Hi Rob,
Yes, but an employer cannot abrogate their Health and Safety
responsibilities - as such, Fire have H&S resp for their cutting
equipment and personnel deployed, and as a service we have H&S resp for
our employees - our employees are under a duty to wear PPE and we as
management representatives of their employing Trust are under a duty to
ensure they are wearing it, as well as seeing that cutters/spreaders are
not flashing too close to body extremities.
In discussions with our Fire chaps, they refer to an inner cordon at an
RTA of 2m, with an emphasis on not being within 2 metres if not actively
doing something to casualty or cutting.
Fire designates officers specifically for H&S at scene at large
incidents and badge them as such in our patch - it certainly seems to
work well.
Out of interest, the model that is being discussed with ambulance
medical directors in our region is that doctors take clinical
responsibility, as they would in hospital, for patients, but for other
issues, such as resourcing, equipment, Health and Safety, loading, etc.,
the senior officer on scene represents ambulance Trust "management" and
our attendant Clinical Governance responsibilities, much the same as in
hospital. Of course, occasionally the same hat can be worn. ;)
We are also very clear that once a doctor arrives on scene, he carries
the medical responsibility for all patient care at that scene as he is
now the senior medical presence. We also encourage paramedics to
vocalise their concerns at the time, modelled on aviation crew team-risk
reduction communication strategies. (Though the rogues would ask if
that worked so well, why aviation adverse incident recording is the
flavour of the month ...)
Anton
Staffs
Rob Dawes wrote:
>
> I thought i'd post this fact as well, but Vic beat me to it.
>
> Just for completeness, the Senior Fire officer is responsible for "health
> and safety" in the inner cordon (which can be any size he deems fit), but
> the "overall" management of the RTA scene still rests with the police. This
> changes if the scene involves Fire.
>
> In my experience, the senior fire officer is not necessarily the one making
> the decisions, (usually an SO/ADO) and will leave it to the OIC of the
> appliance(s) who are already dealing with the extrication or have attended
> because of specialist knowledge, i.e OIC of the major rescue unit or
> whatever it's called in your area.
>
> If the senior fire officer deems that someone is not complying with his
> wishes, he can "request" that the police remove that person, but will have
> to justify that request to the HSE, should it be challenged at a later date.
>
> Cheers
>
> Dr Rob Dawes
> (ex Fire Officer WMFS)
>
> > -----Original Message-----
> > From: Accident and Emergency Academic List
> > [mailto:[log in to unmask]]On Behalf Of Victor Calland
> > Sent: 22 March 2002 15:00
> > To: [log in to unmask]
> > Subject: Re: so who is in control at the roadside?
> >
> >
> > I've been sitting in the background quietly reading all of this debate and
> > would like to offer a contraversial thought.
> >
> > Within the inner cordon or 10 metre action circle (which ever you want to
> > call it) the person ultimately in charge is the senior fire officer. The
> > reasons for this are:
> >
> > 1. He is designated as responsible by the Police, and don't
> > argue with
> > them because the Crown and the Government say they are in overall
> > authority.
> >
> > 2. He is the person ultimately responsible for your safety
> >
> > 3. He has at least four other guys who will paste you if you disagree
> > with him
> >
> > 4. He has the rescue gear and if he takes his bat & ball home you're
> > stuffed.
> >
> > 5. He actually knows what can & cannot be done.
> >
> > 6. Strangely enough he wants to get a live casualty to hospital too.
> > And knowing you know more about medicine than he ever will, he will, if he
> > has any sense, listen to you provided that you are properly equipped to be
> > at the scene and you have authority to be there.
> >
> > As soon as the person has been removed from danger you have the absolute
> > authority for the patient, provided you can identify yourself as a doctor.
> > It does not matter if you are the local dermatologist, but your
> > professional responsibility is not to interfere unless you know you can do
> > better.
> >
> > If you take responsibility for the patient, then you can say where the
> > ambulance goes. Once you are no longer with the patient however, the
> > ambulance crew can always change your decision based on what they percieve
> > to be the changing needs of the patient.
> >
> > Vic Calland
> >
> >
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