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#196910 - 03/01/10 04:39 PM 911 failure
Tyber Offline
Sheriff
Enthusiast

Registered: 04/27/09
Posts: 304
Loc: ST. Paul MN
Found this article and thought it would be good to share here.

http://news.yahoo.com/s/ap/20100228/ap_on_re_us/us_snow911_death

Sometime 911 can't or isn't able to respond even in the city/urban areas.

The article says that at one time the Ambulance was less than a football field away.

There are times that we will all need help, but sometimes we need to have Plan B, or even a Plan C.

This is a cross between three things,
1) Extreme unexpected weather for that region (as memory servers this is NOT a normal snow storm)
2) Sometimes you need to self rescue
3) There are times when "creative" rescue needs to be applied by the Rescuers and not "sit in the Ambulance" technique.


When I did rescue/EMS it was ONLY when creative solutions were necessary, (during the blizzard of 1992 in Maine I rigged up a snowmobile trailer to be a makeshift ambulance) but it bothers me that the rescuers weren't able to think outside the box.

With the level of pain and discomfort that is described I am not sure that a self rescue by the person and his Significant Other would have been possible by themselves, and even a neighbor couldn't get his car out to help.


The thing is after 4 hours I would have started thinking outside the box, started looking for a self rescue, after 10 hours, I would have given up and found my own solution (Give the guy down the block with the 4x4 some money or something to get you out)

This tragedy is a series of significant mistakes.

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#196912 - 03/01/10 05:06 PM Re: 911 failure [Re: Tyber]
chrisrich Offline
Stranger

Registered: 02/26/10
Posts: 1
Loc: USA
Quote:
Sometime 911 can't or isn't able to respond even in the city/urban areas.

The article says that at one time the Ambulance was less than a football field away.


Quote:
• Details of Mitchell's calls weren't passed on from one 911 operator to another as shifts changed, so each call was treated as a new incident.

• Twice, ambulances were as close as a quarter-mile from Mitchell's home but drivers said deep snow prevented the vehicles from crossing a small bridge over railroad tracks to reach him. Mitchell was told each time he'd have to walk through the snow to the ambulances; in neither case did paramedics walk to get him.

• Once, an ambulance made it across the bridge and was at the opposite end of the block on the narrow street where the couple lived — a little more than a football field's length. Again, paramedics didn't try to walk.


Unbelievable. This was preventable....he didn't have to die.
I wonder what kind of discipline the assorted drivers and operators were subjected to.
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#196913 - 03/01/10 05:28 PM Re: 911 failure [Re: chrisrich]
paramedicpete Offline
Pooh-Bah

Registered: 04/09/02
Posts: 1920
Loc: Frederick, Maryland
It is possible that the EMS crews/Emergency Communication are at fault and could have prevented this individual’s unfortunate death. However, before you completely condemn them from news reports (which we all know are always never wrong) let the full investigation take place. During times of a local or regional weather related emergencies, it may be necessary to triage calls and dispatch crews based upon priority levels. It makes little sense to dispatch an ambulance and potentially place both the crew and ambulance into unnecessary danger for a medical condition that is not critical and does not require immediate medical intervention. Until an autopsy and incident investigation can be completed, can we or should we fully judge the actions or inactions of an entire EMS operational system.

Pete

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#196921 - 03/01/10 06:32 PM Re: 911 failure [Re: paramedicpete]
Tyber Offline
Sheriff
Enthusiast

Registered: 04/27/09
Posts: 304
Loc: ST. Paul MN
I think that the point of my posting this is more to remind us (not that we need it) that sometimes people rely too much on the all mighty 911!

