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#55 A Hard Day's Night


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#21 Sue

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Posted 14 November 2010 - 05:18 AM

I will wait for some others to post before I say or ask more, but how far outside of town is this scene?

Sue
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Sue Toberman, RN

#22 SerendepitySaki

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Posted 14 November 2010 - 12:27 PM

roughly 10 to Clinton and 5 to Bee Branch...about 2 to Choctaw...

right now, it's the Choctaw FD on scene...
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Sean G. Smith, RN-Alphabet Soup

#23 LWTRF14

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Posted 14 November 2010 - 03:54 PM

Greetings all....just a few words on the Clinton area and surrounding area. From response and landing experience, there is not much there. It's dark...very dark. You don't want to land and get involved in something that eat up resources real quick. My base is 45 minute response. The quickest is probably AE30 - 20 - 30 minutes. Again, the terrain is rough. If you were to get behind the eight ball...you would never catch it. I would suggest confirming local services have been dispatched, maybe re-con/orbit a few to gather information, relay it and head home...

The only reason for my comments..I saw Clinton, AR and it reminded me- home of our lastest tragedy. Our only true goal everyone: is to go home.
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Earl F Bakke III, NR-EMT-P, CC-EMT-P, PNCCT

#24 pureadrenalin

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Posted 15 November 2010 - 04:22 PM

Looking over a quick topo map of the area, I'm heading for the airport. Not only do I want a solid, level area to land, I can also work on securing fuel which I may need...seeing as the delta time for fuel is already 10min max to orbit the scene. How much do I burn on a hotload, or shut the aircraft down and burn more on startup. Can I get the local PD to shuttle us and our bags to the scene and we can just transport back with a local Ambo? This is of course if we know we have covered the supplies, and made contact with ground crews.
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#25 SerendepitySaki

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Posted 15 November 2010 - 04:46 PM

GREAT job on the topo...!!!!!
which airport? CCA?
do they have the fuel you want?
do they have/do you need instrument approach?
http://www.airnav.com/airport/KCCA
http://www.fly.arkan...n/CLINTON-2.pdf

dwelling fire appears to be cluster of mobile homes/campers
Multiple Choctaw VFD vehicles on scene
there are multiple pastures suitable for LZs


you have no standard dispatch protocols for this.
dispatch is trying reach the chain of command.
dispatch wants to know your Plan A and Plan B.
Pilot thinks he can put down and take off out of here, no problem, but he will time out for anything more than a load and go...

you have 10 minutes on orbit.... more thoughts?
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LET THE WILD RUMPUS BEGIN !!!!!!
Sean G. Smith, RN-Alphabet Soup

#26 SerendepitySaki

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Posted 15 November 2010 - 05:03 PM

your scene is off Round Spring Rd Clinton, AR 72031....
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#27 Speed

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Posted 15 November 2010 - 10:45 PM

I only see two choices; stage at the nearest airport or continue to your home base. If I'm reading it right you haven't received a request for your services (CAMTS 101), and have no contact with command yet. The problem with this situation will be communication. As soon as you switch off your battery the radios are dead unless you have a hand-held. Your cell phone service could be spotty if any at all. If it is truly going to be a multiple patient scene, and air transport is warranted, it may be best to get a staging unit(cop, first responder, wrecker, anything with a working radio) at the airport. Proceed with caution and well paced decisions. Your presence here at this point of the evolution is purely an anomaly, remember that.
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Mike Williams CCEMT-P/FP-C

#28 Sue

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Posted 16 November 2010 - 12:24 AM

I am with Speed on this one. Granted the airport is a distance away from the actual scene, unless we get a true request to be at the scene, I would strongly hesitate to just show up without the request. You are just asking to get caught in the middle of the chaos that is already ensuing at this scene.

I might consider the pilot dropping us at the airport with our IMPORTANT equipment so he can get his relief. I think a staging unit at the airport is a good decision. It is still a better place for multiple aircraft to land, as well.

I don't know if you are planning to bring weather in or not, but I did notice quite a bit of water way on the map, and that alone can bring fog into the smokey mix. Weather could also be an issue with a pilot who is close to timing out on this flight. None of the burn centers are in close proximity to this scene. I do not want my pilot pushing because he is feeling time constraints and because he has weather to worry about. Still...another good reason to go to the airport and drop us off or return and wait until they want us. My personal safety and my crew's personal safety come first and foremost in all of this. Me landing all willy nilly at this scene would compromise this. It would not be the first time we landed away from the scene and then went by ground to the area of the scene. I am also not afraid to get in the back of an ambulance to take someone where they need to go in order to provide safe care.

Sue
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Sue Toberman, RN

#29 pureadrenalin

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Posted 16 November 2010 - 01:22 AM

I had a better reply worked up...gahhh...stupid PC.

