Prevention of deaths related to EMS motor vehicle collisions

[Guest guest]

A recent thread on EMS-L morphed into something that I considered a bit of a

challenge...Dan Gerard and I were discussing the ways that the FOP had

influenced the marked reduction in officer shooting deaths starting in the late

1980s...he pointed out that....

<block quote>

In a message dated 9/24/2008 18:17:21 Central Daylight Time,

dgerard@... writes:

<snip>

The big issue now for PO's, while firearm deaths are still very relevant,

is

motor vehicle collisions.

</block quote>

Why can't the EMS community pull together like the Fraternal Order of Police

and the International Association of Fire Fighters in order to help reduce

our line of duty deaths and disabilities? Our three groups should be working

as hard to reduce losses from motor vehicle collisions as hard as the FOP

worked to reduce the danger from GSW and the IAFF has worked to enforce the two

in/two out rules and improved bunker gear.

Never the less, EMS has some relatively specific needs that the (often non

transporting) FOP and IAFF folks don't need to worry about...

Since MVC's are also one of the leading causes of death and disability for

EMS personnel, one might think that some cooperation between the FOP and

some

national group representing EMS personnel might bear some fruit.

Items that might be investigated would include some way to broadcast

warnings of on coming Emergency Vehicles on 'common intermediate

frequencies' used

by virtually all broadcast radio receivers, as well as a fair percentage of

CD/DVD/tape players...maybe just a nicely dulcet mezzo soprano voice " Pull

Over, Ambulance/Fire Truck/Rescue Vehicle oncoming. " I've noticed that even

in my

rattlely old Jimmy, with the stereo turned just loud enough to hear over

the

road noise (windows closed and AC on), it's tough to hear even a " Q " from

more than 25 yards away.

Similarly, having collision avoidance devices that would sound when two

EV's

were approaching each other (similar to the CADs used by most commercial

aviation flights, which don't always depend on Mode 3 radio transponders,

but

can also use Automatic Position Reporting Systems (first developed by a Ham

Radio group in Tucson, incidentally) tied to GPS locators), cutting down on

the

chance that converging units running RLS will hit different sides of an

intersection at the same time.

Ensuring that EVERYONE responsible for Emergency Vehicle Operations has to

qualify AND maintain qualification (both live and simulator) on a tough

EVOC

system.

Another point would be to have some form of automatically retracting safety

harness that could be installed at several points in the back of the rig,

allowing for several rescuers to work on a patient with less chance of

becoming

human missiles if something does happen to the rig en route.

Additionally, the use of reasonable 'call the coroner from the field'

protocols (with or without on line medical control), will reduce the number

of RLS

runs from the scene to the hospital. Ironically, the use of automatic chest

compression devices (especially associated with the use of automatic,

pressure

limited ventilators and Res-Q-Pods) may actually increase both ROSC as well

as Survival to Discharge in addition to reducing the need for large numbers

of spare bodies in the back of the rig AND the need for the RLS run to the

hospital (since good quality compressions and adequate ventilation are much

easier to maintain with the devices).

So, three suggestions to cut down on collisions/loss of control incidents,

two to increase the safety of the folks in back, and two that will reduce

the

number of high danger RLS runs.

Any takers out there?

ck

S. Krin, DO FAAFP

**************Looking for simple solutions to your real-life financial

challenges? Check out WalletPop for the latest news and information, tips and

calculators. (http://www.walletpop.com/?NCID=emlcntuswall00000001)

[Guest guest]

I think if you are going to take on such an important issue. you should also

address the topic of unnecessary RLS responseto the scene. There are too many

agencies that respond RLS regardless of the circumstances; simply because it is

the " policy " of the agency.

Those unnecessary RLS responses are an additional contribitor to those

unnecessary MVC involving EMS vehicles.

Granted this will most likely be one if not the most difficult of the changes to

get adopted ,but it could potently be the most effective means of reducing those

unnecessary RLS involved MVC's.

Thom Seeber, CCEMT-P

Sent from my Verizon Wireless mobile phone

- Prevention of deaths related to EMS motor vehicle collisions

A recent thread on EMS-L morphed into something that I considered a bit of a

challenge...Dan Gerard and I were discussing the ways that the FOP had

influenced the marked reduction in officer shooting deaths starting in the late

1980s...he pointed out that....

<block quote>

In a message dated 9/24/2008 18:17:21 Central Daylight Time,

dgerard@... writes:

<snip>

The big issue now for PO's, while firearm deaths are still very relevant,

is

motor vehicle collisions.

</block quote>

Why can't the EMS community pull together like the Fraternal Order of Police

and the International Association of Fire Fighters in order to help reduce

our line of duty deaths and disabilities? Our three groups should be working

as hard to reduce losses from motor vehicle collisions as hard as the FOP

worked to reduce the danger from GSW and the IAFF has worked to enforce the two

in/two out rules and improved bunker gear.

Never the less, EMS has some relatively specific needs that the (often non

transporting) FOP and IAFF folks don't need to worry about...

