Do you properly secure patients to the cot?

[mackeydad]

Only takes one to lose everything you own or ever will own.

i guess your position would be to leave me at the scene! you think it is absolutely ridiculous for a paramedic to bargain and compromise with a patient to give him the best care possible. believe me, i sympathize with the position that the legal climate of this country has created for emergency medical providers, where your number one concern in any run is to "cover your own ass". but i had no part in this, but i am paying the price just the same. there is no way i would bring suit against you for allowing me to be transported in a way which is tolerable. i certainly would, however, attempt to gain whatever legal recourse possible, if in my case you attempted to restrain me against my will, and subjecting me to the nightmare and whatever might befall as a result. far better to just leave me at the scene. at least there i will only need to deal with any injuries incurred in the accident, and not be burdened with the aftermath of whatever extra injuries sustained as a result of the actions of an overzealous medic attempting to avoid legal action. i really do not fault you as this legal climate was caused by you either. we surely and WE MUST create a better way, one satisfactory to both patient and provider.

[AnthonyM83]

This is as stupid as a mother riding in the passenger seat of a car with the kid on her lap. Absofreakinglutely NO reason for it whatsoever.

Sure, but we have precedent set for this. In an emergency, seatbelt can't always be your first priority. I guess you weight things out.

For example, GSW's are commonly altered and slightly combative. We could waste a lot time time properly securing with all seatbelts before leaving, but we just take off and try to secure (restrain) en-route. For young peds, medics would rather have them semi-relaxed in mother's arms in gurney, than thrashing about crying on gurney, while he attempts IV access. Sometimes we sacrifice seatbelt risk, b/c patient's current medical condition is seen as a bigger risk.

If the claustrophobic person who posted earlier were truly emergent, we would see it as a bigger risk not to transport. Each patient is different. One crew has a 600+ lb. patient and they had to use a sheet to slide him onto the floor in the back of the ambulance (For once they were glad to have 7 FFs on-scene.) Patient's condition was emergent enough.

[brentoli]

My concern with seatbelts isn't so much the patients safety as it is MY safety. In a roll over where is that unrestrained patient going to go? Around and around like a clothes dryer. I don't much appreciate 200+ pounds of dead weight, plus O2 bottles and Lord knows what else going around and beating the shiznt out of me. If I never have an accident I will be better off for it. But if I do, who is to say the patient being restrained wouldnt save MY life and theirs.

[mackeydad]

My concern with seatbelts isn't so much the patients safety as it is MY safety. In a roll over where is that unrestrained patient going to go? Around and around like a clothes dryer. I don't much appreciate 200+ pounds of dead weight, plus O2 bottles and Lord knows what else going around and beating the shiznt out of me. If I never have an accident I will be better off for it. But if I do, who is to say the patient being restrained wouldnt save MY life and theirs.[/quote

i totally understand and respect your concerns. i further realize that you could end up a defendant in a lawsuit. i think i have made it clear that due to the extent of my claustrophobia, my reactions are involuntary and uncontrollable and i would fight you with all the strength of my body should you attempt to restrain me. it is "no longer me" reacting, but extreme fear, and my one and only mission is to prevent restraint by whatever means necessary. this is definitely not a threat, so please don't be offended, but if you attempt to restrain me----i would become a far bigger threat to your livelihood than any courtroom. when my claustrophobic trigger is pulled, and fear and anxiety take over, i then have but one all consuming thought, to prevent you from restraining me, and i then care not what i do, what i must use, who i hurt or how badly. it is a fight to the finish with no holds barred, and i have absolutely no control. so i ask, no i beg you, if i am ever injured and you make the EMS run--if you cannot see fit to transport me without restraint-----then do us both a huge favor and just leave and let me be.

[brentoli]

My concern wasn't the courtroom. It was the casket. My casket. That was my biggest concern over all. No way in hell are you getting a 6 month hospital stay for a broken spine, and I am getting an admission to the ECU....

