Who Should Handle Lift Assists?

[firedude 985]

Like the title suggests... Who should handle lift assists? Fire, Police and/or EMS?

[Guest truck12345]

Neither

[JJB531 652]

Neither

So.... We should leave the elderly woman who's incapacitated on her bedroom floor there to rot? Where do you volley/work? I want to make sure I don't have family that lives there.

[JJB531 652]

Well it depends. If a lift assist is classified as a rescue, I would say FD because they really are the only ones qualified to handle such an intense task.... I'm only kidding people! Just trying to make light of the recent discussions and bickering, so smile!

In all seriousness I would say EMS because a lot of these lift assists involve underlying, sometimes complex medical conditions that really should be evaluated by an EMS crew. It's in the best interest of the patient, and could prevent EMS having to go back once an underlying condition exacerbates into something worse.

[Guest truck12345]

A full time care giver nursing home

A lot of places the FD does the lift assist sending a engine or a truck co.

[JJB531 652]

Okay, but not everyone has the luxury of affording a full time care giver or nursing home.

[JM15 386]

It should definitely be EMS.. like the previous poster said more often than not there are underlying reasons for the person being incappacitated. Also, EMS can evaluate any potential injuries that the patient recieved while falling.

[SRS131EMTFF 471]

FD and EMS. EMS to evaluate the clear/transport the patient. FD for the extra hands. PD too if they are having a slow day and they feel like it...

These can be generally simple with an extreme potential to go south quicker than anyone would like.

[firedude 985]

In all seriousness I would say EMS because a lot of these lift assists involve underlying, sometimes complex medical conditions that really should be evaluated by an EMS crew. It's in the best interest of the patient, and could prevent EMS having to go back once an underlying condition exacerbates into something worse.

Even if it means taking a rig (and a medic if in Northern Westchester) to a lift assist when they could be responding to a more serious calls (e.g. cardiac arrest or a MVA)? Taking 1 of the 3 medics to respond to a lift assisnt is a waste, IMO, unless there is a need for pain management. I've never been to a lift assist, so maybe I shouldn't be talking, but I'm just looking for clarification and opinions.

Edited May 9, 2012 by firedude

[JJB531 652]

The extra hands are a big help, no sense in breaking your back when extra help is readily available.

[SRS131EMTFF 471]

Even if it means taking a rig (and a medic if in Northern Westchester) to a lift assist when they could be responding to a more serious calls (e.g. cardiac arrest or a MVA)? Taking 1 of the 3 medics to respond to a lift assisnt is a waste, IMO, unless there is a need for pain management. I've never been to a lift assist, so maybe I shouldn't be talking, but I'm just looking for clarification and opinions.

And that is why all of the 60-Control dispatchers are EMD, so they don't send a medic on to pick up Mrs. Jones after she fell out of her wheelchair again this week.

[JJB531 652]

Even if it means taking a rig (and a medic if in Northern Westchester) to a lift assist when they could be responding to a more serious calls (e.g. cardiac arrest or a MVA)? Taking 1 of the 3 medics to respond to a lift assisnt is a waste, IMO, unless there is a need for pain management.

I understand your thought reasoning, and it's not necessarily incorrect. As a medic the last thing I want to do is go to a lift assist because most don't require ALS intervention, but...

#1 - we can't always play what-if's. I could turn around and say what if the lift assist patient did require ALS intervention and now you just delayed the medic 15 minutes because "what if a more serious call comes in", and yet that call never comes; is that fair to the person who called 911 for our services? I've personally responded to a number of lift assists that ended up being cardiac arrests.

#2 - why do we send medics to every call? Who says we have to send the medic to a lift assist? If proper EMD is done, and no flags are raised for a potential for this to be ALS, then we may be able to get away without sending an ALS unit and keeping that unit in-service for the "what if".

What if we take an FD rig out of service and a fire comes in? What if we take a patrol car out of service and a robbery occurs? We can keep on "what-if'ing" but someone's gotta pick grandma up off the floor.

We can only treat one patient at a time, one call at a time. As EMS managers, they need to ensure that their systems run efficiently with the manpower and staffing levels they have to work with without short-changing the public who deserves the services they require.

[JM15 386]

Even if it means taking a rig (and a medic if in Northern Westchester) to a lift assist when they could be responding to a more serious calls (e.g. cardiac arrest or a MVA)? Taking 1 of the 3 medics to respond to a lift assisnt is a waste, IMO, unless there is a need for pain management. I've never been to a lift assist, so maybe I shouldn't be talking, but I'm just looking for clarification and opinions.

