EMS and Lift Assists for FD & PD

[Remember585 815]

Perhaps someone has an actual answer to this and not just opinions.

Why do some fire and police departments respond to EMS calls that aren't CFRs, EMTs or Medics? What is the point and what value does it have for the patient or victim to have untrained people standing there with them, waiting on an ambulance?

As for lift assists, why do PDs and FDs handle these? Is there any kind of liability if "XYZ PD" or "FD" responds on a lift assist, moves a patient and further injures them?

I only ask because our FD only responds at the request of EMS, but discussion has come up about lift assists and what to do when the ambulance doesn't get out for a lift assist. Should Mutual Aid have to handle it, or is another emergency service in town (PD or FD) capable to handle this?

On a personal note, if there's a call for a cardiac arrest, I think no harm would come from sending all 3 services if they have AEDs - get someone with the right equipment to the scene as soon as possible.

Thanks

[OoO 24]

I ride in a district where PD responds to all EMS runs and most of the officers are not CFR or EMT certified.

I think they're presence helps out EMS more than the patient and I greatly appreciate them coming out. Entering someone's home could potentially be very dangerous, you do not know what kind of mental state the patient or family members/bystanders are in. The PD's presence makes a big difference in keeping the scene safe and making me more comfortable entering a dark strange home.

[Bnechis 3,961]

Why do some fire and police departments respond to EMS calls that aren't CFRs, EMTs or Medics? What is the point and what value does it have for the patient or victim to have untrained people standing there with them, waiting on an ambulance?

We send FD & PD. FD is BLS, PD ranges from none to BLS. PD policy is to respond to determine that no scene hazards or crime has been committed. Most cases where non trained responds is because the leadership thinks it "looks good" or it generates numbers. There is little value to the patient unless they are providing other non medical services.

As for lift assists, why do PDs and FDs handle these? Is there any kind of liability if "XYZ PD" or "FD" responds on a lift assist, moves a patient and further injures them?

PD or FD often do this because either the ambulance cant get out (or in a timely manor), we dont have enough of ambulances and have more PD/FD units, and because the ambulance (particularly commercial services) cant bill for non-transport.

There is liability on every call. If non-trained responders ask if the person has any injuries and they say no, then its not likely to be a problem. If they are, then picking them up is not an option and call EMS. We have been doing these calls for 30+ years and while we are all EMT's this is basicly how we do it and its never been an issue. Thats about 4,000 contacts since I've been on the job.

The concern I have is when you assist someone, are you evaluating their situation. We find (particularly on repeat calls) that many of the lift assist calls are seniors and their situation at that moment is they have fallen and can't get up, but the real issue is they may need other service, such as meals, home healthcare or relocating them to a residence that can better accomidate them (Sr. Housing, Community Assisted Living or a "skilled nursing facility"). We have also found that some of these calls require adult protective services.

I only ask because our FD only responds at the request of EMS, but discussion has come up about lift assists and what to do when the ambulance doesn't get out for a lift assist. Should Mutual Aid have to handle it, or is another emergency service in town (PD or FD) capable to handle this?

Sounds like a different issue. Mutual aid should be called because you need additional resources, not because you cant cover a basic call.

[Bnechis 3,961]

Entering someone's home could potentially be very dangerous, you do not know what kind of mental state the patient or family members/bystanders are in. The PD's presence makes a big difference in keeping the scene safe and making me more comfortable entering a dark strange home.

1313 Mockingbird Lane

[eric12401 77]

The FD I'm in responds to most if not all EMS calls, including lift assists. We're a very rural FD, so it takes the ambulance a little while to get to the scene. PD is usually called as well. Most of our guys are part of Marbletown First Aid, so their experience at the scene helps when the ambulance doesn't get there within a few minutes. FF's that aren't medically trained that go to the scene usually just go and help back the ambulance in if needed, otherwise they just stay at the firehouse.