Since MVC's are also one of the leading causes of death and disability for

EMS personnel, one might think that some cooperation between the FOP and

some

national group representing EMS personnel might bear some fruit.

Items that might be investigated would include some way to broadcast

warnings of on coming Emergency Vehicles on 'common intermediate

frequencies' used

by virtually all broadcast radio receivers, as well as a fair percentage of

CD/DVD/tape players...maybe just a nicely dulcet mezzo soprano voice " Pull

Over, Ambulance/Fire Truck/Rescue Vehicle oncoming. " I've noticed that even

in my

rattlely old Jimmy, with the stereo turned just loud enough to hear over

the

road noise (windows closed and AC on), it's tough to hear even a " Q " from

more than 25 yards away.

Similarly, having collision avoidance devices that would sound when two

EV's

were approaching each other (similar to the CADs used by most commercial

aviation flights, which don't always depend on Mode 3 radio transponders,

but

can also use Automatic Position Reporting Systems (first developed by a Ham

Radio group in Tucson, incidentally) tied to GPS locators), cutting down on

the

chance that converging units running RLS will hit different sides of an

intersection at the same time.

Ensuring that EVERYONE responsible for Emergency Vehicle Operations has to

qualify AND maintain qualification (both live and simulator) on a tough

EVOC

system.

Another point would be to have some form of automatically retracting safety

harness that could be installed at several points in the back of the rig,

allowing for several rescuers to work on a patient with less chance of

becoming

human missiles if something does happen to the rig en route.

Additionally, the use of reasonable 'call the coroner from the field'

protocols (with or without on line medical control), will reduce the number

of RLS

runs from the scene to the hospital. Ironically, the use of automatic chest

compression devices (especially associated with the use of automatic,

pressure

limited ventilators and Res-Q-Pods) may actually increase both ROSC as well

as Survival to Discharge in addition to reducing the need for large numbers

of spare bodies in the back of the rig AND the need for the RLS run to the

hospital (since good quality compressions and adequate ventilation are much

easier to maintain with the devices).

So, three suggestions to cut down on collisions/loss of control incidents,

two to increase the safety of the folks in back, and two that will reduce

the

number of high danger RLS runs.

Any takers out there?

ck

S. Krin, DO FAAFP

**************Looking for simple solutions to your real-life financial

challenges? Check out WalletPop for the latest news and information, tips and

calculators. (http://www.walletpop.com/?NCID=emlcntuswall00000001)

[Guest guest]

This is an issue that has plagued the emergency service industry for

some time...private, public, and fire alike. As mentioned, the IAFF is

looking at this as is the IAFC Safety Health and Survival Section. There

is a group specifically looking at EMS. Though this is fire based,

lessons learned are across the board.

We can educate the public, but bottom line, we are responsible for our

own safety. It starts with a culture change among the troops but the

example is visibly set by executive management. Speaking on the fire

side, policies, procedures, and training are available but often times

it is a failure to follow these policies that leads to disaster. Leaders

must lead, set the example, and not tolerate deviation from good safety

practices.

Danny Kistner

________________________________

From: texasems-l [mailto:texasems-l ] On

Behalf Of krin135@...

Sent: Wednesday, September 24, 2008 10:35 PM

To: EMS-L@...; Paramedicine ;

texasems-l

Subject: Prevention of deaths related to EMS motor vehicle

collisions

A recent thread on EMS-L morphed into something that I considered a bit

of a

challenge...Dan Gerard and I were discussing the ways that the FOP had

influenced the marked reduction in officer shooting deaths starting in

the late

1980s...he pointed out that....

<block quote>

In a message dated 9/24/2008 18:17:21 Central Daylight Time,

dgerard@... <mailto:dgerard%40alamedafire.org> writes:

<snip>

The big issue now for PO's, while firearm deaths are still very

relevant,

is

motor vehicle collisions.

</block quote>

Why can't the EMS community pull together like the Fraternal Order of

Police

and the International Association of Fire Fighters in order to help

reduce

our line of duty deaths and disabilities? Our three groups should be

working

as hard to reduce losses from motor vehicle collisions as hard as the

FOP

worked to reduce the danger from GSW and the IAFF has worked to enforce

the two

in/two out rules and improved bunker gear.

Never the less, EMS has some relatively specific needs that the (often

non

transporting) FOP and IAFF folks don't need to worry about...

Since MVC's are also one of the leading causes of death and disability

for

EMS personnel, one might think that some cooperation between the FOP and

some

national group representing EMS personnel might bear some fruit.

Items that might be investigated would include some way to broadcast

warnings of on coming Emergency Vehicles on 'common intermediate

frequencies' used

by virtually all broadcast radio receivers, as well as a fair percentage

of

CD/DVD/tape players...maybe just a nicely dulcet mezzo soprano voice

" Pull

Over, Ambulance/Fire Truck/Rescue Vehicle oncoming. " I've noticed that

even

in my

rattlely old Jimmy, with the stereo turned just loud enough to hear over

the

road noise (windows closed and AC on), it's tough to hear even a " Q "

from

more than 25 yards away.

