- Gather information about what happened from what you can see,
- Initiate patient contact, begin to set up rapport and patient trust,
- Gather information from patient and/or bystanders,
- Provide patient care and/or transport,
- Transfer patient care to hospital by radio patch and then verbal report to the nurse/doctor.
I do NOT think that anyone should delay patient care to wait for everyone to arrive on scene. I DO think that treating a transfer of care between FD personnel on scene with the seriousness and detail that transfer of care to the hospital is treated would be valuable. Why is anyone detailed with the hospital? Because they can't see what happened and they lose all that information unless EMS or the patient provides it to them.
I would like to think that even if a medic on scene has decided that a patient isn't critical, it would be good experience for whomever is taking over patient care to have enough information to understand how he reached that decision. Here's the incident that sparked this conversation with K:
Dispatched to a SNF for a patient who had fallen and was bleeding from a head injury. I arrive on scene and find the patient sitting on the stretcher with bandaging just being finished on her head. I help carry equipment back to the ambulance and get in to help with whatever else needs to happen before we transport. Everyone else stays outside, the medic on scene hands me the demographics and medication list from the facility and tells me the patient is all mine - simple "fall down, go boom". I catch him before he closes the door and ask a couple of questions (including whether they took vital signs inside), which are grudgingly answered and he hops up front to drive before the other volunteer even arrives on scene. I start talking to my patient, taking vitals, history and so on and I discover that I'm not sure she's as okay as everyone makes out. I start her on O2, hook her up to the heart monitor and see something that looks like maybe atrial fibrillation or flutter - which she has NO history of. We get to the hospital without any issues and I'm trying to talk to the nurse about what I saw and the medic interrupts with, "Yeah, she's 80, who doesn't have atrial fib?" When I'm trying to write my report, I have to chase him all over the emergency department to get answers about what happened before I got there. Very frustrating.