Do you properly secure patients to the cot?

[Ridryder 911]

After ignoring and not reading latest posts here is a question.

Q: What do you call an EMT that does not utilize straps, to secure patients to LSB, stretchers; as taught and recognized in the national curriculum?

A: Defendant ... Period

[akroeze]

After ignoring and not reading latest posts here is a question.

Q: What do you call an EMT that does not utilize straps, to secure patients to LSB, stretchers; as taught and recognized in the national curriculum?

A: Defendant ... Period

Quoted for truthiness.

[AnthonyM83]

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.

Some of our rigs have a built in carseat in the captain/jump seat in the back. You remove the back cusion and there's a carseat. If it's a non-emergency transfer, the hospital lets us know and we send that rig. Otherwise, in emergencies child in parent's arms or in severe emergencies (prolonged seizure / rep. arrest) child just laid on gurney, no straps, parents in front to make room, EMT kneeling at side to hold child still and assist...risk of patient flying around is hitting us is assumed risk...like with going code 3.

[Ridryder 911]

Some of our rigs have a built in carseat in the captain/jump seat in the back. You remove the back cusion and there's a carseat. If it's a non-emergency transfer, the hospital lets us know and we send that rig. Otherwise, in emergencies child in parent's arms or in severe emergencies (prolonged seizure / rep. arrest) child just laid on gurney, no straps, parents in front to make room, EMT kneeling at side to hold child still and assist...risk of patient flying around is hitting us is ass/u /me/risk...like with going code 3.

Sorry, but to even think that family, child, etc is able to recognize potential risks during the event of the crisis is not even negotiable. As well, we teach during kinematics of trauma (per PHTLS, ITLS, ATLS, etc) to hold a child during impact is impossible. It would be hard press to defend one self, when 3 of our own national organizations, discuss this in the national education courses and teaches the hazards of such.

Sorry parents, either need to be restrained in the front seat or my preferred method is per another vehicle (except epilgottits cases). Definitely, never in the arms of the parent or even the medic.

I did a 2 year study on pediatric restraints or lack of, enough to write a Federal grant to purchase every EMS truck in my state a child restraint/carrier for the trucks. I was amazed on how EMS, Police, and FD were exempted, assuming they were safer... which we know they are not.

R/r 911

[Laura Anne]

Having been oh so lucky to have been an ambulance accident, let me just state and reiterate Ridryder's point:

Seat belts and restraining the patient(s) properly = THE LAW.

You have a medical problem that you feel makes you special? Unless you're Superman, you're not being safe. If you feel that you cannot be properly treated by the EMS personnel, then I'd have you sign a refusal form stating why you will not allow yourself to be seatbelted/restrained for your safety. Because this is a legal form you'd be signing prior to the continuation of my ALS intervention, you can be assured my legal/professional status will be maintained over your refusal of care due to a medical condition. I am sorry to hear that you have this condition, but I have to do what's best for everyone, including myself. I will seatbelt in my patients properly for every transport while in my care. BTW, we only have two straps on our litters; one chest and one leg. I really like the Pedimate and will have to bring it up to my bosses. Thank you for that, medicmole. 8)

Just remember, at the end of the day, we all have families to go home to, to provide for, to care and be there for. If this means my patient(s) has delayed their own care due to whatever reason, I will make sure my own safety comes first...the safety of my job. Sounds harsh? It's not, it's called life.

[mackeydad]

Having been oh so lucky to have been an ambulance accident, let me just state and reiterate Ridryder's point:

Seat belts and restraining the patient(s) properly = THE LAW.

You have a medical problem that you feel makes you special? Unless you're Superman, you're not being safe. If you feel that you cannot be properly treated by the EMS personnel, then I'd have you sign a refusal form stating why you will not allow yourself to be seatbelted/restrained for your safety. Because this is a legal form you'd be signing prior to the continuation of my ALS intervention, you can be assured my legal/professional status will be maintained over your refusal of care due to a medical condition. I am sorry to hear that you have this condition, but I have to do what's best for everyone, including myself. I will seatbelt in my patients properly for every transport while in my care. BTW, we only have two straps on our litters; one chest and one leg. I really like the Pedimate and will have to bring it up to my bosses. Thank you for that, medicmole. 8)

Just remember, at the end of the day, we all have families to go home to, to provide for, to care and be there for. If this means my patient(s) has delayed their own care due to whatever reason, I will make sure my own safety comes first...the safety of my job. Sounds harsh? It's not, it's called life.

