Stethoscope Techniques, Auscultation Tips and Episode 192

Listener Daniel sent this in from a Facebook message:

I was just listening to your podcast and had a though about that news article about the paramedics being unable to respond to the patient in the water and I wasn’t sure how to post something on the MedicCast website. Anyway, I am an urban first responder and was thinking that even though they were on duty with their ambulance service with the protocol for no water rescues, but what if, like me, one of the rescuers had more qualifications as a lifeguard or water rescue, do you think the ambulance service would bother making an exception for people with advanced training to be allowed to assist the victim in the water?

I can see there being a problem with only having one rescuer to treat them, but at least one trained rescuer would be able to give hands-on instruction to the bystanders instead of just watching them in the water attempting to get the patient onto the longboard and possibly causing more injury to the victim.

I’d like to hear your thoughts on this. As a sidenote, I am a huge fan of the show. Im looking forward to getting my EMT-B and soon after my Paramedic certifications.

Thanks for the informative show!

Daniel,

Thanks for checking in with your comments. I think this would depend on the service and whether they knew of side training or capabilities. My thought is that this is a reaction to a whole series of issues with attacks and other dangerous situations for providers in the U.K.

This has led to many units, chase car paramedics, and other responders being staged to wait for support, police, or more equipment – in many cases in view of the victim and bystanders.

I’m going to try and get Mark Glencourse from the U.K. and Medic999 blog to chime in with his thoughts on this issue.

Hi Chaps,
Sorry its taken so long to comment, Im a tad busy this week in San Francisco.

Right then, firsty I can only comment on what would happen in my own service and what I personally would do. Although we are a ‘national health service’ each of the 12 services in the country do have thier own policies and procedures and may differ from time to time.

Reading the article, it sounds like the 2 inital Ambulance staff we more than willing to get into the water and tend to the injured party, however they were stopped by a supervising officer, stating ‘health & Safety’

In this particular incident, I would have most definitely gotten into the water. Its not as if it was any danger other than getting my feet wet. There have been two time where I have actually gone into the Tyne, the main river through Newcastle, to carry out care on a patient. Each and every paramedic performs a dynamic risk assessment on each job we go to, and Im know for a fact that is a universal truth across the world. If I feel I am safe in performing my actions, I will go in. If I think the risk is too great then I wont, and I will wait for appropriate support.

As for the other cases mentioned in the newspaper article, there are times when you sometimes have to wait for support before going into a job. It would be a dangerous and foolish thing to take the right away from a paramedic to say that they are not going into a job, as they fear for there saftey. However, there needs to be some common sense here too.

The phrase is ‘risk assessment’ not ‘risk averse’. Everything we do carries a risk. Do I say that I am not going to leave the station as the drive to the patient under emergency conditions is the most risky thing that we do, yet we do it day in and day out?

I am not supposed to go to assaults or violent incidents when I work alone on the car, however, if I know for a fact that the police are on scene and the assailant has been dealt with, then I am happy to attend.

Common sense is what is needed here. It is the best skill we have in out tool box, it just needs to be pulled out and used.