EMTs are now authorized to obtain blood samples on DWI stops

[akflightmedic]

youre so right. drawing blood isnt a 'medical capacity'. silly me. lemee guess. youre one of those guys that wants to sit on the couch until a full code or a good trauma call drops. god forbid you get a call beneath your superior skill level.

i see this is a pointless converation. its always hard to motivate the lazy.

I wondered when you would run out of steam and resort to name calling or character questioning.

Knowing nothing about me and yet calling me lazy or a couch potato and implying I think there are calls beneath me. You definitely should step back, apologize and then reenter the debate.

Again you have veered off topic. This has absolutely NOTHING to do with laziness, it is more of an abuse of the medics in the street. This is the first step into a grander level of abuse of our services.

You wish to talk about professionalism, well running blood draws for non medical, no evaluation needed patients is not the way to do it.

By the way, if you ever wish to chat offline, I would be more than happy to do it. Laziness is not something that exists in my work ethic and if you knew me you would feel ashamed for ever implying such.

[DwayneEMTP]

[...I find this interesting. By the public trust, do you mean the public one person at a time, or the community as a whole. Where does the public trust begin and end? where does our responsibility to the community end and the responsibility to the single person begin? This is, indeed, a medical issue at this point for the well being of the person, and the community in general. As long as the BAC is being performed asd part of a police investigation, it is not a betrayal of trust or breach of ethics.

I agree. And if I could count on the rest of the general population that I will be treating to make this same logical argument, to say, "I've not broken any laws, so I have nothing to fear from the medic", then I would abandon my argument. Unfortunately it will likely only take a few visits of the ambulance doing not medically necessary procedures to cause the less educated, particularly when intoxicated, to make the leap that the two are intertwined. And that will mean trouble I think. I believe the logic will be more along the lines of, "He took dad's blood for the cops, so I can't call 911 with all of this pot smoke in the air!" while Suzie seizes during her OD. Logical? Nah, but realistic I believe.

...This does not in any way allow for EMS policing the community. It should not retard the ability to care for them. The major point to this is that we, the EMS personnel, are not initiating the investigation into the patients BAC. The Police are. We are a tool at this point and it is unethical not to participate in an investigation towards a possible felony.

Again, I expect you to make the distinction, but not so much the people that are likely to be in this position.

...By the definition of your comment, I take it that it would also be immoral or unethical to report a person, whether intoxicated, deranged, or simply agitated, that tells you they will kill themselves at the earliest convenience or kill a certain party by name. This is your legal responsibility, but would you forgo your responsibility to your community in lieu of the patient in front of you? Who is being betrayed.. Different, but similar situations.

I see your point, though I do consider the reporting of such behavior a continuation of proper care. Also, it's not so much the particular issue, but the very public nature of the blood draws that I have issues with. I believe that no one is discouraged from calling for help with the common knowledge that I will report such things. In fact each time that's happened I believe the reason I was told was so that I would report it.

There will be no clear explanation when people see me, and the news reports on me, drawing blood from a non medical pt for the sole purpose of causing him to go to jail. Do I mind helping put him in jail. Not at all. Do I mind that others may not trust me and will hesitate to call me because of it? Yes, very much so.

...If you choose to hide behind protocols, then so be it.

I don't understand this part.

...-Just my opinion..I have a few..

And I'm always grateful to have them. Thanks for your thoughts.

Dwayne

[CTXMEDIC]

i see your point about doing somthing medically unneccessary. how many medically unneccessary transports do you do in a month? i can count on one hand how many REAL patients ive transported this week so far. if you have an idea to keep us from doing medically unneccessary transports id love to hear it.

[akflightmedic]

i see your point about doing somthing medically unneccessary. how many medically unneccessary transports do you do in a month? i can count on one hand how many REAL patients ive transported this week so far. if you have an idea to keep us from doing medically unneccessary transports id love to hear it.

There are other threads in regards to that and the #1 answer seems to be more education. Feel free to use the Search feature for further.

If you are transporting them, someone on either the sending or receiving end deemed it necessary, the onus is on them not you, so thus be it.

[ccmedoc]

...If you choose to hide behind protocols, then so be it.

This was in no way intended for you, but a generalization..I saw I had put it in too late to fix it.

The complete quote..

Welcome to the medical field, and community service. The public you serve trust and rely on you to make the correct decision, both for the majority and the individual. If you choose to hide behind protocols, then so be it.

Meaning that the medical field, especially community health, is a tough field. The public expects us to make snap decisions in their best interest. Even well thought out decisions can go awry. Some in our field cannot think past their protocols, or refuse to be the change agent to do so. Whether that be question them or attempt to change them. In not being willing to think past these protocols, which are most often guidelines and not set rules, they sometimes cannot act in the public's best interest. It is easy then to say, "My protocols say I cant, so I wont".

You have to practice with your mind, your heart, and your common sense..and at times they all contradict each other. It is up to us, as individual professionals to choose which is right for us and follow. Some are not willing to make that choice and put it on the protocols, regardless of their feelings.

