Dear Sirenhead: I work with a partner who's anti-rescue. I've taken rescue courses outside my department, but he hasn't. His attitude is that he hired on the job to take care of patients-not rescue them. He says rescue falls under the fire department, and his EMS role is to stand by with gear and a stretcher, ready to receive trapped patients once they're freed by the fire/rescue crew. He also says his size-5' 8" and 250 lbs.-prohibits him from "crawling around on his belly" to enter cars, particularly those not sitting on all four wheels.
His negative attitude hadn't ever hurt a patient, so I never made a big deal of it. But recently he refused to help me on scene at a two-vehicle collision. The crash occurred at 4 a.m. in a rural area of our ambulance district. After a high-speed collision, one vehicle launched off the roadway into a large ditch. It came to rest on its roof, with the driver's side resting against the slope of the ditch.
We were the first unit on scene. My partner went to the vehicle that remained on the roadway after the collision. I went down the embankment to assess the second car and its occupants.
When I reached the vehicle, I could hear the victims moaning and moving around underneath. The driver had severe facial lacerations. The passenger had a nasty head injury, was unconscious and had a compromised airway because of the position of her body in the wreckage. But the vehicle was unstable-teetering every time I touched it.
When the driver of the car on the roadway said he wasn't injured, my partner joined me in the ditch. When I told him we needed to improvise and stabilize the vehicle to get inside, he refused to help me. He said we should wait until the local fire department arrived.
I asked dispatch for a fire department ETA and was told they hadn't yet signed en route. I told my partner we couldn't wait. He again refused to get involved and stood by as I worked to stabilize the car and gain access so I could administer care to the two people trapped inside.
It's a good thing I didn't wait because it took the volunteer fire department 10 minutes to get personnel to their station and their rescue truck manned. Then it took another 12 minutes for them to reach the scene. Twenty-two minutes is a long time to wait on scene and not do anything to assist the patients trapped inside.
I had to improvise cribbing materials to stabilize the vehicle. I found two cinder blocks in the ditch that fit perfectly in the space between the hood and the ground. Because the vehicle had landed upside down in a ditch, one side of its trunk rested closer to the ground than the other. I shoved a sturdy Pelican case in the small space on the left side of the car to fill the void between the ground and the trunk surface. To fill the 3' void on the right side of the vehicle, I raised our stretcher to the height I needed, wedged it under the large space and lifted the head end of the stretcher to secure it in place.
I was able to get inside, control all bleeding and open the unconscious patient's airway. After the rescue was over and we returned to the station, I called our director at home to express my concern about my partner's lousy attitude and failure to help me stabilize the car.
He told me rescue isn't part of our EMT or paramedic job descriptions and our service doesn't require personnel to take rescue training beyond the rescue-principles class offered in the local EMT program. Therefore, he couldn't discipline the guy. Now I feel helpless and mad. What can I do to correct this awful situation?
-Matt S. via Internet
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First let me tell you the entire cast of Survivor couldn't have improvised the cribbing job any better than you did. I can understand your portly partner's reluctance to perform beyond his training level, but there's an unwritten understanding among partners-we always help each other. He could've at least retrieved the items you needed to stabilize the car.
I'd take your chubby partner behind the woodshed and tell him the next time he refuses to help stabilize a car at an emergency scene, you'll knock him senseless and use his rotund rump for cribbing.
Sadly, many non-fire-related EMS services don't prepare their personnel to perform basic rescue procedures. Although I rarely have to wait longer than three to four minutes for a rescue truck to arrive in my territory, occasionally I've had to break out a rear window to reach an unconscious victim.
Ask your director to let you get more involved in arranging rescue orientations for interested personnel. Then ask your fire departments to involve your crews in rescue training and drills. Once others jump on your rescue bandwagon, you'll find the reluctant rescuers will suck up their pride and get involved as well.
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