Canceling Responding Units?

[RWC130 594]

Canceling Responding Units?

POLICE:

Should a Police Officer/Police Dispatcher cancel a responding Ambulance or Fire Apparatus to

the scene of a call if he/she feels they are not needed?

FIRE:

Should a Fire Chief who is responding and not yet on scene cancel responding units to a

report of a structure fire,smoke in a structure, car fire, car accident, etc if notified by dispatcher the

alarm has been downgraded? (i.e. reported structure fire extinguished by the homeowner)

Should you keep everyone coming in? What happens when you do cancel a unit or all units

and you get on scene to find smoke showing or a working fire? Whoops!

EMS:

Should a Fire Chief who is not a CFR, EMT, or Paramedic cancel Advanced Life Support?

Another question... Should an EMT cancel Advanced Life Support that has been dispatched to a call because they feel it's BLS?

As EMT's we can however why not keep them coming in?

Obviously a broken right toe I might cancel ALS. lol

But maybe the broken toe was because of a 35 FT fall? HMMMMMM

Yes, a bit extreme... but do you get a feel for what I mean?

Any liability involved if you do cancel ALS that was dispatched and the patient condition goes bad?

Why not CYA and let the Paramedic evaluate the patient if ALS is dispatched and responding?

We have a lot of Fire Chiefs, Captains, Lieutenants, and Senior FF/EMT's both Career and Volunteer

here on EMTBravo, I asked the questions just to get a feel of what YOU would do?

Some agencies have a policy once a unit is on the road and responding you CANNOT cancel them.

Your thoughts?

GO GIANTS!

[jack10562 414]

1- I feel the police officer on the scene is qualified to assess "his scene" and can make a decision to cancel either fire or ems, or both, if not needed.

2- Dispatch only relies on "hearsay" and that is not sufficient cause to change response.

I don't recall having ever heard a responding Chief or officer issue orders to slow down or return, based on a radio report, unless it was from someone qualified, already on the scene.

Once the situation is confirmed, then he/she can safely order a non-emergency response, or cancellation.

3- An EMT should be able to downgrade the call to BLS, once PT condition is known. ALS can then decide whether to continue in, 10-20.

ymmv

go big blue!

[Guest feraldan]

Another question... Should an EMT cancel Advanced Life Support that has been dispatched to a call because they feel it's BLS?

As EMT's we can however why not keep them coming in?

A lot of the time, I do it out of courtesy. Why waste a medic when they could get a call for something cardiac related 10 minutes into our call? Why risk L&S response on something we can easily handle? What if ALS gets into an accident?

Also there are times where adding a medic to the mix will just complicate things and might even put too many people on the call. You get the whole 'standing around with your hands in your pockets' thing, which doesn't exactly look professional.

[20y2 43]

Yes to all. I know that when working as either a police officer, paramedic or dispatcher I don't do things to 'CYA', I do things because they are the right thing to do and have never gotten into trouble as a result of it. Yes, every once in a while something will go awry, but as long as you can articulate your actions, you will never get into trouble. However, do not confuse this with cutting corners, because that is not what is meant. If we were to do everything 'CYA', it takes discretion and any kind of thought out of the process.

[Guest alsfirefighter]

1. The police officer should notify through their dispatch of what they have and allow the OIC of incoming units to make a decision of what should be done. Unless it is obvious. I have seen occassions where there was a small fire that was extinguished and PD attempted to cancel. It must be kept in mind that all fires by state law are to be investigated and a cause determined by the Fire Chief.

2. No Chiefs with no medical training should not be cancelling an ALS unit. If it say is an MVA with no injuries, different story.

Cancelling units on a callback is a huge liability. The OIC should make this decision based upon a set department policy. Most would have at least 1 engine continue in to confirm. Not doing so puts libability and who knows where the caller is actually calling from. This has happened to a department in Westchester where they were cancelled by call back of the homeowner through the alarm company. The homeowner wasn't home, no units continued in until they went back with fire showing.

