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Home > Topics > Safety
September 04, 2014
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Behind the Patient: Street Portraits
by Michael Morse

4 ways firefighters can prep the EMS scene

Here are some ways firefighters can prepare the scene before EMS arrives

By Michael Morse

I am a great EMS officer working in a busy fire department, and I need good EMTs with me on medical calls.

I was a good firefighter working with great firefighters, but after 10 years I decided my talents were better utilized in our EMS division.

I can still keep up with the firefighters I had been working with; I just wear a different hat. I took a lot of heat for becoming, as people assigned to EMS in Providence, R.I. are called, a “Rescue Blow.” But I was comfortable with my decision, and as time progressed it turned out to be the right one for me.

A big reason I made the move was because the firefighters I worked with were simply bad EMTs.

It wasn’t lack of skill or training; the problem was with the firehouse culture. Most people believed that EMS was a secondary role of the fire service, and though necessary, not all that important.

The firefighters went through the motions of EMS reluctantly, never embracing what could be enormously gratifying responses, and simply showed up and did the bare minimum until “the EMTs” got there.

Changing the firefighter culture

That culture is slowly changing. Some traditions die hard, and firefighters’ reticence to embrace the role of EMT is one of them.

But traditions do emerge, and the very definition of a firefighter is beginning to include EMS with all the rest. The public’s perception of a firefighter now includes the people who arrive before the EMTs, who stop the bleeding, shock the heart, or deliver the medication that gets people breathing again — be it an allergic reaction or an overdose.

Now, if we can get the firefighters to embrace this emerging image, everything will fall into place. In the meantime, here are a few things for the firefighters to consider while “waiting for the EMTs.”

1. Size up the scene

Just like on a fire scene, a good scene size-up is imperative and should be instinctual. Headaches could be linked to CO poisoning, injuries from seizures could be prevented by making patients aware of potential hazards, and an injured child may be being abused.

By being observant on the scene and staying engaged on the call, you can render much more than just medical aid. Through simple observation, causes of illness and injury and subsequent treatment can be vastly improved. Best of all, you don’t even have to touch anybody.

2. Do a basic patient assessment  

The EMS officer en route to the scene is not looking to cure cancer or diagnose a strange disease; we just want a good set of vitals. Think blood pressure, heart rate, respirations, and blood glucose levels if appropriate and you have the right equipment.

Getting vital signs also forces you to connect with the patient, thus becoming more present on scene, which can lead to an overall more satisfactory experience for you, the patient, and the patient’s loved ones. Which leads us to …

3. Put patients at ease

First impressions mean a lot to patients.

You have likely been invited into their home during a stressful time. Be respectful, ask questions without interrogating, and don’t expect everything to be clean and orderly; people live the way they live.

Setting the stage is up to you, and depending on your approach and professionalism, the entire job can go well, or it can go downhill.

4. Make a move

Chances are the patient will be leaving his or her home, and a clear means of egress makes life easier for everybody, especially the EMTs who will be doing the moving.

Think about the job at hand. What will make the moving easier? Is there furniture, boxes or people in the way? Move them.

By working together everybody benefits. After all, we truly are all in this together, even the patient, without whom there would be no need for any of us.

About the author

Michael Morse is a rescue captain with the Providence Fire Department and the author of Rescuing Providence and Responding. He has worked on engine, ladder and rescue companies during his 21-year career. His current assignment is Rescue Company 5. Michael blogs at RescuingProvidence.com.
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