Pretty sure the accuracy of that statement is on a case by case basis. :rolleyes:
My understanding of firefighting is that there are strict protocols and procedures in place and they depend on everyone following the script. Firefighters can’t just run off on their own. They have to work as a team, including working with other departments. They can’t just wing it because it’s an emergency. Their whole careers are a series of emergencies. They have to keep their heads and follow procedure.
Life is not a Shonda Rimes show. Benching them to get their attention is the right response.
If their truck was equipped with oxygen, they could have supplied that without trying to transport her anywhere.
The EMT and the ambulance are designed for highly focused work: getting people stable. All those millions of dollars and decades of training at a hospital are spread across thousands of functions. It’s really apples and oranges.
I’d like to hear a doctor chime in, but it’s always been my understanding that when people are crashing, the guys in the ambulance can do what anyone would do–it’s not rocket science. AND they are on the radio so that the minute they pull in, specialized hands are ready to take over and know exactly what’s going on. That’s not the case if a person without EMT training is the one doing the calling in.
And what might the firefighters have been charged with had they stood there and watched the child die or sustain a life-threatening injury while seizing?
Charged with? Like in legal charges? … you know what? This is will be faster if you tell us what law you think the firefighters would have been breaking if they had waited for the ambulance?
Suppose the child had died en route to the hospital. Would you still be supporting them?
The firefighters were not qualified to perform the medical services they did. Fortunately, they and the child were lucky. But that doesn’t dismiss the fact that the firefighters shouldn’t have done it.
Who knows if monstro was thinking of criminal charges when he said that they probably wouldn’t be charged with anything. But the case to which he linked involved a man who collapsed across the street from a DC fire station and did not receive timely aid from the firefighters. All five firefighters who were involved in the incident faced trial boards; three were exonerated as relying on bad information given by one other. One was terminated, and the fifth, the lieutenant who had supervisory responsibility that day, avoided consequences by retiring before an adverse finding.
So there were no criminal charges filed, and, indeed, likely no criminal law broken. But there certainly were job consequences.
First, the best thing for seizures is to do nothing. Clear space so the person doesn’t hurt themselves, prevent headstrikes, etc.
Monitor breathing. Sometimes a temporary stoppage of breathing occurs.
Some of the stories say she was turning blue, some said she was breathing and had a pulse.
She was reported to have vomited. She could have aspirated some of the vomited material thus blocking the airway.
If that was the case or she stopped breathing, oxygen alone would not be enough, she would need forced respirations.
Since she regained good color en route, she was either breathing all along or she resumed after the seizure ceased.
It amazes me how little information is needed for making life & death decisions for other peoples children by many folks in this thread.
I did not see where the parent told the VFD guys to not take her but they did take her against the parents expressed wishes.
Rules and regulations are frequently the response to a single case resulting in a lawsuit.
A firetruck transports a pt to the hospital 9 times and the pt is saved, everybody is happy.
The 10th time the patient dies and a lawsuit results. New rule, no transporting.
The firefighters probably did the right thing.
PBS story about a JAMA study.
Fortunately a good outcome in this case.
I am with this.
If we ask people to use their best judgment, they will occasionally make mistakes. It seems sometimes in today’s society, we would prefer that everybody follow rules and algorithms all the time. But is that really better? Rules and algorithms give people “legal cover” and, if well written, raise the floor of poor performance, I suppose; at the expense of dropping the ceiling on good performance.
If these guys were wrong, they should be “given a talking to” and the problem with their approach should be used as a “teaching moment” for the other firefighters.
But whatever- they must have a rule calling for suspension. Good robot!
I checked in with my husband, a retired paramedic and firefighter. He made a face and said, “Eh, sometimes you make the call and you take the punishment later.” He’s not outraged they were suspended, nor upset the suspension was lifted. Everyone did everything right, from the call to take the kid on O2 without waiting, to the supervisor that said they shouldn’t have done that, to the dad that stood up for the firefighters.
My husband said twice in his career he transported someone without waiting for the ambulance. And twice he got his wrist slapped for it and didn’t argue.
An ambulance has lots of equipment that a fire truck doesn’t have, starting with a litter that, depending upon the call, can have the patient sitting up, lying flat, or even in Trendelenburg (feet higher than the head) position. In an ambulance, the patient is secured to the litter, which is locked into the floor. The other seats are designed for the EMT/Medics to sit & be able to reach the patient. Additionally those seats have seatbelts so that those attending the patient are secured in the case of an accident.
Kids have a nasty habit of compensating really well until they can’t anymore & then crashing really quickly. First, it sounds like she didn’t really fit in the seat, by the description of piling coats around her. If she crashed they had no way to lay her supine (flat on her back) secured to begin CPR. Ambulances have suction units (on-board & portable). If she vomited & aspirated some of it, an an ambulance could have put her supine & suctioned her immediately.
Alright, by protocol, they shouldn’t have transported her. However, at first glance, they made a judgement call that she needed immediate medical care & an ambulance wasn’t available. Don’t hang somebody for that. However…
If this is true, they screwed up…big time & should rightly have their asses handed to them. Given that neither article talks about them being EMTs, one has to assume that they’re not. But even if they are EMTs handing off to another vehicle explicitly built for transporting patients & that has more equipment to treat said patient in inexcusable!
I don’t think we have enough information to really know. Did the ambulance get to a meeting place when they were 10 minutes away from the hospital (3 minutes away from the scene?) It doesn’t seem likely, if the original eta was 10-15 minutes.
Or did the EMTs realize their buddies were going to get in trouble, and want to stop them and transfer the child half a block away from the hospital to avert the situation that ultimately occurred? If that’s what we’re talking about, I’m glad they didn’t stop and put the child at increased risk to save their butts.
How near the hospital is “near the hospital”, and what was the rationale for transferring her to an ambulance at that point?
Nope, and it’s not even close. You know that ghastly high mortality rate of new mothers? We radically reduced the maternal mortality rate once doctors started washing their hands between deliveries. MRIs definitely haven’t saved nearly as many people.
The risk of a child dying from a seizure is quite small. The only people who die are those who do not stop seizing or who aspirate. Neither happened in this case although if either had, she would be much more likely to die in a fire truck that is incapable of intubation and does not have the ability to give emergency antiseizure medications. The truth is that they didn’t save her life and likely only added to the risk of harm. Seizures are scary but just because the parents felt better with her being rushed to the hospital does not mean that it was the best course of action. IMHO they were wrong and they were lucky.
She was turning blue and her left side wasn’t moving. Something more than a simple seizure was going on.
If she was turning blue because she wasn’t breathing then transporting her could have killed her. Protocol would be to do CPR to maintain oxygenation rather than transporting a possibly hypoxic child which could have caused permanent brain damage. I still think they were wrong.
If I was in that ambulance (& I started running EMS when the first two digits of the year were 1 & 9), & I hear that FD thinks she’s so bad that she needs to be at the hospital NOW, my pucker factor goes up. I can tell you from experience that if while we were enroute we got an ETA request coming from County (essentially the original caller) that was one thing, but if it came from PD on scene, that meant step it up.
Even if he has no medical training, a fire dept captain is not at his first day on the job; he’s seen a bad call or two in his time in the FD. If she’s that bad that he decides she can’t wait, then she needs to be turned over to a better level of care ASAP.