Similarly, having collision avoidance devices that would sound when two

EV's

were approaching each other (similar to the CADs used by most commercial

aviation flights, which don't always depend on Mode 3 radio

transponders,

but

can also use Automatic Position Reporting Systems (first developed by a

Ham

Radio group in Tucson, incidentally) tied to GPS locators), cutting down

on

the

chance that converging units running RLS will hit different sides of an

intersection at the same time.

Ensuring that EVERYONE responsible for Emergency Vehicle Operations has

to

qualify AND maintain qualification (both live and simulator) on a tough

EVOC

system.

Another point would be to have some form of automatically retracting

safety

harness that could be installed at several points in the back of the

rig,

allowing for several rescuers to work on a patient with less chance of

becoming

human missiles if something does happen to the rig en route.

Additionally, the use of reasonable 'call the coroner from the field'

protocols (with or without on line medical control), will reduce the

number

of RLS

runs from the scene to the hospital. Ironically, the use of automatic

chest

compression devices (especially associated with the use of automatic,

pressure

limited ventilators and Res-Q-Pods) may actually increase both ROSC as

well

as Survival to Discharge in addition to reducing the need for large

numbers

of spare bodies in the back of the rig AND the need for the RLS run to

the

hospital (since good quality compressions and adequate ventilation are

much

easier to maintain with the devices).

So, three suggestions to cut down on collisions/loss of control

incidents,

two to increase the safety of the folks in back, and two that will

reduce

the

number of high danger RLS runs.

Any takers out there?

ck

S. Krin, DO FAAFP

**************Looking for simple solutions to your real-life financial

challenges? Check out WalletPop for the latest news and information,

tips and

calculators. (http://www.walletpop.com/?NCID=emlcntuswall00000001

<http://www.walletpop.com/?NCID=emlcntuswall00000001> )

[Guest guest]

Thom,

Its not just responses...its the really unnecessary uses of L & S while

transporting.? This is truly when the crew is most at risk because the care

provider in the back is unrestrained and the person up front is operating the

vehicle alone, potentially with the distraction of a family member plus being

amped up by a patient that is probably not as severely injured or ill as we

think or have been educated to determine.

We talk about standing orders vs. calling med control.? Make it mandatory to

call med control to run lights and sirens to a hospital...bet the numbers would

fall...and we control this piece exclusively.

Dudley

Prevention of deaths related to EMS motor vehicle collisions

A recent thread on EMS-L morphed into something that I considered a bit of a

challenge...Dan Gerard and I were discussing the ways that the FOP had

influenced the marked reduction in officer shooting deaths starting in the late

1980s...he pointed out that....

<block quote>

In a message dated 9/24/2008 18:17:21 Central Daylight Time,

dgerard@... writes:

<snip>

The big issue now for PO's, while firearm deaths are still very relevant,

is

motor vehicle collisions.

</block quote>

Why can't the EMS community pull together like the Fraternal Order of Police

and the International Association of Fire Fighters in order to help reduce

our line of duty deaths and disabilities? Our three groups should be working

as hard to reduce losses from motor vehicle collisions as hard as the FOP

worked to reduce the danger from GSW and the IAFF has worked to enforce the two

in/two out rules and improved bunker gear.

Never the less, EMS has some relatively specific needs that the (often non

transporting) FOP and IAFF folks don't need to worry about...

Since MVC's are also one of the leading causes of death and disability for

EMS personnel, one might think that some cooperation between the FOP and

some

national group representing EMS personnel might bear some fruit.

Items that might be investigated would include some way to broadcast

warnings of on coming Emergency Vehicles on 'common intermediate

frequencies' used

by virtually all broadcast radio receivers, as well as a fair percentage of

CD/DVD/tape players...maybe just a nicely dulcet mezzo soprano voice " Pull

Over, Ambulance/Fire Truck/Rescue Vehicle oncoming. " I've noticed that even

in my

rattlely old Jimmy, with the stereo turned just loud enough to hear over

the

road noise (windows closed and AC on), it's tough to hear even a " Q " from

more than 25 yards away.

Similarly, having collision avoidance devices that would sound when two

EV's

were approaching each other (similar to the CADs used by most commercial

aviation flights, which don't always depend on Mode 3 radio transponders,

but

can also use Automatic Position Reporting Systems (first developed by a Ham

Radio group in Tucson, incidentally) tied to GPS locators), cutting down on

the

chance that converging units running RLS will hit different sides of an

intersection at the same time.

Ensuring that EVERYONE responsible for Emergency Vehicle Operations has to

qualify AND maintain qualification (both live and simulator) on a tough

EVOC

system.

Another point would be to have some form of automatically retracting safety

harness that could be installed at several points in the back of the rig,

allowing for several rescuers to work on a patient with less chance of

becoming

human missiles if something does happen to the rig en route.

