Who to call first? Not DAN?

[Jorbar1551]

Ive been a paramedic for more than twenty years with something more that 20,000 ambulance calls under my belt. im pretty sure I know just a little more than you about the subject. 911 dispatches a call then they are done, period, end of story, no exceptions. Destination is the call of medical control at the base hospital.

BS...just because dispatch dispatches you, it doesnt mean they are done. they are done until the ems crew says their done once they get all the information they need like callback number, exact location or whatever else.

 

[Wildcard]

BS...just because dispatch dispatches you, it doesnt mean they are done. they are done until the ems crew says their done once they get all the information they need like callback number, exact location or whatever else.[/QUOTE
Dispatch is not 911. Do I need to explain the whole process to you?:shakehead
Some peoples kids....
ROTFLMFAO,he's an EMT student telling ME about EMS, OMG!

 

[diverDano]

BS...just because dispatch dispatches you, it doesnt mean they are done. they are done until the ems crew says their done once they get all the information they need like callback number, exact location or whatever else.[/QUOTE
Dispatch is not 911. Do I need to explain the whole process to you?:shakehead
Some peoples kids....
ROTFLMFAO,he's an EMT student telling ME about EMS, OMG!

So, I phone 911, tell them where I am, and what has happened, then they hang up, call whoever isn't having donuts and coffee, and call it done??? Holy, I hope I never get bent.....

 

[diverDano]

Originally Posted by Wildcard
Ive been a paramedic for more than twenty years with something more that 20,000 ambulance calls under my belt. im pretty sure I know just a little more than you about the subject. 911 dispatches a call then they are done, period, end of story, no exceptions. Destination is the call of medical control at the base hospital.

I hope you drive like Junior, cuz if you have to drive me, instead of getting a helo ride, I wanna be driven at light speed.

 

[Dive-aholic]

Wildcard is right. I answered 911 years ago, then I worked as a police officer/first responder before working for the fire department/EMS. Now I'm an ICU/ER nurse. So, I've experienced it from beginning to end.

1. Someone calls 911.
2. In a small facility, the 911 operator dispatches the call. In larger areas, 911 enters the information into a computer for dispatch to send out the call.
3. EMS responds to the call.
4. EMS assesses the situation and transports the patient, usually to the closest facility.

If it is a trauma, then it may be the closest trauma center, but if the patient is critical enough, even that may not be so. Sometimes the crew just wants to get the patient to a hospital where a doctor, who can do more, can assume care. Then the patient will be transferred to another facility once stabilized. In Arizona, the stupid system even allows patients to request a particular facility if they're not that critical. That means an ambulance may be placed out of service of 2 or more hours because they have to transport someone all the way across town!

So back to 911. Oh, after the 911 operator either dispatches the call or gets the information to dispatch, they're done. In larger cities, 911 and meds control are not the same.

 

[diverDano]

2. In a small facility, the 911 operator dispatches the call. In larger areas, 911 enters the information into a computer for dispatch to send out the call.

...isn't this where knowledge of a hot chamber would be???

 

[ArcticDiver]

I just noticed that DAN now has a banner add on SB which indicates that in an emergency you should call EMS or 911 first and THEN call DAN.

I was at the DEMA show a few weeks ago and asked the guys at the DAN booth this same very basic and important question. It was disappointing that they didn't immediately know the answer, but after discussing it among themselves they concluded that you should call DAN FIRST in an emergency. Guess they changed the rules.

I was very interested in this important issue because about a year and half ago I was involved in a diving accident where my buddy needed immediate helicopter evacuation due to complete paralysis which extended from his toes to the abdomen. He was able to breath on his own, but we were a 20-hr boat ride from shore and the situation was desperate (he was on 100% oxygen).

It HAD BEEN my understanding that the proper protocol for DAN members was to call DAN first in a diving emergency where transportation and treatment was required. We did that and ended up with a pretty bad experience.

For some reason, DAN delayed contacting the Coast Guard for something on the order of 40 minutes. We made it crystal clear during the initial contact that we had a very serious diving accident and needed immediate helicopter evacuation. To make a very long story short, the victim is now permanently and severely disabled.

If we had known that DAN was going to waste 40 minutes, we would have called the Coast Guard immediately. In fact, if we had been informed that there was going to be ANY delay on the part of DAN, we would have hung up the sat. phone and called the Coast Guard immediately. We had requested that DAN immediately contact the Coast Guard on our behalf and we were lead to believe that they were doing so.

