Do all orgs transfer people to ED?

sgthighway

Somebody told me that Civil Defence do not transport injured people to hospital. I told him he was talking through his ____. Is there any restriction on some organisations transporting an injured person to the ED? Maybe he was mixed up but I presumed the likes of Civil Defence and Red Cross can provide transport.

palmtrees

Of course they can - I've done 7 this year with civil defence already.

When you arrive at a duty you call ambulance control - they will then list you as an available resource and call you if they need you. If you need ALS/paramedic backup then you can call them too.

There was some confusion about this when it came in first. People thought we had to call control and get a NAS/DFB resource out to us if someone needed transport to the ED. This was never true, it was put in place to help the vols work closer with the 999 ambulance services.

We've called for ALS on many occasions and to be honest, even in those cases, an AP will usually come on our ambulance with their drugs kit and come with us in favour of moving the patient to their ambulance.

ectoraige

There's best practice, and best practicable practice...

HSE guidelines (IIRC) are that serious/life-threatening calls are to be transported in a suitable ambulance and accompanied by at least one paramedic and should you fail to meet this criteria you should instead wait for HSE assets. In practice, the controller may request the vol to transport directly, or advise them to wait until ALS is on scene. As palmtrees says, if the patient is already packaged in the back of a vol's ambulance, then the P/AP isn't about to insist they first move the patient to another vehicle.

To transport omega (non-urgent) cases, you aren't required to have a paramedic, so you could just roll up to the Emergency Department, but it would be polite to give them a heads up. In theory control might request you wait for HSE resource anyway, but in practice, if they are confident the crew are acting responsibly, they won't have a problem with it. Part of acting responsibly is letting control know when there is a crew on the ground at an event so they can be called upon to assist if something is called in nearby.

Note also, that some paramedics are also active members of the vols so in that case they could transport anyway. They'll still be calling ambulance control to let them know what's going on.

timmywex

sgthighway wrote: »

Somebody told me that Civil Defence do not transport injured people to hospital. I told him he was talking through his ____. Is there any restriction on some organisations transporting an injured person to the ED? Maybe he was mixed up but I presumed the likes of Civil Defence and Red Cross can provide transport.

In general no.

However sometimes clinical levels dictate that a particular org at a particular event can not transport. For example an EMT attendant is required, if one is not available then they cannot transport.

Likewise sometimes it is too high a risk to leave an event without cover to transport a non urgent patient, so a NAS/DFB resource may be requested.

sgthighway

Thanks for clarifying.
Yes we need an EMT at a minimum to Transport too.
Yes if our CPGs say call somebody higher than who is at the event we do so.
Once we had no EMT and we made it clear to the Event Organisers about the possible scenario. Luckily they were a regular Customer and we were close to Ambulance Base if needed.

I don't like people bashing other organisations hence I put my question to an open group here.

palmtrees

If we have a dual paramedic crew or higher, more often than not we will get a call from ambulance control to respond to a 999 call.

What are your thoughts on alerting the ED as a vol? I haven't done it ever, but there are some times I regret not doing it.

My opinion: Generally speaking I think if we need to use blue lights we, as EMT's, should be requesting ALS and/or pre-alerting the ED. There are some other cases where a pre-alert may be indicated but blue lights are not necessary (if the patient is an infant, or a mental health emergency, for example).

sgthighway

The main reason you contact Ambulance Control is to let them know there is an Ambulance there because they could get a Serious Call in that area.
e.g. You were on Duty at a Hurling Match in the Local GAA Club. You arrive there 10 minutes before throw in. Meanwhile 2 lads have been playing squash inside the club house for the last hour. They don't know what is happening outside. One of them collapses. The other guy rings 999. Imagine a HSE Ambulance pulling up outside to see a Volunteer Ambulance outside and the poor lad flat out inside. The same is to be said for County Fairs, Festivals etc.

Make the call and let them know where you are and how long you will be there for. It could save a life.

