Hey Gang, What's Up With The Medic and the Baby?

[Meddle]

This story doesn't make much sense.

Side question, when did they start the rapid response units?

http://www.clickondetroit.com/news/e...-dies/33741914

[Honky Tonk]

http://www.clickondetroit.com/news/e...-dies/33741914

This story doesn't make much sense.



Side question, when did they start the rapid response units?

She may be appealing, but not to me she's not. See ya...

[gazhekwe]

Sh obviously needs to seek a new line of work, unless the story is completely wrong somehow.

[Meddle]

Anybody hear any updates?

[Detroitnerd]

They've been trying to add "rapid response units" for more than 10 years. They bought a whole bunch of them about a dozen years ago. The idea is that "Echo units" can get to patients and administer drugs or stabilize them before transporting units get there. It works in some cities.

But in Detroit, the problem is that you get there, and you have no way to transport a patient. So, the nightmare scenario is, you arrive, there are no police on scene, there's grandma on the lawn, and a dozen of her grown kids and grandkids getting pissed off at you, asking, "Why can't you transport her? Take her to the hospital!" And then you're in a very hairy situation.

That's exactly what happened here. The medic wanted police to show up because she anticipated exactly this scenario. And now she's out of a job, but that may be better than what might have happened to her if she showed up and couldn't transport.

Go ahead and say that the medic was a monster who sacrificed a baby's life if you want. I've heard all that. Fact is, this is probably not the last time this will happen. Echo units aren't very well suited to the sorts of situations a medic encounters in Detroit. Last time they spent a bundle on all these SUVs that can't transport patients, I believe they wound up just scrapping the initiative and giving the SUVs to the chiefs for transportation.

[Towne Cluber]

That's exactly what DIDN'T happen here.

1. The medic never said anything about requesting police assistance.

2. An SUV [[or any other type of vehicle for that matter) would have no problem transporting a BABY.

3. The mother was ALONE. There weren't "a dozen grown kids" on the scene.

4. The result of her inaction, a deceased baby, isn't "better than what might have happened"...

5. The result of her inaction is THE NIGHTMARE SCENARIO.

[Detroitnerd]

That's exactly what DIDN'T happen here.

1. The medic never said anything about requesting police assistance.

That's not right. She absolutely did, and it's a matter of record. The computer-aided dispatch record says Thomas “will not make the scene w/o SCT.” Thomas wanted a police car there before she responded. She was also very concerned about having a transporting unit, that is to say, and ambulance, on the scene. She's recorded as saying,"You got ETA on transporting unit?” She says, rather reasonably, I think: “It’s a baby not breathing, no scout available. I’m not about to be on no scene 10 minutes doing CPR. You know how these families get.”

Here's somebody who's obviously concerned about police being on scene, an exit strategy in the form of an ambulance, and not being stranded in a hostile situation. I'm not saying what she did was right, or that firing her was wrong, just that these are very real problems in Detroit that affect the ability of these units to function as they should. And this problem is guaranteed to crop up again.

2. An SUV [[or any other type of vehicle for that matter) would have no problem transporting a BABY.

I believe there are liability issues associated with taking an infant who is not breathing in the back seat of an SUV that is not designed to transport patients.

3. The mother was ALONE. There weren't "a dozen grown kids" on the scene.

That's a nightmare scenario, not an example of what happened here. But I could have clarified that better. Anyway, when you read the dispatch transcript, you can tell that nightmare scenario is a very real concern to her.

4. The result of her inaction, a deceased baby, isn't "better than what might have happened"...

You know what? I totally understand why you're angry about that death. There are few things more emotional or worth mourning in life than the deaths of children, especially a premature baby you hope will live.

But you simply can't blame all of this awful event on one person. I'm not saying this medic was justified, I'm just saying I think this tragic event is indicative of deeper organizational problems at Detroit's EMS. If Detroit is the kind of place where the medics won't go on scene without SCT, and want to get the hell out of a volatile situation, why in the hell would you put medics in cars that cannot transport?

Some of my friends more familiar with the situation tell me that the "Rapid Response Units" are just there to cut down on response time figures, that they're absolutely no good for trauma, where a person needs a surgeon, not a drug box. And Detroit's dispatch unit may lack the skills to implement them to best effect.

SUVs with medics and drug boxes work well in other places, where they're add-ons to a already properly staffed and resourced EMS department. But in Detroit they seem to be Detroit's way of cheaping out on a serious problem.

No doubt; what this woman did was a fireable offense. I'm just saying it's indicative of deeper problems with Detroit's EMS, and that this media lynching may be there to obscure them. Maybe we should focus on a system of fully staffed, functioning ambulances, as other cities do, instead of using "innovative" frills to get better numbers.