It is my understanding that the victim subsequently pursued legal action against DAN. Maybe this very unfortunate incident has changed the policy?

I just took a quick look at their on-line handbook and it says that DAN travel assist must be used to arrange evacuation or they will not pay for the evacuation. I don’t think that the USCG charges for the helicopter ride, but the the protocol still seems a little ambiguous to me. ***?


http://www.diversalertnetwork.org/membership/handbook.pdf

I just joined in and haven't read all the responses to your question. So I may be repeating what someone else has said. Or, after a lot of digressions I could be giving you some worthwhile information.

If EMS is available ALWAYS call them first. There are lots of reasons for that. You may only think you have DCS and it is something else. You could be closer to crashing than you think. Whatever. The ambulance crew is your best chance of getting competent, lifesaving care while things are being sorted out. Not a certainty; but your best chance.

Tell the ambulance crew and the folks at the Emergency Department you think you have DCS and to call DAN, or their prefered hyperbaric specialist. In many US areas there are local Docs who are pretty competent in hyperbarics. The ED can then do their thing to be sure it is DCS, or, if not, what the problem is.

Remember DAN is a Resource Library and a Coordination Center. They are not the Treatment Agency. DAN is at the other end of a phone several miles or thousands of miles away. They do a great job of coordinating logistics. But the success or failure of your treatment lies in the medical folks who can see and treat you.

Finally, remember you chose the location in which to dive. Along with that decision came the decision to accept whatever medical care was available there. It may be great, or it may be poor. Some people, whatever their occupation are competent and some are not. But that is what there is. No one miles away is going to be able to overcome the limitations or enhance the capabilities of the folks there. So be nice and encourage them to do their best.

 

[Dive-aholic]

2. In a small facility, the 911 operator dispatches the call. In larger areas, 911 enters the information into a computer for dispatch to send out the call.

...isn't this where knowledge of a hot chamber would be???

This is where they don't even know what a chamber is! Most smaller cities/towns don't have chamber or even know about them. Most US chambers are in large cities where 911 and dispatch are 2 separate entities.

 

[Wildcard]

2. In a small facility, the 911 operator dispatches the call. In larger areas, 911 enters the information into a computer for dispatch to send out the call.

...isn't this where knowledge of a hot chamber would be???

Again, can you read? this is medical control at the base or reciving hospital. In some very small areas, I live in one of them, 911 dispatch is run by the PD and are SOMETIMES paid by FD and ambulance. Most often, 95% 911 is an answering service basicly, "911, fire, plice or ambulance?" then it is transfered to the dispatch center. Ive even seen areas that the fire dept extorts money from the privates to redispatch them. IE, 911-fire dispatch-EMS dispatch. makes for very slow response times.
As far as "hot" Im not aware of, but there may be, chambers that are staffed 24/7 but it makes little econimic sense and a delay of a couple of hours in the ER awaiting staff would be very common and except for AGE, not particularly harmful.
This immage you have of rushing someone with light and siren into a "hot" chamber is false. It just simply does not work like that.
Advice for new EMTs, which your not yet, you have two ears and one mouth for a reason, shut up and listen, you will learn much quicker.

 

[diverDano]

Again, can you read? this is medical control at the base or reciving hospital. In some very small areas, I live in one of them, 911 dispatch is run by the PD and are SOMETIMES paid by FD and ambulance. Most often, 95% 911 is an answering service basicly, "911, fire, plice or ambulance?" then it is transfered to the dispatch center. Ive even seen areas that the fire dept extorts money from the privates to redispatch them. IE, 911-fire dispatch-EMS dispatch. makes for very slow response times.
As far as "hot" Im not aware of, but there may be, chambers that are staffed 24/7 but it makes little econimic sense and a delay of a couple of hours in the ER awaiting staff would be very common and except for AGE, not particularly harmful.
This immage you have of rushing someone with light and siren into a "hot" chamber is false. It just simply does not work like that.
Advice for new EMTs, which your not yet, you have two ears and one mouth for a reason, shut up and listen, you will learn much quicker.

ummmm....maybe you should should calm down and read more carefully yourself. I am not an emt in training, or desire to be one. I am a working diver in a small town with two chambers locally, with a third within a short flight. Flights from my 'little town' are fairly regular and common. Maybe i'm very fortunate to live in such a diving literate area.