Posted by: medicblog999 | October 11, 2010

A Police Ambulance?????

 

If you have been following me on twitter (@UKMedic999), you will know that I have been participating in a fairly unique project going on in one area of my service. As I have been getting more experience in this role, I have wanted more and more to share what has been going on and find out if you have anything like this where you work. 

So what it is it? 

In my service, when I work on a response car, I am not allowed to be knowingly sent to a patient who is under the influence of alcohol or recreational drugs or has been involved in a violent incident. At times, this must be extremely frustrating for those in the control room, to have a paramedic sitting in a car when jobs are coming in left right and centre which are not suitable to send that resource to. 

There is currently an initiative in another area of my service which is trying to deal with this very thing. In this trial the paramedic has a police officer with him, so that he can be ‘protected’ if in a higher than normal risk environment. This car is under control of our own call centre and whilst it is primarily designed to deal with the main city centre area, it can very easily be pulled out to more remote areas if that is the only resource left. 

Another option is the scheme I am involved in. I believe it is unique, and I am 100% bought in to the value of its presence and the effect it is having in a multitude of different ways. 

In this post, I will explain how it works, then I will follow up in further posts to give examples of the project in action and the benefits to truly working in partnership with our colleagues in the police force. 

Each Friday and Saturday night when I am not on my rostered duty shifts, I travel down to a town called Darlington. Darlington has previously had a bit of a reputation for the myriad of problems that come along with being a busy town centre with alot of bars and nightclubs and young people. Add to that, the fact that 15 miles away is Europe’s largest Infantry training base, and you have a recipe for a particular type of problem with a particular type of response. 

The brain child of Sergeant Dave Kirton, from Durham Constabulary, the Darlington Police project is truly unique in its approach to caring for the people moving into the town centre for hopefully, a night of fun and frivolity on a Friday and Saturday Night. 

Dave runs a local team of Police officers who drive around the town centre enforcing the strict local laws on underage drinking, disorderly conduct and ensuring the smooth running of the “night time economy” within the town (as far as possible). 

Dave noticed a hole in the provision within the town centre. 

Namely the amount of time that the local police officers had to wait for an ambulance response for the more minor and frequent calls for medical assessment from his police officers on the streets – assaults, drunken people incapable of looking after themselves and the more minor medical complaints that seem to raise their heads in the presence of copious amounts of alcohol. There was also the issue of the amount of soldiers coming into town when on R&R from their training camp. 

The solution seemed easy enough. There were 6 seats in his police van and currently only 3 Police officers occupying them. 

After a prolonged negotiation time with the Ambulance Service it was agreed that a paramedic would be provided to work alongside the officers on this team and provide immediate triage to the `potential patients` that his colleagues were calling ambulances for. 

The other string to the bow of this new town centre resource was the presence of a Military Police officer from the local Garrison to help control any of the more ‘lively’ elements of the infantry recruits that were travelling in for some well deserved down time. 

The team was now complete. 

1 Sergeant 

2 Police Officers 

1 Paramedic (Cat C Trained so they can diagnose and advise on scene) 

1 Regimental Police Officer. 

This works very, very well, but only due to a couple of reasons. 

  1. The vehicle and our responses are controlled by the Police officer in charge of the vehicle (which is usually the Sergeant)
  2. Dave actively listens to his radio channel for any officers calling out for an ambulance. Once he hears a request, he will relay that to me and ask if we can deal with it. We will always attend anyway, but if it sounds like a minor illness/injury that we can deal with, we will get the ambulance travelling in, to stand down.
  3. The Ambulance service does not get to allocate the details. If a job comes in to my radio from my control and it is not “life threatening”, I will ask Dave if it is appropriate to help. Usually, if it is close by, and the town isn’t too busy, then we will attend and care for the patient. If however, Dave believes that moving out of the town centre is not an option (for whatever reason) then we will not attend. After all, it must be remembered that this is primarily a police resource.
  4. Once on scene with a patient, the dynamic of the team changes and I then take the lead with the police officers helping out as directed.
  5. Once my assessment is done, if the patient needs to go to hospital, if Dave agrees, then we will transport the patient to the local A&E department (which is only a 5 minute drive from the town centre) in the police van (No, not in the cage!) so that we can keep an ambulance free to attend other more serious incidents in the wider area.