3. Yes, BLS should be able to cancel ALS. This is called resource management. But only after arriving on scene, assessing the patient and ensuring that it is a BLS call. I have some agencies I deal with that are great at this and others that cancel you as you're walking through the door. Borderline cases yes have them continue in. There also is no "feeling its BLS," either the condition falls within your scope of practice that you can manage or they need more then your scope and you need ALS. The liability of cancelling ALS and having the patient go south is more of not returning ALS as an intercept or getting them to a facility. There is very little that can go wrong based on a clinical decision and proper BLS treatment. When I get called for intercepts, I only get done what I can while the vehicle is in motion. Distance to facility dictates this being one of the most important actions is getting the person to more difinitive care. Some systems have limited resources based on unit numbers and area covered, and in some systems ALS is dispatched on every call, just because they are dispatched doesn't mean you need a medic to evaluate. This concept in many areas has led to a dependency on ALS. Some dispatchers through EMD processes prioritize calls very successfully where ALS isn't dispatched to low priority calls. This is basically the same process...most good dispatchers will weed out the broken toe from a 35' fall. Even if they don't you will when you get there and either request ALS or allow them to continue in.

What exactly is "10-20." If you want to even use plain english "proceed with caution," everyone does that on every call. You either need ALS or you do not. Decisions aren't generally made across a radio. The old signal 10-20 is a misnomer that departments/agencies should have written a policy on for what to do. I've seen the gambit. You are either Hot or Cold...lights/sirens or nothing at all. There is no in between. You tell me to proceed with caution you may be sitting there waiting for me for a while because I'm shutting everything down.

[bmfd231 3]

I do not believe the police should cancel responding units once the button is pushed for their response. Since the fire department would have a response proticol to follow, the FD should continue in regardless. The PD should contact the fire chief or officer in charge of the response, who would make the decision.

[ONEEYEDMIC 68]

Lots of time we get called for AUTOMATIC ALARMS. Patrol will get there and find out that there is no real problem and attempt to cancel the FD. We then call 60 Control and let them know what we have. Most of the time, the FD Chief will be on scene and cancel the other Apparatus. On the other hand, I find out from the homeowner where the alarm came from. On a call once I did this and found that a MICROWAVE had gone bad and actually started to heat the inside of the wall. After touching the wall and it was HOT I wanted the FD to check it out.

We have to dispatch the MEDIC to EVERY CALL which I personally think is ridiculous. But it is what it is. I know that you can't go on dispatch INFO for PT info. You know the UNKNOWN MEDICAL. How do you have and UNK MED? Never figured that out. If you are calling for the AMB there has to be SOME KIND OF PROB. Regardless, we send the MEDIC. I would say 90% of the time the MEDIC is there first anyway so they determine if it is going to be ALS or BLS. Given the nature of the original call, if the AMB wants to cancel the MEDIC then so be it. EMT's know the difference between ALS and BLS don't they?

[20y2 43]

Oneeye, why do you capitalize so many words? I notice that you do this for every post and am not bashing you, I'm just trying to figure out why you do it.

[meat441 43]

Every department has their responsibility to act as they were trained, Police, Fire and EMS.

A few examples in my area? PD arrives at the scene of an automobile fire. Officer utilizes his and another PD extinguisher. Fire is quelled and the officer cancels FD and requests a towing company. Towing company arrives, the tow operator is winching the auto onto the flatbed and the auto re-ignites and the tow operator receives minor burns. Fire and (now EMS) respond. The tow operator is very upset upon arrival of FD and begins screaming at them why they did'nt properly extinguish the fire, to say the least. FD tells him that they were cancelled by PD. OOPs? This is still in litigation and the officer gets time off.

Fire alarm activation at a drug store early morning. PD arrives on scene reporting nothing showing from his patrol unit and tries to cancel FD. All fire unit's held in quarters for the exception of the FD officer. Upon arrival FD officer looks into the storefront window and can't see inside because of the heavy smoke condition covering the windows. The PD officer thought they had tinted glass? Working structure. Officer got time off.