Additionally, the use of reasonable 'call the coroner from the field'

protocols (with or without on line medical control), will reduce the number

of RLS

runs from the scene to the hospital. Ironically, the use of automatic chest

compression devices (especially associated with the use of automatic,

pressure

limited ventilators and Res-Q-Pods) may actually increase both ROSC as well

as Survival to Discharge in addition to reducing the need for large numbers

of spare bodies in the back of the rig AND the need for the RLS run to the

hospital (since good quality compressions and adequate ventilation are much

easier to maintain with the devices).

So, three suggestions to cut down on collisions/loss of control incidents,

two to increase the safety of the folks in back, and two that will reduce

the

number of high danger RLS runs.

Any takers out there?

ck

S. Krin, DO FAAFP

**************Looking for simple solutions to your real-life financial

challenges? Check out WalletPop for the latest news and information, tips and

calculators. (http://www.walletpop.com/?NCID=emlcntuswall00000001)

[Guest guest]

Dudley,

While I agree with you that the transporting phase of the call is one of the

most " at risk " portions of the call because of the factors you mentioned, I

feel I must point out that this is a factor that is at least partially

controllable. I say this simply because the crew (for the most part) makes

the determination of what mode of travel they will take. These decisions

should be made based upon several factors. For example:

1. Will time make a difference in the outcome of the patient's condition?

2. How much time-leeway exists for that type of problem?

3. How much time can actually be saved by the use of RLS?

4. When the patient actually gets to the hospital, will the time that was

saved be significant compared with the time spent waiting for care such

as X-rays, lab tests, etc.?

The question we must ask is how much time is spent during an agency's Field

Training Program in developing a medic's decision making ability to

determine the need for RLS during transport to the hospital? I for one

cannot tell you the last time (outside of a CPR in-progress) that I

transported a patient using RLS.

We have spent the past 40 some odd years developing equipment, techniques,

and training to ensure our personnel are capable of delivering quality

emergency medical care to the ill and injured, rather than just racing them

to the nearest hospital as fast as we can.

That being said, the one aspect that the crew has no control over is the

response mode. That mode is dictated by agency policy. Unfortunately, a

great number of services still maintain the same antiquated policy that EMS

started off with; that of sending every response RLS regardless of the type

or seriousness of the need.

With between 12,000 to 15,000 EMS vehicle collisions occurring each year, I

believe as an industry, we must begin to look at all possible ways of

reducing these numbers. There is no one absolute solution to this problem.

However, if we as a profession do not begin to address the contributing

factors, those statistics will do nothing but escalate.

Thom Seeber, CCEMT-P

Prevention of deaths related to EMS motor vehicle collisions

A recent thread on EMS-L morphed into something that I considered a bit of a

challenge...Dan Gerard and I were discussing the ways that the FOP had

influenced the marked reduction in officer shooting deaths starting in the

late

1980s...he pointed out that....

<block quote>

In a message dated 9/24/2008 18:17:21 Central Daylight Time,

dgerard@... writes:

<snip>

The big issue now for PO's, while firearm deaths are still very relevant,

is

motor vehicle collisions.

</block quote>

Why can't the EMS community pull together like the Fraternal Order of Police

and the International Association of Fire Fighters in order to help reduce

our line of duty deaths and disabilities? Our three groups should be working

as hard to reduce losses from motor vehicle collisions as hard as the FOP

worked to reduce the danger from GSW and the IAFF has worked to enforce the

two

in/two out rules and improved bunker gear.

Never the less, EMS has some relatively specific needs that the (often non

transporting) FOP and IAFF folks don't need to worry about...

Since MVC's are also one of the leading causes of death and disability for

EMS personnel, one might think that some cooperation between the FOP and

some

national group representing EMS personnel might bear some fruit.

Items that might be investigated would include some way to broadcast

warnings of on coming Emergency Vehicles on 'common intermediate

frequencies' used

by virtually all broadcast radio receivers, as well as a fair percentage of

CD/DVD/tape players...maybe just a nicely dulcet mezzo soprano voice " Pull

Over, Ambulance/Fire Truck/Rescue Vehicle oncoming. " I've noticed that even

in my

rattlely old Jimmy, with the stereo turned just loud enough to hear over

the

road noise (windows closed and AC on), it's tough to hear even a " Q " from

more than 25 yards away.

Similarly, having collision avoidance devices that would sound when two

EV's

were approaching each other (similar to the CADs used by most commercial

aviation flights, which don't always depend on Mode 3 radio transponders,

but

can also use Automatic Position Reporting Systems (first developed by a Ham

Radio group in Tucson, incidentally) tied to GPS locators), cutting down on

the

chance that converging units running RLS will hit different sides of an

intersection at the same time.

Ensuring that EVERYONE responsible for Emergency Vehicle Operations has to

qualify AND maintain qualification (both live and simulator) on a tough

EVOC

system.

Another point would be to have some form of automatically retracting safety

harness that could be installed at several points in the back of the rig,

allowing for several rescuers to work on a patient with less chance of

becoming

human missiles if something does happen to the rig en route.

