3 times rule

[nick72]

We've all encountered drug addicts needing EMS. A lot of the time they need Narcan. A lot of the time we have to put them in restraints and risk our lives because they are combative.

I have had discussions with EMS personnel who advocate a "3 times rule." If you OD on drugs and require EMS, we will help you 3 times. But if you ever drink or drug again to the point of needing EMS after 3 times, we will refuse to help you. 

After all, there are SO many innocent people who require EMS because of natural health issues, why should we continue to render aid to combative drug addicts who don't even value their OWN lives, let alone yours?

 

What's your opinion?

[Richard B the EMT]

Watch how quickly you as an individual,  as well as your EMS agency,  get sued by the family of the 3 strikes patient, when said patient dies. You and agency will be charged with "Failure to act", under malpractice. It could mean your certification or license revocation, as well as the state Department of Health closing down the agency.

This would be the potential results,  were this to follow what I believe are New York State DoH rules and regulations. I'm going on memory, as I'm now retired 10 years.

Addendum: Would you refuse a frequent flyer who calls for help due to more than 3 times, due to their Angina condition? An uncontrolled diabetic? An asthma patient?

[nick72]

25 minutes ago, Richard B the EMT said:

Watch how quickly you as an individual,  as well as your EMS agency,  get sued by the family of the 3 strikes patient, when said patient dies. You and agency will be charged with "Failure to act", under malpractice. It could mean your certification or license revocation, as well as the state Department of Health closing down the agency.

I realize that. I was speaking hypothetically.

[Richard B the EMT]

I have heard of many U S jurisdictions considering 3 strike rule implementation.  Unfortunately, 3 strikers, and the full run of frequent flyers, are a part of the job.

I didn't like those calls when I was still working, either, but some of that is actually our bread and butter.

Everyone would be a PTSD case, if all we handled were multiple alarm fires, 20 car pileups, and planes into apartment buildings, in the course of a workweek.

Just administer the Narcan to effect, get them breathing again. Restrain them as nessesary as per your regional accepted policies, and transport. NEVER slam the entire amount of Narcan, as that's when they're going to really become agitated, and they'll attack anyone and everyone who, in their muddled AMS state, they associate with the ruining of their high!

[Just Plain Ruff]

Hypothetical or not - this is a terrible idea - plain and simple.   No matter how many times we run the same addict, we still took an oath and it's part of the job - we go to help the person.  

We don't put the same parameters on the person who is 400 pounds (due to very poor diet) who we go get every week or 3 x a week at home and transport to the hospital 

We don't put the same parameters on the elderly person who is living at home who pushes the button on their medic alert device

We don't put the same parameters on the drunk who continues to fall down and passes out do we

We don't put the same parameters on the diabetic who refuses to take their insulin or medication but still continues to eat mcdonalds or every time you go to their house you find a huge bag of Haribo gold gummi bears and a case of coca cola. 

 

I learned long ago that "It's not my emergency, I'm not paid to get my panties in a bunch because I B Bangin" overdosed again for the 36th time in Heroin alley and I've got to put on my "Supermedic" hat to go save his life again.  My service pays me to go and put a IV catheter in his vein, dump a little bit of narcan in his body and wake him up again and have him sign the refusal so he can go do this again for the next crew.  

A good friend of mine in sunday school was teaching and he had a wonderful class topic called "My response is my responsibility" and in the end, how I respond to this situation dictates how I deal with I B Bangin's condition and I choose to treat him like I would treat my own family member who overdosed on heroin - Im going to do everything in my power to bring him back from the dead and let him see his next fix.  

I'm not here to pass judgement, I'm here to work.   If anyone reading this falls into the "3 strikes and your out" mentality that seems to be slowly pervasively moving into EMS, then honestly, get the Fuck out of EMS, you don't belong here, your thinking SUCKS Big donkey balls.  And if your service is beginning to think like that then as a very very valued member of this forum (DustDevil god rest his soul) used to say "Your service Sucks" and that I agree with.  

Edited June 14, 2021 by Just Plain Ruff

[rock_shoes]

1) Why is this posted in "Funny Stuff"?

 

2) Who made any of us judge, jury, and executioner? When someone calls in emergent medical distress, my job is to answer that call not engage in social judgement as to why that person ended up in a particular situation.

 

3) Previous forms of "3 strike rules" have been complete, epic, failures. Why should this particular line of thinking be allowed to prevail?

 

[Richard B the EMT]

I had to look back, so no idea why it's under Funny Stuff.

While the question of 3 Strike Rules might be hypothetical, I feel that, hypothetically, the aforementioned Malpractice by failure to act could be applied, at someone, or an agency's expense, in the millions of $$$.