[sirrealone]

A baby isn't breathing and you've been told that you are the one person that has a chance to make that baby breathe again. How do you turn your back on that? How do you say no? If the other thoughts by the other posters were in her head, then fine, but as a human being, "Go try and save this baby" should have driven her actions that evening.

[Towne Cluber]

That's not right. She absolutely did, and it's a matter of record. The computer-aided dispatch record says Thomas “will not make the scene w/o SCT.” Thomas wanted a police car there before she responded. She was also very concerned about having a transporting unit, that is to say, and ambulance, on the scene. She's recorded as saying,"You got ETA on transporting unit?” She says, rather reasonably, I think: “It’s a baby not breathing, no scout available. I’m not about to be on no scene 10 minutes doing CPR. You know how these families get.”

Here's somebody who's obviously concerned about police being on scene, an exit strategy in the form of an ambulance, and not being stranded in a hostile situation. I'm not saying what she did was right, or that firing her was wrong, just that these are very real problems in Detroit that affect the ability of these units to function as they should. And this problem is guaranteed to crop up again.



I believe there are liability issues associated with taking an infant who is not breathing in the back seat of an SUV that is not designed to transport patients.



That's a nightmare scenario, not an example of what happened here. But I could have clarified that better. Anyway, when you read the dispatch transcript, you can tell that nightmare scenario is a very real concern to her.



You know what? I totally understand why you're angry about that death. There are few things more emotional or worth mourning in life than the deaths of children, especially a premature baby you hope will live.

But you simply can't blame all of this awful event on one person. I'm not saying this medic was justified, I'm just saying I think this tragic event is indicative of deeper organizational problems at Detroit's EMS. If Detroit is the kind of place where the medics won't go on scene without SCT, and want to get the hell out of a volatile situation, why in the hell would you put medics in cars that cannot transport?

Some of my friends more familiar with the situation tell me that the "Rapid Response Units" are just there to cut down on response time figures, that they're absolutely no good for trauma, where a person needs a surgeon, not a drug box. And Detroit's dispatch unit may lack the skills to implement them to best effect.

SUVs with medics and drug boxes work well in other places, where they're add-ons to a already properly staffed and resourced EMS department. But in Detroit they seem to be Detroit's way of cheaping out on a serious problem.

No doubt; what this woman did was a fireable offense. I'm just saying it's indicative of deeper problems with Detroit's EMS, and that this media lynching may be there to obscure them. Maybe we should focus on a system of fully staffed, functioning ambulances, as other cities do, instead of using "innovative" frills to get better numbers.

Again, the scenario that you describe in support on the former medic is not accurate.

1. You're conflating a request for an SCT [[Specialty Care Transport) with a request for a police presence. She requested the former, not the latter.

2. There aren't any liability issues with EMS transporting a patient in an SUV. Police do it with patrol cars when EMS arrival time isn't sufficient. The only liability issues are in cases like this one -- intentionally not performing one's duty.

3. Any medical, fire, accident situation is potentially volatile and potentially a nightmare scenario, however, it is not standard procedure -- nor practical -- to send police on every one of those runs as well.

4. Yes there are deep problems with Detroit EMS/Fire/DPD, but there are also deep workforce problems in Detroit [[i.e. lack of qualified workers).

5. Likewise, this lynching of anything considered "mainstream" [[the media, the government, majority public opinion) may also be a way to distract from the medic's gross negligence.

I understand why you're angry about this case and want to take the "anti-establishment" position here, but some things are just indefensible.

[Detroitnerd]

Again, the scenario that you describe in support on the former medic is not accurate.

1. You're conflating a request for an SCT [[Specialty Care Transport) with a request for a police presence. She requested the former, not the latter.

Thanks for clearing that up, but, be that as it may, she still wanted the police there. Thomas asked the dispatcher when the ambulance and police would get there. Then there's the full quote in the transcript: "It’s a baby not breathing, no scout available. I’m not about to be on no scene 10 minutes doing CPR. You know how these families get.”

http://www.clickondetroit.com/news/d...ation/34176128

Read for yourself. It's right there in the article.

2. There aren't any liability issues with EMS transporting a patient in an SUV. Police do it with patrol cars when EMS arrival time isn't sufficient. The only liability issues are in cases like this one -- intentionally not performing one's duty.

That may be, but it's still beside the point. The units are not designed to transport, and that's because you don't have room to treat or stabilize a patient properly. The baby is not a good example, but how do you, say, hustle a 300-pound unconscious person into an SUV without a gurney? It's the wrong tool for the job.

3. Any medical, fire, accident situation is potentially volatile and potentially a nightmare scenario, however, it is not standard procedure -- nor practical -- to send police on every one of those runs as well.

Then, again, why use a unit that can't transport?

4. Yes there are deep problems with Detroit EMS/Fire/DPD, but there are also deep workforce problems in Detroit [[i.e. lack of qualified workers).

