Recently, the Internet has “blown up” over the two firefighters who, instead of waiting for an ambulance, put a seizing infant in their engine company and transported to a local hospital. Of course, I wasn’t there and as such, it’s virtually impossible to know everything about the call in question. However, that’s never stopped the attorney (or medic) in me from applying the 20/20 hindsight spectacles.
First things first. Pediatric calls scare all of us in EMS. We rarely have either much training or experience in pediatrics. Combine that with the all-too-natural instincts to panic when there’s a sick child and it’s a recipe for making some rash decisions. Not necessarily a wrong decision, but a rash decision. Most pediatric seizures resolve on their own and those that don’t require ALS medications. Also, the cab of most fire trucks aren’t set up for patient transport and/or treatment. Much like the National Registry exam, much of EMS (and medicine in general) is about choosing the “best” answer to your problem. I can think of very few cases in which transporting a patient in the back of a fire apparatus is the best answer. The legalities of using a vehicle not licensed for patient transport aside, it’s a potential legal quagmire in the event of a bad outcome. The back cab of a fire truck is NOT set up to safely transport a patient, especially a child, much less provide working space (or even equipment access) for a medic to treat a patient. For the overwhelming majority of medical patients, “scoop and run” or “load and go” went out with the Cadillac high-top ambulance. We’re medical professionals. We need to be taking care of business, making good decisions for our patients, not panicking, and then playing the “hero card” when we are held accountable for our decisions.
Of course, like anything in law or medicine, the more you know, the less absolute your answers become. But that’s another topic for another post….