Thoughts on staging away.

[fireman2138 0]

Just a thought guys but Ive noticed way to often that when a possible violent or hostile situation is dispatched with ems, Even stated at dispatch that it is recommended you "Stage Away" People still get to close. Sometimes right around the corner from the incident or right at the end of the street. The problem I see with this is the possibility of someone attempting to flee the scene running into you and thinking well I can slow them down or worse yet being so crazed and seeing our flashing lights and coming after us thinking we are PD.

I guess my question is When staging away What amount of Away Is sufficient? and is enough thought being given to apparatus and manpower placement in these situations?

Mike

[Oswegowind 17]

If it is the type of situation you just described, and you were informed to stage away, then I would have to say, TURN YOUR RED LIGHTS OFF to begin with! Obviously all you are going to do is rush to wait! Take your time, stage at a major intersection in the area and await further instructions. 2-3 blocks away is best, I think.

[fireman2138 0]

If it is the type of situation you just described, and you were informed to stage away, then I would have to say, TURN YOUR RED LIGHTS OFF to begin with! Obviously all you are going to do is rush to wait! Take your time, stage at a major intersection in the area and await further instructions. 2-3 blocks away is best, I think.

good point... but how many people think to do that. I mean in the moment at the scene are they going to think of turning the lights off . plus a fly car or chiefs car will resemble very closely a police car.. and some more rural areas dont have "blocks" and may not have somewhere convenient to pull off and wait .

Just some stuff to keep in mind and think about to stay safe..

Also HAPPY HOLIDAYS.

[Scottyk107 9]

Why would you go emergency in the first place? Go non emergency and if they give you the all clear then respond in. People usually respect fire and ems and see them as only there to help so I dont think that they will target you but there still is a chance you can get in the way.

[Guest EFFP411]

Why would you go emergency in the first place? Go non emergency and if they give you the all clear then respond in. People usually respect fire and ems and see them as only there to help so I dont think that they will target you but there still is a chance you can get in the way.

You never know what you have until you get there, if you go "Non-emergency" and take your time, and pd advises scene secure, critical situation, and you are not so close, you will be wasting valuable minutes.....

[RescueKujo 130]

You never know what you have until you get there, if you go "Non-emergency" and take your time, and pd advises scene secure, critical situation, and you are not so close, you will be wasting valuable minutes.....

I see both sides of it, having been on the bus and in dispatch, but I agree with what is quoted above. Our units roll hot, as our contracts do not give exemptions for "standbacks" (what we call them).

As for where to stage, I was taught out of sight of the location. I can't tell you how many times I've looked at our AVL maps and a unit "staging" is within 3-4 houses of the incident. While I would feel bad if something happened to the crew, I advised them to standback and they made the decision where. And when giving the verbal info, I make sure the crew acknowledges the need to stand back.

[x134 46]

I agree with the cold responce and staging away, far enough away. There needs to be good communication between the police dispatcher and ems/fire dispatch that the scene is safe and to proceed in. Lights and siren do not make up that much time. Mabey 30 to 45 secounds.

Edited December 23, 2007 by x134

[ONEEYEDMIC 68]

Here is the way I see it at least from a PD standpoint. You have an EDP. VIOLENT or not your are probably going to need an ambulance to TXP the person to PSYCH. AMB gets dispatched and told whether to respond with caution to a set area already designated by the an OFFICER AT THE SCENE. At no time should that crew come even close to where the CRISIS is before hearing so by the PD.

I guess the same thing goes for staging at a FIRE SCENE. If you don't want to get blocked in, then don't go anywhere near the scene. I know that if I get to a fire scene I park like a mile away.(Joking), but far enough that If for some reason I have to get out of there then I can. Not fun being blocked in by some fire trucks or fire hoses. I have seen that done.

Maybe there should be a training night dedicated to just staging and what your function is at the scene. We can't plan every scene or where every scene will be, but we can try.

On the way to any call I always run down certain scenario's. My friend MURPHY always seems to find me so I want to take him out of the EQUATION before I get there. Fastest Route for that time of day, Where to park, What to do if so and so happens. An old Teacher put that in my head and I will never forget it. You can also do this in your everyday life as well. BE PREPARED FOR THE WORST AND HOPE FOR THE EASIEST.

[Guest alsfirefighter]

You never know what you have until you get there, if you go "Non-emergency" and take your time, and pd advises scene secure, critical situation, and you are not so close, you will be wasting valuable minutes.....

Actually no you won't. Besides that the average time saved by running hot is only about 30 seconds or so, in most cases you will be playing the hurry up and wait game. You do not save time by running lights and sirens...most time wasted in trauma calls is on scene by doing things that can and need to be done while you are moving to the hospital.