The systems that are in place can and may fail, due to either, human error, or overloading due to emergencies, or even natural disasters. We need to be ready for that.


and people need to be willing to be somewhat self reliant.

seriously no one within say 4 blocks of that house donesn't have a 4x4? even a stock subaru can push 12 inches of snow out of the way, (been there, done that)



Edited by Tyber (03/01/10 06:33 PM)

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#196922 - 03/01/10 06:39 PM Re: 911 failure [Re: paramedicpete]
Susan Offline
Geezer

Registered: 01/21/04
Posts: 5163
Loc: W. WA
"It makes little sense to dispatch an ambulance and potentially place both the crew and ambulance into unnecessary danger for a medical condition that is not critical and does not require immediate medical intervention."

The units had already been dispatched and the paramedics were sitting on their butts 1000' feet away because they didn't want to get their feet wet. Like they say, If it was easy, everyone would be doing it.

Self-evacuation sometimes isn't an option if you're having a heart attack, appendicitis, etc.

Sue

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#196929 - 03/01/10 07:46 PM Re: 911 failure [Re: Susan]
paramedicpete Offline
Pooh-Bah

Registered: 04/09/02
Posts: 1920
Loc: Frederick, Maryland
Sue, I agree 100% if that was the case and they were too lazy to walk the distance, they should suffer the consequence of their inaction. I was not there, so it is for me to judge their actions/inactions until a full investigation has been completed. I can only say what I would have done based upon previous calls. In 93’, 3 others and I walked 2.5 miles though a snowstorm after we had to abandon our 4-wheel drive Utility truck to get to the home of a pregnant woman. It took us an additional 3-4 hours to evacuate her using a plastic rescue litter and two snowmobiles dragging it 3 miles (had to go a different way) to the ambulance. I have been on other calls where we have had to walk to the patient through the snow, only to have to wait for a snowplow to open up the road to evacuate the patient, each call is different.

What I can say is, during the storms that took place here a few weeks ago, there were many EMS calls that had to go unanswered until conditions improved. Crews did their best, but countywide, ambulances, fire apparatus, snowplows, tow truck, police and even the National Guard got stuck on occasion.

Pete

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#196931 - 03/01/10 08:22 PM Re: 911 failure [Re: paramedicpete]
ILBob Offline
Old Hand

Registered: 02/05/10
Posts: 776
Loc: Northern IL
I would not be surprised to learn that the rescuers involved were not to blame for failing to get to the needy person. These days a lot of times rules that sort of make sense during normal times prevent people from being a little creative now and then. Its not unheard of for breaking such a rule to get one into a lot of hot water.

Quote:
Now Pittsburgh officials have ordered an investigation and reforms of the city's emergency services system as Mitchell's case highlighted key shortcomings:

• Details of Mitchell's calls weren't passed on from one 911 operator to another as shifts changed, so each call was treated as a new incident.

Where were the supervisors and managers of the 911 center while this was going on? Did this violate a procedure? Since the story does not say so, I am guessing the 911 operators did what they have been told to do.

Quote:
• Twice, ambulances were as close as a quarter-mile from Mitchell's home but drivers said deep snow prevented the vehicles from crossing a small bridge over railroad tracks to reach him. Mitchell was told each time he'd have to walk through the snow to the ambulances; in neither case did paramedics walk to get him.

• Once, an ambulance made it across the bridge and was at the opposite end of the block on the narrow street where the couple lived — a little more than a football field's length. Again, paramedics didn't try to walk.

The story says that when told to walk, the guy cancelled the call.

Quote:
"We failed this person," said Michael Huss, the city's public safety director.

To be sure, Mitchell's ordeal unfolded as the storm dumped nearly two feet of snow on Pittsburgh; the 911 system was swamped with more than twice as many calls as usual and overall emergency response was hampered.

Regardless of how deep the snow was, Huss said it was unacceptable that paramedics didn't walk to help Mitchell. If they had, Huss believes Mitchell may have survived.

"... You get out of that damn truck and you walk to the residence," Huss said. "That's what needed to happen. We could have carried him out."

Why don't you go carry him out Mr. Huss? Santimonious ^^^^^. I am pretty sure the rules of the forum prohibit me saying what I think about this guy.

Quote:
The six paramedics on the three ambulances could be disciplined, Huss said. He declined to say what that might be.

