Jumpline magazine February 2025 - Flipbook - Page 48
48
ROC, Paper, Trauma Sheers
The ability for us to provide pre-hospital care should not be taken for granted. It is a privilege afforded to us by
our county commission. It is dif昀椀cult to
see where we have fallen short as an
organization and in some cases not providing optimal care to our citizens.
It was the call heard around the country. One of our units responding to a
reported “dif昀椀culty breathing.” Despite
only being a mile away and that it was
after midnight, the response time was approximately six minutes and 40 seconds. The actual travel time was just under 昀椀ve
minutes. The patient had activated their “medical alert” button.
The patient was pronounced DOA.
The reason the call made national attention is because the
family 昀椀led a wrongful death lawsuit. This was attributed to the
response time and that the report stated the patient was “cold
to touch, apneic, and pulseless, EKG asystole.” The EKG was
pulseless electrical activity at 20+ beats/minute. The department and employees were cleared of the lawsuit due to “quali昀椀ed immunity.” The doctrine of quali昀椀ed immunity protects state
and local of昀椀cials from individual liability unless the of昀椀cial violated a clearly established constitutional right.
We all work under the license of the medical director. This is why we do not have to request orders to administer medical care. That is why we
have protocols. Unlike the days of “Emergency”,
when Jonnie and Roy had to consult Rampart for
orders.
Abiding by the protocols protects you. Sovereign Immunity
protects you, especially in a wrongful death action. MDFR was
involved in another lawsuit related to the death of a patient.
The family had arranged for the patient to be transported to a
hospital, which was not the closest to the scene. The crew took
the patient to the closest hospital because the patient was in
cardiac arrest, and therefore unstable. The family sued MDFR,
as well as the closest hospital. The court ruled in our favor
because the report clearly showed the
patient to be unstable.
Paul D Blake, Ret.
Treasurer
it’s law enforcement body cameras, the baby monitor within a
home, the doorbell, or a cellphone video from a citizen.
The department has begun to use the disciplinary process to
hold personnel accountable for their actions/inactions. This is a
stark departure from the days of errors being a remediation and
“CEU” opportunity. While I do not necessarily agree with this,
I will say that it is very hard for me to support appealing these
actions before an arbitrator, especially when they are supported
with video footage of incidents where “we should have done
better.”
I believe we do an inadequate job educating our personnel
in pre-hospital care. When you look at our budget and number of calls, it’s fair to say that while EMS is most of them, the
commitment to EMS is not re昀氀ected that way in it. We have
relied on Vector Solutions to be our mechanism to attain CEUs.
There should only be so much. Updates to the protocols should
be done in a manner that ensures persons reviewing that they
understand them. Changes to procedures and introduction of
medications and/or equipment must be done in person.
At the same time, individuals need to take some form of ownership for their skills and education. We have a very young
workforce, in terms of time in the 昀椀re service. We have varying
levels of education and experience. We have no mechanism
that ensures competency on an annual basis, whether it’s in
suppression or EMS. Perhaps a task book for each uniformed
employee that documents critical skills to be performed on an
annual basis. Those that do not demonstrate knowledge of
their ability, will be required to do so. Whether it’s stretching
a jumpline or performing an intubation, the 昀椀rst time it must be
done should not be the 昀椀rst time it has ever been done.
When we fall short, it should be seen as an opportunity to
learn and improve. What was overlooked, and what tools or resources might have made a difference if applied? In my opinion,
some patients present with signs and symptoms that cannot be
addressed, even in a hospital setting. Unless we share these
cases across the entire department, we risk repeating the same
outcome in another unit or location. You can’t identify someone’s gaps in knowledge until those gaps become evident.
Ensuring your care is in line with departmental protocols and rules keeps
you out of trouble. You may still get
subpoenaed and sued, but you are protected if your care and treatment comply
with our rules. Back in the day, we didn’t
have easy access to the Medical Operation Manual. It was a printed book that
was found in the stations and on the
units. My general rule was whether my
actions would pass “the headline test”
meaning if the call made the newspaper, did my actions and that of my crew
pass public scrutiny. Nowadays, it has
become viewer comments on a social
media page. Everything you do has
the potential to be recorded. Whether
We also need more oversight. It isn’t
solely on EMS to provide it. There are
simply too many calls to review, and
hundreds of thousands of reports. Four
to 昀椀ve on duty EMS Captains and a QA
Committee cannot adequately review all
the reports in my opinion. We need to
昀椀nd a way for the unit’s captains to review reports of the of昀椀cers assigned to
their units and Battalion Chiefs should
be reviewing the reports of their captains, including response times. Not just
EMS calls either.
There was a time when Rescue Captains reviewed all medical reports. That
is the reason for the 15 minutes of
overtime, before and after each shift.
Because of the time it took to get the
March 2025 | JUMPLINE Magazine