PD arrives on scene of a reported stabbing to the back of a female. BLS and ALS are responding and the officer reports to cancel ALS because it's a small cut? BLS attends to patient finding no breath sounds from upper lung fields. ALS requested back to scene, 3 minutes later cardiac arrest. OOP's

These are real incidents that i have witnessed. Everyone is trained for what their specialty is. If you choose the liability side than i think you have chosen poorly. I know as an EMT if their is a fire incident then let fire handle it. If it's a PD incident, then it's their's.

DOCUMENT, DOCUMENT, DOCUMENT, it's no fun to be in front of a jury or even better a GRAND JURY to explain why this occured. Liability. On my day's off i'd rather be sitting at my lake fishing then not getting payed sitting in a court room because of someone else's mistake.

Policies and procedures before it occurs. After these incidents their are now procedures.

[ONEEYEDMIC 68]

Oneeye, why do you capitalize so many words? I notice that you do this for every post and am not bashing you, I'm just trying to figure out why you do it.

I do it mostly to emphasize certain points of my post that I want to stick out. Sorry if it bothers you. Just a habit that I like to do. I read by scanning. I don't read every word in a sentence. When I see CAPS, my brain tells me to read that sentence because it may be something important.

I notice this on lots of posts, not only mine. Great minds must think alike then.

[turk182 37]

Why would a police officer/firefighter/emt or who ever want to assume the liability of canceling another department. I can understand advising any incoming units of what you have. Once another department is dispatched it should be up to that departments IC how to handle that call.

[Bnechis 3,961]

1- I feel the police officer on the scene is qualified to assess "his scene" and can make a decision to cancel either fire or ems, or both, if not needed.

If the officer is not trainined then how can he/she be qualified?

Our PD likes to transport psychs to MVH and often has had EMS disreguard or RMA these pts. then they are transported by PD. in 2006, 4 of those pts were admitted to MVH ICU for metabolic problems, not psych.

2- Dispatch only relies on "hearsay" and that is not sufficient cause to change response. I don't recall having ever heard a responding Chief or officer issue orders to slow down or return, based on a radio report, unless it was from someone qualified, already on the scene.

Once the situation is confirmed, then he/she can safely order a non-emergency response, or cancellation.

We do this almost every day. Home owner calls and says the A/A was steam from a shower, or cooking or the fire place damper was not open, we send everyone back except the 1st due Eng. who continues at non-emergency mode.

We have over 40,000 automatic alarms in the last 20 years and less than a dozen have been working fires. Can't risk getting members or the public killed on these numbers. I bet we have had more workers descovered by just spotting them when out driving (training, inspections, dinner, etc.)

3- An EMT should be able to downgrade the call to BLS, once PT condition is known. ALS can then decide whether to continue in, 10-20.

Generally yes. But, over the years I've seen a few crews that would downgrade everything because they didn't like ALS. So downgrading is fine as long as there is a good QI/QA program to keep things on track.

[Bnechis 3,961]

What exactly is "10-20." If you want to even use plain english "proceed with caution," everyone does that on every call. You either need ALS or you do not. Decisions aren't generally made across a radio. The old signal 10-20 is a misnomer that departments/agencies should have written a policy on for what to do. I've seen the gambit. You are either Hot or Cold...lights/sirens or nothing at all. There is no in between. You tell me to proceed with caution you may be sitting there waiting for me for a while because I'm shutting everything down.

10-20 was always supposed to mean, proceed under normal driving rules. But it did not fit nice on the cheat sheets, so it was written "proceed with caution".

Everytime 60 Control uses the plain speak with this line, I cring. since we should always proceed with caution, isn't that the law. I think that term, just makes it more likely you'll end up talking to lawyers.