RiderOnTheStorm

I am with a sea rescue org (comes under Community Rescue Boats Ireland umbrella), and we have a rescue ambulance (crewed by EMTs). Its our understanding that we are not allowed to transport a patient to ED. We regularly have to hand over our pt to an NAS crew, even though the pt is packaged up safely and on a spinal board (we often have trouble getting our board back!). Two things occur to me here, that might explain why we dont transport. (1) none of our pt's (so far) have been life threatening .... if its a matter of life & death, then anyone can drive to the ED in any vehicle they want .... and (2) we dont inform ambulance control when we are doing first aid cover. I imagine that (like palmtrees says) if you declare yourself to NAS before cover / shift and then you get dispatched by NAS, you are therefore allowed to bring patient to ED.

limericklad87

Would it be a case that ye are not allowed transport is because ye are not an ambulance service maybe...... Just wondering

stevie06

RiderOnTheStorm wrote: »

I am with a sea rescue org (comes under Community Rescue Boats Ireland umbrella), and we have a rescue ambulance (crewed by EMTs). Its our understanding that we are not allowed to transport a patient to ED. We regularly have to hand over our pt to an NAS crew, even though the pt is packaged up safely and on a spinal board (we often have trouble getting our board back!). Two things occur to me here, that might explain why we dont transport. (1) none of our pt's (so far) have been life threatening .... if its a matter of life & death, then anyone can drive to the ED in any vehicle they want .... and (2) we dont inform ambulance control when we are doing first aid cover. I imagine that (like palmtrees says) if you declare yourself to NAS before cover / shift and then you get dispatched by NAS, you are therefore allowed to bring patient to ED.

I'd imagine ye are not allowed to transport as you are not operating for a PHECC approved organisation. you can only operate to EMT level if you are doing so on behalf of a PHECC approved Organisation who privilege you to work as an EMT.

limericklad87

EMTs operating outside a PHECC organisation are pretty much out on their own....

RiderOnTheStorm

Correct, we are not an ambulance service (we are told regularly that we are a 'rescue ambulance'). I guess thats why we dont transport.

So, answer to op's question 'do all orgs transport?', is No. The sea rescue / CRBI vol org's dont, Red Cross and Civil Def do .... Not sure about mountain rescue or cave rescue orgs. There are more vol emergency service orgs out there than IRC & CD.

limericklad87

I think the only voluntary organisations that transport patients to hospitals would be those abiding by PHECC cpg and recognised as such.

I would think the likes of Mountain Rescue etc would bring a casualty to RV point and handover to HSE.

Never heard of a rescue ambulance... That's New to me

And what events do Ye do first aid cover at?

RiderOnTheStorm

limericklad87 wrote: »

And what events do Ye do first aid cover at?

Football matches, horse races, running /cycle race and large public events like food fairs and festivals. Anywhere local that we are invited to.

Red Dwarf

RiderOnTheStorm wrote: »

Football matches, horse races, running /cycle race and large public events like food fairs and festivals. Anywhere local that we are invited to.

You cannot practice as a practitioner unless all elements of the PHECC Triple Lock are in place. "Credentialing, licencing and privileging will be incorporated into the PHECC practice or context for practice regime. This generates a "triple lock" situation where all three requirements must be in place in order to legally practice."

However, there are a lot of practitioners providing event cover (paid & voluntary) with non CPG approved organisations.

limericklad87

Is there many rescue ambulances around operating in this capacity

Mycroft H

I've heard of this before, alerting NAS control that we're in the area. I tend not to do it. It's not as if we can leave the Racecourse to go attend an arrest down the road. We're paid to be on site and provide a service, not to go running off the country covering the HSE

palmtrees

Mycroft H wrote: »

I've heard of this before, alerting NAS control that we're in the area. I tend not to do it. It's not as if we can leave the Racecourse to go attend an arrest down the road. We're paid to be on site and provide a service, not to go running off the country covering the HSE

Fully understand where you're coming from. Our instructions are to call them, but to actually think before blindly responding to a 999 call. If there is a cardiac/respiratory arrest and I'm covering a boxing tournament - there's no doubt that I'll go to the arrest. One of our crews got pulled from a motorcross duty to attend a stroke patient as there were no HSE resources available. It happens.

