Leaving equipment at the hospital?

[P_Instructor]

"Sounds to me like there is a supervisor with WAAAY too much time on their hands writing stupid policies.

OR the company is to cheap to have more than one of these items available for each truck."

Oh, does this sound so familiar. The policy is really bogus and I agree with medicgirl that patient care is not being taken into account. Your company should have extra equipment available to get you back to service as soon as possible.

I am not sure how many hospitals you serve, but here, we have the ER put equipment out in secured lockers for retrieval later if needed. It is 50/50 if the equipment is cleaned or not.

[Eydawn]

My hospital has its own storage room for gear left by EMS crews. I know, because I had to go looking for my SAR team's backboard recently (surprise!). They not only clean them, but they sort stuff by type, and if they know where it came from they'll try to mail it to you instead of letting it fester forever in the storage room...

I would say this policy is short-focused and not good patient care... and it will result in negative outcomes if people follow it without good judgment. I understand wanting to minimize losses from gear... but you gotta take care of the patient first.

Wendy

CO EMT-B

[nypamedic43]

We leave our equipment with the patient. It's all labled with our name and phone number. We are busy enough that if we waited until the equipment is removed...we would be even busier, trying to catch up. We also have extra KED's and traction splints at the main station so that we arent out of service any longer than it takes to drive there from the ED to get the replacement.

I'm not sure that your company has the patients best interests at heart....not to mention providing patient care that "does no harm"

[emtdennis]

Welcome to the boards, stick around, there is much to learn!

I would not want to be the emt that has to take the traction splint off a pt while they are waiting for care so I can leave. Just not happenin!! Is the author of this policy even an EMT? Ok, I guess that wasn't nice..

Our stuff is labeled and the hospital keeps it generally safe.

[Just Plain Ruff]

I find that makers and writers of stupid policies often don't ask the right questions when they write them.

They often just write the policy and disseminate it out to the crews and expect that to be the end of it.

Here is what you do. You can't leave the hospital per policy until you get the equipment off the patient. Well next time you get a trauma and you take them to the trauma center, you let the patient get to surgery before you can get to the patient to take off the piece of equipment you can't "afford" to leave behind.

You then put yourself out of service for awaiting of equipment. Don't leave the hospital until you get that equipment. It might be an hour or two before you can get the equipment back. That will leave you one ambulance short for coverage.

Let dispatch know you are delayed due to equipment retreival.

When you get back and you get called into the supervisors office, which you know you will, make sure you have the policy in hand and say "You were only following policy" and that you did bring the equipment back with you.

Throw the policy back at them and say that it delays coverage and delays your getting back to help out with system coverage.

You do this enough times, and make sure all the other crews do the same, and that policy will be a thing of the past.

This is a stupid policy.

One other thing, when you transport your idiotic moronic policy writer with fractured femur and a traction splint or whatever, make sure you expend every effort in getting that equipment back. Make sure that you take the equipment off them and exchange it with what the hospital has. I'll bet the policy will be a thing of the past if you do that as well.

[Chief1C]

Our stuff gets stolen, not lost or destroyed, stolen, all the time. Trauma teams cut our spider straps.. Other services RURAL METRO for example, steal our LSB's and CID equipment left and right. Nothing you can really do, unless the hospital takes an active role in seeing that your equipment is returned. After all, you're bringing some business to them. That would be the right thing to do, only a few ER's do that here. The rest leave your shit out for the picking. I've never taken what wasn't ours, w/o the purpose of 'dropping it off at x station on the way home'. But we've had stuff returned months or years later, with other services stickers on it, or covering our stickers. Usually the service doesn't give two craps. And they're usually the ones who don't have to worry about the cost of replacing stuff. Bastards. That's right, R/M... You're crews are often total schmucks.

[Cookie]

Back when dinosaurs roamed the earth and I was doing my clinicals one company had the policy of taking their equipment with them when they left. While I was there they brought in a pt who had a fractured hip. They had the traction splint on, needless to say the ripped that puppy off that patient and pulled the lsb they had to roll her onto to get her in the amublance, out from under neath her, causing her to let out some of the most blood curdling screams I have ever heard. They had the same policy of not leaving equipment behind. That being said we mark all our equipment with name and town, whatever and we frequently retrieve them from Emergency Rooms that day or even days later, we have never had a problem with theft.