[NWFDMedic 58]

Should a Police Officer/Police Dispatcher cancel a responding Ambulance or Fire Apparatus to

the scene of a call if he/she feels they are not needed?

No and by state law the police officer cannot cancel responding fire apparatus. In obvious cases, (ie. an MVA dispatched that turns out to be a disabled vehicle) the police can advise the responding units and allow them to decide at their discretion.

Should a Fire Chief who is responding and not yet on scene cancel responding units to a

report of a structure fire,smoke in a structure, car fire, car accident, etc if notified by dispatcher the

alarm has been downgraded? (i.e. reported structure fire extinguished by the homeowner)

This should NEVER happen. I have no problem slowing units to code 1 or continuing the first engine and manning other apparatus in quarters, but as a fire chief you are just plain stupid to take the dispatcher's information without seeing it. How many times have we heard of trained firefighters putting out a fire and finding out that it wasn't out and you are going to trust the word of a homeowner?

Should a Fire Chief who is not a CFR, EMT, or Paramedic cancel Advanced Life Support?

This should never happen, unless of course it's the false medical alarm type call. If there's a patient and it's dispatched ALS, it's ALS until a qualified medical professional says otherwise. I'll address my feelings about this in the next questions.

Another question... Should an EMT cancel Advanced Life Support that has been dispatched to a call because they feel it's BLS?

As EMT's we can however why not keep them coming in?

The EMT cirriculum is designed to teach providers patient assessment that will identify apparent life threats. Good EMT's should have the assessment skills to decide if they are comfortable with a patient or not. Of course, if the paramedic is not comfortable with taking the cancellation based on dispatch information, he/she has the authority to continue in regardless of whether he/she is canceled.

Any liability involved if you do cancel ALS that was dispatched and the patient condition goes bad?

Why not CYA and let the Paramedic evaluate the patient if ALS is dispatched and responding?

Actually the liability can rest with the EMT, the BLS service, the paramedic, and the ALS service. However, good assessment should protect you in most of these cases if you did what a "reasonable practitioner" would do. I'd reverse this question... why would you want to continue a paramedic on a call that is clearly BLS? There are not paramedics on every street corner and they don't need to be taken out of service for CLEARLY BLS patients. If it's borderline, by all means, keep them coming, but otherwise, put them back in service.

Some agencies have a policy once a unit is on the road and responding you CANNOT cancel them.

If an agency has that policy, I'd hate to be their lawyer when an unnecessary piece of apparatus gets in an accident and kills someone. If you don't need them, turn them back.

GO GIANTS! - agreed!!!

[firecapt32 282]

My father once told me somthing about the fire service that I have never forgotten--" you can always tell them why the apparatus is there but believe me you will have a much harder time telling them why they arent" so I think they were good words to live by back then-- and good words to live by now.

[Bnechis 3,961]

A few examples in my area? PD arrives at the scene of an automobile fire. Officer utilizes his and another PD extinguisher. Fire is quelled and the officer cancels FD and requests a towing company. Towing company arrives, the tow operator is winching the auto onto the flatbed and the auto re-ignites and the tow operator receives minor burns.

Our common version is; MVA PD determines its propert damage only and cancelles FD & EMS. Then 20 minutes later as tow truck is removing the car, calls FD back for Fluid Spill in roadway.

[NWFDMedic 58]

Our common version is; MVA PD determines its propert damage only and cancelles FD & EMS. Then 20 minutes later as tow truck is removing the car, calls FD back for Fluid Spill in roadway.

Why would the FD get called back to this? The tow company is there, shouldn't the spill be their problem?

[INIT915 1,119]

Should a Police Officer/Police Dispatcher cancel a responding Ambulance or Fire Apparatus to

the scene of a call if he/she feels they are not needed?

No and by state law the police officer cannot cancel responding fire apparatus. In obvious cases, (ie. an MVA dispatched that turns out to be a disabled vehicle) the police can advise the responding units and allow them to decide at their discretion.

