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Recall
Feb 8, 2005 12:23:42 GMT -5
Post by Medic13 on Feb 8, 2005 12:23:42 GMT -5
Well, the two little guys on my shoulders have been going at it for a few days now... the evil guy won. So before this thread goes byebye, I have to ask the question I erased the other day. What's the big deal? I can't count the number of times I've scrambled/cancelled the birdie, or ALS when I run volunteer. The last time was just as uneventful as the first. Not once did I grow any more hair on my chest, nor did any of my body parts get bigger. So why is it an issue? I've never cancelled any fire/rescue service, and have no interest in doing so (nor have I heard any of my fellow employees do it). We're all there for the same goal, but each service has a different job. I can understand why it's "legal" for an EMT with the fire dept to cancel EMS resources, and why EMS can cancel rescue resources, but what's so special about doing it? Doesn't it just make sense for the fire chief to decide what resources are needed for fire/rescue, and EMS command decide what EMS resources are needed? Why does it always seem like a race to be the first person to get on the air and cancel? I understand the problem is the ego thing, but I really don't see why. Who can possibly benefit by cancelling a resource 2min before a member of that service arrives? So I ask again, what's the big deal?
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Recall
Feb 12, 2005 14:10:14 GMT -5
Post by CMTMedic on Feb 12, 2005 14:10:14 GMT -5
Well chief, I havent been avoiding the question, just busy. Here it is.
Pennsylvania Department of Health Operations 112– BLS – Adult/Peds NON-TRANSPORT OF PATIENTS OR CANCELLATION OF RESPONSE STATEWIDE BLS PROTOCOL Criteria: A. EMS provider cancelled before arriving at the scene of an incident. B. EMS provider who has been dispatched to respond encounters an individual who denies injury/illness and has no apparent injury/illness when assessed by the EMS practitioner.1 C. EMS provider transfers care to another provider. Exclusion Criteria: A. This protocol does not apply to an on-scene EMS provider evaluating a patient who is ill or injured but refuses treatment or transport – see Protocol # 111. Procedure: A. Cancellations: 1. After being dispatched to an incident, an ALS or BLS provider may cancel its response when following the direction of a PSAP or dispatch center. Reasons for response cancellation by the PSAP or dispatch center may include the following situations: a. When the PSAP/ dispatch center diverts the responding provider to an EMS incident of higher priority, as determined by the PSAP/ dispatch center’s EMD protocols, and replaces the initially responding provider with another EMS provider, the initial provider may divert to the higher priority call. b. When the PSAP/ dispatch center determines that another EMS service can handle the incident more quickly or more appropriately. c. When EMS personnel on scene determine that a patient does not require care beyond the scope of practice of the on scene provider, the EMS practitioner may cancel additional responding EMS providers. This includes cancellation of providers responding to patients who are obviously dead (see Protocol #322). d. When law enforcement or fire department personnel on scene indicate that no incident or patient was found, these other public safety services may cancel responding EMS providers. e. When the PSAP/ dispatch center is notified that the patient was transported by privately owned vehicle or by other means (caller, police, or other authorized personnel on the scene). f. When BLS is transporting a patient that requires ALS, ALS may be cancelled if it is determined that ALS cannot rendezvous with the BLS provider in time to provide ALS care before the BLS ambulance arrives at the hospital. 2. Ambulance services or regions may have policies that require the responding provider to proceed to the scene non-emergently if the on-scene individual that recommends cancellation is not an EMS practitioner. B. Persons involved but not injured or ill:1 The following apply if an individual for whom an EMS provider has been dispatched to respond denies injury/illness and has no apparent injury/illness when assessed by the EMS practitioner: 1. Assess mechanism of injury or history of illness, patient symptoms, and assess patient for corresponding signs of injury or illness 2. If individual declines care, there is no evidence of injury or illness, and the involved person has no symptoms or signs of injury/ illness, then the EMS practitioner has no further obligation to this individual. 3. If it does not hinder treatment or transportation of injured patients, documentation on the EMS PCR should, at the minimum, include the following for each non-injured patient: a. Name b. History, confirming lack of significant symptoms. c. Patient assessment, confirming lack of signs or findings consistent with illness/injury. 4. If serious mechanism of injury, symptoms of injury or illness, or physical exam findings are consistent with injury or illness, follow Patient Refusal of Treatment Protocol # 111. C. Release of patients: 1. When patient care is transferred to another EMS practitioner, the initial practitioner must transfer care to an individual with an equivalent or higher level of training (e.g. EMT to EMT, ALS to ALS, ground to air medical crew) except in the following situations: a. Transfer to a lower level provider is permitted by applicable protocol or when ordered by a medical command physician. (e.g. ALS service releases patient care and/or transport to BLS service) b. Patient care needs outnumber EMS personnel resources at scene and waiting for an equivalent or higher level of care practitioner will delay patient treatment or transport. D. Provider Endangerment: 1. Under no circumstances should a provider be required to endanger his or her life or health to provide patient care. See Scene Safety protocol #102. Notes: 1. Pertains to persons who have had EMS summoned on their behalf by a third party, but deny being injured or ill (i.e.: a person in a minor MVA who denies complaints). This is not applicable if the patient has symptoms. Performance Parameters: A. Review cases of cancellation of ALS by BLS personnel for appropriateness.
As for my thoughts on the subject.... I still stick with the belief that the transport agency should at least have the final say. In a perfect world any EMT would be able to make that determination. But, in a perfect world many of us would be out of a job. From my personal experience I have had resources (specifically the helocopter) stood down. On the one that sticks in my head I arrived to find a paitient with a diminished mental status following an MVC. The EMT (responded with a non-qrs rescue) stated that the pt was diabetic and probably had hypoglycemia. How does an EMT know for sure that is the cause? Fortunately the patient did only have hypoglycemia and no other resources were needed. Guess the EMT had the crystal ball close by. I'm not trying to bash BLS with this but a BLS provider cannot assess a blood glucose level in the field, so how did the EMT know for sure that it wasn't a head injury or something else....
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GVEMS30
Full Member
"Anyone who has never made a mistake has never tried anything new." - Albert Einstein
Posts: 75
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Recall
Feb 15, 2005 8:02:51 GMT -5
Post by GVEMS30 on Feb 15, 2005 8:02:51 GMT -5
Well, the two little guys on my shoulders have been going at it for a few days now... the evil guy won. So before this thread goes byebye, I have to ask the question I erased the other day. What's the big deal? I can't count the number of times I've scrambled/cancelled the birdie, or ALS when I run volunteer. The last time was just as uneventful as the first. Not once did I grow any more hair on my chest, nor did any of my body parts get bigger. So why is it an issue? I've never cancelled any fire/rescue service, and have no interest in doing so (nor have I heard any of my fellow employees do it). We're all there for the same goal, but each service has a different job. I can understand why it's "legal" for an EMT with the fire dept to cancel EMS resources, and why EMS can cancel rescue resources, but what's so special about doing it? Doesn't it just make sense for the fire chief to decide what resources are needed for fire/rescue, and EMS command decide what EMS resources are needed? Why does it always seem like a race to be the first person to get on the air and cancel? I understand the problem is the ego thing, but I really don't see why. Who can possibly benefit by cancelling a resource 2min before a member of that service arrives? So I ask again, what's the big deal? Egos in emergency services… Never! We are all just one big happy family. Stand by…Reality Calling… Yes DrFocker you make many a fine point with you comments. Ego, officers offended because someone dared to assume a leadership role in their absence, and just plain my “radio” is bigger then your “radio”. I doubt we can change attitudes overnight, but this is a start. Score one for Teamwork! ;D
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