Anyhow. Here is how I am looking at this stiuation.

We have yet to make contact with the ground crews. I don't like the idea of orbiting with near empty tanks. So, for me, if we have a stong sense that we are the only HEMS service near the scene, and that a PT WILL benefit from our capabilities. I'm heading for the airport. Chances are we are very early into the incident. So having said that and assuming we can take a PT with the pilot time/dispatch mess...

1. Ground EMS in this are is assumed to be volunteer BLS, maybe BLS with IV's, knowing that, they are going to be frantic for control of the scene and PT's and to get these PT's away from their truck(s) ASAP. Landing on the scene isn't going to help matters in the least.

2. The closest airport with Jet-A is about 24NM due E of the Clinton airstrip. If they want HEMS and we are only available ship near the scene, have the ground crew head for the airport when they have the most severe PT set for transfer. Should only take us about 10min to get there, and begin fueling for the flight to the burn center in Little Rock. This wll also allow time for crew to prep for PT.

3. Knowing that we are on the edge of pilot time, possible weather, and night time flying..I'm still reluctant to take the flight. Is the pilot current with his NVG usage? Do you have appropriate charts and NAV aids for the flight?
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#30 SerendepitySaki

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Posted 16 November 2010 - 01:38 AM

doing REAL good, Pure....

and thinking, thinking, thinking! i LOVE it!!!!!!!

minor clarification... your tanks are NOT near empty... bingo and/ or RTB is my slang for saying you've got a 10 minute orbit WITH a comfortable margin to fly home on.....

is there a burn center in Little Rock?

and the sentiment expressed in your point #1.... hmmmmm... did i mention that i probably actually know a few of those volunteer folks? you might want to give them the benefit of the doubt... it's good PR... even if I wasn't FROM clinton..... B)

as for your NVG question....can you state the actual numbers for RW in non-controlled airspace VMC/IMC?
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LET THE WILD RUMPUS BEGIN !!!!!!
Sean G. Smith, RN-Alphabet Soup

#31 pureadrenalin

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Posted 16 November 2010 - 02:20 AM

doing REAL good, Pure....

and thinking, thinking, thinking! i LOVE it!!!!!!!

minor clarification... your tanks are NOT near empty... bingo and/ or RTB is my slang for saying you've got a 10 minute orbit WITH a comfortable margin to fly home on.....

is there a burn center in Little Rock?

and the sentiment expressed in your point #1.... hmmmmm... did i mention that i probably actually know a few of those volunteer folks? you might want to give them the benefit of the doubt... it's good PR... even if I wasn't FROM clinton..... Posted Image

as for your NVG question....can you state the actual numbers for RW in non-controlled airspace VMC/IMC?


Thanks. I am just finishing paramedic school, and have worked ground EMS for a few years in very busy servicer, and a decade in the fire service, 7 years worth spent surrounded by small communities similar to the one we are speaking of here....(just as a bit of background) I want to do HEMS in a future life. Just here trying to learn.


Okay, so, fuel is in an ok state...I'm still heading for the airport. I like the idea of a secure, flat area to put down in. A county my service covers has routine flights due to distance to truama center, and the local airport is actually a PDLZ, unless there is a clear, secure area near the scene. That county mimics this area of Arkansas actually...not much room to put down a helo easily.

The burn center I speak of is at a childrens hospital, not certain if they do adults too. That's the only one google came up with. At Arkansas Childrens hospital.

As for knowing those around that area..I'm sure you, do, and I'm sure there are some fantastic people there. But I know first hand how calls like this can go, and from entry level crew, to 20 year veteran with a bunch of ridiculous calls like this under their belt, everybody on the first due piece is going to be amped, and there may be utter chaos for the first 10-15min untill the scene gets organized.

Im unsure of NVG minimums. I don't know which FAR part they fall under. I just know the pilot has to be in line with required competencies to fly with them.
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#32 SerendepitySaki

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Posted 16 November 2010 - 02:54 AM

i'm unintentionally confusing you some more... there are minimum standards of visibility that vary for different conditions...that what i was asking....standard question on FP-C and CFRN exam....try looking up VMC/IMC.... Visual Meteorological Conditions / Instrument Meteorological Conditions

and you're right on arkansas children's ....sue hit it earlier....y'all might just need angel one.....and they DO do adult burns....

as for the scene itself....choctaw has two 1970s era pumpers, you get the idea... trust me....they're waaaaay too busy right now to demand that you "respect their authoritay...." but you got the chaos part right.....

and it's about to get a heck of a lot worse.....B)
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LET THE WILD RUMPUS BEGIN !!!!!!
Sean G. Smith, RN-Alphabet Soup

#33 Speed

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Posted 16 November 2010 - 10:43 AM

Hyperbaric scavenger hunt
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Mike Williams CCEMT-P/FP-C

#34 backseatrider23

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Posted 16 November 2010 - 06:41 PM

Coming in late on this........but I have a few questions.