[katbemeEMT-B]

1) What is a stretcher? Everyone walks...

2) Seriously, this is a ridiculous conversation....

2.a) You would call a doctor regarding securing a patient to the stretcher? WTF would they know?

2. You never have any ambulatory patients? I.e. jumpseat seatbelt only?

2.c) So people either get tickets for lack of a seatbelt in their personal vehicle due to their anxiety or are they somehow exempt?

2.d) I like how "being partially sedated is not sufficient" is mentioned. Please tell me you have been in this situation and THEY ACTUALLY SEDATED YOU....The "rendered unconscious" thing is equally ridiculous.

I don't use the shoulder straps on 99% on my patients.

First off, if you think this is a ridiculous conversation why take part in it? I think it is actually very interesting to see just how many EMS personnel are breaking OSHA regulations in the US by not using ALL straps on the cots (this would be the straps at the legs, waist, chest, and shoulders). They are put there for the safety of the patient and EMS personnel should there be an accident. I also would like to hear from more people on how they handle claustrophobics and their anxiety.

By the way, the calling the Med Control was a joke but apparently you have no sense of humor.

Also, we place 99.9% of our patients on the cot. The jumpseat is used for our staff or if a family member such as the parent of a child is riding with us.

[medicmole]

The idea of transporting a child or infant in parents arms has been mentioned. How do most of you transport children? have you seen or do you use a Pedimate or similar piece of equipment?

Pedimate

And no I am not a sales rep, this just happens to be the site I found.

[katbemeEMT-B]

We use the Pedimate on the ALS service that I work for. It's compact and easy to use.

The volunteer service I work on we have an inflatable carseat that is a pain in the ass. We are looking at other options.

We have also used the childs own carseat if it was not involved in a car accident.

[CBEMT]

In an emergency, seatbelt can't always be your first priority.

When transporting, my first priority is to deliver the patient SAFELY to definitive care. If during a crash the patient splatters against the inside wall of the ambulance because I chose not to secure him/her to the stretcher properly, I have failed in my most basic purpose. And broken the law.

One crew has a 600+ lb. patient and they had to use a sheet to slide him onto the floor in the back of the ambulance (For once they were glad to have 7 FFs on-scene.) Patient's condition was emergent enough.

If your service is unable to afford it, perhaps a multi-jurisdictional approach could be used for the purchase or availability of a bariatric unit. Many private services have them now, sometimes more than one. With bariatric stretchers. That have all necessary restraints.

In a roll over where is that unrestrained patient going to go? Around and around like a clothes dryer. I don't much appreciate 200+ pounds of dead weight, plus O2 bottles and Lord knows what else going around and beating the shiznt out of me.

Here too we see that most EMS providers often fail to secure ANYTHING, much less the patient. There should be NO unsecured equipment in the patient compartment. Monitors, O2 bottles, anything.

I'm telling you people, get yourself to a lecture by Dr. Nadine Levick if you don't believe me. What you don't know about ambulance crash safety WILL kill you.

The idea of transporting a child or infant in parents arms has been mentioned. How do most of you transport children? have you seen or do you use a Pedimate or similar piece of equipment?

Pedimate

The Pediatric Intensive Care Transport team I work with has a Pedimate, and I LOVE the freakin thing. Patient is secured conveniently to the stretcher where providers can perform care and still remain belted in most cases.

Most departments around here use the childseats that are built into the airway seat. I absolutely HATE these, because NO care can be performed while the provider is belted. The private service I work for buys regular, full-sized childseats for all units.

Personally, I think the Pedimate should be the only acceptable method of pediatric restraint. Quick, easy, safe, nothing gets in the way, fits any standard EMS stretcher, rolls up for storage in a compartment.

[akroeze]

My truck doesn't move until all dangerous objects are secured. That includes the stretcher, the equipment, my patient and myself. Exceptions will be made in order to facilitate treatment but only in exceptional circumstances.