STEMI call. Lights & sirens. Dispatch problem.

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AfxEMT

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So were a private ambulance& we were posted outside a freestanding ER & the RRT came up to us & told us we have a STEMI, so we rolled in & seen a nurse talking to our dispatch before we even got the page.

Went in the room & seen the pt, the nurses working on the pt, family, my medic got the report straight from the doctor which was kinda cool. Then finally got the page from dispatch "immediate-1" on our service is lights & sirens. Loaded the pt. Ran lights & sirens.

Got to the hospital. Went directly straight to the cath lab. Transferred pt. Call was done. The whole call took 18 minutes. Loaded the stretcher back in the unit & got a page from dispatch "did you ran lights & sirens?? I was supposed to call the county." Me & the medic were like "freaking STEMI!! Means lights & sirens!!!" Told them pt has been transferred, yes we ran lights & sirens, got a reply saying for future reference please notify dispatch.

So my question to you guys & girls are do you take the time to call dispatch on a call of such nature? And they dispatched us immediate-1, which means lights & sirens?

I had a discussion about this with my supervisor & she said we should've taken the time to call cuz we could be fined or sometimes what they(sending facility) says is not 100% accurate. Notifying dispatch or asking dispatch to run lights & sirens does not sit well with me, they're not there to make that judgment call of "oh sh*t! Run X now!!!"

What do you guys think? Thanks.
 
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Chewy20

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They dispatched you lights and sirens. Doesn't mean you have to return to hospital with them. Though obviously a STEMI warrants that. We have to put what category and code we are going to the hospital on our MDC before we leave scene on every call. If the Internet is down we get on the radio. It takes less then 10 seconds. If your company requires you to do so. Then do it. You didn't get in trouble. They gave you an FYI. There's multiple different reasons they need to know if you're going lights and sirens to the hospital. Mostly to cover their back if the call were to ever go to court.
 
Ewok Jerky

Ewok Jerky

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I don't know 100% what a dispatchers job is, but I rely on them to know everything I am up to, so that if something goes wrong A)there is a record, and B)if we don't check in or be where we are supposed to when we are supposed to, they will make sure we are safe.

Whenever you get flagged down or a walkup or whatever, you should notify dispatch so they can put you on scene of an active Incident. It sounds like you may not have even acknowledged their initial dispatch page? And of course you should notify them of your transport disposition that's a no brainer.
 
Akulahawk

Akulahawk

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This is actually pretty darned simple to correct. We used to do this with every transport. If we were taking someone to the ED code 3, it went out over the radio as "Dispatch, we're Code 3 with 1 (patient) to the ED." I never bothered to tell dispatch why I was transporting C3... because they would be able to hear it for themselves when I called in to the hospital. If I didn't know the hospital status, I'd ask for that... then after receiving the info, state my transport intent. It doesn't take much to do the proper notifications...
 
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DesertMedic66

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We have to inform dispatch of our transport destination, how many patients we have, how many family riders we have, fire riders, PD riders, also if we upgrade from code 2 to code 3 or downgrade.

"Medic 107 code 3 to desert with 2 fire and 1 family riders".
 
CALEMT

CALEMT

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DesertMedic66 said:
We have to inform dispatch of our transport destination, how many patients we have, how many family riders we have, fire riders, PD riders, also if we upgrade from code 2 to code 3 or downgrade.

"Medic 107 code 3 to desert with 2 fire and 1 family riders".
Click to expand...

2 fire riders for a STEMI? Well you're going to desert so I'm assuming its Palm Springs Fire which would make sense.
 
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DesertMedic66

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CALEMT said:
2 fire riders for a STEMI? Well you're going to desert so I'm assuming its Palm Springs Fire which would make sense.
Click to expand...
I was just saying in general not for a STEMI patient. I try not to have PSFD riders at all
 
CALEMT

CALEMT

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RedAirplane

RedAirplane

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DesertMedic66 said:
We have to inform dispatch of our transport destination, how many patients we have, how many family riders we have, fire riders, PD riders, also if we upgrade from code 2 to code 3 or downgrade.