That said - for an RTC, seizures, diabetic emergencies, etc. I will be thinking about whether or not it is reasonable for us to respond given the duty we are covering. Generally speaking, it will be ok...we have a responsibility to the organisers of the duty as well as the public so it's a decision that needs to be thought out.

Mycroft H

palmtrees wrote: »

Fully understand where you're coming from. Our instructions are to call them, but to actually think before blindly responding to a 999 call. If there is a cardiac/respiratory arrest and I'm covering a boxing tournament - there's no doubt that I'll go to the arrest. One of our crews got pulled from a motorcross duty to attend a stroke patient as there were no HSE resources available. It happens.

That said - for an RTC, seizures, diabetic emergencies, etc. I will be thinking about whether or not it is reasonable for us to respond given the duty we are covering. Generally speaking, it will be ok...we have a responsibility to the organisers of the duty as well as the public so it's a decision that needs to be thought out.

I'll have to clarify what the org/regional policy is for this. As a unit we tend not to do it.

iceage

It make perfect sense to notify Control that you are covering a rally, boxing tournament etc, what if you have a cardiac arrest, seizure, diabetic emergency at your event and You need ALS to attend you?

If you have informed Control of your presence it makes the whole process so much simpler to deal with.

palmtrees

iceage wrote: »

It make perfect sense to notify Control that you are covering a rally, boxing tournament etc, what if you have a cardiac arrest, seizure, diabetic emergency at your event and You need ALS to attend you?

If you have informed Control of your presence it makes the whole process so much simpler to deal with.

This can be hit and miss sometimes in my experience. Last time I called they went through the whole 999 call taking process - ALS had actually arrived and she was still asking me questions! The only other time I requested it there was no hassle at all

Mycroft H

I've rang control on one occasion requesting the assistance of an AP. No issue. We didn't pre-alert them. On that occasion we met the en-route and the AP travelled with us.

icv1111

When we decide somebody needs to be transferred we ring ambulance control and let them know, who then pass on the message to the ED or AMAU of our ETA.

There was a time when we used to ring the hospital directly but we stopped that due to the ED not answering the phone 9/10. The nurse not being interested when they hear its a vol, and the nurse not passing on the message to anybody that we're on the way so we still get grief for showing up unexpectedly.

We were encourage to ring ambulance control to let them know we're at a certain event. I used to do it whenever it was a larger event or say covering something around the town.

But I found that even though we did this they never called upon us. There has been a few times when I informed them, then something happened only a few hundred meters away, and they never called us, instead a NAS ambulance would rock up and we'd have no idea. Or a member of the public would come to us and let us know about a patient, AFTER they called 999 and we hadn't heard anything from ambulance control.


Which I suppose is fair enough. If there's a NAS resource nearby and it's not life threatening then theres no real panic to get us there aswel.

Cahill

I would be wary in honesty, of attending a call by 999.

I'm involved in two orgs, and its only occurred in one of them that I am aware of, where contacting control is done the odd time. Two members of the unit at emt level would call control to inform them we're on a duty (usually race track or football event). Logistically although it ''sounds'' cool to be available for 999 response, we couldnt realistically/ethically leave the event we're at.

I was told in the past that if the ambulance isnt available the match couldnt go on... Realistically a client is paying for a service, so its precommited and we cant just leave to go for another call?

Emt can only transport minor cases, otherwise a paramedic or above is needed, but the NAS is unlikely to call a vol for a minor injury/illness and again, if they did, you as an emt on duty for your organisation by a paid client isnt outweighed by the likes of a fractured leg down the road?

I'd be hesitant on weighing the pro's and con's of the topic without knowing the orgs policies, but based on rudimentary issues here, I'd have to go with staying on scene, if there was an injury at your duty, serious or not, while your ambulance and crew was attending a 999 call, the organisation would not look impressive... Not fulfilling your duty as a paid service..


As for transports, I've crewed on transports to the ed with serious injuries (or suspected).. Only once if at all, do i remember the ed being contacted before hand.