Searching Psych Patients

[emt2359]

ALL transports. ALL the time. NO exceptions.

Just curious, how do you justify placing the public, yourself, your partner and patient in increased danger by transporting EVERY patient with L & S?

[paramedicmike]

He didn't say he did L&S on all transports. He said that on all the transports he does the family doesn't follow the ambulance. Did you read the question he was asked before you replied?

-be safe.

[Dustdevil]

[AnthonyM83]

Kev,

The way consent (with normal LOC adult) was explained to me in EMT class was as informed consent. We have to explain each step of treatment, not only because we're being nice, but as a technicality, so that at each step they know what the treatment is and what it's for, so they can continue giving consent (even though they're not actually saying "yes" to each treatment). Now, obviously, there's going to be times when that's not possible, things are moving too quickly, and we just do without. But as explained to me by the instructor (whose position at his Fire Dept. is to investigate complaints/mistakes) consent to treatment is not just a blanket consent without restrictions.

The rudimentary patting down for purposes of searching would still not be a treatment and someone could turn it around on you, after the fact. (I'd probably try to disguise it as a full secondary survey.) If it's a psych or EtOH patient, then like I said, I'd think you'd have a pretty good justification if it went to court. If searching if part of your protocols, then it can even fall under a treatment that you had to give and would be covered by implied consent (in my opinion).

I like your idea of searching their belongings after they've been removed from them, though...thus not touching them.

And again, I think we both agree on the same bottom line. Doing what you have to in order to come home safe. My goal with these posts is just to pass on info and defend EMT100 b/c his statements were technically right on legalities.

[Dustdevil]

My goal with these posts is just to pass on info and defend EMT100 b/c his statements were technically right on legalities.

According to whom? Your no-name basic EMT instructor in California?

Next class, I hope you intend to ask him for a reference to the specific federal statute that backs up his claim so you can see the "deer in the headlights" look on his face when you both realize he's talking out of his ass.

[AnthonyM83]

Who said anything about no consent? They either consent or they wait for police to transport them. Given that choice, I have never had one refuse.

And you broken records who keep pretending to know of a specific law prohibiting us from searching patients need to either produce the law, verbatim, along with a verifiable link to it, or step off. And this needs to be a federal law, since you continue to claim that this applies to all of us.

Dustdevil, we've been talking about searching without consent, like doing a pat down and removing weapons. If there's consent, then there's no problem. I would also give them that choice: Give consent or wait for police transport.

The law doesn't need to be a federal law, because every state has some sort of battery or unlawful touching law. Like I've said before, I don't know the specifics of everyone's laws, so you need to check with local police, DA, etc etc etc. I'm not some expert. I just wanted to share what I thought was an important point to be aware of, but everyone's jumping on me for it. I thought of not even mentioning it, b/c I'm a newbie here and not a great way to start off, but decided it was important enough to at least point it out.

Look, I'll provide my law if someone can provide me a law saying you can search and can remove something that might be used as a weapon. Remember, I already said I don't think any police officer would actually arrest for this, but I don't have to tell you how many ridiculously stupid suits have been won on a technicality, so just be aware.

(I'd post it right now, but right away I'm going to get debates on what the law really means. I can see it now, a 10 page thread. But the reply will be that it's been explained to me by police officers and instructors several times what the law constitutes. It comes down to touching without permission. We even covered this slightly in EMT class discussing how some EMTs won't hold c-spine before introducing themselves as an EMT and asking permission to treat because it's technically batter...though in that case you can justify it b/c if they do accept treatment they might be injured if they move before accepting treatment.)

Sorry for being so awfully wordy.

[Dustdevil]

Again, consent is not even an issue here. If the patient says no, I don't know any medics who are going to engage in a wrestling match with the patient in order to achieve the search. After all, avoiding physical confrontation is the whole purpose of the search in the first place.

So what we are left with is exactly what you suggest. Either the patient says "okay" and gets searched, or they refuse -- in which case I am fully justified in disengaging -- and they get to go with the police. No assault. No battery. No illegal search.

I don't know what all these psycho instructors are teaching out on the left coast, but here they still teach safety first.

[PRPGfirerescuetech]

Wow...yall are like two monkeys at either end of a football... :munky2:

When a patient gives consent for treatment, they give consent to be touched, when appropriate by the provider. There is no stipulation by the patient on how they can be touched, or even where.

Searching a patient, and assessing a patient, go hand in hand.

PRPG

[Dustdevil]

Yep, and shouldn't all patients be completely exposed anyhow? That's what the DO's say!

[kevkei]

Look, I'll provide my law if someone can provide me a law saying you can search and can remove something that might be used as a weapon. Remember, I already said I don't think any police officer would actually arrest for this, but I don't have to tell you how many ridiculously stupid suits have been won on a technicality, so just be aware.

Anthony, on the risk of offending you, I'll be point blank. If you are going to practice on the street based on your comprehension of "law" in your area or what an instructor has told you, you are going to get hurt some day. If you are going to put the "law" ahead of your safety, you will be one of those people that runs into a shooting scene because you feel obligated to protect the patient firts. Remember what they drill into your head in scenarios SCENE SAFETY is paramount and occurs before you do anything else. This means neutrilize any potential threats.

Your comprehension of a patient giving consent is based on textbook and classroom teaching and is wrong. When a patient gives consent (whether it is stated or implied) you don't need to ask, "can I feel your head?" "can I expose your chest?" "can I take your blood pressure?" for every thing you do. You need only ask once or it is implied when they willingly accept assessment, no more. Consent ends only when they voice disapproval, and not until.

Because there is no law that stipulates you are allowed to search a patient does not mean this is a restricted activity. It would be encompassed in many other laws, such as those already mentioned.

Based on your description of these laws and with respect to battery, we would all probably be guilty of battery on a daily basis. If you search a patient and they don't object, there is no battery. End of story. If they object, they get the hell out of my personal space and leave or deal with the police, those are their two choices. Then anything found during a search can be used against them in criminal proceedings.

Go and gain some experience on the streets working in a hostile environment and then come back and talk to us about how we are being impolite to some of our patient group. Until then, I rest my case. (And this is posted with respect, not with belittling, as you appear to have some intelligence.)

Remember, mothers know best, right?. Even they used to tell us to put butter on burns.