The benefits to this system are numerous. 

  • The response times to jobs in the town centre are usually less than 1-2 minutes.
  • Once on scene, the other officers dealing with the patient can be made available for other duties whilst we, as a team, take over the care role.
  • The community sees a cohesive partnership working together to keep their local area safe.
  • We are responding to calls which would have resulted in an ambulance response to the city centre.
  • The police members of the team are also trained in MOE (mechanism of entry) techniques, so if they are called in to force entry into a location for a ‘concern for occupant’ call, then I am there with them to provide care to the patient once we gain entry to the property.
  • If any of the police team either in the van or in the town centre gets injured, again, I am right there!
  • There are financial incentives (especially for the ambulance service) involved in hitting targets and reducing the amount of ambulances having to come into the city and transport patients to the hospital.
  • The police do also have their primary role to perform and at the times when they are dealing with the less compliant members of the community, I tend to just stay next to the vehicle and keep a low profile. I do not get involved in any violent scenarios until my colleagues have made the area safe for me to work in. 

    My Alternate treatment area (the back step!)

     

    Our police van does have a cage in the back, and is used for arresting people and transporting them to the cells if required. Again, in these circumstances, I just keep my head down and try to keep out of the way. Surprisingly though, we have also found that the presence of a paramedic on a scene which was initially violent can be a bit of a calming effect for some reason! 

    Over all, I am honoured and very excited to be part of this project. I can see the benefit of this rolling out to many areas across the United Kingdom, and with a little bit more tweaking and a custom vehicle which can have a little patient treatment areas as well as the cage in the back; we could really be onto something special! 

    I’m sure you have lots of questions. 

    Ask away and I will try to answer them as best as possible and even pass them onto Sergeant Kirton if needed. In fact, that’s a good idea………Let’s see if I can get him to write a guest post. 

    More to come…. 

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Responses

  1. What do you carry for equipment?

  2. Sounds like simple common sense to me. Another example of the value of listening to the people on the ground doing the job.
    Is it going to be rolled out further in your area?

  3. Sounds like a very innovative idea and I can see how this helps with sending vehicles to more serious callouts.Seems to make perfect sense working in partnership with the Police,they not hanging round as much when you can deal with the minor ailments and yet your protected against any aggressive.
    How long is the scheme set to last?Will you have any input into whether the scheme continues?Do you still complete an assessment form on the Pts you see?
    Wish you well with what sounds an exciting venture.

  4. I can see where this would be invaluable! I wonder how this could be adapted to work in the US?

  5. There are already several Police/EMS Models here in the US. Look at Woodbury in MN as one. I know the EMS Chief there.

    • I have heard from many people how LE and EMS work together in the US since I posted and even about places that have the PD handle EMS. I will check our Woodbury though anyway. I have been surprised by what I have found out about LE and EMS.

  6. I can imagine you as a paramedic being there as a calming influence. If I was some guy on the street being arrested by the cops I would wonder what these cops are going to do that requires the paramedic to be there

    • At least in the US, fairly often citizens under arrest develop “incarceratis” or complaining of a medical condition so as to end up in the ER, not police station… and I’m sure having a paramedic around to filter BS helps…

  7. Good project.
    Mark, can you tel us what exactly ‘Cat C Trained’ is all about? & is it a local thing?

  8. Innovative solution, as long as you don’t act like this guy.

    Sorry, I couldn’t resist. 😉

    • AD, he’s a therapist just trying to cure someone of Acute Hickory Deficiency!

