How to handle Medical/Accident while CC/OC

[okboomer]

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paramedic70002 wrote:

I am the author of that article.

Outstanding!

I really liked your comment that most "legal" guns will be in holsters, rather than simply stuck in waistbands :celebrate

In your next artical, you might discuss the sense of responsibility that most gun owners feel and that securing the gun is a top priority for any responsible gun owner. A mention of the consequences of a non-secured gun might help EMT's to understand.

 

[paramedic70002]

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RE: Abandonment

And not to hijack the thread, but thought you guys might like a little sample of what we have to deal with.

Say I get on scene with a patient who is complaining of abdominal pain. There is no way I can tell what's wrong with him. Could be a bad lunch or could be a heart attack, or diverticulitis or an abdominal aneurism, or any of a number of other things ranging from suck it up to a life threatening emergency.

I am in a small town with one hospital. The patient does not want to go to that hospital. He wants us to transport him to a different hospital which is about 20 miles away. EMS regulations no longer require us to transport to the nearest hospital if the patient is stable, but we must get the local hospital ED Doc's OK to bypass them. We are also reluctant to bypass the local hospital because it takes the only manned ambulance, and the best chance for the next patient to get Paramedic level care, far away from our coverage area.

Do you refuse to take the patient to the next town, even if he is not refusing care?

If the local Doc says "Bring him here" but the patient refuses, what now?

Say you have a patient who can't make up his mind. How long do you stay tied up on scene waiting for a decision before you give an ultimatum?

Usually these issues can be resolved by gentle persuasion, either by the EMS crew or family. Sometimes they can't.

In my long career in EMS, there has been only one patient that I walked out on. She called 911 for difficulty breathing. We got on scene and found her lying on a sofa. She immediately requested to be taken to a hospital that was a few miles farther away than the one I would have chosen. Her true complaint was a stuffy nose from a cold. As I went about gathering vital signs, I noticed a hospital band on her arm. Upon questioning I discovered that she had just gone to the closer hospital but walked out because they made her sit in the waiting room instead of taking her straight back. So she went home and called 911. This really got my goat, so I told her that she was wasting our time and keeping an ambulance from someone who might really need it, and suggested that she find her own way to the hospital. I was wrong, but she really won the prize among the many people I have seen abuse EMS.

 

[r6-rider]

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TechnoWeenie wrote:

r6-rider wrote:

skidmark wrote:

Oh! The ambulance folks are telling me "Get in and we are leaving for the ER now, or we leave you her in the middle of the intersection." No time to get a receipt from the LEO if I want to get to the ER and get treatment for my two hands that do not work and hurt like heck.

you got to be kidding?!?!?

abandonment is a VERY serious crime. one no emt/paramedic ever wants to be charged with. if i were you i would of got their names and defiantly reported them to the MD. that is not a threat you make to a patient under any circumstances. glad it worked out for you though you defiantly got lucky

What? I don't know if you were ever an EMT/Paramedic, but it's called patient refusal. As long as a patient is cognizant and aware of his/her decision and does not have a decreased LOC (level of consciousness), and not under immediate threat, he has every right to 'not go', and the ambulance crew CAN give the people an ultimatum, stay or go. Usually crews get a signed waiver, stating they refused transport and aren't liable for anything that may happen as a result of the refusal.

Implied consent comes into play when a person is not conscious or has a decreased LOC, and it's presumed that the person WANTS help, as they would be asking for it if they were aware of the situation. In such a situation with a decreased LOC and/or a critical injury, then yes, abandonment would come into play.

exactly. it didnt sound as if the emt was offering a patient refusal form, it sounded like he was saying hop it or we're leaving you.

correct me if im wrong but without a signed refusal form that patient could be popping back into your life next year saying you left him no?

 

[KBCraig]

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paramedic70002 wrote:

Say you have a patient who can't make up his mind. How long do you stay tied up on scene waiting for a decision before you give an ultimatum?

Until either: he falls out, at which time you have implied consent; or, until another call comes in, at which time you prioritize by triage.

 

[choover]

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I'm not anti cop enough to care if they take it and run checks if I am whisked away to a hospital for a emergency. I don't think they should but what are they going to find on me... I mean in a emergency situation regarding your health i think thats the last thing you should be worried about. Give them to the LEO if you dont have a trusted party there. They arent all like kimberguys cop buddies