ATTENDING A SCENE

DIFFERENT CALL TYPES & HANDLING THEM

EMS receives calls for emergency and non-emergency assistance via phone, radio, and dispatch. Civilian Down (911) calls are sent to dispatch when a downed civilian flexes their 'G' muscle to request assistance. Alternatively, they can do /911 to contact emergency/non-emergency services and relay a message. Injured civilians will often contact EMS if they are injured and need transportation to a hospital. Civilians can also use the Services App on their phones to call us directly and request assistance. LEO will switch to radio channel five (5), to request EMS attend a scene with either injured civilians or LEO. If an LEO goes down (is incapacitated and starts to bleed out) during a scene an 'Officer Down' alert will appear in the dispatch. All dispatch, radio, and phone requests for medical assistance should be answered, there are a few things to consider, however, when deciding which call should take priority, etc.

DISPATCH CALLS 

These are the most common types of calls. When a new call is received it will appear on Dispatch (in the top right-hand corner of your screen) and will be visible for a few moments. To open Dispatch and review recent calls, flex your 'Insert' muscle. Any available EMS (Advanced EMT+) can answer Dispatch calls. As an EMT you should only answer calls with your FTO. 

1) ATTACH TO DISPATCH CALL - To attach to a Dispatch call you can flex your 'E' muscle, this can be rebound as the same muscle opens and closes doors, etc. Alternatively, you can open Dispatch, select the call by clicking on it and manually attach, or detach from the call by clicking the appropriate option at the bottom of that call. 

2) RADIO TO INFORM OTHER EMS YOU ARE HANDLING THE CALL  You should always notify fellow on-duty EMS and FD members of your intention to respond to a call. Use the radio to tell them you are 10-76 to the latest civilian down, 911, etc. 

LEO/FD DOWN CALLS

 Law Enforcement Officer (LEO), or Firefighter (FD) down calls are the HIGHEST PRIORITY type of call EMS receives. These should be handled as swiftly as possible. If Dispatch displays an Officer Down call, EMS staff should switch to TAC 3 and ask LEO if they require assistance. ALWAYS contact LEO before heading to the scene of the Officer Down, these scenes are often Code 6 (Scene Not Secure), LEO can be involved in gun fights, car chases, etc. EMS interference could potentially hinder LEO investigations or ongoing operations. When multiple Officer Down calls are received, EMS will often station near the location of the call (a minimum of two blocks from an active scene). EMS should wait until officers inform them the scene is Code 4 (Scene Secure) before approaching to provide medical assistance. 

STEP-BY-STEP HANDLING

• Officer Down Dispatch Notification Received

• Switch Tac 3 & Contact LEO - Ask If They Need Assistance

• If Assistance Needed - Station 2-3 Blocks From Scene (Multiple Ambulances If Necessary)

• Wait For LEO To Call Code 4

• Approach & Transport (LEO First)

NOTE: If there are multiple people down, LEO, and civilians, ALWAYS treat LEO, EMS, and FD before treating injured civilians. LEO, EMS, and FD calls ALWAYS take priority over Civilian Down calls. 

LEO REQUEST FOR ASSISTANCE CALLS 

At times, LEO will switch TAC to TAC 5 and request EMS assistance. In these situations, it is usually suspects who require medical attention. LEO will provide a postal address. The EMS responding to the call should notify other EMS of their intention to take the call "10-76 to latest request for EMS assistance", etc. 

SPECIAL TREATMENT FOR SUSPECTS - These patients/suspects can be transported to Pillbox, they should ALWAYS be taken upstairs. As a general rule, we always treat suspects behind the locked doors, upstairs in Pillbox. As a note, officers will usually refer to suspects as 10-95's or 95's. If they ask "Where is the 95 you just brought in?" They are asking where the suspect you just transported is. 

NOTE: Suspects can be stabilized, but are not to be treated fully unless LEOs are on the scene at the hospital.  