Additionally, the use of reasonable 'call the coroner from the field'

protocols (with or without on line medical control), will reduce the number

of RLS

runs from the scene to the hospital. Ironically, the use of automatic chest

compression devices (especially associated with the use of automatic,

pressure

limited ventilators and Res-Q-Pods) may actually increase both ROSC as well

as Survival to Discharge in addition to reducing the need for large numbers

of spare bodies in the back of the rig AND the need for the RLS run to the

hospital (since good quality compressions and adequate ventilation are much

easier to maintain with the devices).

So, three suggestions to cut down on collisions/loss of control incidents,

two to increase the safety of the folks in back, and two that will reduce

the

number of high danger RLS runs.

Any takers out there?

ck

S. Krin, DO FAAFP

**************Looking for simple solutions to your real-life financial

challenges? Check out WalletPop for the latest news and information, tips

and

calculators. (http://www.walletpop.com/?NCID=emlcntuswall00000001)

[Guest guest]

Excellent points Thom...

Here are some questions for everyone on the list from Thom's post:

1.? What conditions would a patient have where time is of the essence requiring

L & S transport??

2.? What conditions exist that have a " time-leeway " where even saving 45 seconds

is worth the life of you, your partner, and your patient? (BTW, that is the

decision you make when you turn on the L & S...you are now saying your life is

worth losing to save the patient you are transporting)

3.? If you save 45 seconds (the time in our agency) or 3 or 4 minutes...what

occurs in those 3 or 4 minutes at the hospital that will make a difference in

the patient's outcome that you can not?or are not doing enroute?

4.? Lastly, (and my favorite), why do we insist on running L & S when we are doing

CPR?? What magic pill or tool do they have at the hospital that makes the risk

of running " hot " matter?

Please, answer these...this is as big a problem and probably as controversial as

helicopter crashes...and if we can figure out these answers...my bet is we will

make better decisions about helicopter utilization as well.?

Fire away!!!

Dudley

Prevention of deaths related to EMS motor vehicle collisions

A recent thread on EMS-L morphed into something that I considered a bit of a

challenge...Dan Gerard and I were discussing the ways that the FOP had

influenced the marked reduction in officer shooting deaths starting in the

late

1980s...he pointed out that....

<block quote>

In a message dated 9/24/2008 18:17:21 Central Daylight Time,

dgerard@... writes:

<snip>

The big issue now for PO's, while firearm deaths are still very relevant,

is

motor vehicle collisions.

</block quote>

Why can't the EMS community pull together like the Fraternal Order of Police

and the International Association of Fire Fighters in order to help reduce

our line of duty deaths and disabilities? Our three groups should be working

as hard to reduce losses from motor vehicle collisions as hard as the FOP

worked to reduce the danger from GSW and the IAFF has worked to enforce the

two

in/two out rules and improved bunker gear.

Never the less, EMS has some relatively specific needs that the (often non

transporting) FOP and IAFF folks don't need to worry about...

Since MVC's are also one of the leading causes of death and disability for

EMS personnel, one might think that some cooperation between the FOP and

some

national group representing EMS personnel might bear some fruit.

Items that might be investigated would include some way to broadcast

warnings of on coming Emergency Vehicles on 'common intermediate

frequencies' used

by virtually all broadcast radio receivers, as well as a fair percentage of

CD/DVD/tape players...maybe just a nicely dulcet mezzo soprano voice " Pull

Over, Ambulance/Fire Truck/Rescue Vehicle oncoming. " I've noticed that even

in my

rattlely old Jimmy, with the stereo turned just loud enough to hear over

the

road noise (windows closed and AC on), it's tough to hear even a " Q " from

more than 25 yards away.

Similarly, having collision avoidance devices that would sound when two

EV's

were approaching each other (similar to the CADs used by most commercial

aviation flights, which don't always depend on Mode 3 radio transponders,

but

can also use Automatic Position Reporting Systems (first developed by a Ham

Radio group in Tucson, incidentally) tied to GPS locators), cutting down on

the

chance that converging units running RLS will hit different sides of an

intersection at the same time.

Ensuring that EVERYONE responsible for Emergency Vehicle Operations has to

qualify AND maintain qualification (both live and simulator) on a tough

EVOC

system.

Another point would be to have some form of automatically retracting safety

harness that could be installed at several points in the back of the rig,

allowing for several rescuers to work on a patient with less chance of

becoming

human missiles if something does happen to the rig en route.

Additionally, the use of reasonable 'call the coroner from the field'

protocols (with or without on line medical control), will reduce the number

of RLS

runs from the scene to the hospital. Ironically, the use of automatic chest

compression devices (especially associated with the use of automatic,

pressure

limited ventilators and Res-Q-Pods) may actually increase both ROSC as well

as Survival to Discharge in addition to reducing the need for large numbers

of spare bodies in the back of the rig AND the need for the RLS run to the

hospital (since good quality compressions and adequate ventilation are much

easier to maintain with the devices).

So, three suggestions to cut down on collisions/loss of control incidents,

two to increase the safety of the folks in back, and two that will reduce

the

number of high danger RLS runs.

