Transporting patient possesions

[medicgirl05]

I had an issue last night with a patient's wheelchair. This particular patient is a frequent flier and we have in the past taken his walker, and he was very mad that we couldn't take his wheelchair. He tried to hit me and called me a whole bunch of not so nice names. He refused to go with us until deputies talked to him, then we transported him without the wheelchair.

I don't know how to safely transport a whelchair. Has anyone had any experience with this? If you do take the wheelchair, where does it go? How do you secure it?

Thanks!

[island emt]

Is this a regular chair or power chair? If a regular, then they fold up and can be strapped down in the front of the captains chair using the seat belts. If you are running a van type then it might not be possible to fit it in. Unless it's specially adapted to suit his needs then, You can explain to them they have wheelchairs for use at the hospital.

[scubanurse]

Have PD transport the chair in their car or have a wheelchair van come pick it up if it is the power kind. Either way they can be very expensive and efforts should be made to transport the chair to the same destination as the patient.

[medicgirl05]

We don't have a wheelchair van and the hospital is 30 miles away and out of the county, so the SO can't take it.

We were at a residence.

I't won't fit behind the captain's chair. Any other suggestions?

[fakingpatience]

I have typically folded the wheelchairs and placed them by the captains chair or between the bench seat and the stretcher (buckled in).

I realize this is probably the "wrong" answer, but in all honestly, in this situation, I simply wouldn't take the wheelchair, and would not go out of my way to arrange transport for the wheelchair after the pt had become physically and verbally abusive towards me. I also know that the director of my company would support me in this decision (especially with the frequent flyer we have that I'm thinking of). We will take him if he wants to go, but if we cannot transport the wheelchair then he will have to go without it, or stay home.

Was he acutely ill? Why did he want the wheelchair this time, when the walker has sufficed in the past?

[medicgirl05]

No he was not acutely ill, he does have significant medical problems though.

We take him at least once a week. I did call my supervisor who was in agreeance with me that taking the wheelchair was not necessary. This patient is a drug user/alcoholic who has nowhere to really go. He rides his wheelchair through town and calls 911 at night when he has nowhere to sleep. He was living in an apartment until he got kicked out becuase he had a meth lab. The owners of the house where he happened to be this time(his cousin), were agreeable to leaving the wheelchair in their garage until the patient could retrieve it. I made sure of that before I told him we could not take it with us.

I have never encountered someone wanting to take a wheelchair and he has never needed it before. I am just looking for safe ways to secure it when it happens next week.

Thanks!

[fakingpatience]

Can the wheelchair fold? What problem did you see when trying to get it to fit into the ambulance?

[medicgirl05]

The only place I think it will fit is beside the stretcher. To do that properly it needs to be secured somehow so it won't become a flying/falling object. The seatbelt on the bench seat is not long enough/I don't know how to make that work.

Yes it does fold.

I think the reason that it bothers me is because this patient is a frequent flyer that we get frustrated with. I really was bothered by his reaction to me and it made me question if my refusing to take his wheelchair is a reflection of him, or a reflection of me. If it was a different patient would I have tried harder to make it work? I know that can't be answered by anyone but me. And I also know I have never transported any other wheelchairs, so I don't think I was treating him unfairly, but it still is a thought that I have...

I was hoping for a clear cut answer as to how to safely transport a wheelchair, but I guess there really isn't one.

[fakingpatience]

Perhaps you could tie 8' strap/ backboard straps to the ends of the seatbelt on the bench-seat, to make it longer. Or if that won't work (if the end you need to click it into is flush so you can't tie anything onto it and isn't compatible with the backboard straps) use the backboard straps to tie it to the side of the stretcher, so it can't go anywhere.

For better or worse, I think that it is human nature for us to go more out of our way/ try harder to help those who are nice to us and/or acutely ill. Another way to look at it is perhaps not being able to get his wheelchair to the hospital in the ambulance would be a deterrent to him abusing EMS and hospital resources. Does your town have a public bus? If it does then to be ADA compliant they need to have a way to transport wheelchair users also, maybe he'd rather go to a homeless shelter that is on the bus route then part with his wheelchair to go to the hospital just for a bed/ meal. Has your agency looked into contacting any social services resources to work with him?

[medicgirl05]

There is not much we can do for him because he refuses to give up his drug habit. He had county housing but lost that due to marijuana. Then he lost an apartment because of the meth lab. He doesn't want help, but he abuses the system. He has been arrested but that doesn't do any good because he doesn't pay for anything and he just doesn't care. We are a small town 30 miles from a bus system, we don't have public transportation. We don't have any homeless shelters nearby. The churches help people when they need it, but this guy had burned all those bridges. He has no friends that will drive him anywhere. At one point he was taken to a hospital 120 miles away but he still managed to get back to our county. We take patient to any of 6 hospitals that are all 30 miles from us depending on patient preference. He changes which facility he wants to go to and goes there until the hospital staff gets fed up, then he picks another facility. We can't force him to go to one particular facility due to protocol. He is a nuisance but I don't know what we can legally do with him.

His complaint is ALWAYS chest pain. Occasionally he might actually be sick, but he is such a good faker that you never really know. He knows how to get what he wants, and while I usually know I'm being played, I am afraid that one day he may actually be having a heart attack so I always work him.