"Medic 107 code 3 to desert with 2 fire and 1 family riders".
Click to expand...

2 firefighters, 1 family member, you, the patient = 5 in the back?

Could you actually get anything done?
 
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DesertMedic66

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RedAirplane said:
2 firefighters, 1 family member, you, the patient = 5 in the back?

Could you actually get anything done?
Click to expand...
Family is up front and seat belted in in the passenger seat.

As long as everyone knows their role in the back it is not hard to do at all.
 
Tigger

Tigger

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AfxEMT said:
So were a private ambulance& we were posted outside a freestanding ER & the RRT came up to us & told us we have a STEMI, so we rolled in & seen a nurse talking to our dispatch before we even got the page.

Went in the room & seen the pt, the nurses working on the pt, family, my medic got the report straight from the doctor which was kinda cool. Then finally got the page from dispatch "immediate-1" on our service is lights & sirens. Loaded the pt. Ran lights & sirens.

Got to the hospital. Went directly straight to the cath lab. Transferred pt. Call was done. The whole call took 18 minutes. Loaded the stretcher back in the unit & got a page from dispatch "did you ran lights & sirens?? I was supposed to call the county." Me & the medic were like "freaking STEMI!! Means lights & sirens!!!" Told them pt has been transferred, yes we ran lights & sirens, got a reply saying for future reference please notify dispatch.

So my question to you guys & girls are do you take the time to call dispatch on a call of such nature? And they dispatched us immediate-1, which means lights & sirens?

I had a discussion about this with my supervisor & she said we should've taken the time to call cuz we could be fined or sometimes what they(sending facility) says is not 100% accurate. Notifying dispatch or asking dispatch to run lights & sirens does not sit well with me, they're not there to make that judgment call of "oh sh*t! Run X now!!!"

What do you guys think? Thanks.
Click to expand...
I am assuming you called your own dispatch and told them when you started transport and when you reached destination. That's how that works.

I did briefly work in an area where we were supposed to notify the city fire dispatcher whenever we were traveling emergent anywhere. Well not we specifically, that was up to our dispatchers to do. The city could also deny us permission to respond emergent and dispatch their own apparatus and private EMS contracted ambulance instead. They could deny permission to transport emergently.

Is it up to the crews to call the county to advise them of that in your system? Seems silly.
 
SpecialK

SpecialK

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Travelling under lights generally, in an urban area, saves only a small amount of time.

In most circumstances, the amount of time saved is not clinically significant thus the balance of risk is transporting at road speed. However, in specific patients, the time saved can be likely to be clinically significant; for example a patient with STEMI going directly for pPCI or a leaking AAA going to theatre

For these patients, it is worthwhile travelling under lights at road speed using the lights/siren to ensure uninterrupted passage, especially through intersections.
 
RedAirplane

RedAirplane

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Is there any clinical significance to being scared out of your mind during a STEMI?

My experience is exclusively in a first response role so when I did ride alongs, I found going backwards with lights and sirens very scary. Especially when you look out the back and realize you're on the wrong side of the street.

I actually had a STEMI patient on the ride along and the paramedics kept vigorously urging the patient to calm down, which was having the opposite effect. Does being calm help the disease? And as such, could RLS driving worsen it?

Just curious. Not trying to go into lights vs no lights, more of a medical question.
 
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squirrel15

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When you notify your dispatch you're transporting how difficult is it to say its code 3. I hate a lot of the things dispatch wants to know, but transporting code 3 is reasonable to inform them of.
 
Tigger

Tigger

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At one point I thought I had come across a study showing worse outcomes in MI patients who were transported emergently. I cannot seem to find that now, however.
 
RedAirplane

RedAirplane

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Chewy20 said:
Wait, for the providers or the patient? Yes patients are usually freaked out when they are having a heart attack. No the provider should not be.
Click to expand...

Sorry my post was confusing. What I was saying was that the first time I rode with lights and sirens I was a bit startled, so I imagine a patient would certainly be.
 
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