What ground EMS support do you have (ALS/BLS) and number
has any agency actually requested a helo if so how many
who is the groud contact
anticipated number of injuries and what type
potential hazardous substances
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#35 SerendepitySaki

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Posted 16 November 2010 - 07:10 PM

ground resources- very limited
no foormal request at this time
no ground contact at this time
unknown
unknown

good questions... read back thru the thread... there might be some info there of interest...
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LET THE WILD RUMPUS BEGIN !!!!!!
Sean G. Smith, RN-Alphabet Soup

#36 pureadrenalin

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Posted 16 November 2010 - 08:01 PM

Forgot about hyperbarics..feel like an idiot..lol. Our local burn center has a few mono-place tubes, another facility has two, 10 place tubes. Can I safely assume that the burn center we will be flying to has hyperbarics? Or are we going to have to source another facility?

I hope i'm right on the VMC/IMC stuff here...difficult to find. I know VFR/MVFR/IFR rules, but am new to the VMC/IMC.



VMC- 3 statute miles visibility, 2000 ft. horizontally from clouds, 1000ft above and 500 ft below clouds


IMC I can't find anything on, seems to follow IFR rules.
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#37 SerendepitySaki

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Posted 16 November 2010 - 08:39 PM

generally speaking, you are right...

specifically,...it kind of varies by Federal Aviation Regulation (FARs, generally 91 and 135) and what class of airspace (A-E, and G) you're in....good backpocket stuff for you to know....nice to know vs. need to know....

and you're comparing flight RULES (VFR/IFR) with flight CONDITIONS (VMC/IC).... Visual vs Instrument....

and you threw the term MVMC out there...that's your clue as to how to define Instrument Meteorological Conditions.... once you pass thru Marginal, Instrument is anything less than VMC.....

here's your clinical application, certification exam/exam of real life type application questions: if your pilot says "1000 and 3", how would you translate that....and how does that relate to VMC/ IMC? and if you are a VFR only program could you launch...?

and don't worry guys.... you have about beat the AMRM horse dead.... who's ready for escharotomies and inhalation injuries? YIKES!!!!!!!:blink:
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LET THE WILD RUMPUS BEGIN !!!!!!
Sean G. Smith, RN-Alphabet Soup

#38 Sue

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Posted 16 November 2010 - 09:17 PM

generally speaking, you are right...

specifically,...it kind of varies by Federal Aviation Regulation (FARs, generally 91 and 135) and what class of airspace (A-E, and G) you're in....good backpocket stuff for you to know....nice to know vs. need to know....

and you're comparing flight RULES (VFR/IFR) with flight CONDITIONS (VMC/IC).... Visual vs Instrument....

and you threw the term MVMC out there...that's your clue as to how to define Instrument Meteorological Conditions.... once you pass thru Marginal, Instrument is anything less than VMC.....

here's your clinical application, certification exam/exam of real life type application questions: if your pilot says "1000 and 3", how would you translate that....and how does that relate to VMC/ IMC? and if you are a VFR only program could you launch...?

and don't worry guys.... you have about beat the AMRM horse dead.... who's ready for escharotomies and inhalation injuries? YIKES!!!!!!!:blink:








I say bring on the Escharotomies and stuff!!!
If I am VFR only and we are truly looking at 1000 and 3, at dusk, etc....I would not be hot to jump on this one. What is the weather like at my potential receiving? What is the forecasted weather for the next few hours here in this area and where I am going? It would be an in-depth discussion with the med crew and the pilot.
I understand we will be going on this flight, eventually. The conditions are less than ideal, and there are still many variables to consider. Just because you have your minimums does not necessarily mean you should be out there flying in it.

Sue
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Sue Toberman, RN

#39 SerendepitySaki

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Posted 16 November 2010 - 09:26 PM

sorry sue...didn't mean to confuse the issue...was just asking PA a question about minimums in general, NOT with regards to this specific scenario.... just stuff that you need to know and that you're very likely to see on a certification exam....

as for moving to the clinical phase in this specific scenario.... stand by....
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LET THE WILD RUMPUS BEGIN !!!!!!
Sean G. Smith, RN-Alphabet Soup

#40 Sue

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Posted 17 November 2010 - 02:34 AM

sorry sue...didn't mean to confuse the issue...was just asking PA a question about minimums in general, NOT with regards to this specific scenario.... just stuff that you need to know and that you're very likely to see on a certification exam....

as for moving to the clinical phase in this specific scenario.... stand by....


Sorry 'bout that. I jumped the gun. I will chill and wait for further clinical information.

Sue
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Sue Toberman, RN