101| Arriving first on scene | Big personalities taking over calls | Respect for the ambulance as our office | Fire crews riding in the ambulance | Transporting after reversing hypoglycemia or opiate OD

Some ambulance crews may not have the best understanding of how a fire crew is going to run a call, with everyone assigned specific roles – often the fire department will be allowing a new crew member to lead the call

I always struggled with arriving first on scene on the ambulance because that role is more work and more pressure 

What does fire like from the ambulance crews when they arrive first?

First on scene should be allowed to lead the call and ask for help where needed, second on scene should not be pushing their way in and trying to take over the call

Sometimes the providers that take over lack experience or are not yet comfortable enough with their own skills to allow someone else to lead

If you have another provider on scene constantly trying to interrupt, give them something to do - often this applies to a disruptive family member

Does the ambulance paramedic have to attend in the back if the fire paramedic rides in?

As a previous ambulance paramedic, I viewed the ambulance as my space, meaning I always appreciated it when the fire paramedic had the respect to treat it as such, asking to ride into the hospital as opposed to telling me they were riding in. 

As a general rule, if the fire paramedic believes they need to ride in due to acuity, the ambulance paramedic should also attend

Kash, as a medical director, gives his opinion on this situation

I really appreciated it when the fire crews respected our ambulance because the front is truly our office

EMT’s can ride in too on low acuity where more hands, not ALS treatment, is needed

I’ve talked before that a paradigm shift is needed for the paramedics at times, where they are more likely to have to attend more calls then their EMT partners -  easy for me to say from outside the field now – but transporting the patient is almost always the safest, lowest liability option, we shouldn’t be trying to get out of transports just because it’s less work

Always treat the patient like they are a family member

We are looking for proof that the patient is not sick, as opposed to assuming they are not sick from the outset, our approach is different in emergency medicine

We have, historically, reversed hypoglycemia or opiate OD, and the patient has refused when maybe transport to the hospital is warranted despite the fact that we have temporarily fixed a major problem

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Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.