Where does it say it would involve an ALS response? BLS is more than sufficient

[PEMO3 523]

If the lift assist is truely a case of a "I fallen and I can't get up" EMS should definitely respond to evaluate the patient for possible injuries from a fall and if a medical condition exists that precipitated the fall along with PD or FD depending on the area of responsibility for possible forced entry. When the lft assist becomes a "regular" then contact should be made with a family member or a DSS referral should be made to the office of aging for the persons safety. If the person has become a fall risk and clearly needs 24 hour care as a health care provider you can not ignore this situation either. While it may not be a true emergency it can escalate into one when the next fall is down a flight of stair or in a full bathtub. These lift assists are looked at as nussance calls but lets face facts they are really cries for help from patients with a voice that sometimes we either don't understand or don't take the time to understand. Remember we can all be that "lift assist" some day.

[Pagers 197]

I know around here the Fire Departments are called for assistance. I think that is a fairly common all around and probably the most logical...

[firedude 985]

I understand your thought reasoning, and it's not necessarily incorrect. As a medic the last thing I want to do is go to a lift assist because most don't require ALS intervention, but...

#1 - we can't always play what-if's. I could turn around and say what if the lift assist patient did require ALS intervention and now you just delayed the medic 15 minutes because "what if a more serious call comes in", and yet that call never comes; is that fair to the person who called 911 for our services? I've personally responded to a number of lift assists that ended up being cardiac arrests.

#2 - why do we send medics to every call? Who says we have to send the medic to a lift assist? If proper EMD is done, and no flags are raised for a potential for this to be ALS, then we may be able to get away without sending an ALS unit and keeping that unit in-service for the "what if".

What if we take an FD rig out of service and a fire comes in? What if we take a patrol car out of service and a robbery occurs? We can keep on "what-if'ing" but someone's gotta pick grandma up off the floor.

We can only treat one patient at a time, one call at a time. As EMS managers, they need to ensure that their systems run efficiently with the manpower and staffing levels they have to work with without short-changing the public who deserves the services they require.

Thanks for explaining!

Where does it say it would involve an ALS response? BLS is more than sufficient

For most lifts, BLS is sufficient. However, in rare cases, I have heard lift assists turn into ALS transports. Read above as well.

I know around here the Fire Departments are called for assistance. I think that is a fairly common all around and probably the most logical...

Agreed. It's much more common upstate to have the FD respond.

Edited May 10, 2012 by xfirefighter484x

[JetPhoto 626]

All the above:

Fire Department to build & configure a lifting system

EMS to evaluate the patient

Police Department to keep the bystanders back that are gawking over a person that fell

and

Acme Crane Service for the ones that need it.

[INIT915 1,119]

If the lift assist is truely a case of a "I fallen and I can't get up" EMS should definitely respond to evaluate the patient for possible injuries from a fall and if a medical condition exists that precipitated the fall along with PD or FD depending on the area of responsibility for possible forced entry. When the lft assist becomes a "regular" then contact should be made with a family member or a DSS referral should be made to the office of aging for the persons safety. If the person has become a fall risk and clearly needs 24 hour care as a health care provider you can not ignore this situation either. While it may not be a true emergency it can escalate into one when the next fall is down a flight of stair or in a full bathtub. These lift assists are looked at as nussance calls but lets face facts they are really cries for help from patients with a voice that sometimes we either don't understand or don't take the time to understand. Remember we can all be that "lift assist" some day.

Perfect response.

[CIG II 1]

So.... We should leave the elderly woman who's incapacitated on her bedroom floor there to rot? Where do you volley/work? I want to make sure I don't have family that lives there.

This is the topic of our volunteer ambulance corp at the moment. we are trying to figure out who should be taking the lift assist calls. We have answered a ton of list assists calls over the past years that come in and then another serious call comes in and either does get covered after multiple tones or goes mutual aid due to the early morning calls or short staffed.

I beleive personally that fire guys or police should be able to go out and help with the lift assist calls. If an ambulance is needed then call us but just to lift up the elederly and place them back in bed should be able to be handled by fd or police.

And that is why all of the 60-Control dispatchers are EMD, so they don't send a medic on to pick up Mrs. Jones after she fell out of her wheelchair again this week.

Yes but I agree with firedude, When a call comes over as fallin indiviual, it doesnt always say lift assist so a medic and a rig responds and turns into just a lift assist now you have taken a medic and rig oos until the call is cleared when a major car accident or cardiac arrest comes over.

