Thursday, January 28, 2010

Acceptable risks

It has been a little since I have made a post. I wanted to start with a statement I heard from a speaker representing a national organization at a state health and safety conference. He was the opening speaker by the way. The topic was on firefighter safety. As part of the presentation the individual who held a chief level position said that he considered it to be an acceptable risk for his firefighters to be unbelted in the patient compartment of the ambulance.

I restrained from reacting right in the middle of the session of over hundred safety officers and chiefs, but have to confess that I am still troubled by the fact that anyone would consider this an acceptable risk when there are safety features in the patient compartment to protect our personnel. Granted, the safety components are not the best and the design of the patient compartment is drawing national attention including the NFPA who is creating a standard. We should be looking at ways to protect our personnel and challenging others, NOT promoting it as an acceptable risk.

What are your thoughts on acceptable risk of firefighters being unbelted in any vehicle?
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  1. I think treating a patient while getting him to the ED for definitive care ASAP is a risk I'm willing to take. You can't treat a patient while sitting belted the entire trip. I'm sorry, I'm a progressive, professional fire officer who cares deeply about firefighter safety, but some people are going way overboard with the seatbelt issue. How is intubating a patient or prepping narcotics any less worthy of risk than a VES operation?

  2. I don't think anyone can treat a patient when they are seatbelted.... I agree when you are in a rolling fire appartus there is no reason not to be belted, but the back of the ambulance is another story!!! You have a patient and the pt is your priorty at the time. When you are trying to start a IV line and performing assesments you need to able to move around and get to the proper equipment in the compartment doors. If you have family riding along with the patient I have them belted and usually in the front with the driver. It is a risk I am willing to take, I have faith in my driver that he will drive safely and in the rest of my crew. I don't want to be known as a rolling taxi service and not give the proper care because I am seatbelted.

  3. I ALWAYS belted in. Was once unbelted enroute to a person through the ice call, putting on a dry suit....was thrown to an fro, I can't imagine having a traffic incident.

  4. Two things come in to mind here, No.1 Is your chauffeur an experienced, senior man? Or is he the 2-3 tear probie that just became qualified to chauffeur an engine, truck or ambulance? No.2 Is you chauffeur more than just a "I'll only drive if I kno9w it's a false call." Or Is your chauffeur the person to get you water from a rock and not stop until he can feed all interior lines before the 2nd due engine is pulling on the block?

    I have ridden with both over the last 18 years, not to sell short the senior guys that "think" they can drive...., and send you flying to and fro. But the best chauffeurs I've had, I know I can get geared up for a fire, a rescue requiring rigging gear or what ever the alarm requires, and then sit down or grab the "oh Jesus" bar and enjoy the ride. On the other hand I have been en-route to working fires with just my lowers on and the rest in my arms. I found my self looking like Eddie Murphy in Beverly Hills Cop, saying "just tell me where the seat belt's at!", as we take a corner on 3 wheels.

    As for seat belts or no seat belts, now I have no choice. The truck we just got has the red seat belts and an alarm if someone is sitting in the seat without wearing the seat belt. Good, bad or indifferent.... some day it might save a life. Weather we agree with NFPA or not we should at least know most of the NFPA sections and how they affect us.

  5. While Im not for being unbelted....Pt care must take priority. I can see the headlines now. "Man dies in FD Ambulance while Paramedic buckels up for safety" or "Fd chooses buckels over public" something like that.

    Bottom line is until there is something better, you cant do proper CPR, buckled, you cant reach critical equipment while buckeld, you basically cant do your job. EMS is the one aspect of our job where we have a direct impact on actual pt survivability....far more than rescues froma fire building or any other aspect of our duties. I would love to be safe but that pt trusts me to do the right thing and I have to take that risk in order to keep them alive.

  6. Nice going people. Way to dumby this down to "tossed to and fro" as if that is the only consequence of an obvious unsafe act. We ride without the belts because we get away with it, pure and simple, guilty as charged. But that does not make it right or justify the practice. And how dare you place the concern for headlines over the life of even one of our brothers or sisters. So now let's ramp this discussion up to where the white shirt and gold badge bean counters of the world don't want it to be. If the patient is that critical you are traveling at high speed. If your medic unit is stopped dead or violently changes direction you won't. Remember mass X velocity =. You probably use it in your safety presentations. What on god's green earth makes you think it does not apply to you. "Tossed to and fro". How naive can you get? I applaude the author for at least considering cutting that speaker off in the middle of the presentation. Our job is to see to it we go home to our families after the end of every shift. God help us if our own rank and file are the ones supporting middle management suck up cost savings decisions that place us in jeopardy; especially when the solution is as simple as this. Buckle up, harness up. Call an all hands on deck and take guys off the ladder company, if necessary, to be extra hands for that GSW transport to the trauma center.

  7. eastcoasturbanfirefighterFebruary 2, 2010 at 8:36 AM

    I have worked 3 codes while riding in the PT compartment of a fire department medic in the past four months. Had I been seat belted in, I would not have been able to do the chest compressions needed on any of those patients.

    I have spiked IV bags routinely while we have been moving and wouldn't have been able to reach the sharps containers to dispose of needles if I was seatbelted in. Sure we could move the sharps containers closer, but then you'd sacrifice something else's close proximity, like where we store the BVMs, trauma dressings or the defibrillator. Just what I need, something else beeping at me and diverting my attention while trying to perform patient care...


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