Any takers out there?

ck

S. Krin, DO FAAFP

**************Looking for simple solutions to your real-life financial

challenges? Check out WalletPop for the latest news and information, tips

and

calculators. (http://www.walletpop.com/?NCID=emlcntuswall00000001)

[Guest guest]

Excellent points, I agree 100%. I anxiously await the day we stop transporting

arrests emergency.... or how about we stop transporting those we dont

resuscitate?

Prevention of deaths related to EMS motor vehicle collisions

A recent thread on EMS-L morphed into something that I considered a bit of a

challenge...Dan Gerard and I were discussing the ways that the FOP had

influenced the marked reduction in officer shooting deaths starting in the

late

1980s...he pointed out that....

<block quote>

In a message dated 9/24/2008 18:17:21 Central Daylight Time,

dgerard@... writes:

<snip>

The big issue now for PO's, while firearm deaths are still very relevant,

is

motor vehicle collisions.

</block quote>

Why can't the EMS community pull together like the Fraternal Order of Police

and the International Association of Fire Fighters in order to help reduce

our line of duty deaths and disabilities? Our three groups should be working

as hard to reduce losses from motor vehicle collisions as hard as the FOP

worked to reduce the danger from GSW and the IAFF has worked to enforce the

two

in/two out rules and improved bunker gear.

Never the less, EMS has some relatively specific needs that the (often non

transporting) FOP and IAFF folks don't need to worry about...

Since MVC's are also one of the leading causes of death and disability for

EMS personnel, one might think that some cooperation between the FOP and

some

national group representing EMS personnel might bear some fruit.

Items that might be investigated would include some way to broadcast

warnings of on coming Emergency Vehicles on 'common intermediate

frequencies' used

by virtually all broadcast radio receivers, as well as a fair percentage of

CD/DVD/tape players...maybe just a nicely dulcet mezzo soprano voice " Pull

Over, Ambulance/Fire Truck/Rescue Vehicle oncoming. " I've noticed that even

in my

rattlely old Jimmy, with the stereo turned just loud enough to hear over

the

road noise (windows closed and AC on), it's tough to hear even a " Q " from

more than 25 yards away.

Similarly, having collision avoidance devices that would sound when two

EV's

were approaching each other (similar to the CADs used by most commercial

aviation flights, which don't always depend on Mode 3 radio transponders,

but

can also use Automatic Position Reporting Systems (first developed by a Ham

Radio group in Tucson, incidentally) tied to GPS locators), cutting down on

the

chance that converging units running RLS will hit different sides of an

intersection at the same time.

Ensuring that EVERYONE responsible for Emergency Vehicle Operations has to

qualify AND maintain qualification (both live and simulator) on a tough

EVOC

system.

Another point would be to have some form of automatically retracting safety

harness that could be installed at several points in the back of the rig,

allowing for several rescuers to work on a patient with less chance of

becoming

human missiles if something does happen to the rig en route.

Additionally, the use of reasonable 'call the coroner from the field'

protocols (with or without on line medical control), will reduce the number

of RLS

runs from the scene to the hospital. Ironically, the use of automatic chest

compression devices (especially associated with the use of automatic,

pressure

limited ventilators and Res-Q-Pods) may actually increase both ROSC as well

as Survival to Discharge in addition to reducing the need for large numbers

of spare bodies in the back of the rig AND the need for the RLS run to the

hospital (since good quality compressions and adequate ventilation are much

easier to maintain with the devices).

So, three suggestions to cut down on collisions/loss of control incidents,

two to increase the safety of the folks in back, and two that will reduce

the

number of high danger RLS runs.

Any takers out there?

ck

S. Krin, DO FAAFP

**************Looking for simple solutions to your real-life financial

challenges? Check out WalletPop for the latest news and information, tips

and

calculators. ( http://www.walletpop.com/?NCID=emlcntuswall00000001 )

[Guest guest]

-----BEGIN PGP SIGNED MESSAGE-----

Hash: SHA1

dudley-if we objectively look at this,,the answer is clear--rls are

pretty much not necessary and ultimately dont help our patients, period!

now, getting someone to try this type of responses might be another

thing......however, We are cutting back on rls responses and almost

never running rls to the hospital... ht

THEDUDMAN@... wrote:

>

>

> Excellent points Thom...

>

> Here are some questions for everyone on the list from Thom's post:

>

> 1.? What conditions would a patient have where time is of the essence

> requiring L & S transport??

>

> 2.? What conditions exist that have a " time-leeway " where even saving 45

> seconds is worth the life of you, your partner, and your patient? (BTW,

> that is the decision you make when you turn on the L & S...you are now

> saying your life is worth losing to save the patient you are transporting)

>

> 3.? If you save 45 seconds (the time in our agency) or 3 or 4

> minutes...what occurs in those 3 or 4 minutes at the hospital that will

> make a difference in the patient's outcome that you can not?or are not

> doing enroute?

>

> 4.? Lastly, (and my favorite), why do we insist on running L & S when we

> are doing CPR?? What magic pill or tool do they have at the hospital

> that makes the risk of running " hot " matter?

