Code 3 riding, how is it done?

[Ped101]

Hey people!

I was just really curious how the code 3 riding is done in other places,

here we go to each call code 3, regardless of it, and then after assessment, we decide which code to transport patients

How is it done in other places?

I hear you dont go code 3 on highways, why?

(btw im not an ambulance driver so i never really paid attention to those things, much rather ride in the back xD)

 

[JPINFV]

Code 3 response decisions are made either through the use of dispatch protocol (evidence based or otherwise), hairs on the back of the dispatcher's neck (dispatcher's discretion), or by protocol (some places do not allow non-911 ambulances to respond code). Transport decisions are either made through protocol/policy (based on complaint and findings. Also some places transport everyone code 3 regardless of assessment) or by the attendant's discretion.

For the highways, it really depends. If it's a limited access divided highway (i.e. freeway), then a lot of areas do not use lights and sirens because either the traffic pattern is so packed and slow that no one has anywhere to move or because traffic is moving so fast that it's faster to not use lights and sirens. Traffic flow is fluid, just like a gas or liquid. The only difference is the relative size of the individual particles (cars vs molecules). Having all the particles lined up and moving relatively the same speed (laminar flow) is faster and safer than trying to get past cars moving out of your way (turbulent flow).

 

[VentMedic]

Traffic flow is fluid, just like a gas or liquid. The only difference is the relative size of the individual particles (cars vs molecules). Having all the particles lined up and moving relatively the same speed (laminar flow) is faster and safer than trying to get past cars moving out of your way (turbulent flow).

Wow! Did you learn that in your science classes?

You've also described the basic theory behind ventilating a patient and fluid administration.

How I wish others in EMS would see how much every day use they could get from college level classes in the sciences.

My apologies. I had to hijack the thread for an education plug.

 

[fortsmithman]

This is what my service uses

Code 1 Immediate life threatening

Code 2 Non life threatening

Code 3 Assist fire dept

Code Medevac Medevac (self explanatory)

Code Zulu Pick up dead body

Our code one is equivalent to your code 3. We use lights and siren for code 1 and sometimes code 3 and code medevac. We do not use lights and siren for code 2 or code zulu. We use lights only when on the airport tarmac due to airport regulations.

 

[Shishkabob]

Priorities 1-2-3

Priority 1 gets code 3 (L/S)-- Life threatening emergent.
Priority 2 is up to responding unit as how they will get there. Emergent non-life threatening
Priority 3 is drive like civilians. No L/S

 

[46Young]

NYC - Priority 1-6 are lit up, 7-8(EDP's, minor injury, and such) are not. Fairfax - almost all responses are priority one(lit up). In both places, we determine the appropriate txp category by the severity of the pt. Time sensitive pts such as CVA's, MI's, serious trauma, APE, any shock, and legit resp issues will be txp'd hot. All others are taken slow, as it is unnecessary to endanger ourselves, the pt, and civillians.

 

[WolfmanHarris]

My service, and any other Ontario service that uses MOH Central Ambulance Communications Centres and their crappy DPCI2 system.

Code 1: Deferrable (never dispatched this was, but often return priority)
Code 2: Scheduled transfer (uncommon due to private IFT companies)
Code 3: Prompt
Code 4: Urgent (only code that will have L&S and that at total discretion of crew)
Code 8: Stand-by

The other codes aren't relevant.

Now unfortunately the dispatch protocols here make a large percentage of calls Code 4, making the process somewhat meaningless. I am almost always sent on a 4 but hardly return on one.

With any luck we'll switch to the still flawed, but better then current, MPDS system used by Toronto and Niagra.

 

[marineman]

We have EMD here that decides our response code based on information received from the caller. Our responses are ABCDE.

A is for an obviously non life threat. I don't want to open that can of worms again but a fall is usually an A level response meaning non emergency ambulance only

B is also non emergency but they dispatch a fire engine as well as the ambulance. If it is a B response to an MVC on a highway we respond emergency to clear the roadway sooner but otherwise non emergency.

C is an emergency response, they send an engine and ambulance emergency.

D is an emergency response also getting an engine and ambulance. D level response codes also usually get an LEO coming emergency.

E is a PNB, they send anyone and everyone that is available.

What you refer to as code 3 we call simply emergency opting for plain english or if you want it's 10-33.

Transport decisions are left completely up to medic discretion. We used to have a page in our protocols to be used as guidelines for transport priority but too many people were using it as a protocol rather than a guideline so it was removed and now it's simply medic choice.

 

[Ped101]

wow!!
Thanks people that was really cool!


Here we roll on Code 1, 2 ,3 or green, yellow, red

Code 1 - Stable patient,
Code 2 - Stable patient with possible unstability
Code3 - Unstable patient


The code in which we transport is at total discretion of the crew, and we roll to the places we get called for at code 3 as mentioned

But we are a 911 volunteer emergency service xD


Do you people charge for the services?

 

[djmedic913]

Here we are dispatched through a state EMD who then sends it to the local dispatchers...
We have 2 priorities for 911...

Priority 1: HOT...which is almost everything and in my opinion based off dispatch info not always required, but dispatch loves to tell me where to go..
Priority 2 (Alpha)...Cold...with flow of traffic...rarely get dispatched P2, and I think it should be used more...
Once Pt was assessed transport decision was made, P1 or P2...attendant's discretion.

For the transfer side...it is a little ridiculous...our company dispatch is not EMD certified...and therefore clueless....