[vin1230 8]

Although Ardsley has its own PD, we have volunteer EMS and volunteer FD. Our PD goes to lift assists, and they determine on scene whether or not the person needs medical attention and the VAC needs to be toned out (FD is never requested). I guess in this situation, its more of a matter of not wanting to tone out and wait for the ambulance when PD can just handle it on their own.

[vin1230 8]

And as for PD's who are not EMS trained, they often need to fill out a report on the call as well.

[wraftery 1,275]

As Bnechis said, there is liability with everything you do. If you don't want to do lift assits because your people are not trained in EMS you have options. You could train them. Or you could refuse to respond (that looks good in the newspaper). Or your city can have another agency handle this type of call. I suggest Sanitation, since they are trained lifters.

[NJMedic 96]

This is a local issue. My town has career PD, FD, and EMS. Police do not respond to EMS incidents unless there is a shooting, stabbing, or domestic violence. FD responds to MVAs with injuries, cardiac arrests, if EMS is delayed, and to all EMS requests in a certain area of town because if it's remote distance and highway delays. And of course EMS responds to everything. EMS will usually respond by themselves to life assists. EMS will call additional resources as needed.

[SECTMB 612]

Our volunteer FD responds to lift assists to do just that, assist in the lift. The PD stopped doing lift assists several years ago due to potential injury issues. The appropriate 1st due engine does not initiate a response until it is confirmed that the ambulance is staffed and responding unless the engine has an EMT on board.

There are, of course many instances when the ambulance crew is sufficiently staffed so as not to need any assistance but as everyone knows there can

be an unlimited number of circumstances and conditions that justify the "many hands make light work" approach.

FD response is immediate for all ambulance calls for MVA or PIAA.

[JFLYNN 681]

Perhaps someone has an actual answer to this and not just opinions.

Why do some fire and police departments respond to EMS calls that aren't CFRs, EMTs or Medics? What is the point and what value does it have for the patient or victim to have untrained people standing there with them, waiting on an ambulance?

As for lift assists, why do PDs and FDs handle these? Is there any kind of liability if "XYZ PD" or "FD" responds on a lift assist, moves a patient and further injures them?

I only ask because our FD only responds at the request of EMS, but discussion has come up about lift assists and what to do when the ambulance doesn't get out for a lift assist. Should Mutual Aid have to handle it, or is another emergency service in town (PD or FD) capable to handle this?

On a personal note, if there's a call for a cardiac arrest, I think no harm would come from sending all 3 services if they have AEDs - get someone with the right equipment to the scene as soon as possible.

Thanks

What exactly do you mean by... "when the ambulance doesn't get out for a lift assist" ?

To answer your question, as you have already noted, this is handled differently from place to place, however what we should all keep foremost in our minds is that, while these "lift assists" may not seem so glamorous to us as responders (no hero factor here whatsoever), to the patient and their family, this is a true emergency. These patients should not have to wait inordinately long periods of time for adequate help to arrive, and when the help arrives the responders (from whatever agency) should be capable and well trained. If this is not the case in any jurisdiction, immediate steps should be put in place to solve this serious problem. Some suggestions I would suggest be explored are cross training FD/ PD, regionalization or consolidation, and / or hiring career staff.

[JFLYNN 681]

Perhaps someone has an actual answer to this and not just opinions.

Why do some fire and police departments respond to EMS calls that aren't CFRs, EMTs or Medics? What is the point and what value does it have for the patient or victim to have untrained people standing there with them, waiting on an ambulance?

As for lift assists, why do PDs and FDs handle these? Is there any kind of liability if "XYZ PD" or "FD" responds on a lift assist, moves a patient and further injures them?

I only ask because our FD only responds at the request of EMS, but discussion has come up about lift assists and what to do when the ambulance doesn't get out for a lift assist. Should Mutual Aid have to handle it, or is another emergency service in town (PD or FD) capable to handle this?

On a personal note, if there's a call for a cardiac arrest, I think no harm would come from sending all 3 services if they have AEDs - get someone with the right equipment to the scene as soon as possible.