DANGEROUS SCENES

EMS can be called to a variety of dangerous scenes and situations, with this in mind; always approach with caution. Slow down as you near the location of the call and listen for gunshots, or other sounds that might indicate an altercation is in process. If you see, or hear anything that gives you cause for concern, move to a safe location, switch TAC to TAC 3, and ask for LEO assistance. "EMS requesting assistance at postal ___, gunshots heard." Wait for LEO to arrive and inform you the scene is secure before returning to the scene of the call. 

EXAMPLES OF DANGEROUS SCENES

• A Civilian Down Is Surrounded By LEO's

• A Robbery Is Taking Place

• A Gunfight Is Occurring

• A Hostage Situation Is Ongoing

HANDLING DANGEROUS SCENES

When handling dangerous scenes, safety first. Drive the ambulance from any immediate danger and station near the location of the call (a minimum of two blocks from an active scene). EMS should contact LEO and request assistance then wait until officers inform them the scene is Code 4 (Scene Secure) before approaching to provide medical assistance. 

STEP-BY-STEP HANDLING

• Gunfire Is Heard/Seen (Or Other Behaviour That Causes Concern)

• Move At Least TWO Blocks From Scene To Secure Location (Code 2 - Lights Only)

• Switch Tac 3 & Contact LEO - Ask For Assistance

• Wait For LEO To Call Code 4

• Approach & Transport (Injured LEO First - If Applicable)

NOTE: If there are multiple people down, LEO, and civilians, ALWAYS treat LEO, EMS, and FD before treating injured civilians. LEO, EMS, and FD calls ALWAYS take priority over Civilian Down calls. 

ARRIVING ON SCENE

Once you arrive on the scene, assess the situation. Is the patient conscious or unconscious? If they are unconscious, the priority is stabilization. 

1) Is  It Safe To Treat? Patients who are in dangerous locations (the middle of the road), should be moved before treatment if it is safe to do so. Putting your own life at risk to treat a patient may result in more than one patient needing treatment. 

2) Is The Patient Conscious? Unconscious patients have bled out, they will need immediate stabilization using either CPR or the defibrillator. Use the Individual First Aid Kit (Ifak) to restore vitals and ready the patient for transportation. 

3) Are There Signs Of Back/Neck Injury? Patients who may have sustained back or neck injuries should be strapped to a backboard, have a neck brace, etc. fitted before transportation. 

Once stabilized, the patient may not remember what happened to them as injury can cause memory loss. Ask them instead; "Where does it hurt?" You can also look for visual clues. If there is an abandoned motorbike next to them and you find them in the middle of the road, it is not a massive jump to assume they may have been involved in a motorbike accident.  If other people are present, ask them if they know what happened. 

TRANSPORT - A stabilized patient should be transported, as soon as possible, to the nearest hospital before further treatment can be provided.

Always remember to use 10 Codes to inform other EMS Staff on duty that you are in transit, transporting a patient, and will be returning to the hospital shortly. 

TRIAGE & HOW TO HANDLE MULTIPLE PATIENTS

Triage is a process utilized in medical settings to prioritize patient treatment based on the severity of their condition. It involves rapid assessment and categorization of patients to determine the order in which they should receive medical attention.

ASSESSMENT - Typically, patients are sorted into three main categories: those who require immediate attention to save life-threatening conditions, those who need medical care but can safely wait for a short period, and those whose injuries or illnesses are minor and can wait for treatment. Simply put; the patient most likely to die from their injuries is treated first. 

Triage ensures that those most in need of medical care receive it before those who can safely wait. 

TRIAGE, SOP & LEO - EMS SOP states that if there are multiple people down, LEO, and civilians, ALWAYS treat LEO, EMS, and FD before treating injured civilians. This contradicts standard triage principles but does not rule them out. Triage is performed differently; first assess all LEO, EMS, and FD and prioritize treatment accordingly then assess civilian casualties and treat according to triage rules.