Its hard for me to put into words, a feeling mostly. This is the best I can explain now..

I take my responsibility for the community very seriously, both as a Medic and a nurse. I try very hard not to breach the trust of a patient, but at times it is necessary for their health and continued well being. It is not all black and white, and none (or very little) of this is taught in school. Certainly not in Paramedic school.

[Asysin2leads]

so if a 15 year old kid calls 911 because she believes her mom is on heroin and you show up to an obviously high woman in NO distress, is she your patient? if you gave her narcan wouldnt that be unethical as it was an invasive and un-needed treatment? she was high, so what? im betting youd still transport her to the ER if the cops had her in custody, wouldnt you? you might even draw some labs. so whats the difference? neither are 'sick' and both were referred to you by the cops.

again, do i really want to be doing this in addition to the 15+ calls i get a shift? Uh, HELL No! but i guess we'll have to disagree on why. i dont want to do it because we already run our ass off, not because i think its unethical or 'not my job'.

For the record, if the parent was AOx3, no she would not be getting any Narcan as being 'high' is not significant enough reason to risk giving Narcan. I don't give drugs or draw blood because a law is being broken, I do it if the patient needs it.

[crotchitymedic1986]

Well I would admit that my anti-stance on this is driven more by laziness than ethics, but what if you looked at it from this view:

When it come to interraction between fire, PD, and EMS, we in EMS take alot more than we give from our brothers in the other two services. They help us on calls alot more than we help them (statistically). So, is it wrong to give a little back, and help PD on some of their calls ?

[DwayneEMTP]

[CTXMEDIC]

Agreed. But in this case, is it possible that we’ve breached the pt’s trust in advance simply by giving the appearance that we are untrustworthy? And if we do so, how do we regain it later?

you could make the same argument for reporting victims of child abuse. why would a parent seek medical attention for their kids if theyre the ones that inflicted the harm and they knew we had a legal obligation to rat em out?

As for collecting evidence? your PCR is a collection of evidence. Us taking a blood sample isnt violating the publics trust. theyve already been caught. if we picked up a drunk/high patient and law enforcement wasnt already involved and then we called the cops to rat the guy out, that would be violating trust. same thing for kicking parents out of the truck when i talk to kids about sensitive subjects. if i dime off the kid to mom, i just volated their trust.

[akflightmedic]

First, your debate tactics of comparing apples to oranges is old and ineffective. By the things you keep arguing which are "similar" in your opinion are truly not. None of those situations involve you being called out to a Non-patient to do a procedure which is unwarranted. None of them.

The crux of the issue is, should we be called out repeatedly to do a blood draw when there is no medical justification for our response or treatment/procedure rendered?

Agreed. But in this case, is it possible that we’ve breached the pt’s trust in advance simply by giving the appearance that we are untrustworthy? And if we do so, how do we regain it later?

you could make the same argument for reporting victims of child abuse. why would a parent seek medical attention for their kids if theyre the ones that inflicted the harm and they knew we had a legal obligation to rat em out?

Many of them do not already. We know this is an issue. Child abusers do not seek help unless they have some incredible story to accompany the injuries or the child quits breathing.

Many abuse cases are discovered/reported via astute school employees or confidants within the child's social circle.

However, having been on a number of scenes where abuse is suspected, the parents are NEVER given an indication of my thoughts. I get the child transported and then make them known to the physician. As far as the parents know, I was oblivious and the doctor noticed it. Therefore, on the surface, I have not appeared to violate the appearance of trust.

As for collecting evidence? your PCR is a collection of evidence. Us taking a blood sample isnt violating the publics trust. theyve already been caught.

If they have been caught, why do they need more evidence? It is the officer's job to obtain what he needs and that does not involve calling me out for non patients. We can take this a step further, which no one has done yet and really weave a sticky web for ourselves.

If we respond, are we now obligated to MAKE this a patient? Are vitals necessary? What type of report do we have to do? That PCR will now be called into court as well, plus we may be subpoenaed to further corroborate the officer's story. Now we have just involved ourselves into a whole different realm all because we were called out for a non patient, when the PD should already have a system in palce where they do not tax other emergency response systems. They should have 1-2 officers or more trained on each shift capable of collecting the evidence and leaving EMS out of it entirely.

if we picked up a drunk/high patient and law enforcement wasnt already involved and then we called the cops to rat the guy out, that would be violating trust.

If I ever pick up the aforementioned patients and the cops are not already on scene, why would I stay on scene waiting for them. If they need me in an EMS capacity, and they need to go to the ER, I am not sitting on scene waiting for a cop so I can rat them out.

same thing for kicking parents out of the truck when i talk to kids about sensitive subjects. if i dime off the kid to mom, i just volated their trust.

Now you have taken it to a personal argument instead of a legal one. We have no right to disclose to the parents what the child may tell us in confidence, excluding abuse cases and even then I would pass it on to the receiving physician and let him do what he is supposed to.

Please give an example of this scenario. I have several in mind but none of them would I ever disclose. I want to know what your line of reasoning is here.