Thanks

One further question / point...in regard to the concern for PD or FD members being liable for causing further injury. isn't moving an unconscios patient part of all basic Firefighter training?

[M' Ave 1,466]

Ah the lift assist! This run varies for us. The engine is often sent on an EMS assist when the bus is already on scene. This is not an EMS run for the engine, as they are not requesting any EMS services. These seem to run the gamut. Sometimes it is some who is so large that the two EMS workers cannot lift the stretcher from it's lowest position to one that will allow them to get the patient into the bus. Other times it's a person who has been placed in a stair chair, but they project elevators aren't working and they need help carrying this person down 20 flights. I've even responded to assist the M.E. with a 500 lb corpse. You never know.

This run, at least for the FDNY, turns us into simple, reliable grunt labor. Which is fine! EMS has it tough out there sometimes. They carry a lot of heavy equipment and it's often two people left all by their lonesome. 95% of the time, we're happy to help them out. You get the occasional person who hands off the patient and vanishes until you've arrived at the bus, but that's rare.

As for liability....well, if we didn't help do what had to be done to get them out, they'd be in deep trouble. So....

[Remember585 815]

What exactly do you mean by... "when the ambulance doesn't get out for a lift assist" ?

You know what I mean. Stop trying to bait me or someone else. Nobody hear is ignorant enough to think that every EMS call is covered by the local agency all of the time. I'm pretty sure dozens of discussions of this type have happened here.

To answer your question, as you have already noted, this is handled differently from place to place, however what we should all keep foremost in our minds is that, while these "lift assists" may not seem so glamorous to us as responders (no hero factor here whatsoever), to the patient and their family, this is a true emergency. These patients should not have to wait inordinately long periods of time for adequate help to arrive, and when the help arrives the responders (from whatever agency) should be capable and well trained. If this is not the case in any jurisdiction, immediate steps should be put in place to solve this serious problem. Some suggestions I would suggest be explored are cross training FD/ PD, regionalization or consolidation, and / or hiring career staff.

You're right, it is handled differently in each jurisdiction. It's also handled differently every call, it seems. I hear some lift assists being handled by PD, others by EMS and some by FD - all in the same communities. I also agree that they are a legitimate call for help and that someone needs to respond and handle them in as timely a fashion as possible. I also think that since there is no medical emergency reported, there is no reason for responding personnel to utilize lights and sirens.

I suppose I could re-post my question with different wording...

Why do agencies continue to respond to medical emergencies and not have any certified training (CFR, EMT, etc.)?

Can a PD or an FD respond to and "correct" a lift assist without being EMS trained?

I know that Bnechis mentioned that NRFD routinely goes on Lift calls, and I also know that often times they request EMS for an evaluation/transport. It's good that they respond to these calls with their EMTs - but should other FDs not responding with EMS personnel even go - or should it be left to the EMS "professionals?"

[helicopper 1,050]

You're right, it is handled differently in each jurisdiction. It's also handled differently every call, it seems. I hear some lift assists being handled by PD, others by EMS and some by FD - all in the same communities. I also agree that they are a legitimate call for help and that someone needs to respond and handle them in as timely a fashion as possible. I also think that since there is no medical emergency reported, there is no reason for responding personnel to utilize lights and sirens.

I suppose I could re-post my question with different wording...

Why do agencies continue to respond to medical emergencies and not have any certified training (CFR, EMT, etc.)?

Can a PD or an FD respond to and "correct" a lift assist without being EMS trained?

I know that Bnechis mentioned that NRFD routinely goes on Lift calls, and I also know that often times they request EMS for an evaluation/transport. It's good that they respond to these calls with their EMTs - but should other FDs not responding with EMS personnel even go - or should it be left to the EMS "professionals?"

Several good points and questions here.

You're absolutely right that a "lift assist" is not an emergency and nobody should be using lights and siren to get there.

With regard to you second question, I'm not sure if you're calling "lift assists" medical emergencies and I think you're not because of your prior comment so I'll comment on both sides.