Seems to me that when everybody's jumping down on a specific employee with both feet, it's a good time to remind people of very specific management problems that play into it. Can't do anything about a worker who disobeys orders other than let her go, but the systemic things we CAN do things about. That's the difference.

5. Likewise, this lynching of anything considered "mainstream" [[the media, the government, majority public opinion) may also be a way to distract from the medic's gross negligence.

Nobody is working to distract from the employee's problems. The chorus of condemnation is loud and unanimous. As for the problem of EMS management pulling a fast one by using rigs that can't effectively transport patients, not so much. I think it's a good opportunity to talk about a troubled program the EMS has pursued for years.

I understand why you're angry about this case and want to take the "anti-establishment" position here, but some things are just indefensible.

Again, Towne Cluber, as I've said multiple times, I AM NOT DEFENDING THE MEDIC. If people concerned about EMS service want to improve service and prevent things like this in the future, they'd do better to spend their time trying to understand what happened instead of simply damning one employee.

[EastsideAl]

Echo units aren't very well suited to the sorts of situations a medic encounters in Detroit.

So, why is it that you think rapid response type units, run properly, can't work as well in Detroit as they do in other cities around the country?

I have a good friend who worked for several years as and EMT in New York City, and this is precisely how it works there. The rapid response is usually first on scene within minutes and investigates and stabilizes the situation before the arrival of the actual ambulance. If the ambulance isn't immediately necessary or necessary at all [[and it isn't in a lot of cases), the first unit calls it off or gives it the go-ahead to take a higher priority call. This serves to increase the efficiency of the whole system, helps prioritize treatment and transport while still providing rapid on-site aid. This system was evolved over years of dealing with the problems of providing public ambulance service. And if it works reasonably well in a city with the size, density, and traffic of NYC [[and other large cities) I'm still not sure why, with effective management, it couldn't be made to work in much less dense Detroit.

[Detroitnerd]

So, why is it that you think rapid response type units, run properly, can't work as well in Detroit as they do in other cities around the country?

I have a good friend who worked for several years as and EMT in New York City, and this is precisely how it works there. The rapid response is usually first on scene within minutes and investigates and stabilizes the situation before the arrival of the actual ambulance. If the ambulance isn't immediately necessary or necessary at all [[and it isn't in a lot of cases), the first unit calls it off or gives it the go-ahead to take a higher priority call. This serves to increase the efficiency of the whole system, helps prioritize treatment and transport while still providing rapid on-site aid. This system was evolved over years of dealing with the problems of providing public ambulance service. And if it works reasonably well in a city with the size, density, and traffic of NYC [[and other large cities) I'm still not sure why, with effective management, it couldn't be made to work in much less dense Detroit.

Yup, they do work in other cities, and pretty well too. First and foremost, you need excellent dispatchers, people who understand that an SUV is no good for some cases, and can get there early and help in others. It's common knowledge that Detroit dispatching has a range of problems, like any other underfunded agency. Second, when you don't have enough ambulances, putting SUVs on the street isn't going to help all that much, especially when you have a limited operating budget: In order to put SUVs on the street, you're cutting back on your transporting rigs to do so. So response times might improve a little bit -- an SUV might get someplace -- but then when does the ambulance get there to take somebody to the hospital? Not everything can be dealt with on-scene with a drug box.

Then there's the safety concern: For more than 10 years, I've heard from several Detroit EMTs and medics that the scenario they're concerned about is being left with their asses hanging in the breeze, trying to save somebody while no ambulance and no police are on scene. So when I heard about this case, I remembered how I'd heard about this years and years ago. Don't get me wrong: The woman is obviously at fault. But the fact that this can happen is also indicative of management that doesn't take seriously the concerns of its workers. In this particular case, it seems to have been unreasonable fear; but that doesn't mean that the fears of something bad happening are unreasonable across the board.

Taken altogether, it makes me take seriously complaints that this is about these units being a way of cheaping out on a serious problem and hoping to get better-looking numbers. Again, rather than trying "innovative" solutions, why not focus on having better dispatching and a fully staffed fleet of functioning ambulances? Once you have that, then the Echo units can do what they're supposed to do, and do it well.

[Towne Cluber]

Your 300 lb person hypothetical example is besides the point. The real-life situation involved a BABY, who could have been easily transported in any type of vehicle...much less a large SUV.

Almost any motor vehicle can transport a person to the hospital. Yes, certain types of vehicles are better suited than others for the job, but to say that an SUV "can't transport" is completely false.

If it makes you feel any better that "everyone is ganging up on one person", I also blame the other paramedic for following her unlawful order and not rendering assistance.

Again, this situation is also a good opportunity to remind people about Detroit's very real workforce problems [[i.e. poor customer service, lack of qualified workers, etc.). Again, that is not to ignore that there are also major problems with the system, but in this case, it was the decisions of two individuals which directly lead to disaster.