Also if the argument wants to be made about saving time and responses and such, everyone would have staffed EMS coverage 24/7.

How far is far enough. That depends. If you can see the place and a person has a firearm that projectile can reach you. I often have also taken issue where some other units have staged. And regardless of the call if you are parked and not a hazard turn your lights off. There is no reason to light up a neighborhood and bring attention to yourself and you have a greater risk of someone not paying attention because of your emergency lights then you do with your hazards and marker lights on. Cover and concealment. While the thought process is great that yes someone could bolt out of the place, most cases if you look at them occur with one or 2 thoughts. The person commits an act and immediately bolts, there is a 911 call. A 3rd party reports a crime in progress and/or the person bolts immediately or PD arrives and there is a standoff. Rarely do you hear of this scenario occurring, most will not want to take part and flycars do not resemble PD cars where I work by any means. They want to distance themselves from the crime and the PD.

Either way...stage away and communicate if you have other resources where you are staging.

[JetPhoto 626]

And if you witness a fleeing suspect don't pursue the subject, just note the description and direction of travel and relay to 911.

Leave the police work to the people who get paid to do that job, Your no good to anyone if your dead.

[moggie6 54]

I just want to add that you should stay out of sight as much as possible. I know of some EMS crews who worked in Poughkeepsie that were put in bad situations because a crowd formed outside the scene and the ambulance was in the line of sight of the crowd. Try and remember some basic cover and concealment basics. Don't pull up to a street corner if at all possible or on a straight away. Park on a side street with a building blocking the ambulance and turn off the lights and siren. The siren will make people turn their head to the direction you are coming from. When your in a rurual setting stage even further then you would in a city scenario. Remember just like us, normal people have scanners and will listen to hear where your staging.

[fireman2138 0]

Guys all great ideas but sometimes things just don't work out... My town is rather large and sometimes you can be responding a distance greater then 20 minutes normal travel time..sometimes 20 minutes is just to much, we would be driving to the scene in a "non emergency" mode when the scene is still an emergency and here we are 15 minutes from the scene when pd clears it and tells us its a critical incident then we have to step it up. we could have been a lot closer .. (I know lights and sirens do not make the roads any shorter but the traffic is more of a killer then the distance sometimes.)

also... we have roads where there is no where to turn off and hide. sometimes your staging is on the side of the road awaiting pd to clear the scene.

Unfortunately most of the time in a Volli. setting there is no officer there to tell you where to stage and you cant really preplan that type of thing.. just use some common practices like stage in a large well lit and well traveled commercial establishments parking lot if possible and such.. and without being in direct communication with PD also doesn't help the police have to contact there dispatcher who contacts the 911 center who contacts us to tell us its clear. Maybe in a critical incident cut out the pd dispatcher and they still have to go through the 911 center which yes I know only takes a few seconds but still if they could tell you stage at such and such location before you get there that would be best.. And I know they have more important things on there mind so thats never going to happen

Mike.

[Guest alsfirefighter]

we would be driving to the scene in a "non emergency" mode when the scene is still an emergency and here we are 15 minutes from the scene when pd clears it and tells us its a critical incident then we have to step it up. we could have been a lot closer .. (I know lights and sirens do not make the roads any shorter but the traffic is more of a killer then the distance sometimes.)

I'm not saying I don't understand this and I work where traffic is the major factor over distance. The first thing I just want to chime in on is if you get dispatched to an "unknown medical" or you get the update that there was commotion in the background of a person asking for an ambulance, how is that an "emergency?" With that said, the overall point is there is a time and a place for everything and not using lights and sirens is an excellent option to assist in crew safety of such incidents.

Unfortunately most of the time in a Volli. setting there is no officer there to tell you where to stage and you cant really preplan that type of thing..

This is the only statement I disagree with. Why would anyone need an officer to tell you where to stage for such incidents? And yes you can preplan that type of thing. When you are dispatched to stage that is the time to preplan. Figure out where you are going to stage before you get into the area. In rural settings where your on roads, if that means at the closest intersection or cross street so be it. But you should have this decided quickly.

Moggie gave great points about staging and the thought that needs to be put into it. I'm not sure what staging in large commercial well lit areas that are well travelled does for anything. Just stage in a good area that protects you.

[helicopper 1,050]

Just a thought guys but Ive noticed way to often that when a possible violent or hostile situation is dispatched with ems, Even stated at dispatch that it is recommended you "Stage Away" People still get to close. Sometimes right around the corner from the incident or right at the end of the street. The problem I see with this is the possibility of someone attempting to flee the scene running into you and thinking well I can slow them down or worse yet being so crazed and seeing our flashing lights and coming after us thinking we are PD.

