Who Legally is Aloud to Make the Call?

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Permalink Reply by John Fekety on May 24, 2009 at 7:22am

According to the state-wide protocols these are the situations when EMS can stop responding when someone other than EMS personnel cancels the response.

"When law enforcement or fire department personnel on scene indicate that no incident or
patient was found, these other public safety services may cancel responding EMS
providers.
e. When the PSAP/ dispatch center is notified that the patient was transported by privately
owned vehicle or by other means (caller, police, or other authorized personnel on the
scene)."

Assuming that your Chief found a patient but decided that ALS service was not required, the above protocols do not give you the right to recall. So, if you do not trust the Chief's judgement I would continue in to the scene. BUT be prepared for political fallout from your decision. Also, since you are not authorized to cancel by the protocols, if the patient has a bad outcome there is the possibility of a lawsuit since you deviated from the protocol. And finally, there is always the possiblity of sanctions by the DOH for violating protocols.

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Permalink Reply by Mark A. Duell on May 24, 2009 at 1:06pm

I guess I need to clarify my question better. On scene there is a walking wounded self extricated from a vehicle. Vehicle has rolled once with airbag deployment and some intrusion into passenger compartment. Obvious AOB. Prior to BLS arriving on scene, chief recalls medic. Upon secondary survey you find pt. nuero. functions are diminishing on one side. You redispatch the medics to meet you enroute. Did that chief have the right to recall the medics to begin with?

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Permalink Reply by Connie Hensley on May 24, 2009 at 7:23pm

I don't think a chief should recall the ALS, even if he is an EMT. I think that should be up to the BLS providers that are going to be responsible for pt. care, even if it is a pt. refusal. Unfortunately, I've had this happen to me. As a BLS provider, I've rolled into a scene when the ALS has been canceled, only to find a pt. that would have benefited from ALS intervention. I need to ask for ALS to be redispatched, and then have received a lecture from the ALS provider for being canceled in the first place, when it wasn't my fault. I've had QRS units do this, also. Ultimately, unless that person is going to take responsibility for the pt., no one should be canceling ALS.

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Permalink Reply by Mark A. Duell on May 25, 2009 at 10:46am

I agree and ditto on the other stuff also.

Connie Hensley said:

I don't think a chief should recall the ALS, even if he is an EMT. I think that should be up to the BLS providers that are going to be responsible for pt. care, even if it is a pt. refusal. Unfortunately, I've had this happen to me. As a BLS provider, I've rolled into a scene when the ALS has been canceled, only to find a pt. that would have benefited from ALS intervention. I need to ask for ALS to be redispatched, and then have received a lecture from the ALS provider for being canceled in the first place, when it wasn't my fault. I've had QRS units do this, also. Ultimately, unless that person is going to take responsibility for the pt., no one should be canceling ALS.

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Permalink Reply by Robin Renfrew on May 25, 2009 at 11:37am

I would rather have ALS be dispatched, arrive on the scene and be cancelled than just cancel them outright. Better to be safe than sorry!

Also, QRS units have NO business cancelling ALS, as QRS will never be the transporting unit. It's a different story if you have a critical patient and ALS is still a good distance away - you can always perform the necessary appropriate interventions, place the patient in the BLS unit and meet ALS enroute.

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Permalink Reply by Jody McKibben on June 8, 2009 at 9:00pm

The answer to your question is NO. According to the protocols mentioned there was an incident and there was a patient, and he has no to little training in EMS so he had no right to recall the medics.

Mark A. Duell said:

I guess I need to clarify my question better. On scene there is a walking wounded self extricated from a vehicle. Vehicle has rolled once with airbag deployment and some intrusion into passenger compartment. Obvious AOB. Prior to BLS arriving on scene, chief recalls medic. Upon secondary survey you find pt. nuero. functions are diminishing on one side. You redispatch the medics to meet you enroute. Did that chief have the right to recall the medics to begin with?

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Permalink Reply by antonio craig on November 1, 2009 at 8:26pm

well as per protocols the should be by the emt. seeming as though the emt has the training to realize the difference between bls and als.

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