Friday, July 3

You Make the Call...MCI

You are assigned to a two person volunteer ambulance squad dispatched to assist at a multi vehicle accident in the next town over. In your corner of the world, this is a major MCI.

As you arrive on scene, the local fire squads are cleaning up, all patients had been transported and they didn't know you were coming. As you exchange hellos, one of the pressurized hoses from the extrication equipment ruptures, spraying fluid on roughly 6 persons nearby, including fire and police personnel, even one state trooper.

The firefighter closest to the rupture has fluid in his eyes, the others were struck on the extremeties and protective gear, the trooper in the face, but he was wearing sunglasses which protected his eyes.

You agree most should be cleaned off and examined, the fluid could cause trouble, it was highly pressurized.
They all request transport for evaluation, but there are no ambulances except you available in the area considering the recent event.
A fluid rinse is helping our friend with the most severe trouble, you would take him code 2 if he was alone.
An appropriate hospital is 30 minutes away, the other ambulances are still enroute to the trauma center 45 minutes away.
Do you call for assistance or take them all in your rig?

You make the call.


The Road Doctor said...

Man, that is a lot of PCR's to write. LOL

Seriously though, I would take them all, if they wanted transport by ambulance. It sounds as though some could go POV or by another means.

However, I know I can handle one priority 2 patient and five walking wounded. At least as long as I have a mod. I don't think we'd all fit in a vanbulance...

Anonymous said...

I'd take 'em all in one truck, if private transportation wasn't available. Your resources are already way down due to the other patients transported, so you may be waiting for an extended period of time for the next 3 or 4 available EMS units to arrive.

Hull Coastguard (UK) said...

As above - if safe and practical to do so then take them all - failing that then take the two that got fluid in or around the face as priority with backup handle the rest.

Doc Hog said...

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SJMedic said...

I would explain the situation and suggest the walking wounded seek personal transport or have a fire apparatus transport them to the hospital. Do they need emergent treatment or any care other than decon and vital signs q15? The guy with fluid in his eyes, albeit only a code 2 transport, deserves your full attention. They're all EMS professionals who I am sure would understand the situation.

Anonymous said...

The one with liquid in the eyes goes in the ambulance, the others are told they don't need an ambulance and if they want "checking over" at a&e, are free to make their own way there!
That's a Uk thing though.

The Bus Driver said...

take em all.. they;re all your brothers they probably wouldnt mind the ride. lol

But if you have to choose the most serious.. i agree with the ones with the water in the eyes/face to be the more serious

Ckemtp said...

I'd probably end up piling them all in my 'bulie and taking them in. The whole way, I'd be worried about being in trouble for it.. but I would still do it.

My explanation to the "powers that be" would be this: It's a back-to-back MCI with depleted resources and taking them all is best for patient care. What?? the billing office is going to be mad?

Extraordinary situations call for extraordinary solutions.

(sorry if I misspelled something, had a night and then a morning off and my MGD fridge was calling)

Dantarius said...

Triage them, and treat those that need the transport appropriately, and give the ones that may not need you the information they need to make an informed decision. Sounds like one person needs your help, others just need a rag to wipe it off. Take anyone who feels they need ambulance transport, and let those who don't arrange their own transport if they even go. Being sprayed is not likely a problem unless there is an injection or it actually gets into the eyes. Also, don't delay the care of the person who needs you to wait for additional units, but rather meet them halfway.