Passing the buck
by

I started out in rural EMS and ended up moving to the Big City, partly to help expand my skill level. I'll never forget one call my partner and I ran on. In our county, the FD is primary response, with Private BLS as transport only.

My partner and I responded to an unknown transport call (FD dispatch rarely fills our dispatch center in on what's happening). We arrive on scene to find a 5 month old female (born 3 months premature) with the family and FD on scene. I get the story from Fire as this:

Patient's pertinant history is chronic lung disease on home O2 6L blowby PRN. Turns out Dad was changing the baby's diaper, when he noticed that she wasn't kicking. He looked up and she was "purple". He then felt and listened for respirations and heart beat and detected none. While he started CPR, his wife called 911. On our arrival, the baby was breathing at 70 with a heart rate of 150. The child was also lethargic. "And, oh yeah, the family did 5 cycles of CPR before they got a heartbeat and respirations."

As it was my turn to Tech, I asked if the Medics had evaled the kid and received a 3 minute circular discourse on why they canceled the medics on their arrival, "But I'll call them back if you'd like".

The closest appropriate hospital was 25 minutes running Code, but the closest Medic unit was 15 minutes, so I took them up on the offer, figuring (wrongly) that the kid would be an ALS call. The medics arrived and were informed that my partner and I refused to transport, so the FD called them. I bit my tounge at that one. After a 1 minute exam, the medics called it bradycardia secondary to the chronic lung disease and ordered us to transport, so I smiled and we loaded up.

Enroute the kid started to get cyanotic again (resp. still at 70 and a heart rate at 150), so I started 02 10L by NRM blowby, which helped a little, but not much). I made my report to the ER at 3 minutes out and advised them that it was a medic eval (cleared for BLS), the kid's hx of CLD, her vitals, activity level (still lethargic...even to poking and prodding) and the O2 that I'd started, as well as the fact that the child had 5 cycles of CPR performed before she had spontaneous resperations and heartbeat (prior to the FD arrival).

On our arrival at Children's, I was met by the RN, MD, LPN and a crash cart.

Needless to say, the Doc had a "slight" fit when she discovered that my partner and I were BLS and that the Medics had pawned yet another transport off on us, especially after I gave her the "official diagnosis" from the Medics.

Life in the big city.
Another Anony-Mouse