Can you cite this law?

[INIT915 1,119]

Here's a twist-

Hypothetically:

You are notified that you can 'cancel', but decide to continue in. While doing so, you negligently cause an accident. Do you have increased liability in this instance?

[NWFDMedic 58]

Can you cite this law?

I can get you the exact wording next time I'm in my chief's office, but the long and short of it is that the fire chief is responsible for the property that the fire department is dispatched to upon dispatch. It is the responsibility of the fire chief to insure that the property is safe before it is turned back over to the property owner.

[helicopper 1,050]

Here's a twist-

Hypothetically:

You are notified that you can 'cancel', but decide to continue in. While doing so, you negligently cause an accident. Do you have increased liability in this instance?

If you're using lights and siren after being advised that you can respond "10-20" or "with caution" for a situation already assessed by emergency responders on scene, YES, you may have greater liability. There have been instances where this has happened around the country.

[NWFDMedic 58]

Here's a twist-

Hypothetically:

You are notified that you can 'cancel', but decide to continue in. While doing so, you negligently cause an accident. Do you have increased liability in this instance?

I can answer this easily and most people won't like the answer. If you negligently cause an accident, then you are liable regardless. If you acted with due regard and it can be shown that you did, but still get in an accident, your liability will be increased if you are not responding to a "true emergency". A true emergency would be one that you have reason to believe that there is a significant risk to life and property. If you are told that you can 'cancel', you should be responding code 1 because there is very little chance of an imminent risk to life and property that could be mitigated by your code 3 response.

[helicopper 1,050]

10-20 was always supposed to mean, proceed under normal driving rules. But it did not fit nice on the cheat sheets, so it was written "proceed with caution".

Everytime 60 Control uses the plain speak with this line, I cring. since we should always proceed with caution, isn't that the law. I think that term, just makes it more likely you'll end up talking to lawyers.

Exactly!

[NWFDMedic 58]

10-20 was always supposed to mean, proceed under normal driving rules. But it did not fit nice on the cheat sheets, so it was written "proceed with caution".

Everytime 60 Control uses the plain speak with this line, I cring. since we should always proceed with caution, isn't that the law. I think that term, just makes it more likely you'll end up talking to lawyers.

Hey, if you really want to cringe, there are agencies in both counties that I work in that will respond code 3 even if the call is EMD'd to a code 1 response. Every call gets lights and sirens. I can understand at times where you may be familiar with the patient and have reason to believe the call may be more severe, but I would be calling dispatch and telling them that I am going to respond code 3 based on past history and the possibility of the call being a true emergency.

[helicopper 1,050]

I can answer this easily and most people won't like the answer. If you negligently cause an accident, then you are liable regardless. If you acted with due regard and it can be shown that you did, but still get in an accident, your liability will be increased if you are not responding to a "true emergency". A true emergency would be one that you have reason to believe that there is a significant risk to life and property. If you are told that you can 'cancel', you should be responding code 1 because there is very little chance of an imminent risk to life and property that could be mitigated by your code 3 response.

If you're told to cancel by a competent authority (depending on your system, that may be a variety of players) then you should have cancelled! Why are you still responding in any mode if you've been told you're not needed and can clear?

If you are acting with due regard and are involved in an accident, your liability will increase? Is that a typo? You will probably be indemnified if you're acting in good faith and with due regard. If you ignore response instructions (codes for response or other directions) you're probably going to bear some personal responsibility.

As for other disciplines cancelling each other, that depends on the structure and sophistication of the system that the resources are operating in. We don't have a very sophisticated system and are still quite territorial so this doesn't work very well in our area. In other parts of the world, when a unit arrives and assesses the scene, they broadcast the assessment and may cancel some resources or request others and it works very well. At the very least, the ranking officer from a different service uses that assessment to determine what his/her agency will do/how they will respond. I still find it absurd that when the IC (that is the person on scene in command) requests a modified response, or that resources stage at a given location, these instructions are ignored because they're coming from a person in a different uniform. That's ridiculous.