Anyone could respond to a lift assist as it is not a medical emergency. If they get there and ask, "are you OK?" and the response is "yes, I just can't get up (or I can't lift grandpa by myself)", I don't know what the issue would be.

I can't speak for why FD would respond to medical emergencies if they have no medical training but the PD may be responding to insure scene safety, insure that no crime occurred, complete a required report, protect the municipality from liability (sidewalk falls, incidents on municipal property, etc.), or it may simply be the "way that jurisdiction does things". I can think of several jurisdictions that send PD on everything and complete an aided report on everything regardless of where it occurred.

As with the point on use of lights and siren, FD and PD going to a "lift assist" aren't going on a medical call, they're going on a service call.

I'm not sure what your angle is here. Are you suggesting that lift assists are medical calls and should get a full EMS response? Is there a problem with the PD or FD responding to these service calls?

[M' Ave 1,466]

Why do agencies continue to respond to medical emergencies and not have any certified training (CFR, EMT, etc.)?

Can a PD or an FD respond to and "correct" a lift assist without being EMS trained?

I know that Bnechis mentioned that NRFD routinely goes on Lift calls, and I also know that often times they request EMS for an evaluation/transport. It's good that they respond to these calls with their EMTs - but should other FDs not responding with EMS personnel even go - or should it be left to the EMS "professionals?"

I think you need to clarify exactly what you mean by a "lift assist". To me, a lift assist is an EMS agency needing assistance moving a larger individual. If that's the case, why do the "lifters" need training. If you have PD of FD respond to help EMS, then all you are asking for is a little muscle. If an engine company comes to help carry someone down several flights of stairs, or a ladder or rescue responds to move someone via cargo-net (happens more than you might think) because they're that heavy...why do they need any medical training? It would be nice for everyone to have some basic medical training, but that's a whole separate issue.

[PFDRes47cue 653]

I think you need to clarify exactly what you mean by a "lift assist". To me, a lift assist is an EMS agency needing assistance moving a larger individual. If that's the case, why do the "lifters" need training. If you have PD of FD respond to help EMS, then all you are asking for is a little muscle. If an engine company comes to help carry someone down several flights of stairs, or a ladder or rescue responds to move someone via cargo-net (happens more than you might think) because they're that heavy...why do they need any medical training? It would be nice for everyone to have some basic medical training, but that's a whole separate issue.

In my opinion, there are two types of "lift assists" One is helping EMS or the ME who is on scene and simply does not have the manpower to move the patient whether on a stretcher, stair chair, reeves, scoop, stokes, scoop, etc. The second would be getting called to a house because the caller fell or for some other reason can not get up.

I think Remember585 is referring to the my second "lift assist." I can not speak for him or say for sure but that is what it seems. Basically, the question is should FD's or PD's that do not have EMS training, be responding to "lift assists" in which the caller or the patient needs lifting assistance to get up off the floor, out of the tub, off the can, etc. These often are not medical problems just a problem with the elderly or people suffering from a previous injury not having the strength to get up. Now you have FD's or PD's without medical training being in contact and helping to maneuver a patient. What is this patient does need medical help? The patient may say they feel fine because they may not notice a medical issue. The FD or PD agency may also not notice the medical issue because they are not trained to do so. Say the patient dies an hour later....is the FD or PD that does not have medical training liable? Should an agency that has medical training (EMS) go to all "lift assists" for this reason?

Once, again, no guarantees that I am getting this right, but I think this is what Remember585 is referring to. "Lift assist" is a non-specific term that can be of assistance to a crew on scene or to a person who is alone but can not get up.

Also, great thread!

[JFLYNN 681]

You know what I mean. Stop trying to bait me or someone else. Nobody hear is ignorant enough to think that every EMS call is covered by the local agency all of the time. I'm pretty sure dozens of discussions of this type have happened here.

