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Accident today 2-Oct-2008 At 7:11:37 PM J Qui

Message

>Hi Nina,
>
>Good to hear that Jenny is back with friends and recovering.
>
>I hope both you and Jenny will understand that some of the negative comments
>about the emergency services that have been posted in this thread are genuinely
>the result of the climbing community witnessing occasional 'over-reactions'
>by authorities to simple and non life-threatening extraction situations.
>
>And, as has been pointed out, these self-same authorities often have little
>alternative but to deploy all the resources at their disposal in order
>to ensure that "everything that could be done WAS done" to counter any
>subsequent criticism (or litigation?).
>
>So maybe it is sometimes incumbent upon us, we who engage in these activities
>that occasionally result in an emergency call out, to accept a little responsibility
>for the provision of accurate details about the nature of the emergency
>and the condition of the injured person when we call 000, so the authorities
>can better respond with the appropriate level of rescue input?
>
>Just a thought!
>
>

Hiya Kuu

The triage that occurs on the phone during 000 calls does ask for any known injuries. That however,
makes little difference in the bigger picture.

That is a good thought however, and raises many issues regarding the appropriate level of response to
situations. Quite often we cringe at the amount of resources that go into certain situations...it is
diabolical. Being on the other side of the fence provides a clear view of why it is necessary.

Being a paramedic here in Melbourne, and also an educator in wilderness medicine, it is very difficult
to determine what level of response is appropriate. Many factors, some of which are obvious, others
not, must be considered. Mechanisms and patterns of injury (that could potentially get worse over
time), pre-existing illnesses, distracting injuries (that may be masking other pains or injuries),
environmental conditions, time versus distance to definitive care... and many more, all impact on the
decisions made.

For example, and this is purely a hypothetical construct on the rolled ankle. Highly plausible however,
and possible.

This person only rolled their ankle. However, what if it were a fracture, what if it compromised
circulation or nerve function (which must be addressed ASAP)? What if this person had an underlying
vascular disease (which further compromised circulation)? What if the weather was turning inclement -
making evacuation more difficult? What if the person's English was poor, in which their account of the
situation was not interpreted correctly (where in reality it was actually worse)? What if the patient's
ankle was causing great pain, masking another, more sinister injury somewhere else? At the same
time, what if this person was on a medication regime for other illnesses, in which they forgot to take
their meds with them (and that happens a lot)?

Considering all of this, sometimes, emergency responses will send the closest 'emergency' equipped
vehicle to commence treatment, until ambo's or the like can get there.

So, the situation could have turned 'ass-up' for the patient if it were merely assumed that it was just a
rolled ankle.

In addition, there was a reason why they phoned for help. Was it because they didn't know what to do?
Was it because they didn't want the responsibility on their own to manage this person? Was it cause
they were frightened? Was it because they knew that little bit more than the layman, perhaps
considering one the questions outlined above? That alone, is sufficient enough reason for us to
respond and take action. Perhaps you or I wouldn't have phoned. Nevertheless, send an entourage,
and be done with it. It's good practice also.

You mentioned that all the resources are sent to avoid subsequent criticism or litigation. Perhaps,
perhaps not. Sometimes it is about considering those things listed above, and realising that the best
action to take, in the best interest of the patient's health and future welfare, is to deploy all the
resources. Many people don't understand the bigger picture.

Just a thought.