When I worked in the city of Buffalo, NY we were dispatched by the county dispatch but posted by our company dispatch...
so when we went anywhere we had to notify 2 dispatches...and of course their codes/priorities were backwards...
County dispatch:
Code 1: Cold...flow of traffic...
Code 2: Hot...
Company dispatch:
Priority 1: Hot
Priority 2: Cold...
So this always got screwed up and the dispatches would have to double check sometimes could we would call the wrong code/priority when sirens could be heard in the back ground...

 

[MMiz]

I'm so confused. What's the point of a properly trained EMD if all calls go out RLS/Code 1/"Hot"? You're telling me that the call for a jammed finger goes our as a priority call? What about psych. patients with PD on scene?

We were dispatched priority:
1 - Lights/sirens
2 - No lights/sirens, may upgrade if needed.
3 - No lights and sirens

 

[hrmeeks]

We have EMD here that decides our response code based on information received from the caller. Our responses are ABCDE.

A is for an obviously non life threat. I don't want to open that can of worms again but a fall is usually an A level response meaning non emergency ambulance only

B is also non emergency but they dispatch a fire engine as well as the ambulance. If it is a B response to an MVC on a highway we respond emergency to clear the roadway sooner but otherwise non emergency.

C is an emergency response, they send an engine and ambulance emergency.

D is an emergency response also getting an engine and ambulance. D level response codes also usually get an LEO coming emergency.

E is a PNB, they send anyone and everyone that is available.

What you refer to as code 3 we call simply emergency opting for plain english or if you want it's 10-33.

Transport decisions are left completely up to medic discretion. We used to have a page in our protocols to be used as guidelines for transport priority but too many people were using it as a protocol rather than a guideline so it was removed and now it's simply medic choice.

Whats fun is when alpaha calls turn in to delta call once on scene

 

[lightsandsirens5]

Around here we only have two priorites. Code and Non-Code. It is also at the crew's descretion weather to run code or not. Despite my screen name I don't run code that much. Not that there aren't exceptions, but really only to respiratory or cardiac calls and also to moderate-major trauma. Also an MVA around here gets a code response, although I have rarely come back from an MVA going code.

 

[colafdp]

Whats fun is when alpaha calls turn in to delta call once on scene

lol...or even an echo call...have had that happen once or twice.

 

[djmedic913]

I'm so confused. What's the point of a properly trained EMD if all calls go out RLS/Code 1/"Hot"? You're telling me that the call for a jammed finger goes our as a priority call? What about psych. patients with PD on scene?

Here for a jammed finger we go Hot...the call would dispatched as an extremity injury...
As for psych with PD on scene we definitely go Hot coz the cops don't want to wait around...

Our EMD sucks coz in my opinion we go Hot to calls waaaaay too often.
Transport to the hospital, I very rarely go Hot...If I could get away with it I would cold to the hospital with a cardiac arrest. There is not much different that the ER is going to do for that patient then I am already doing...IV, ET, meds and monitor...they follow the same ACLS that I do, so why put myself, driver, and usually 2 firemen helping in danger for a stable patient...

Dead is the most stable patient we get...and we have to go ahead and try and make them unstable again...

 

[Sasha]

As for psych with PD on scene we definitely go Hot coz the cops don't want to wait around...

There is not much different that the ER is going to do for that patient then I am already doing...IV, ET, meds and monitor...they follow the same ACLS that I do, so why put myself, driver, and usually 2 firemen helping in danger for a stable patient...

But you put yourself in danger because the cops don't want to wait around? Personally, if I die in a fiery ambulance crash and it was because cops don't want to wait around, I'd haunt whoever made that policy 'til they cried like a baby.

 

[Melclin]

We use AMPDS here in Melbourne, Australia. I think pretty much all the states use AMPDS. It certainly has its flaws, but its pretty risk adverse I'm told.

PRIORITY ZERO: Relatively new one, known cardiac arrest. They gave the fire brigade some AEDs so they could respond as well. Creates an aweful bloody cacophony when an engine or more turns up at the same time as an ambulance and an intensive care ambulance.

CODE 1: L/S- Threat to life. (CP, uncontrolled bleeding, severe SOB ) sometimes gets and intensive care ambulance response.

CODE 2: "Emergency" requiring care within 20 mins, L/S at discretion. (broken bones, cuts, minor accidents)

CODE 3: Issue requiring attendance - usually just a transport to hospital. I have limited experience, but I've yet to see a CODE 3 that needed an ambulance (granny can't get out of bed, blocked catheter, back pain since 1972).

State run and funded service but people are supposed to have "ambulance membership" where they pay something like $50 a year for full coverage. You'd be a special kind of stupid not to have it. You'll be forking out about $600-800 for a standard trip to hospital if you don't.

 

[frdude1000]

In Montgomery county maryland we only have emergency and routine. All calls are dispatched emergency except for service calls (need help getting back in bed, etc.) and unsafe scenes where police have not arrived yet. Even sick persons, mo's, broken arms, headache are all emergency. Also, even if an engine is on scene and the ambo is enroute, the ambo still goes hot.

 

[marineman]

To add to my previous post we cover multiple counties here, about 5 years ago two of our counties switched to EMD but the third still wanted us to run hot to all calls. One of our rigs got T-boned going through an intersection for a fall. Neither driver was at fault in the accident just poor timing. Within 2 weeks that county started using EMD.

 

[Epi-do]

We go to the scene RLS for everything except "assist a person" runs. The other exception would be if we are specifically advised by dispatch not to do so. Transport to the hospital is determined after the patient is assessed, but most of the time is non-RLS