>

> Please, answer these...this is as big a problem and probably as

> controversial as helicopter crashes...and if we can figure out these

> answers...my bet is we will make better decisions about helicopter

> utilization as well.?

>

> Fire away!!!

>

> Dudley

>

> Prevention of deaths related to EMS motor vehicle collisions

>

> A recent thread on EMS-L morphed into something that I considered a bit of a

>

> challenge...Dan Gerard and I were discussing the ways that the FOP had

> influenced the marked reduction in officer shooting deaths starting in the

> late

> 1980s...he pointed out that....

> <block quote>

> In a message dated 9/24/2008 18:17:21 Central Daylight Time,

> dgerard@... <mailto:dgerard%40alamedafire.org> writes:

> <snip>

>

> The big issue now for PO's, while firearm deaths are still very relevant,

> is

> motor vehicle collisions.

>

> </block quote>

>

> Why can't the EMS community pull together like the Fraternal Order of Police

>

> and the International Association of Fire Fighters in order to help reduce

> our line of duty deaths and disabilities? Our three groups should be working

>

> as hard to reduce losses from motor vehicle collisions as hard as the FOP

> worked to reduce the danger from GSW and the IAFF has worked to enforce the

> two

> in/two out rules and improved bunker gear.

>

> Never the less, EMS has some relatively specific needs that the (often non

> transporting) FOP and IAFF folks don't need to worry about...

>

> Since MVC's are also one of the leading causes of death and disability for

> EMS personnel, one might think that some cooperation between the FOP and

> some

> national group representing EMS personnel might bear some fruit.

>

> Items that might be investigated would include some way to broadcast

> warnings of on coming Emergency Vehicles on 'common intermediate

> frequencies' used

> by virtually all broadcast radio receivers, as well as a fair percentage of

> CD/DVD/tape players...maybe just a nicely dulcet mezzo soprano voice " Pull

> Over, Ambulance/Fire Truck/Rescue Vehicle oncoming. " I've noticed that even

> in my

> rattlely old Jimmy, with the stereo turned just loud enough to hear over

> the

> road noise (windows closed and AC on), it's tough to hear even a " Q " from

> more than 25 yards away.

>

> Similarly, having collision avoidance devices that would sound when two

> EV's

> were approaching each other (similar to the CADs used by most commercial

> aviation flights, which don't always depend on Mode 3 radio transponders,

> but

> can also use Automatic Position Reporting Systems (first developed by a Ham

> Radio group in Tucson, incidentally) tied to GPS locators), cutting down on

> the

> chance that converging units running RLS will hit different sides of an

> intersection at the same time.

>

> Ensuring that EVERYONE responsible for Emergency Vehicle Operations has to

> qualify AND maintain qualification (both live and simulator) on a tough

> EVOC

> system.

>

> Another point would be to have some form of automatically retracting safety

> harness that could be installed at several points in the back of the rig,

> allowing for several rescuers to work on a patient with less chance of

> becoming

> human missiles if something does happen to the rig en route.

>

> Additionally, the use of reasonable 'call the coroner from the field'

> protocols (with or without on line medical control), will reduce the number

> of RLS

> runs from the scene to the hospital. Ironically, the use of automatic chest

> compression devices (especially associated with the use of automatic,

> pressure

> limited ventilators and Res-Q-Pods) may actually increase both ROSC as well

> as Survival to Discharge in addition to reducing the need for large numbers

>

> of spare bodies in the back of the rig AND the need for the RLS run to the

> hospital (since good quality compressions and adequate ventilation are much

> easier to maintain with the devices).

>

> So, three suggestions to cut down on collisions/loss of control incidents,

> two to increase the safety of the folks in back, and two that will reduce

> the

> number of high danger RLS runs.

>

> Any takers out there?

>

> ck

> S. Krin, DO FAAFP

>

> **************Looking for simple solutions to your real-life financial

> challenges? Check out WalletPop for the latest news and information, tips

> and

> calculators. (http://www.walletpop.com/?NCID=emlcntuswall00000001

> <http://www.walletpop.com/?NCID=emlcntuswall00000001>)

>

>

[Guest guest]

Hi Folks,

I believe the question isn't as simple as " go lights and siren and risk your

life " or " don't go lights and siren and be safe " .

It's been a really long time since I ran hot, rather than running a

computer, but when I used to teach emergency driver training to new EMS

folks, I spent a ton of time and said lots of ways, that running hot only

made the trip faster by: (1) saving the time that would have otherwise been

spent stuck in traffic, and (2) saving the time difference between waiting

for a red light to change vs. stopping and waiting for the citizen drivers

to clear the intersection, so we could safely proceed.

It's hard to get the new kids to calm down and drive safely, but it's

critical. Dudley's statement below that driving L & S is equivalent to

deciding that your life is worth losing to save the patient's, is scary, and

doesn't need to be true, in my humble opinion.

I certainly had many occasions when riding with an inexperienced (or not

well trained) driver (EMT or Medic) where I had to verbally help them slow

down and drive safely, and at least two occasions with particularly stubborn

folks, where I had to threaten to make them stop and either let me drive, or

let me out of the rig, and they could go on without me to their doom.

