Friday, July 17

You Make the Call...Unknown Driver

Dispatched to an ALS intercept in a very rural area you are an EMT driving your experienced, trustworthy Paramedic partner.

Radio advises you they are receiving updates from a volunteer fire squad at the scene of a rollover MVA with ejection, one person still alive. You have asked for the helicopter to be launched, but it has just launched for a long trip and will not be available for some time.

Arriving on scene you find two volunteer firefighters standing near the man who is prone on the ground. They are not even EMTs in this area, just Firefighters for their small community.

The patient is unconscious and unresponsive. You do your best to get him immobilized and O2 on while instructing the firefighters what to do and how to help. Loading the patient your partner looks from you to the firefighter and says, "I'm going to need a lot of help back here," and turns to one of the firefighters, "can you drive us as far as our district so we can get another driver to intercept us?"

Seems like a logical decision this far out. It took you almost 40 minutes just to get here, calling for another driver to respond would take forever.

Do you allow a driver you've never met to operate your ambulance in order to assist the medic in the back?

You make the call.


Just Me said...

I've been in very similar situations, and where mutual aid is required by a volunteer fire department then usually when everyone else shows up it turns into a big collaborative effort - we drive whatever needs to be driven and the closest person available gets snagged to do it. In rural areas where the jurisdictions are so big it seems the most practical. That's my call :)

The Bus Driver said...

Yes, only if the person/volunteer firefighter is comfortable with operating the rig. Plus the local firefighter may know an easier way to drive back.

Capt. Schmoe said...

Sorry, not going to happen. One of the firefighters might ride in and be an extra set of hands, but I'm not going to allow an unknown to operate an ambulance.

It's scary enough riding in the back of the box, let alone with an untrained driver who is
probably "jacked up" from the call in the first place.

My agency's policy and that of the ambulance company are going to back me up on this.

emt.dan said...

Agree ^. My company only insures its own employees to drive it's vehicles. The driver of an ambulance has the capacity to kill all aboard, the tech just the patient. I'd rather the medic explain to the FF how to do things then have to explain a crash.

Aren't medical helicopter pilots not told anything about their patient before seeing them-- so that it doesnt impact their margins of safety? They need to be able to operate the chopper safely with every takeoff, irregardless of the patient condition (pedi, elderly, etc.)

Anonymous said...

Déjà vu -- Happy stopped getting into my head and reading my thoughts, you might get scared and run away.

I can tell you want the agencies I dispatch for do.

If they require a driver from the fd, they asked for one, and the captain gives them one if possible. The ff is only allowed to drive COLD - NO LIGHTS, NO SIRENS - into the ambulance's district, where the FF jumps out and let the a waiting medic jump in and leave there HOT - LIGHTS and SIRENS BLARING.

We use this process for the rural volunteer FD,and our city FD. The only difference is the city ff drive straight to the hospital for the medics.

Once we actually left a rural ff standing on the street curb in the hood waiting for his department to send in a vehicle to pick him up; he was lucky the medic who partner was driving to the hospital left him come sit in the ambulance until his ride came.

Anonymous said...

Hey emt.dan, I don't know about the States, but the Heli-Medivac pilots we have in Canada are not normally medically trained, they are Joe Citizen who fly the helicopter from base, to the scene, to the hospital, and back to base. The medics are of course at the top of the Medical Higher Archy.

The helicopter that I use for Heli-Medivacs also has a priority systems to determine what event is more serious then another. Sometimes, there are more serious events going on in the area, and we just have to deal with the fact that we can't use a helicopter.

The Happy Medic said...

Dan, in my experience with Lifeguard Helicopter in NM, the pilot is only notified that there was a request for launch, then he checks the weather and decides to launch or not. That way he isn't pushing the envelope for a sentimental call. And like Little Girl said, most of the Pilots are just that but pick up enough just being there.
Oh, and a quick reminder from a pilot I met once. I asked him what the landing zone folks can do to make his job easier. he replied "Stop waving your arms, I see you" and "Don't EVER touch my aircraft for any reason. You need a door open, ask."