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Monday, April 5, 2010

Legality vs Morality

I recently came across a news story from Pittsburgh where a man died because paramedics didn't get to him....within 30 hours. That's what I said, HOURS! Not minutes.

The man had severe abdominal pain (after having had cholecystitis I have a new found respect for abdominal pain) and was not able to walk. His girlfriend later told CNN that her boyfriend "couldn't walk or move, and had to lie down with stomach pains."

The problem with the response was that Pittsburgh was having a heavy snowstorm. They received almost 2 feet of snow in 24 hours. This delayed the response. In fact, on three separate occasions, ambulances were dispatched to the home of this man and all three times they never got closer than "two to four blocs from the house." Three of the city's 13 ambulances got stuck in this snow storm.
Now I understand that weather conditions can make 911 calls challenging. I've been in a very similar call. But I don't understand why the crews gave up. Doesn't the writing on the side of the ambulance say paramedic RESCUE? Maybe they just didn't think they had enough manpower or equipment....
So would this be more manpower and equipment? It's even designated as RESCUE 1!! Maybe they mean rescue if you aren't really trapped. Or maybe we'll rescue you if it's not too cold or wet. What the hell?!?!

Now if the patient had died in 30 minutes of the original call (the girlfriend called 911 ten times during the 30 hours) I would not even be writing this post. But while I was sitting here I put myself into their shoes. What would I do if I were unable to drive to the patient?

My first instinct would be to hike in. Been there done that. The Pittsburgh Public Safety Director Michael Huss said it perfectly, "You get out of the damn truck and you walk to the residence."

Let's say that for some reason you can't walk. Try calling for additional resources. We're not talking about some small town like Monowi, Nebraska where there is no one else to call. Pittsburgh has a population of over 1/3 of a million people. 

So let's see. First, call for a snow plow.
I find it hard to believe that they wouldn't have one within a 30 HOUR drive but for arguments sake we'll say there wasn't one. 

Let's not just give up. Call for a could have called and had one transported from Colorado and still had time to spare.
...or get creative. Local citizens love to help.
Hey! Call the military. Put your defense dollars to work. With the time that they had the military could have flown it in from Iraq!
Call a redneck...There's got to be a few of them around.
Try calling for a helicopter to come in and do an aerial rescue. I ended up having to do this on my snow rescue.
If all that fails, grab a couple hundred volunteers and some shovels and dig.
How long would it really take a group of determined people to shovel enough snow to get an ambulance 4 blocks?

I guess the thing that bothers me most about this story is that the emergency responders gave up. And now that someone lost their life because of it they are arguing that they didn't do anything legally wrong.

This man and his girlfriend called 911 in their moment of need and we did not answer the call in an expeditious manner. It makes me sick.

I don't want to be associated with fire and EMS crews that give up because the call isn't an easy one. Or because they won't be held legally responsible. It wasn't as if their lives were in immanent danger if they continued on the call. No one was going to shoot them. They might have gotten a little cold and wet. I was fairly hypothermic after my snow rescue. But we still got to the patient, treated her, and got her out.

To the crews that were on this call (and those who sympathize with them), find a new profession. You may not have been legally liable but you sure had a morally duty to act. You Fail. Go become a waiter or something. Get out of my profession. You embarrass me.

I can't get over 30 HOURS!! Sad.


(I realize that I don't have all the information as to what happened on this call. The information I did get is from a few articles on the site. If you agree with me or, more importantly, if you don't, let me know. If you have more information I would love to have it)


TOTWTYTR said...

I'd say not only do you not have all of the facts, but you don't have ANY of the facts.

Snow plows? Ixnay, the same public safety director who wanted to fire the medics made a command decision that special requests for snow plows were not to be responded to.

Helicopter? During a record setting blizzard? Right.

40 or so people to help? From where, given the afore mentioned blizzard?

Just walk to the house? Then what? How do you get the patient back 1/4 of a mile through 22 inches of snow, downed power lines, while carrying all your equipment?

Call the FD? Maybe, if they'd come out for something like this. Then what? You'd have three or four men to help, but the snow still remains, the power lines still remain, the problem is essentially unchanged.

Not to mention that there were numerous call backs from dispatch and medical control during which Mr. Mitchell decided he wasn't that ill and could wait.

Apparently in addition to being overwhelmed, the people responsible for planning for events like this before they happen didn't have a plan for severe weather events during winter. In Pittsburgh, which isn't exactly the tropics.

What's unbelievable is the rush to judgment so many so called EMS professionals have made since this happened.

That's what I find really SAD.

Firefighter/Paramedic said...

I understand that helicopters are not going to fly in a blizzard. I still don't get giving up.

In a similar situation, two of us hiked in over a mile with minimal gear....not 4 blocks. We then fashioned a sled out of a sheet of plywood and some rope, wrapped the patient up in their own blankets, and drug them out. We made it work. Was it easy. No. Improvise.

There are obviously issues with the way management has things set up but, to me, that does not absolve the paramedic of the moral responsibility to get to the patient. For all the medics new the patient had a snowmobile in the garage! Hike in and assess the situation.

I said I don't have all the facts but I know I would have made it to the patient.

Fire Wife Katie said...

"...there were numerous call backs from dispatch and medical control during which Mr. Mitchell decided he wasn't that ill and could wait."

What I don't get is why no one tried to simply make patient contact, to assess the guy. Even if there was absolutely no way to get him to a hospital, at least he could have a medical professional check him out and help him, instead of having to self-diagnose with the aid of a dispatcher.

melaniek said...

Right on FF and Katie, I totally hear you on this. I was just dumbfounded that this guy died without any care whatsoever. I'm right there with FF/Paramedic on the whole abdominal pain...seriously, I couldn't imagine suffering for 30hrs just waiting for someone, anyone to come help me. I guess the way I see it is if you're in this're in it to help people, to make a difference in a person's life. They call in their moment of need and you come ready willing and able. These guys out in Pittsburgh dropped the ball, big time.

Like Katie said, why couldn't two medics get to this guy and start assessing and treating him while it was figured out how to get him out of there? I'm sure someone know's someone who has a snowmobile and a sled can be made out of a number of things to get this guy the 2-4 blocks to the ambulance. That's what really frustrates me, 2 to 4 blocks!???? Are you kidding me?

brian said...

County copter! Sure...we'd go help Pittsburgh out :)

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