When is an EMT obligated to call Police?

[Arctickat]

No worries Richard, I just wanted to make the point that not everyone works in a location with reliable radio service and almost as many police cars as taxi cabs.

Libraries...snicker.

[Bernhard]

Recently had an interesting case about that topic, maybe you have some thoughts to share: We were called to scene of "young man with intoxication of unknown kind". Around 22:00 hrs, warm summer night, dark, rural setting. On scene we found three people from 16 to 20:

#1, male, 18y/o: nausea, vomited once, feeling respiratory distress but relieved after vomiting. Known allergy to grass and insect stings.

#2, male, 20y/o: mild sore throat ("just like when you smoked a pack of cigarettes at once")

#3, female, 16y/o: same as #2

All SpO2 99%, other vital signs perfect. No obvious appearance of alcohol or other drugs at first glance.

After some questioning they stated that they walked by a small wood and there was something in it, some large animal or sth. like that. They smelled a substance and then the symptoms started.

We offered to call police to protect their rights if there was some attack or prank on them. They denied.

After some more questioning they relieved they had built in a new exhaust pipe to one of their cars and tested it, apparently about 1000m away (near the wood). New exhaust pipes may be covered with some protective agent which is burned out on first usage and may smell funny, but should be not dangerous. The owner of the car (#1) was unsure if the modification was allowed and insisted on not calling police.

So far, OK for me. There was no public danger just some funny young folks. I called a second ambulance for transporting the three, since I suggested at least a checkup maybe including laboratory blood test) on possible intoxications, where they agreed.

That was what got dispatch crazy. They asked if we need police. No. Dispatch: "What's the nature of the intoxication?", Me: "Not known, maybe some raction on the protective agent of a new exhaust pipe". Dispatch: "So, CO/CO2-poisoning?". Me: "Probably not, could even be psychic". Dispatch: "So, you need police". Me: "No, patients deny and there is no public danger!". Dispatch: "Why do you know this?" Me: "I'm here on scene and see no danger!". Dispatch: "What if there is a gas leak?". Me: " I have no evidence of this!". Dispatch: "So, do you need police?". Me: "NOOO!". And so on. Finally the patients were transported, police did not come.

I had a talk about that incident with the dispatcher after the call where she suddenly hung up, running out arguments after accusing me beeing guilty if some baby dies the next days. Glad, there wasn't media followup the next days about a major explosion or such, so I guess there wasn't a gas leak...

My arguments for not calling police were:

• I myself had no evidence of public danger.
  
• I myself had no evidence of an ongoing crime (a possible illegally modified car is no crime).
  
• The patients denied police involvement and I'm obliged to confidentality.
  

Since our dispatch is superior to me in general tactical decisions (as long as no supervisor is on scene) and not obliged to patient confidentality, they simply could have called police without asking me. Still wonder why they simply didn't do it, instead going on my nerves asking me (and the other ambulance) several times over radio...

What would you have done? Call police? If so, why: to prevent a possible danger, just CYA or simply to get dispatch calm?

EDIT: the "patients" were released after staying the night in the hospital without diagnosis, lab tests were negative.

Edited September 20, 2012 by Bernhard

[Arctickat]

I see no reason to have called the police in your circumstances either. i deal with intoxicated people all the time and never have the need to call.

[JPINFV]

Somewhat tangentially related, physicians are required to inform people who have been threatened by a patient with a psychotic disorder of that threat. So if a patient says specifically that the voices are telling him to murder his neighbor, by case law (Tarasoff v Regents of the University of California) the physician (or other provider) has a duty to warn or protect the intended victim. This is normally done by notifying the police agency local to the provider, who then notifies the police agency local to the target of the threat.