[Detroitnerd]

Your 300 lb person hypothetical example is besides the point. The real-life situation involved a BABY, who could have been easily transported in any type of vehicle...much less a large SUV.

In this instance it's beside the point, but I'm sure you must be aware I'm talking about something much broader than this particular case. And there are definitely instances where an SUV is the wrong tool for the job.

Again, this situation is also a good opportunity to remind people about Detroit's very real workforce problems [[i.e. poor customer service, lack of qualified workers, etc.). Again, that is not to ignore that there are also major problems with the system, but in this case, it was the decisions of two individuals which directly lead to disaster.

Ah, but there's a chicken-and-egg thing going on here too. Bad practices, bad management, and improper resources lead individuals to make bad decisions. I sorta wonder why you are so reluctant to discuss that part of it, but I'll just have to accept that it's something you don't want to acknowledge. But it is real. And unless something changes, I believe we'll see it again.

[Towne Cluber]

Indeed, there's a chicken-and-egg dynamic to this entire situation. Bad practices, bad behavior, and bad work ethic lead to both bad management as well as bad individual behavior and bad societal conditions. I too wonder why you only want to acknowledge only one aspect [[management) of both the event itself as well as the entire culture behind so many of the problems in Detroit. We agree that there's a much broader issue than just this case, however, you only see it as one-sided.

[mam2009]

Thanks for clearing that up, but, be that as it may, she still wanted the police there. Thomas asked the dispatcher when the ambulance and police would get there. Then there's the full quote in the transcript: "It’s a baby not breathing, no scout available. I’m not about to be on no scene 10 minutes doing CPR. You know how these families get.”

http://www.clickondetroit.com/news/d...ation/34176128

Read for yourself. It's right there in the article.



That may be, but it's still beside the point. The units are not designed to transport, and that's because you don't have room to treat or stabilize a patient properly. The baby is not a good example, but how do you, say, hustle a 300-pound unconscious person into an SUV without a gurney? It's the wrong tool for the job.



Then, again, why use a unit that can't transport?



Seems to me that when everybody's jumping down on a specific employee with both feet, it's a good time to remind people of very specific management problems that play into it. Can't do anything about a worker who disobeys orders other than let her go, but the systemic things we CAN do things about. That's the difference.



Nobody is working to distract from the employee's problems. The chorus of condemnation is loud and unanimous. As for the problem of EMS management pulling a fast one by using rigs that can't effectively transport patients, not so much. I think it's a good opportunity to talk about a troubled program the EMS has pursued for years.



Again, Towne Cluber, as I've said multiple times, I AM NOT DEFENDING THE MEDIC. If people concerned about EMS service want to improve service and prevent things like this in the future, they'd do better to spend their time trying to understand what happened instead of simply damning one employee.

http://m.clickondetroit.com/news/emt...-dies/33741914

If u open the link to the pdf document in the article, it shows the internal department investigation concluded the EMT did NOT request a scout car, only once inquired about the ETA for a scout car, never expressed to the dispatcher or any one else outside her vehicle that she was concerned for her safety, and several times refused to go treat the baby after being specifically told yo do so without explanation [[except not wanting to do CPR for ten minutes. She also said in her departmental investigation interview that she wasn't "scared."

[Detroitnerd]

http://m.clickondetroit.com/news/emt...-dies/33741914

If u open the link to the pdf document in the article, it shows the internal department investigation concluded the EMT did NOT request a scout car, only once inquired about the ETA for a scout car, never expressed to the dispatcher or any one else outside her vehicle that she was concerned for her safety, and several times refused to go treat the baby after being specifically told yo do so without explanation [[except not wanting to do CPR for ten minutes. She also said in her departmental investigation interview that she wasn't "scared."

Riiiiiiiggghht. She was asking when the police were going to be there, when the ambulance was going to be there, and "you know how these families get." And yet that totally didn't concern her, because she didn't explicitly say so. Har-de-har-har.

She just was lazy, right? Didn't want to do CPR for 10 minutes. Wanted to risk losing her job for absolutely no reason at all.

Why don't you try selling that bridge to somebody else, OK?

[Towne Cluber]

She clearly showed devotion to duty, caring for others, and the temperament for the job. An above and beyond the call of duty type that should serve as a model in her profession.

Maybe she was lazy? How can you automatically dismiss that very real possibility? People risk losing their job all the time for absolutely no reason. Again, how can you act as if that is some type of impossibility?

Why don't you try a little harder on selling that you would trust her [[and her partner) with your life and/or the lives of your family and friends. OK?

[Towne Cluber]

Here is an example of a real EMT:

http://www.nbcnews.com/news/us-news/...s-life-n410066