsewhere letting your loved one die you would be really P.O. ed.

    It has to be treated like a first in first out system. Changing priorities willy nilly is just unacceptable and crazy.

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    Quote Originally Posted by ScareCrow57 View Post
    Good point. If you have multiple units responding that would change things. One unit stops the other continues on. However, if you are the only responding unit you should notify the folks at the accident that additional help is on the way. And continue on. Free lancing would really screw up any controls and procedures that were in place. If it was your loved one who you had called for help for and you found out the ambulance went elsewhere letting your loved one die you would be really P.O. ed.

    It has to be treated like a first in first out system. Changing priorities willy nilly is just unacceptable and crazy.
    And if your loved one died after the ambulance or fire truck stopped at the accident and told you to just wait for the next one before they drove off, you would be OK that?

    It does not have to be treated as a "first in/first out system". It isn't a deli, and you are well within your rights and well within accepted standards to stop and render aid regardless of who called for you first. Quite honestly, you can easily be found negligent for telling someone to wait for the next responder as you just drive away.

    Common sense dictates how you treat these situations as each one will be different.

    This very thing happens several times a day in busy urban systems without a hitch.

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    Quote Originally Posted by jakesdad View Post
    And if your loved one died after the ambulance or fire truck stopped at the accident and told you to just wait for the next one before they drove off, you would be OK that?

    It does not have to be treated as a "first in/first out system". It isn't a deli, and you are well within your rights and well within accepted standards to stop and render aid regardless of who called for you first. Quite honestly, you can easily be found negligent for telling someone to wait for the next responder as you just drive away.

    Common sense dictates how you treat these situations as each one will be different.

    This very thing happens several times a day in busy urban systems without a hitch.
    In the rural area, things are a bit different. When I was working EMS, I ran into a very similar situation where we were running to a medical emergency and came upon an accident en route. We stopped quickly and told the bystanders another ambulance was on their way and proceeded, advising dispatch to send rescue and another ambulance.

    This raised this very debate. The ambulance district's attorney at the time had the "opinion" that had we stopped and requested a unit to respond that was further away, we could have been sued for abandonment. His advise was to proceed to the call and let the next unit assist with the MVA.

    Granted, different attorney's have different opinions, so the next guy may have said the exact opposite. However, I'll stick by the decision I made that day and would do the same, given the same circumstances.

    On a little bit of a tangent, I also had a situation where we came upon an MVA while transporting the patient. Since we were running a unit with an EMT and a Medic, and were running an ALS transport, my partner checked on the MVA for injuries and treated what he could until another unit arrived.

    This situation prompted the discussion of whether it would be treading a thin line if I had left him with the ALS patient, who was stable, and had rendered treatment on the MVA, had their been more serious injuries. It was another one of those "it depends" situations, based on the severity of the various patients. Plus, I was still within feet of the transport patient, so I could have swapped back had they crashed.

    Far too many variables to set a black-and-white protocol or to make a blanket statement.

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    Quote Originally Posted by jakesdad View Post
    And if your loved one died after the ambulance or fire truck stopped at the accident and told you to just wait for the next one before they drove off, you would be OK that?

    It does not have to be treated as a "first in/first out system". It isn't a deli, and you are well within your rights and well within accepted standards to stop and render aid regardless of who called for you first. Quite honestly, you can easily be found negligent for telling someone to wait for the next responder as you just drive away.

    Common sense dictates how you treat these situations as each one will be different.

    This very thing happens several times a day in busy urban systems without a hitch.
    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.

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    Quote Originally Posted by Catch22 View Post
    This raised this very debate. The ambulance district's attorney at the time had the "opinion" that had we stopped and requested a unit to respond that was further away, we could have been sued for abandonment. His advise was to proceed to the call and let the next unit assist with the MVA.

    How can you be sued for abandonement if you haven't even made contact with the patient?

    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.

    Each circumstance will be different and that is why you need to have competent, trained people making the important decisions on the fly.

    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.

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    Quote Originally Posted by ScareCrow57 View Post
    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.
    You can sue anyone you like for any reason you like.

    That doesn't mean you will win, and it doesn't even mean your lawsuit will he heard.

    It isn't about the incidents proximity to the station. It is about coming across an incident, then making CONTACT with the ill and injured, and then proceeding to leave them.

    If anyone would have a legitimate case for a lawsuit, it would be the person that has been abandoned, which in this case, is not the first caller.

    Again, it isn't about waiting your turn. Emergency services isn't a dry cleaning service and police, fire and EMS units are rerouted all the time.

    A competent, trained professional making an educated and informed decision to render aid after coming across an accident or sick person, or being flagged down while enroute to another run can easily defend that decision during any frivilous lawsuit you might bring forward.

    An adequate defense for leaving someone injured in the street with no care whatsoever cannot simply be that " they have to wait their turn".

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    Quote Originally Posted by jakesdad View Post
    You can sue anyone you like for any reason you like.

    That doesn't mean you will win, and it doesn't even mean your lawsuit will he heard.

    It isn't about the incidents proximity to the station. It is about coming across an incident, then making CONTACT with the ill and injured, and then proceeding to leave them.

    If anyone would have a legitimate case for a lawsuit, it would be the person that has been abandoned, which in this case, is not the first caller.

    Again, it isn't about waiting your turn. Emergency services isn't a dry cleaning service and police, fire and EMS units are rerouted all the time.

    A competent, trained professional making an educated and informed decision to render aid after coming across an accident or sick person, or being flagged down while enroute to another run can easily defend that decision during any frivilous lawsuit you might bring forward.

    An adequate defense for leaving someone injured in the street with no care whatsoever cannot simply be that " they have to wait their turn".
    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.
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    Quote Originally Posted by ScareCrow57 View Post
    True, when declared by a medical professional. Frantic wife calls in and says her husband is unconscious and not breathing. Perhaps he is breathing, just very shallow. People who are experiencing a medical emergency for a loved one don't always use the right terms. We have had several choking and not breathing calls only to find it they were choking and breathing.
    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?

    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.
    You have flu like symptoms and call for the bone box because you are pukign crap and crapping puke and don't want to barf in your car on the way to the ER...

    A call comes in for a child who fell off a playground slide and is bleeding from a head lac and is unconcious.

    The kid is going to come first... go hire the ambulance chaser and sue.
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    I have for the most part worked in a urban East Coast city where we have all career members, aka paid department, with close to 40 companies at one given time in history.

    I have in several occasions been dispatched on a call and "came up" on a MVA or a structure fire. We have always stopped for that incident, assess the situation and then if we didn't have anyone who needed first aid, aka- EMS, we would proceed to the first call. BUT, only after we had notified the fire radio operator (FAO) and were assured that the services of the fire department werenít required. If we were to needed to remain on the scene, we would advise the FAO this and they would send another fire unit to our original call.

    If it was a structure, we would take that job and request that a box be transmitted for the new call to fill out and get the necessary apparatus.

    I have been sent on an EMS call's at O-God-Thirty only to find that the nurse in the assisted or nursing home had found Mr. Jones or Mrs. Smith cold and non responsive, that by her protocol she would call 9-1-1 and we would go there to find that the person was cold, stiff and dead. Having said that we would have to wait for the ambulance to make the scent before we could clear and return.


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