Transported against her will

[Caduceus]

Man, that's a mess. Big mistake on the crew's part, not only are they likely to get in trouble but they left that poor lady with a hefty bill.

[HellsBells]

What is with the big hard-on for air medivacs in the USA? It seems like the threshold is very low for who they fly out. Only critically ill patients get flights here in Western Canada.

[ERDoc]

I don't know if it is so much getting off on seeing the helicopter as it is a comfort level with even slightly sick pts.

[paramedicmike]

Or simply laziness at having to transport over a distance.

[Arctickat]

Interestingly enough we had a similar issue here recently. The patient refused to be transported by helicopter, multiple times. He was lucid and unimpaired, yet the flight crew administered 30mg Diazepam to sedate him because he was too agitated for the flight. Fortunately it wasn't sufficient and they elected to send him by ground. I wish i would have been there though, there is no way I would have allowed them to do that. Turns out as soon as he knew he wouldn't be flying he calmed right down and had an uneventful trip into the city.

Edited March 25, 2015 by Arctickat

[medicmole]

What is even more ridiculous is the fact they drove her to a regional hospital and loaded her in a helicopter to take her to another hospital. Why not take her in to the local er to have her assesed there?

[rock_shoes]

Interestingly enough we had a similar issue here recently. The patient refused to be transported by helicopter, multiple times. He was lucid and unimpaired, yet the flight crew administered 30mg Diazepam to sedate him because he was too agitated for the flight. Fortunately it wasn't sufficient and they elected to send him by ground. I wish i would have been there though, there is no way I would have allowed them to do that. Turns out as soon as he knew he wouldn't be flying he calmed right down and had an uneventful trip into the city.

Any idea what the reasoning was behind the decision to sedate and fly an unwilling but competent patient?

The situation reminds me of a STEMI patient I picked up one time. In the greater Vancouver area there are 3 Cath hospitals within a 20 km radius. My patient refused to be taken to the closest of the 3 but was otherwise a willing patient. Rather than argue with him I broke standard policy (take all patients to the closest appropriate hospital) and drove him to one of the other Cath hospitals another 10 minutes drive away. True I broke service policy, but in the end my sick patient received appropriate care instead of refusing life saving treatment. The point being, sometimes it's better to be inventive than right.

As it turned out he refused transport to the closer Cath hospital because his life partner died there due to similar circumstances. I was always prepared to defend my decision but oddly enough nobody ever questioned me on it.

[Arctickat]

Any idea what the reasoning was behind the decision to sedate and fly an unwilling but competent patient?

My thinking is that they figured they knew what was better for him than he did.

[Secouriste]

Where I work, an adult lucid patient who isn't under any rights restriction (mental illness etc...) cannot be forced to anything regarding his/her health. If a patient refuses to go the hospital we have to speak for a while with him/her to explain why he/she should undergo some medical examinations. Sometimes it works, sometimes not.

In the case of an unconscious adult it's easy, we treat. In the case of a drunk adult who has no other mental condition, we decide and we can ask police support to make sure we can work properly.

In the case of a lucid minor, the parents decide, however, if there is any suspicion of life-threatening injury/condition, EMS can start any needed procedure even against parents' consent. If parents prevent EMS from undertaking the required medical procedures, EMS call the Prosecutor to have the parental authority temporarily suspended (which will open an investigation) and a police force sent to ensure the medical crew can work properly.

In the case of a mentally ill person, the designated tutor makes the decisions.

[Arctickat]

That's the issue Secouriste, it's supposed to be the same way here as it is where you are.