winsorhelpdesk@gmail.com

In regards to the living wills, in most places, living wills dictate to designated person what are the patient’s wishes but are not generally honored in the field. Whereas, DNRs are physicians orders made with the input of the patient and/or the patient’s family or designee. We just recently switched to allow not only the state EMS DNR form but to allow DNR documentation in a patient’s chart to be honored. Originally, EMS could only honor DNRs that were on the EMS DNR form.

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John-Luke R. Ord, EMT-P

I would love to see an episode of EMS Garage or EMS Leadership about selecting EMS Officers. Training these leaders has been talked about for awhile but the first question we need to answer is how do we chose them?

Thanks for putting out such a great show.

Jeff Anderson
Bossier City, LA

We have the radio system already in place, in the North East Ambulance Service (NEAS), which Tom mentioned. We too were a little concerned regarding the passive listening function on the handset, however, this only comes in in certain “exceptional” circumstances. I obviously cannot comment on how London ambulance service will run this facility, but in our service, for it to be activated, the crew member has to press the emergency button, which automatically opens passive listening, so the control room can hear what is happening without the member of staff having to call in an emergency in a dangerous situation. The only other time that it can be activated is when the senior control manager has a legitimate concern for a crew that they cannot contact via any other means. This has to be recorded and logged with the specific reasons for the activation, which is then reviewed at a senior level at the earliest opportunity. Overall, we have not seen this as an intrusion into our privacy, but as a welcome safety measure.

The other comment is on the discussion regarding solo responders going to “dangerous” or volatile situations.
Again, this is handled differently in NEAS. we have a standing arrangement that rapid response (solo) paramedics will NOT be sent to any “known” incidents where alcohol, drugs, violence or a “volatile” environment is heard by the call taker. This is obviously not 100% fool proof as the control can only dispatch on the information that is given to them, but over all, we do not get sent to a fraction of the “dangerous” scenarios that Tom mentioned. Maybe we are just fortunate in this respect.
The whole place of solo responders in the EMS system is another argument entirely!!
Great Podcast chaps, Thanks.

Someone mentioned having to wait for a patient to be lowered from a high angle environment. In many rescue scenarios immediate ALS intervention would pose a larger hazard. The exeptions could be in a trench or other rescue where compartment syndrome would be present. Most patients would be better served after they have been removed from the hazardous environment.

The University of Louisville has an excellent program for medical personnel, on how to triage patients while in the hotzone. I have not taken this class, yet.

Again for buck’s information we do have a joint emergency services team. The joint esu is comprised of police, EMS, fire, emergency management and hospital staff.

Regards,

Joel Neild (rescue_monkey)
FF/Paramedic
Worthington Fire Department

Stay safe brothers and sisters,

Dan Gerard

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