For EMS, there is no reason at all why a trained EMS professional (CFR, EMT, or medic) can't cancel ALS if the call is BLS or vice versa. To require an ALS response on every call is not practical or cost efficient (I know, there are lots of examples where this still happens around here).

Sure there are going to be instances where a patient triaged to BLS changes status and would benefit from ALS but they are in the minority and easily captured by the system's QA/QI program as BNECHIS indicated. Medics can triage patients to BLS too. In many systems the BLS providers are entirely too reliant on the medics and won't cancel them even when other calls are holding and the one they're on is clearly BLS.

Please do provide the citation on this elusive law that people often refer to when discussing who should be in charge or who's the ultimate authority. There are laws that require certain things of certain officials but there is nothing that I'm aware of that prohibits resources from cancelling each other - again that's a system issue.

[helicopper 1,050]

Hey, if you really want to cringe, there are agencies in both counties that I work in that will respond code 3 even if the call is EMD'd to a code 1 response. Every call gets lights and sirens. I can understand at times where you may be familiar with the patient and have reason to believe the call may be more severe, but I would be calling dispatch and telling them that I am going to respond code 3 based on past history and the possibility of the call being a true emergency.

There are agencies all over the place that respond TO everything with lights and siren and FROM the scene to the hospital with EVERY patient with lights and siren. It is absurd, dangerous, and if you really think about it, illegal.

It is pathetic and just goes to show how far we have to go before we have a real emergency services system around here.

[Bnechis 3,961]

Why would the FD get called back to this? The tow company is there, shouldn't the spill be their problem?

Our tow company just tows, sometimes they sweep up the glass. But hazardous fluid spills on a road way they will not touch.

[ex-commish 490]

Canceling Responding Units?

POLICE:

Should a Police Officer/Police Dispatcher cancel a responding Ambulance or Fire Apparatus to

the scene of a call if he/she feels they are not needed?

No.

FIRE:

Should a Fire Chief who is responding and not yet on scene cancel responding units to a

report of a structure fire,smoke in a structure, car fire, car accident, etc if notified by dispatcher the

alarm has been downgraded? (i.e. reported structure fire extinguished by the homeowner)

No.

Should you keep everyone coming in? What happens when you do cancel a unit or all units

and you get on scene to find smoke showing or a working fire? Whoops!

Keep them coming but maybe kill the lights and sirens.

EMS:

Should a Fire Chief who is not a CFR, EMT, or Paramedic cancel Advanced Life Support?

No.

Another question... Should an EMT cancel Advanced Life Support that has been dispatched to a call because they feel it's BLS?

No. Why put yourself out there.

As EMT's we can however why not keep them coming in?

Good point.

Obviously a broken right toe I might cancel ALS. lol

But maybe the broken toe was because of a 35 FT fall? HMMMMMM

Yes, a bit extreme... but do you get a feel for what I mean?

Any liability involved if you do cancel ALS that was dispatched and the patient condition goes bad?

Why not CYA and let the Paramedic evaluate the patient if ALS is dispatched and responding?

CYA is the name of the game. Too many lawyers out there.

We have a lot of Fire Chiefs, Captains, Lieutenants, and Senior FF/EMT's both Career and Volunteer

here on EMTBravo, I asked the questions just to get a feel of what YOU would do?

Some agencies have a policy once a unit is on the road and responding you CANNOT cancel them.

Your thoughts?

GO GIANTS!

[20y2 43]

Can you cite this law?

I believe he is stretching the 'origin of all fires' law to fit this question, which would be incorrect.

[20y2 43]

Here's a twist-

Hypothetically:

You are notified that you can 'cancel', but decide to continue in. While doing so, you negligently cause an accident. Do you have increased liability in this instance?

The municipality is usually relieved of liability if by the rules and regulations you are to disregard and do not do so.