All togeather a rescue or Engine should be able to respond and pick up the patient.

In many locations around my area, the staff arent allowed to help lift patients up even though its a assisted living facilities.

[efdcapt115 1,511]

I agree, well written post Joe. We didn't look at these calls as nuisance though.

We used to ride around the district and I'd spend a lot of time staring out the window at the neat row after row of little pink houses, block after block, ain't that America. Aided's, lift assists, water conditions, all the service calls gets all of that look behind the doors and locks of the little pink houses. The encounters would soften the hardest cigar chomping brutes of the job. They softened everybody.

There'd be the poor, frail elderly and oft neglected by remaining family or friends, victim; stuck in some torturous position for God knows how many hours, wedged behind a fixture, soiled, humiliate, scared, confused.

And the compassion that flew forth from otherwise stoic members of the services was always warming. Yet the whole scene always enveloped me. The old photos on the wall from when the husband was still alive, from their younger days of love, family, children, photos from later when those kids grew up, got married, moved on...

In the end, this poor compassion-needy person is stuck, helpless on the floor of her bathroom with acid burns from having been unable to relieve herself properly. Each and every single call, heartbreaking in a way. Makes the self-preservation instinct kick in for a lot. Trying to fit humor in some where when picking up.

In a way, Americans are all victims of our collective success, relatively luxurious compared with much of the rest of the world. Yet, here we are, all separated, elderly abandoned and left to their own means. Isolated. Alone. Half of everybody in this country has got some kind of head problem because of how we are all so alone so much even within the hustle and bustle of large populated areas.

Yeah, those lift assists. You've got to construct an iron ring around your heart for the time you do these jobs, because if you let all of that despairing into yours...it leaves scars.

[INIT915 1,119]

I beleive personally that fire guys or police should be able to go out and help with the lift assist calls. If an ambulance is needed then call us but just to lift up the elederly and place them back in bed should be able to be handled by fd or police.

That's a problematic approach. Too many lift assists are more complicated then they may appear. The variables involved with events preceding the fall and resultant injuries from the fall really necessitate a medical evaluation. It is difficult enough for dispatchers to parse through callers information to identify which ones are truly mundane, uncomplicated left assists.

Does your agency respond to medical alert calls? By that logic, there is even less of a need for an ambulance response to those, as so many are unfounded or accidental activations. Do you propose a "check and advise" approach on the part of law enforcement. No, the answer is no.

[JJB531 652]

This is the topic of our volunteer ambulance corp at the moment. we are trying to figure out who should be taking the lift assist calls. We have answered a ton of list assists calls over the past years that come in and then another serious call comes in and either does get covered after multiple tones or goes mutual aid due to the early morning calls or short staffed.

I beleive personally that fire guys or police should be able to go out and help with the lift assist calls. If an ambulance is needed then call us but just to lift up the elederly and place them back in bed should be able to be handled by fd or police.

Sending PD or FD is commonplace in a lot of areas. Is it wrong? Probably not... Personally I feel it's an EMS function. I already gave my opinion on the what-if's. In reality, how many times has a unit been tied up on a lift assist and missed a serious call? I'm sure at some point in time it has happened, but sometimes people use that line of reasoning simply cause they want nothing to do with the boring lift assist, and use that as a plausible excuse; well what if.....?

Is it okay to tie up PD because what if a major crime comes in? Or what about tying up FD and now a structure fire comes in? I don't understand why EMS personnel feel they're the only ones who are gonna miss the big one if they have to pick up grandma, so someone else should do it for them?

[wedgeclose 59]

Sorry but I have to comment. In a VOLUNTEER district when a call comes in for a lift assist it should be first answered by police. They take the call and do the dispatch. There are many more police officers on duty in cars than there are vehicles for ems. When the call comes in IF the caller indicates that there is an injury or medical need then of course dispatch the ambulance. If the call is just to help the party back into a chair or bed then the call can and should be handled by police. Once again...should the called indicate a need for medical treatment fine then send the ambulance but DON'T send them and tie up the only EMS crew in the district for a LIFT unless the first responder requests one.

[x4093k 654]

Sorry but I have to comment. In a VOLUNTEER district when a call comes in for a lift assist it should be first answered by police. They take the call and do the dispatch. There are many more police officers on duty in cars than there are vehicles for ems. When the call comes in IF the caller indicates that there is an injury or medical need then of course dispatch the ambulance. If the call is just to help the party back into a chair or bed then the call can and should be handled by police. Once again...should the called indicate a need for medical treatment fine then send the ambulance but DON'T send them and tie up the only EMS crew in the district for a LIFT unless the first responder requests one.

