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Good Question. The answer is "Adult Diapers" (AKA " It DEPENDS" Get it...Depends? I crack myself up...) Anyway... It varies by state to state law, but generally every state has SOME version of law that requires mandatory reporting in the following cases: Animal Bites New Onset STD's (applies to all healthcare providers, but this is seldom if ever a concern for EMS) New Onset of certain highly infectious Diseases, i.e. Tuberculosis, meningitis, anthrax. Gunshot wounds of any type Puncture wounds and blunt force trauma believed to have occured in an assault. Injuries believed to have been encountered during a criminal activity ANY injuries believed to have occurred in domestic violence, or any injuries or illness believed to be the result of abuse (physical/sexual/emotional) or neglect (physical or medical) to a vulnerable population group (i.e. the elderly, disabled, or children) Now a comment on mandatory reporting: Each state has different definitions of who and what is a mandatory reporter (EMS is usually included in some form or another) as well as who you report to. Depending on the situation you would report (or in some states causing to be reported is acceptable ...in others it is not) to either law enforcement (in Idaho defined as a "Peace Officer" - specific legal definition outlined in code) or the health/social services Department (s) (child and elderly protection falls under this in Idaho), or BOTH. Most laws require reporting within a certain period, typically " as soon as practical" with in 24 to 72 hours though the actual wording may vary by state. So, if the patient is already being transport, an EMT may decide to "report" later (as in when the patient isn’t around and will get pissed off) when it is safer to do so if he is already getting transported. This does not cover situations where EMS will request law enforcement for safety reasons. For example, if a patient is intixicated, drunk, agitated, or otherwise goofy and it makes the EMS crew uncomfortable, Law Enforcemnt may be called. I hope this helps. All the time. Sometimes the initial cal for dispatch will be some a benign complaint (i.e. chest pain) when it is drug related just to avoid a law enforcement dispatch. Usually a seasoned medic has a pretty good BS detector though, and we can usually tell when a story doesnt match the injury pattern. That said, patients can be pretty creative in their BS.

This is a great question, and your answer is: it depends. There is something in the law called the "Emergency Exception" (relating to emergency responders entering private property without the consent of owners when there is a verifiable emergency). It depends on your state what the exact limitations and the statues, but I'm pretty sure every state has one of these. In addition, the facility may have some sort of Emergency Action Plan (EAP) with local emergency crews. It depends largely on where you are, and what kind of facility it is (is it large, prone to emergencies, ect), but many places will establish an EAP with first responders in case of emergencies. For example, in my area the local schools, malls, and assisted living homes have EAPs with us, so we'll know where to go in the event of an emergency, who can get us access into places, and so on. However, it's very possible (and unfortunately, probably also probable) that your facility doesn't have one of these, or is capable of getting one (not every facility is "worthy" of coordinating an EAP with local first responders, and most agencies would rather not bother). We can still find ways of getting into the gate. I actually carry a battering ram in my bus (laugh at me all you want, call me a whacker, whatever, I'm prepared). And btw, if there is an emergency, we probably won't be the first on scene. I'm sure somebody will be there calling 911 and holding the gate open for us when we arrive.