I guess my question is When staging away What amount of Away Is sufficient? and is enough thought being given to apparatus and manpower placement in these situations?

Mike

How far you stage away depends on a number of things - the type of environment (in a city, one block may give you three or four escape routes while in a rural area you may need to be substantially farther away) and the type of hazard (an EDP in a 5th floor apartment is a different threat than a street shooting or a structure fire) as examples. Many moons ago my partner and I "staged away" from a shooting job in a parking lot (lights out I might add) about 5-6 blocks away and the incident turned into a pursuit that terminated at the intersection right in front of our seemingly safe parking lot. Needless to say we had front row seats to the action - and we both wouldn't fit in the glove compartment!

Guys all great ideas but sometimes things just don't work out... My town is rather large and sometimes you can be responding a distance greater then 20 minutes normal travel time..sometimes 20 minutes is just to much, we would be driving to the scene in a "non emergency" mode when the scene is still an emergency and here we are 15 minutes from the scene when pd clears it and tells us its a critical incident then we have to step it up. we could have been a lot closer .. (I know lights and sirens do not make the roads any shorter but the traffic is more of a killer then the distance sometimes.)

also... we have roads where there is no where to turn off and hide. sometimes your staging is on the side of the road awaiting pd to clear the scene.

Unfortunately most of the time in a Volli. setting there is no officer there to tell you where to stage and you cant really preplan that type of thing.. just use some common practices like stage in a large well lit and well traveled commercial establishments parking lot if possible and such.. and without being in direct communication with PD also doesn't help the police have to contact there dispatcher who contacts the 911 center who contacts us to tell us its clear. Maybe in a critical incident cut out the pd dispatcher and they still have to go through the 911 center which yes I know only takes a few seconds but still if they could tell you stage at such and such location before you get there that would be best.. And I know they have more important things on there mind so thats never going to happen

Mike.

As ALS said, time and distance are your friend - even on rural roads one mile is a long way for someone to travel on foot and if the "threat" is leaving the scene in a vehicle he/she is probably not going to care about your ambulance parked on the side of the road a mile from the crime they committed. You don't necessarily have to "hide" - just be far enough away to avoid an immediate threat.

You don't need an officer on the ambulance to tell you to practice good scene safety, size-up techniques, or common sense! That's week one of EMT class. Relying on someone else to make decisions for you is no way to work in the field! Everyone's got to be thinking - especially about safety!

You absolutely can pre-plan for these types of things! Develop an SOP on what the appropriate response will be (hot/cold), where staging should be considered, how communications with on-scene units will be coordinated, etc. Then exercise it in training! Use pictures of the area, a command board, just local "trouble spots" that everyone will know, and run through scenarios with crews to get them thinking about safety in a practical and efficient way.

Finally, if you've got 20 minute response times as the norm because of the size of your area, I would suggest thinking about sub-stations or other ways of reducing the delay in delivering care to someone in need. That's an awfully long time to be waiting for oxygen, don't ya think?

[firemoose827 324]

Guys all great ideas but sometimes things just don't work out... My town is rather large and sometimes you can be responding a distance greater then 20 minutes normal travel time..sometimes 20 minutes is just to much, we would be driving to the scene in a "non emergency" mode when the scene is still an emergency and here we are 15 minutes from the scene when pd clears it and tells us its a critical incident then we have to step it up. we could have been a lot closer .. (I know lights and sirens do not make the roads any shorter but the traffic is more of a killer then the distance sometimes.)

I think that the point that gets misconstrued the most is the fact that lights and sirens can HURT you more than help you clear traffic. I have seen studies where most people cant hear the sirens untill you are on top of them, with all of the new air tight cars and high tech radio systems. So, if you are going through traffic hot, most people wont react untill its too late and then they will cause more of a clutter for you to avoid. Some times you will even cause an accident. Going cold is safer, and with the PD on scene you already have medically trained people there to render any life saving treatment like CPR, bandaging and airway maneuvers. ( Atleast the PD here are trained to First Responder level, some even EMT level.)

Maps are too often not used. Look up the address of the call and choose a safe distance away to stage. If you are rural like I am, there are a lot of farms with enough area to pull off the road and even "Hide" your rig in the barn, or behind it, or even use the corn fields to your advantage. I know it sounds stupid but most times there are access roads through the corn fields you can back into. The bottom line is know your response area, use the topography and features to your advantage to keep your crew safe, and prevent injuring any other innocent civilians during your response. Lights and sirens WILL NOT save you any time.

Stay safe and use common sense out there.

Moose

[AFS1970 504]

It is interestign that everyone here is discussing the best way to stage, but pretty much all agreeing that to stage is a good thing. I heard a call on the Radio the other day but it is certainly not a new or unusualo occurance for the agencies involved.