yes, it does sound harsh, and IT IS harsh. and yes it certainly is called life. but "life" is also the reason for patients dying because they cannot afford the surgery to cure it, and also the reason for massive employee layoffs and plants moving to foreign countries for cheaper labor in the unending search for the "bottom line". this is all called life but does that make it right? what is destroying the delivery of medical care in the united states is not the fault of the patient, nor the emergency caregiver. it lies in our legal system. to think that, in making a run where the patient states that they FULLY understand their situation and the risks they are taking, and still refuse care, the provider can be sued for negligence for not providing the medical care the patient did not want, and be held liable is a DISGRACE. that being said, we return to the question at hand. i am a human with frailties and medical conditions, the majority of which are beyond my control. i did not ask to be claustrophobic. it is just something that happened. before anyone asks, yes i have had extensive treatment in an attempt to rid myself of this condition, and for reasons unknown to the therapist or me, it has failed. so that leaves me the victim of a MVA with injuries for which emergency care is summoned. after all the physical examinations,histories, and investigations have taken place, the EMS makes the determination i must be transported to the emergency room. it has been recommended that i go, i do not refuse, i want to go, but because of a technacality of our laws, i cannot. i have never doubted the advantages which wearing seatbelts offer. i wish i could wear mine. i am not against mandatory usage laws nor primary enforcement, but all states i am aware of which have adopted mandatory safety belt usage laws contain EXEMPTIONS to cover people who cannot wear seatbelts for medical reasons. is there a reason why our EMS cannot offer these exemptions? this would save people like me tons of anguish and pain. i do not possess the knowledge to diagnose or treat myself, so therefore i refrain from so doing. i ask only that when deciding what is the best option for the patient, that this be done by making use of ALL pieces of the puzzle, including what the patient can tolerate. is it better to leave a patient at roadside to fend for himself than to treat/transport him? i hear most of you already saying that it is not the responder not offering care but the patient not accepting it. on the surface this is indeed hard to disagree with, but disagree i must, because your decision is based on flawed evidence that the patient is making a "choice" not to accept treatment. this cannot be farther from the truth. you must understand that it is NOT a choice when i refuse and resist restraint application, it is a fact of life. claustrophobia isn't something you can turn on and off depending on the situation. it is not something a person chooses to be. YOU JUST ARE. there is something very fundamentally wrong with a system that will not make exceptions in order to offer care to ALL individuals. it is true that it is not our fault, but it is also true that it is us who must fix it. thank you and may God bless you all.

i wish to say to laura anne, please tone down that attitude. you are not SUPERMAN, nor WONDER WOMAN either. and please do not be offended as this is constructive criticism. you come across as a "big know-it-all with a huge superority complex". and i wager that this is far from the truth, and a mistaken impression. i realize the laws are important and what you put at risk if you break them. i find it hard to disagree with your reasoning. what makes this an even more complicated issue is the realization that i know and accept the advantages seatbelts offer and agree that i should wear mine. this is very difficult for me, as i accept your premise and realize you are right. but i do not feel that you understand my problem and the reality resulting from it. understanding and compassion for people, not derision, will make you a far better medic than you obviously already are. finally, answer this question for yourself----------how many of your past actions and decisions made as an emergency care provider would have been different if you did not have the need to worry about the possibility of being sued?

[brentoli]

Even if I knew it was impossible to sue me, I still would not carry an unrestrained patient. I do not want to DIE when we wreck because you didn't have a seatbelt on and snapped my neck when you landed on me.

You would never ride in my POV either. NO ONE goes in my car with out seatbelts. A backseat unrestrained passenger is deadlier than anything else in a vehicle.

[AZCEP]

mackeydad, your situation is unique, at best. No one should be expected to allow any condition that will be unsafe to them. You may well be within your rights to not be restrained by applicable law, but that does not give you the right to place the EMS provider at risk. If you are unable to tolerate the thought of having a restraining device placed on you, how is it that you are able to be in the patient compartment of an ambulance?

I do not wish to argue the point, but this is a question that I continue to come up against as I'm reading your responses. Just looking for some clarification.

You have the right to refuse, and I'd be sure to document the situation thoroughly. This would not protect me from the eventuality of you becoming a lethal object in the event of an accident. Not only would I be responsible for the injuries that I allowed to happen to me, but I would also be negligent in allowing you to become further injured because I did not reasonably restrain you.

I apologize now, but my safety comes well before anyone else's.

[MeekoBB]

Err, you don't have straps on your LSB and/or there are people who refuse to use said straps that comes with the back board?

We have spider straps but we don't like using them because they are time consuming and a pain and the ER is scissor happy. easier and more secure IMO with cravats. cheaper too.

[Dustdevil]

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).

Can you please give us an exact quote from OSHA regulations that states this?

Chapter and verse, please.