How do you know that I know what you mean? I don't and if I did I wouldn't have asked the question. Please don't accuse me of trying to bait you. I'm concerned that in any community, but in particular where my mother and also my children live and attend school, there may be an issue with EMS responses. From your question, it seems that there may be a problem with "the ambulance getting out" . The way you phrased your question, it seemed to me that you were almost accepting it as a regular occurence in your community that the ambulance "doesn't get out". That is how it <B>seemed</B> to me. Of course, unlike you, I did not assume to know exactly what you meant and I asked a question for clarification.

The funny thing is, I actually have a lot of respect for EMS volunteers. At least they have to meet the same training and certification levels as their career counterparts. They do an often thankless, difficult job with very low "hero" and glamour factor as opposed to fire departments. It seems that the problem in your community may be not with those who volunteer to perform EMS services, but rather with those who don't. Rather than blame or criticize those who are actually out there giving of themselves and doing this work, I am happy to support any efforts to, as I mentioned previously, consolidate, regionalize, encourage fire department members to also respond to EMS calls, and / or hire career staff.

Edited February 8, 2011 by jack10562
reformat quote tags

[Bull McCaffrey 162]

What exactly do you mean by... "when the ambulance doesn't get out for a lift assist" ?

To answer your question, as you have already noted, this is handled differently from place to place, however what we should all keep foremost in our minds is that, while these "lift assists" may not seem so glamorous to us as responders (no hero factor here whatsoever), to the patient and their family, this is a true emergency. These patients should not have to wait inordinately long periods of time for adequate help to arrive, and when the help arrives the responders (from whatever agency) should be capable and well trained. If this is not the case in any jurisdiction, immediate steps should be put in place to solve this serious problem. Some suggestions I would suggest be explored are cross training FD/ PD, regionalization or consolidation, and / or hiring career staff.

Interesting topic and one that is often over shadowed by more of the "glory" type work. Being that I have relatives that live there, how are lift assists handled in Yonkers?

[antiquefirelt 994]

Not for nothing but "Doing the Right Thing" also means doing the right thing for the people we serve not just ourselves. Guys love using DRT, FTM, EGH and such with regard to taking care of each other, they are real cool on t-shirts too, but our purpose or mission is still to serve the public. So if the EMS service in town can't get out fast enough or with enough, step up and be there for the people in need instead of furthering the problem. Then take up the increased volume with the proper officials.

As for my FD, I guess it's a non issue as we provide both fire and EMS, lift assists (assisting the EMS crew) is part of the job. And the "I've fallen and I can't get up calls" are ours too. Once in a while we assist the private transfer trucks when they need help, and while we hate helping them, we always will help our citizens.

Edited February 7, 2011 by antiquefirelt

[stvrap79 8]

IMO a lift assist 9X out of 10 is exactly how it sounds. That being said, unless there is trauma or underlying medical concerns it is a "good intent" call. I know some agencies allow attendants or other members w/o medicalTraining to move and lift patients. If in fact it is just helping a elderly person back into bed, can't FD or PD assist?

[SRS131EMTFF 471]

From the Phoenix FD

VOLUME 1 – Operation Manual

CUSTOMER RELATIONS PROGRAM

"Being a professional on the Phoenix Fire Department means doing the "whole job". Doing the

"whole job" includes focusing on the extra interpersonal dimensions and sensitivities of

empathy, concern, care and compassion. Our work often involves respecting peoples’ property

during their most vulnerable moments, when they need help the most and have to rely on our

members. We have become the "Agency of Last Resort" for the poor, the homeless, the destitute,

the mentally, emotionally and physically challenged, the chronically ill, the indigent, the

incarcerated, and the immigrant. Interpersonal awareness and sensitivity is our responsibility.

Indifference or lack of empathy is a professional weakness. The public does not need one of our

members to be having a "bad day" when they call us for help... they're already having one of

their own."

http://phoenix.gov/FIRE/11301.pdf

[antiquefirelt 994]

IMO a lift assist 9X out of 10 is exactly how it sounds. That being said, unless there is trauma or underlying medical concerns it is a "good intent" call. I know some agencies allow attendants or other members w/o medicalTraining to move and lift patients. If in fact it is just helping a elderly person back into bed, can't FD or PD assist?

