Is transport necessary

[Minion34]

Hello all I am jay and I’m a medic in ny in a busy municipality. And I have a question that I would like to pose to those who probably know more than me. I have been a medic for 3 years. And my question is do we have to transport a pt if it’s not an emergency. Or we deem it to not be an emergency. Are ems providers legally obligated to transport a pt if it’s a bs call. A little background is probably needed. We are a combo paid/volunteer agency. We only do 911. And we get probably 80-90% calls that don’t require an ambulance. Mostly from doctors offices for people who have trouble breathing or chest pain going on for months. Nothing acute. No distress and completely stable. And the town we are in is small most of these offices are less than 5 minutes from the hospital. I am curious if it’s legally appropriate to tell them they don’t need an ambulance and then have them transport via private vehicle. Or taxi,Uber,lyft. If any of you have any insight I’d greatly appreciate it. To be honest I’m not keen on making people do this. But we are overwhelmed and understaffed. And it affects the care of people who need a ambulance in a real emergency. So any help would be good. Thanks again and take care. Safe tour and silent pagers. 

[Kmedic82]

Great question!

We all know that the creation of EMS is what's in the name. EMERGENCY. But what constitutes an emergency? Who's emergency is it? Why exactly was I called here?

No matter where you work, majority of your transports are going to be for CYA (cover ya asses) purposes. Especially from another medical facility. If a family doc see's a chest pain patient at their clinic, documents it as chest pain, takes basic vitals, and then tells them to drive them self to the ER, that doc is at a HUGE risk for law suit. Even if everyone in a five block radius knows this person is stable, anything that happens to that patient from the clinic to the hospital will come back to that doc. The patient falls in the parking lot, finally has an MI, or even smashed by a meteor, some sleazy lawyer will come after that doc and their family. We transport 70% of our patient population for the possible 5% of terrible or nearly impossible situations that COULD happen. A lot of our job is dictated by legal and political crap. I work for a hospital based system currently (I have worked for just about any type of service) and we are up to our eye balls in this type of stuff. Especially when you reach to leadership level. It begins to haunt your dreams... *clutches pillow* I'm drowning... drowning... drowning is bull shit!

To help create some peace of mind, just remember that transport is the game we play. It's how some of us get paid. It's how we all get new equipment and facilities. In order to keep working, the CYA covers YOU and YOUR family. Just keep in mind that everyone deserves a ride no matter how much BS the call is swimming in. Again, if you get that refusal, call a cab, and that patient comes into contact with any harm (no matter how small), it's going to fall back on you. Yes, you got the refusal. Yes, they understood the risks of going against medical advice. But lawyers know how to get around these things. They will pull up refusal frequencies, vital signs, destroy the grammar of your narrative, and will have what was once an agreeable patient with you scream bloody murder in the court room. *side note: jurors have to be able to read at a sixth level. Write all of your narratives at that level. It's a legal document, not a medical document.*

It's a dangerous game we play for the little amount of money or volunteering hours we receive. But we keep with it for the small population that we really get to use our skills and help. 

Now, I am not saying this legal situation is ok. It's crap. But our society is greedy and they expect their emergency services to be faster than burger king, stronger than an athlete, the attitude of a saint, and that the bill to be free. So, keep yourself safe in a legal aspect. If it wasn't documented, it didn't happen. The patient has a legal right to transport. When the day becomes the crappy transport bus, just keep in mind why you got into this in the first place! Even on the BS calls, you can impact someone's life!

Hope this dissertation helped! Longer than I expected!

 

[Minion34]

Hey kmedic82. Thanks for the reply. Very funny and informative. And I greatly appreciate it. True it’s a shit system and we are stuck with it. But that’s life. Thanks again. 

[Kmedic82]

Glad to be of help. 

I am always covering topics like this on my blog. 

https://wordpress.com/view/theglorifiedtaxi.wordpress.com

Keep up the good spirit!