PD, FD & EMS get sent to an EDP call, I believe it was an attempted suicide call with ALS Potential, but a staging order (with no specific location) was given out over the air to the FD & EMS units on initial dispatch. Everybody responds, and PD is the lead on scene handling the call. Several minutes into the call the FD unit's Officer calls in and asks if they are clear to go in or they still need to stage, because the EMS unit did not stage, followed the PD right in and the crew is inside the building.

How on earth is this practicing scene safety? First of all the begining of such an incident is probably the most unstable, and the PD units have more to worry about than just the safety of us as EMT's (who at that point are little more than bystanders with uniforms) until the situation is as calm as possible. But this is brought to light by the FD unit that follows orders and does one thing while an EMS unit from a different agency freelances and gets involved in apotentially dangerous call.

Now as often happens, this call ended well for all responders, thankfully noone got hurt and everyone went home that night. But I wonder why anyone would think that because most calls end well, that they all will end well. We can not afford to get so complacent with our own safety. But how do you deal with this type of situation, when there are multiple agencies involved?

[NWFDMedic 58]

I guess my question is When staging away What amount of Away Is sufficient? and is enough thought being given to apparatus and manpower placement in these situations?

Hi Mike. I think the answer to your first question is that the answer lies in knowing your response area. If you are in a city environment with short response times, I wouldn't even turn on the lights and siren. If you're responding from further away, I'd cut the response sometime around 5 minutes from the scene. You should consider traveling well-traveled and well-lit roads if possible. You should avoid areas likely to be involved (ie. a bar with a "reputation" that is 5-6 blocks from the scene). Along with this, you should consider the possible means of egress for a perpetrator. I went to a shooting yesterday morning and pretty much all of these things came to mind in my response. All of these things come down to being vigilent in learning your response areas.

Apparatus and manpower placement is a whole different situation. No offense to any police officers on this forum, but a dispatch notification that the "scene is secure" only changes the situation from hot to warm in my book. As an EMS provider or firefighter, your job is to cover your rear end and your crew's, don't take anyone's word for it. I can remember a shooting several years ago where we responded with 2 ambulances and specifically placed one away from the hostile crowd and faced it out in case it became an evacuation situation. We left that ambulance in a close but safe area with a driver ready to go.

[fireman2138 0]

This is the only statement I disagree with. Why would anyone need an officer to tell you where to stage for such incidents? And yes you can preplan that type of thing. When you are dispatched to stage that is the time to preplan. Figure out where you are going to stage before you get into the area. In rural settings where your on roads, if that means at the closest intersection or cross street so be it. But you should have this decided quickly.

quote]

ALS, Im not saying you need an officer i was responding to someone elses post that said an officer should tell you where to stage.

[Guest alsfirefighter]

ALS, Im not saying you need an officer i was responding to someone elses post that said an officer should tell you where to stage.

Bro..I'm not replying to you directly..I never do..just what was in your post is a general manner. I just post off of others content for conversation and educational purposes.

[Goose 188]

Any time i get a call and i am directed to stage away this is what i do:

In the event that I'm not given a specific staging area i will respond non-emergency and stage approximately a block away. This means pulling over on the side of the road. Advise dispatch that I'm staged at xyz street and await the confirmation from PD that the scene is safe.

If the scene is cleared and dispatch advices that a critical patient is found, and your still enroute, then just shift into a code 3 response.

[MerlinMedic 5]

Some good thoughts here. What many have forgotten is that all too often the call is for general illness & in walks EMS into a bad situation. I know 2 crews that have had firearms pulled on them. One during CPR & one was a set up. Opening the door to the house & staring down the business end of a rifle sux. I also recall that until recently PD were rarely sent to EDP calls, or if they were there, as soon as EMS came up the PD were gone.

Poor judgement by some changed that. I know the EMS provider who tried to push thru the PD lines to "talk down" Mr. XYZ with the 12 gauge in his hands. Why the PD did not arrest that person is still a mystery to me.

It all comes down to judgement, as many people have said. Some of theat judgement comes from the school of hard lessons. Why do dispactchers check our status after X minutes? Because of crews like the one who walked in to be taken hastage -- back in the '80s EMS for the most part did not carry portables. No cell phone. Soooo after not hearing from the crew for nearly an hour someone was sent to check up on them and then the problem was discovered. Not that the crew was at fault. The person wanted drugs & called ES to take thier non-existant drugs -- it was an intermediate agency.

If the call seams suspcious, stay back. If you don't feel safe, call for PD or FD as the case warents. Use your head & go home at the end of the day alive.