Those are my 2 cents.

BTW, I spent some time as a full-time helicopter medic in Kansas City, and

must say that I'm glad I did it for the experience, but also very glad that

I stopped after a couple of years.

Thanks for listening! - Todd Stout, EMS Nerd

From: texasems-l [mailto:texasems-l ] On

Behalf Of THEDUDMAN@...

Sent: Monday, September 29, 2008 12:17 PM

To: texasems-l

Subject: Re: Re: Prevention of deaths related to EMS motor

vehicle collisions

Excellent points Thom...

Here are some questions for everyone on the list from Thom's post:

1.? What conditions would a patient have where time is of the essence

requiring L & S transport??

2.? What conditions exist that have a " time-leeway " where even saving 45

seconds is worth the life of you, your partner, and your patient? (BTW, that

is the decision you make when you turn on the L & S...you are now saying your

life is worth losing to save the patient you are transporting)

3.? If you save 45 seconds (the time in our agency) or 3 or 4 minutes...what

occurs in those 3 or 4 minutes at the hospital that will make a difference

in the patient's outcome that you can not?or are not doing enroute?

4.? Lastly, (and my favorite), why do we insist on running L & S when we are

doing CPR?? What magic pill or tool do they have at the hospital that makes

the risk of running " hot " matter?

Please, answer these...this is as big a problem and probably as

controversial as helicopter crashes...and if we can figure out these

answers...my bet is we will make better decisions about helicopter

utilization as well.?

Fire away!!!

Dudley

Prevention of deaths related to EMS motor vehicle collisions

A recent thread on EMS-L morphed into something that I considered a bit of a

challenge...Dan Gerard and I were discussing the ways that the FOP had

influenced the marked reduction in officer shooting deaths starting in the

late

1980s...he pointed out that....

<block quote>

In a message dated 9/24/2008 18:17:21 Central Daylight Time,

dgerard@... <mailto:dgerard%40alamedafire.org> writes:

<snip>

The big issue now for PO's, while firearm deaths are still very relevant,

is

motor vehicle collisions.

</block quote>

Why can't the EMS community pull together like the Fraternal Order of Police

and the International Association of Fire Fighters in order to help reduce

our line of duty deaths and disabilities? Our three groups should be working

as hard to reduce losses from motor vehicle collisions as hard as the FOP

worked to reduce the danger from GSW and the IAFF has worked to enforce the

two

in/two out rules and improved bunker gear.

Never the less, EMS has some relatively specific needs that the (often non

transporting) FOP and IAFF folks don't need to worry about...

Since MVC's are also one of the leading causes of death and disability for

EMS personnel, one might think that some cooperation between the FOP and

some

national group representing EMS personnel might bear some fruit.

Items that might be investigated would include some way to broadcast

warnings of on coming Emergency Vehicles on 'common intermediate

frequencies' used

by virtually all broadcast radio receivers, as well as a fair percentage of

CD/DVD/tape players...maybe just a nicely dulcet mezzo soprano voice " Pull

Over, Ambulance/Fire Truck/Rescue Vehicle oncoming. " I've noticed that even

in my

rattlely old Jimmy, with the stereo turned just loud enough to hear over

the

road noise (windows closed and AC on), it's tough to hear even a " Q " from

more than 25 yards away.

Similarly, having collision avoidance devices that would sound when two

EV's

were approaching each other (similar to the CADs used by most commercial

aviation flights, which don't always depend on Mode 3 radio transponders,

but

can also use Automatic Position Reporting Systems (first developed by a Ham

Radio group in Tucson, incidentally) tied to GPS locators), cutting down on

the

chance that converging units running RLS will hit different sides of an

intersection at the same time.

Ensuring that EVERYONE responsible for Emergency Vehicle Operations has to

qualify AND maintain qualification (both live and simulator) on a tough

EVOC

system.

Another point would be to have some form of automatically retracting safety

harness that could be installed at several points in the back of the rig,

allowing for several rescuers to work on a patient with less chance of

becoming

human missiles if something does happen to the rig en route.

Additionally, the use of reasonable 'call the coroner from the field'

protocols (with or without on line medical control), will reduce the number

of RLS

runs from the scene to the hospital. Ironically, the use of automatic chest

compression devices (especially associated with the use of automatic,

pressure

limited ventilators and Res-Q-Pods) may actually increase both ROSC as well

as Survival to Discharge in addition to reducing the need for large numbers

of spare bodies in the back of the rig AND the need for the RLS run to the

hospital (since good quality compressions and adequate ventilation are much

easier to maintain with the devices).

So, three suggestions to cut down on collisions/loss of control incidents,

two to increase the safety of the folks in back, and two that will reduce

the

number of high danger RLS runs.

Any takers out there?

ck

S. Krin, DO FAAFP

**************Looking for simple solutions to your real-life financial

challenges? Check out WalletPop for the latest news and information, tips

and

calculators. (http://www.walletpop.com/?NCID=emlcntuswall00000001)