Now I cannot speak to the rules/laws in your state, but in mine, these are EMS runs. A caller calls 911 and says I've fallen. The dispatcher asks if they're hurt. This immediately starts off as an EMS call with just that little. No one's first question is are you shot or were you struck? No: Are you on fire or slip on a haz-mat spill. So it's clearly an EMS call. SO the dispatcher send the most appropriate service to the call, the ambulance service. In my state once the calls is dispatched, the EMS service owns it. You'd better either get EMS personnel to the call yours or mutual aid or the patient better have cancelled you. BTW all of our dispatchers are all EMD certified and part of the State EMS system as EMD dispatchers.

Now can a nice policeman come and help before EMS arrives, rendering their response unneeded? Sure. I suspect the same is true of the FD if they have no EMS authority, but they shouldn't typically be jumping EMS runs as having untrained and unsolicited responders arrive first routinely will lead to a problem at some point.

Edited February 7, 2011 by antiquefirelt

[PFDRes47cue 653]

Not for nothing but "Doing the Right Thing" also means doing the right thing for the people we serve not just ourselves. Guys love using DRT, FTM, EGH and such with regard to taking care of each other, they are real cool on t-shirts too, but our purpose or mission is still to serve the public. So if the EMS service in town can't get out fast enough or with enough, step up and be there for the people in need instead of furthering the problem. Then take up the increased volume with the proper officials.

As for my FD, I guess it's a non issue as we provide both fire and EMS, lift assists (assisting the EMS crew) is part of the job. And the "I've fallen and I can't get up calls" are ours too. Once in a while we assist the private transfer trucks when they need help, and while we hate helping them, we always will help our citizens.

Well said. Enjoy your 100th Rep Point.

[JFLYNN 681]

Interesting topic and one that is often over shadowed by more of the "glory" type work. Being that I have relatives that live there, how are lift assists handled in Yonkers?

Same as on your job Mr. Bull. Your relatives are in good hands...

[16fire5 693]

Same as on your job Mr. Bull. Your relatives are in good hands...

We (fire operations) almost never get called to help people back in bed. As M Ave. said when we get a run for lift assist it is to assist an EMS crew with a heavy patient. I'm not sure who gets these calls in NYC. That being said if I got the run we would do what the fire service does best handle it.

[islander 27]

Now you have FD's or PD's without medical training being in contact and helping to maneuver a patient. What is this patient does need medical help? The patient may say they feel fine because they may not notice a medical issue. The FD or PD agency may also not notice the medical issue because they are not trained to do so. Say the patient dies an hour later....is the FD or PD that does not have medical training liable? Should an agency that has medical training (EMS) go to all "lift assists" for this reason?

On the flip side, if EMS is on scene and the patient says "they feel fine", RMA's and then dies an hour later does the RMA absolve all of us there (PD/FD/EMS) of liability? Probably not.

And what level of training is acceptable to properly handle a lift assist? CFR? EMT? My guys/gals (PD) only have first aid certification through the department, but in that training they're taught that when in any doubt in a lift job, mva, etc. to call for EMS. Common sense dictates that if they need resources beyond the level of service that they've been trained or can provide, they call for them. My cops aren't intubating grandpa, they're just helping him back into his chair.

[stvrap79 8]

My cops aren't intubating grandpa, they're just helping him back into his chair.

My point exactly. One should know when to help and when to step aside and ask for additional resources.

[moggie6 54]

I don't care who is helping with the lifting. Just get it over with and move on. Next call please! If anything maybe the topic should have been turned around to "How Lift Assist help with Public Relations". The first agency through the door wins the PR. (that is not an excuse for a lights and siren response.)

The other lift assist, i.e. helping EMS agencies out with lifting, are other excellent opportunities for public relations.

[Bull McCaffrey 162]

Same as on your job Mr. Bull. Your relatives are in good hands...

Good to know you're on the job JFlynn. Helps me sleep better at night knowing that men such as yourself are standing at the ready should the need arise.