Paramedics or firefighters will now be required to go to a caller's door.

"Everyone needs to get a response," Huss said Thursday.

And as the guy supposedly in charge, you are the one who failed this citizen if anyone did. If one ambulance crew does something, that might be that crew's fault, but if three seperate crews do the same thing, that is the system's fault, and that would be you Mr. Huss. Man up and resign.


<added> The story mentions the call was never coded as an emergency. its entirely possible that it is against the rules to abandon their vehicle in such cases.


Edited by ILBob (03/01/10 08:51 PM)
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Warning - I am not an expert on anything having to do with this forum, but that won't stop me from saying what I think. smile

Bob

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#196935 - 03/01/10 09:10 PM Re: 911 failure [Re: paramedicpete]
paramedicpete Offline
Pooh-Bah

Registered: 04/09/02
Posts: 1920
Loc: Frederick, Maryland
One other item, which may or may not influence your view of how this incident unfolded. I live in an area where both urban and rural environments may be encountered. In general our Fire/rescue personnel deal with many situations requiring us to think outside the box. Individuals, who for the most part respond in strictly urban settings may not have the training or access to methods either by protocol, equipment or cultural (within the fire/rescue service) norms to deal with patients who cannot be directly transported from their inside their homes into the back of the ambulance.

Again, this may be a case of pure laziness, but it could also be the case where local protocol is so engrained into their thought processes, that using anything other that the ambulance cot may not be an option. For example, one of the main injuries EMS responders are subject to is back injuries from picking up patients. Many jurisdictions, utilize power devices on their cots or stair chairs to assist in raising the patient and loading them into the ambulance. Faced with the prospect of having to carry the patient through the snow without the benefit of the cot/power assist device, may have violated their local protocols, presented the possibility of self-injury and/or potentially ran the risk of dropping the patient. It is clear they misjudged/under-judged the significance of abdominal pain in this case, but having dealt with many patients whose chief complaint was abdominal pain, they may have decided not to risk injury. With all of that said, whether or not they were in the position to transport the patient back to the ambulance, in my humble opinion they should have at least made a reasonable attempt to access the patient.

Pete

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#196952 - 03/02/10 01:12 AM Re: 911 failure [Re: ILBob]
James_Van_Artsdalen Offline
Addict

Registered: 09/13/07
Posts: 449
Loc: Texas
I'm reluctant to pass judgment on the field crew when every press story quotes extensively the caller/dispatcher calls and none of them quote a single dispatcher/EMT exchange.

Originally Posted By: ILBob

Where were the supervisors and managers of the 911 center while this was going on?...

That's the one clear failure. This storm was unusual but not unprecedented: there needs to be procedures in place for supervisors to make sure the ball isn't being dropped when the dispatchers and field teams are stressed. In addition to shift hand-off issues they need to have an automatic review of any case that is open too long, or if there are too many calls rom one place in a short period.

And it means that Michael Huss, and the other political officials, had better have good answers as to where they were and what they were doing at the time. This was known to be a "all hands on deck" situation well in advance.

Quote:

The story mentions the call was never coded as an emergency.

I"m also thinking: if it's not an emergency, and the caller won't come out, what are the chances that crew has better things to do, i.e. other emergencies? When the dispatcher told the crew that the (non-emergency) caller would not come to the vehicle, did the dispatcher mention other emergency calls? How did dispatch react to their decision to leave and go to another call?

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#196955 - 03/02/10 02:10 AM Re: 911 failure [Re: James_Van_Artsdalen]
Eugene Online   content
Carpal Tunnel

Registered: 12/26/02
Posts: 2995
We may not know all the details but I can see how it could happen. Big city/union rules saying no one gets out of the ambulance without police escort due to being in the not so good part of town but the police were busy and never came. Unfortunately right and wrong can get get lost in the rules and paperwork.

Long story short but seeing the back end of 911 is why I started to prepare for myself.

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