[mikeymedic1984]

I see both sides from field and management, equipment is very expensive and if you work in an urban environment it is not uncommon for your well-marked equipment to get pilfered by one of the flybynight services. On the other hand, patient care comes first, and often times the patients who would need this equipment may not be released from the equipment immediately. If they are asking you to wait on the equipment, I am guessing you are a rural service, as no busy urban system has the time to "wait". Either way, my suggestions:

If rural, talk with your local air-ambulance provider, and see if they will retrieve it and take it back to their station; Air-methods did this for us, as a courtesy when they had competition they were fighting. I am guessing they just had a guy in a truck who went around once a week and rounded it up from all the trauma centers (usually the distant facilities, we would go to local ones frequently each shift, so no issue).

Rural or Urban: Report equipment left to dispatch or your supervisor, and the supervisors should make a daily (nightly instead of sleeping), weekly, or biweekly drive to round it all up. Paint (or order) your equipment in an obnoxious color like neon pink so that no one wants it, and so that it is readily noticeable on other trucks.

Lastly, you guys should report that you are waiting on equipment (stating ER said it will just be another 10 minutes, then another, then another) and then always or frequently report that it is contaminated and you will be delayed while you are attempting to clean. After about two weeks of long ETAs because you are stuck at the hospital due to this policy, I imagine a supervisor with sense will make the other supervisors get off their ass and do something besides write policy.

[tskstorm]

I understand the principal of this policy however there is a lot left to consider.

First, as a Paramedic I want to see where in my job description retreiving equipment is written, and even if taking care of your own equipment is in there, picking up other crew's equipment is probably not. Further if it is not written I would like to see the policy for my raise for my added responsibility of retreiving other crew's equipment.

Next I also see the management point of view its been stated many times but just to hammer it home equipment is expensive.

Further, I'm not a complete rebel, and I dont suggest you be either, I wouldn't purposefully wait an extended period of time, and i wouldn't purposefully try to leave the equipment there either. The policy clearly states "if possible" which means a supervisor could deem it possible when you do not and vice versa leaving your butt in a sling.

As far as possible solutions perhaps we couild add a line with a time limit of what acceptable waiting length is. ex: 15 mn past conclusion of patient transfer.

Perhaps you and the hospital can work out an exchange program?

The hospital we work with here just puts our equipment in a closet, bu we frequent the ER 2 or 3 times a shift per vehicle with 4/5 vehicles in service at a time so not usually a problem.

Good luck and keep us posted with what happens.

[mffrhorne]

I don't see any easy solution to the equipment pilferage problem. The hospitals here had a closet with an exterior door. It used to be everything was thrown in together. More recently some of the hospitals have moved the retrieval area inside and separated it by service. If you are from one county you can only get the key for that counties storage closet. An adjacent county that we work with a lot is terribly underfunded by their county council. Their staff cannot get enough equipment to take care of their patients so they misappropriate ours. I had gone to retrieve equipment from a hospital in this adjacent county and found one of their crews loading two of our backboard sets into their unit. I told them I was there to retrieve the equipment and I wanted it surrendered right then. They acted like I was the one being an A-hole. I finally lost my temper and told them I would be on the radio to our EMS duty officer if they did not surrender the equipment. They tried to act unconcerned so I used the radio. The EMS duty officer was busy directing operations at a multiple vehicle collision. He told me to turn on the outside speaker on the utility truck I was driving and then he gave me a direct order to summon the State Police if the equipment was not surrendered. The State Police here must respond when called even if the area in question has a local police force. He then told me that if they left prior to the arrival of the Sate Police I was to go the county commissioner's office to swear out a warrant. I assume that last was for dramatic affect because I knew I did not have the authority to swear out a warrant on behalf of my county. His tactic worked and the equipment was turned over to me but I concerned that crew and likely a lot of their coworkers would be looking for payback because I had lost my temper and embarrassed them. There were some hard looks on later calls but it never came to more than that. Their dispatchers monitor out radio nets and vice versa. They must have gotten their supervisors involved because several senior officers were in a meeting between the two counties before the day was out even though the incident happened around 3:00 and the senior officers normally go home at 4:30. The problem then diminished for a time but of course it came back gradually to it's old level. The separate locker thing helps but some of the equipment gets pilfered while it is waiting to be taken to the locker. This happens when the boards or splints are standing against the wall outside of X ray for instance these being extremely busy hospitals. It has been suggested that hospital security should review the security video when equipment goes missing but anyone who thinks about that idea knows that they don't have the time I don't have any good answer. I suppose that is what EMS duty officers are for but they cannot produce miracles.

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Tom