Just what I was about to post...Very well put.

[JM15 386]

Sorry but I have to comment. In a VOLUNTEER district when a call comes in for a lift assist it should be first answered by police. They take the call and do the dispatch. There are many more police officers on duty in cars than there are vehicles for ems. When the call comes in IF the caller indicates that there is an injury or medical need then of course dispatch the ambulance. If the call is just to help the party back into a chair or bed then the call can and should be handled by police. Once again...should the called indicate a need for medical treatment fine then send the ambulance but DON'T send them and tie up the only EMS crew in the district for a LIFT unless the first responder requests one.

Maybe in Ossining the Police answer the call and dispatch but thats not neccessarily the same for other places. Your stating that you are in favor of the old "Check and advise" scenario. This is something that the fire service has been trying to get away from for many years.... What if you send that one un-trained police officer and it isn't a lift assist but its something more serious? Can that police officer accurately try and figure out what caused that person to fall without medical training? I 100% believe that EMS should be sent on a "lift assist."

Why do some think that providing lift assists are a waste of time? Whether you like it or not emergency services are a customer service business and we are here to help the public its part of the job.

[antiquefirelt 994]

Up here "Lift assists are definitely EMS calls. I've never heard of PD or a FD doing a lift assist without EMS being called, it just doesn't happen. In my mind, EMS is the only trained people to properly evaluate a person for potential injuries (EMS trained LEO's and FFer's aside). What happens when the FD or PD arrives and finds the victim really should be evaluated? Now we send EMS, a greater delay and more resources tied up. We don't send EMS to activated smoke detectors so they can call the FD if there's actually smoke, why send anyone except the resource most appropriate to the situation. My FD as I've said before does both Fire and EMS and we run a ton of "lift assists" of which probably 1/3 turn out to be transports to the ED when the initial call gave no indication that transport was indicated.

Those that say anyone but EMS should do these are really only thinking of this out of convenience. Do you tell PD or the FD to check out MVA's for injuries before responding?

[wraftery 1,275]

I think that lift assists should be handled only by people who realize that one day they might be old and need a lift. It doesn't matter if it's FD,PD, EMS or the local Boy Scout Troop. All should be able to recognize a more serious situation and notify the proper agency.

The old lady you helped may be saying "What nice boys those firemen are" to her friends and family. You may want those people on your side when layoff time is near.

Reading some of the posts, my conclusion is this: If I call, I would rather have guys like EFDCAPT115 take the call than alot of you guys who posted.

[INIT915 1,119]

Sorry but I have to comment. In a VOLUNTEER district when a call comes in for a lift assist it should be first answered by police. They take the call and do the dispatch. There are many more police officers on duty in cars than there are vehicles for ems. When the call comes in IF the caller indicates that there is an injury or medical need then of course dispatch the ambulance. If the call is just to help the party back into a chair or bed then the call can and should be handled by police. Once again...should the called indicate a need for medical treatment fine then send the ambulance but DON'T send them and tie up the only EMS crew in the district for a LIFT unless the first responder requests one.

Just what I was about to post...Very well put.

So, to get this straight, you actually advocate "check and advise"?

[JJB531 652]

Sorry but I have to comment. In a VOLUNTEER district when a call comes in for a lift assist it should be first answered by police. They take the call and do the dispatch. There are many more police officers on duty in cars than there are vehicles for ems. When the call comes in IF the caller indicates that there is an injury or medical need then of course dispatch the ambulance. If the call is just to help the party back into a chair or bed then the call can and should be handled by police. Once again...should the called indicate a need for medical treatment fine then send the ambulance but DON'T send them and tie up the only EMS crew in the district for a LIFT unless the first responder requests one.

A VOLUNTEER system should function no differently then a paid system. It's about setting a standard of care that should be followed by all EMS systems, whether paid or VOLUNTEER. The person on the floor shouldnt get a lower standard of care just because they're served by VOLUNTEERS. One police officer isn't enough to pick up someone off the floor. Now you have to send 2 cars. Some jurisdictions only have two cars on patrol to cover an entire village. It's okay to leave a whole village without police protection just because the EMS system is VOLUNTEER?

[JetPhoto 626]

Regardless of who does it, you have to worry about responders getting back injuries or other types of injuries. So safety first, lift with your legs, not your back.