Code 3 IFT?

[RedAirplane]

Every few weeks I'll see the IFT ambulances running with lights and sirens.

Does that happen only when something goes wrong, or are there ever "scheduled emergencies?"

 

[DesertMedic66]

It can be a mix of everything. A local IFT company who has the NICU contract with one of our hospitals has in their contract that they will respond code 3 to the hospital to pick up the equipment and staff.

 

[DieselBolus]

That's highly variable and depends on the company. IFT companies run SNF->ER all the time. Often its abnormal labs and doesn't require a code 3 tx.

However, an AMS call that turns out to be positive on the Cincinnati sometimes get transported BLS because their ETA to definitive care is close enough to ALS's ETA to the patient.

Also, CCT interhospital transports can often be Code 3, such as an active brain bleed to a neurosurgical capable hospital. Rendezvous with air crews can also frequently be code 3. If you know that a company holds no hospital contracts, it can be pretty suspect.

That said, running a code 3 code 7 isn't unheard of.

 

[Ewok Jerky]

It sure happens. Code 3 pickups. Transplant transports, team transports, emergent pickups from fixed/rotor wing aircraft and your run of the mill Code 3 transfers for whatever. Plus sometimes the poop hits the fan. And then other times your late for pickup :/

 

[Angel]

or the have an overzealous EMT on board who is panicked or just wants to brag about going code 3.
the only code 3 IFTs Ive done is for confirmed brain bleeds to a stroke receiving facility, (45-50 mins away) and even then, it doesnt save THAT much time

 

[DieselBolus]

or the have an overzealous EMT on board who is panicked or just wants to brag about going code 3.
the only code 3 IFTs Ive done is for confirmed brain bleeds to a stroke receiving facility, (45-50 mins away) and even then, it doesnt save THAT much time

Oft it's protocol to go loud and blinky for any known threat to life and limb, regardless of known clinical outcomes.

 

[wtferick]

Some IFT companies have back up 911 to some cities

 

[Angel]

Oft it's protocol to go loud and blinky for any known threat to life and limb, regardless of known clinical outcomes.

I know, but for the sake of everyone's safety, if its on a highway with no traffic, id be fine if we just went at normal speeds and got there safely than someone going pedal to the floor because they can. but i dont make the rules so...it is what it is

 

[DieselBolus]

I know, but for the sake of everyone's safety, if its on a highway with no traffic, id be fine if we just went at normal speeds and got there safely than someone going pedal to the floor because they can. but i dont make the rules so...it is what it is

Sounds like ****ty personal judgement, commensurate with the other poor professional conduct you're experiencing at your service.

Code 3 should never mean faster, it's just a loud and bright suggestion that regular traffic should yield. Anyone who drives otherwise is an *******.

 

[Jim37F]

Only time I went Code 3 for an IFT Company was on a CCT unit transporting a STEMI across town to an open cath lab. Since we took the sending ED Doc with us I drove the exact same route back afterwards....the ~10 min Code 3 transport turned into an over half hour drive back thanks to dense urban traffic and red lights every 5 feet (or so it felt like lol)

 

[COmedic17]

Back when I did IFT we would pick people up from urgent cares/clinics who were having stemis, etc. We also had all contacts to nursing and rehab facility's in the city. They called us, not the fire dept. saw a TON of cardiac that way. Also you would be surprised how many people get shot/stabbed and drive themselves to a hospital that doesn't have a trauma center and they have to be transported out.

 

[RedAirplane]

I guess the follow-up to my question is: if its emergent enough to go Code 3, why would the sending facility not call 911? (It seems dumb to wait 30 minutes for Company XYZ to show up and then save 18 seconds by going Code 3 across town, when the fire ambulances are practically next door).

 

[DieselBolus]

I guess the follow-up to my question is: if its emergent enough to go Code 3, why would the sending facility not call 911? (It seems dumb to wait 30 minutes for Company XYZ to show up and then save 18 seconds by going Code 3 across town, when the fire ambulances are practically next door).

Emergent IFT services such as CCT contracts with guaranteed response times exist for a reason. If you're calling 911 in a situation covered by emergent IFT contracts, you're unnecessarily drawing resources out of the 911 service. Some county protocols even specify that 911 should only be as an absolute last resort for interhospital transfers. Try finding me a street medic that would be happy to run an IABP call, or a patient on multiple anticoagulants, antiplatelettes, pressors, and nitro...or a bolted patient with multiple invasively monitored parameters when CCT resources exist.