  9. EMS 2.0 at work. you gotta love it! Do what makes sense….. what a concept!
    UU

  10. The Yorkshire Ambulance Service have a Police/Para car on in York on Weekend nights, tasked by ambo HQ, which sounds like the trial NEAS are doing, but your project sounds like a brilliant idea. It’ll be interesting to hear how it goes

  11. I like the idea very much, and I can see the value of having a paramedic on hand. Furthermore, the attendance of the MP is useful, as it provides a fit pair of hands if it kicks off, and a very useful pair of hands if you need assitants at a scene.

    Innovative, and very good reasoning.

  12. Cat C is that Advanced Para/ECP level?

  13. Very interesting model, and it’s great to see it’s working well. I benefit from an excellent relationship with Police in my service, and see how far it really goes. A few questions, thought:
    — What equipment and supplies do you carry? How much of the van does it take up? Do you have narcotics? A monitor? Immobilization equipment?
    — Do you maintain the ability to ride in with the ambulance if a call requires it? How do you meet the police van back in?
    — Do the police keep the ability to prosecute your patients, for example, for underage drinking, and how does the transfer of information work, privacy-wise?
    — Are the police officers medically trained in any way? Can they help you spike a bag? Immobilize? Perform CPR?
    — Is it considered abandonment if you refuse a call, because of PD traffic?

    Thanks again!

    Dan

  14. I’d love to see it in our area, but unfortunately in N.Ireland the police are regarded by terrorists as legitimate targets, and therefore anyone working with them would be too.

  15. We’ve been running some trials down here in London too:

    1) Paramedic(s) in a police car
    2) Police officer in an LAS FRU
    3) A police radio in an LAS FRU

    Without going into huge details, the basic theory was with each trial that a truck would only be sent if the medics on scene requested them. Often it was minor cuts sorted on scene or the patient could travel in a car.

    Options 1 and 2, while useful and helped save loads of ambulance journeys have (as I understand it) ceased. This was mainly because having police and LAS on the same vehicle may have been seen as making patients more hostile to the medics believing us to be in league with “the fuzz” thus damaging the patient/medic relationship.

    Option three, while there are some teething problems, appears to be the most likes solution from both police and ambo bosses. The FRU is ring fenced and can’t be sent out side of the specific policing borough. They listen to the police radio and self activate to calls which sound like they may be needed for and get the police dispatchers to tell our control we are going. We can also be send by our lot to calls which will need police and we can liaise direct with police as when it is safe to approach.

    These are only trials so who knows where it will go but it definitely looks like there will be more police / medic partnerships out there!

  16. […] drug, alcohol and violence in a local town centre. For an explanation about how it works you can click here for an earlier post, but tonight I thought I would take you through one of the shifts I have worked. Obviously various […]

  17. An interesting model, here in the States, my town as well as a few other municiplaities are trying some other police ems models. Multiple towns operate one model, which part time police officers, they have full powers on duty, but do not carry or have powers off, are certified EMT-B’s. They staff ambulances for 12 or 24 hr shifts and are dispatched via county radio room like the volunteer squads are. All of these towns have volunteer bls, and these officers supplement that coverage. its common to see ambulances painted like radio cars and lettered “Anytown Police Department EMS” coming into the hospital

    In my town, we opperate slightly differently. Primary EMS response for our town is volunteer, they staff the buildings from 2200-0600 and are paged during the day. We have a 1 paid fire engine 7-5, with 6 FF/EMT’s. During the day, when EMS calls come, the tones are hit, 1 FF/EMT may respond if available. The Police Department employs officers who do routine traffic and other ticket-able offenses, will break from patrol, and respond to the ambulance building. Its not uncommon to see a XXX Volunteer First Aid Squad amublance pull up and a FF/EMT and a LEO get out. Its interesting to see the LEOs with a gun on their hip, a sethoscope around their neck and state EMT patch on their sleeve


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