Your opinions on a run

[HERBIE1]

One thing I missed in the original scenario was that you guys did not establish contact with the receiving hospital-or a telemetry call to give them a heads up. This situation was BEGGING for more folks to get involved to CYA. I agree about the insurance stuff- if the person leaves AMA, I thought insurance does not cover the ambulance bill, but maybe I am mistaken. In my private days, I know we wouldn't have touched the patient unless we had cash, a check, or an approved credit card.

The other issue I am not clear about is the mentation of the patient and if the family had power of attorney to make medical decisions for the patient. That seems like a potential liability as well- maybe the patient WANTED to stay and the family disagreed. You simply never know what family drama you are getting into with situations like this. Folks may SWEAR to you grannie is too confused to make her own decisions, when in fact she may be more alert than the providers. Tough situations to be sure.

[paramedicmike]

Really?

Here, we would have the power to decide ourselves.

Yes. Really. I say this for a couple reasons.

First, this is a huge potential lawsuit. I am all for advocating for my patient. But I'm also all about protecting myself from what appears to be a really ugly situation involving both the family and the sending hospital. That is not something I want to get into the middle of. If the family and the hospital are that unhappy with one another that both sides would potentially (based on limited information presented here) jeopardize the life and/or well being of a patient that's one thing. Getting me involved in the middle of it is something else entirely.

I'm not saying I wouldn't have done the job. I simply would've wanted a supervisor there in an effort to help protect me and my partner.

Secondly, getting my command doc on the phone and then handing the phone to the attending at the first hospital might help me out in the sense that my command doc would, I hope, explain what we needed and why. Many times it seems that physicians, especially those with little prehospital exposure, would rather converse with another physician. If that helps me out then all the better for everyone involved.

No. I am not normally this conservative in dealing with patients and hospitals. However, there's more to the story that I'm sure the OP doesn't know. And that's the dangerous part.

[HERBIE1]

Yes. Really. I say this for a couple reasons.

First, this is a huge potential lawsuit. I am all for advocating for my patient. But I'm also all about protecting myself from what appears to be a really ugly situation involving both the family and the sending hospital. That is not something I want to get into the middle of. If the family and the hospital are that unhappy with one another that both sides would potentially (based on limited information presented here) jeopardize the life and/or well being of a patient that's one thing. Getting me involved in the middle of it is something else entirely.

I'm not saying I wouldn't have done the job. I simply would've wanted a supervisor there in an effort to help protect me and my partner.

Secondly, getting my command doc on the phone and then handing the phone to the attending at the first hospital might help me out in the sense that my command doc would, I hope, explain what we needed and why. Many times it seems that physicians, especially those with little prehospital exposure, would rather converse with another physician. If that helps me out then all the better for everyone involved.

No. I am not normally this conservative in dealing with patients and hospitals. However, there's more to the story that I'm sure the OP doesn't know. And that's the dangerous part.

I totally agree with your last point. I guarantee there is more to the story- as in the family is contemplating litigation against the originating hospital. I asked in my original post why this patient remained in the hospital for so long. My guess is there were complications during the surgery or post op, and there is a real- or perceived- issue of a future lawsuit. That could also explain why the hospital staff was so reluctant to help and/or give a proper report- they were in full CYA mode.

This is not a case where I would want my arse swinging in the breeze. Reach up for help, pass the buck- whatever phrase you like, but this is a classic example of making sure all your i's are dotten, t's are crossed, and you get multiple folks to sign off on what you are doing and document the hell out of everything. The transport itself is easy- assuming the patient is stable, but the peripheral issues make this a minefield you do not want to navigate alone.