I absolutely understand where you're coming from, it makes sense that only the legit 911 contractors and fire should be running code 3, but EMS is much more complicated than that.

 

[COmedic17]

I guess the follow-up to my question is: if its emergent enough to go Code 3, why would the sending facility not call 911? (It seems dumb to wait 30 minutes for Company XYZ to show up and then save 18 seconds by going Code 3 across town, when the fire ambulances are practically next door).

Because the city has contracts, all facilities, including nursing homes, urgent cares, etc had us. Residents had the fire dept. we had stations throughout the city much like fire did.

 

[Angel]

Sounds like ****ty personal judgement, commensurate with the other poor professional conduct you're experiencing at your service.

Code 3 should never mean faster, it's just a loud and bright suggestion that regular traffic should yield. Anyone who drives otherwise is an *******.

say what now? you dont think its important to get an active head bleed to a neuro facility in an expeditious but safe fashion?

ETA: NVM, after seeing a couple of your posts I can see you make it your purpose to troll and annoy people. guess who else just made my ignore list...bahaha

 

[gonefishing]

When I was an EMT use to go code every once in a while if on an ift call. Things happen. Say your 5 out from the ed and patients on your gurney are you really going to wait 6-10 minutes for als to do a work up etc and you are now into the 15-20 minute range. You could of been at the ed.

 

[Jim37F]

I guess the follow-up to my question is: if its emergent enough to go Code 3, why would the sending facility not call 911? (It seems dumb to wait 30 minutes for Company XYZ to show up and then save 18 seconds by going Code 3 across town, when the fire ambulances are practically next door).

I'll admit that when I worked for private ambulance I sometimes wondered the same thing...Now that I work for the FD, and our base hospital likes to call us for emergent transfers (I've responded there for STEMI and trauma transfers) I wonder why they call us as opposed to the dedicated private ALS unit.

Yes we have a station two blocks away...but that also happens to be one of the top two busiest ambulances in our entire regional dispatch system, routinely getting ~15 calls in a 24hr period. There's absolutely no guarantee our closest available unit isn't across town 20 min away Code 3. And if you happen to call when we're already slammed...then you're pulling a neighboring city's 911 unit on mutual aid for your IFT. Meanwhile you already have a private ALS unit sitting across the street posted awaiting the scheduled discharge off the 3rd floor. Trust me..we really don't care (and probably won't even notice) the private ambulance going Code 3.

If it's an ALS level transfer than the patient is probably more stable in the hospital under the doctor's care waiting for the private medic (who btw, went to the same schools, and passed the same tests to be a medic as the fire guy did) than he is being rushed into the back of my box simply because it's red. While our fire medics are probably slightly better (by virtue of more experienced at it) at showing up to someone's house (or an accident scene) and doing initial stabilization, treatment and transport lasting all of 10 minutes, conversely I'm betting the private medic has more experience taking a patient with an established advanced treatment plan and managing them for 30-60+ min transporting to whichever specialty center you want.

 

[Angel]

you should have to go code for that, but i get what youre saying. some counties have it where if youre 10min or less away from the ER you just take the patient. I know with EOAs things get complicated but the patient should come first.

 

[DieselBolus]

say what now? you dont think its important to get an active head bleed to a neuro facility in an expeditious but safe fashion?

ETA: NVM, after seeing a couple of your posts I can see you make it your purpose to troll and annoy people. guess who else just made my ignore list...bahaha

Though I made an ignore list,

I apologize, I confused you for another member with a similar username having issues with professionalism at their agency.

I do think getting neuro patients to a capable facility in a timely manner is important, but not at the expense of provider safety like many people drive.

 

[Ewok Jerky]

IFT EMTs and medics are (read: should be) just as proficient at assessing treating and transporting as "street" medics and EMTs. There is a lot of crossover with people who work two jobs, one IFT and one 911. I would actually bet money that there are more IFT EMSers than 911 across the country.

As for response times, a good IFT will have units posted near busy hopsitals. And an IFT system can absorb several out of town transfers at the same time while a 911 system would crumble under the weight of multiple IFTs. When I was on a ALS IFT unit we were dispatched once or twice a week for a Code 3 response to a private office or ED for emergent transfers. Not everyone having a heart attack or stroke calls 911, some go see their doctor.