Would you stop?

[vs-eh?]

I haven't read all the responses.

Dutton immediately retreated, running toward the rear of the ambulance. His partner, paramedic Joseph Fraiman, and their Northeastern University paramedic student observer, Duncan Regonini began to emerge from the rear doors of the ambulance.

That is the main thing that bothered me. That is abandonment in its purest form.

The fact of the matter is that if a similar thing happened here (with an assumed "stable" paed post-ictal, assume febrile), a crew would stop (all other things not withstanding). This is a very large municipal system (300k+ responses a year) where YOU are the only service allowed to respond to calls. In the end it is up to the crew (believe it or not) to decide on the stability of their current patient and the need to stop at the call/accident.

This obviously doesn't happen on every call or crews stop on every accident. However there are times if an ALS crew (with a "stable patient) who is close to a BLS crew who is asking for ALS assistance (honestly this happens fairly rarely).

This happened last week (but probably happens daily). A BLS crew requesting ALS (keep in mind we are a municipal system and the only EMS service) for a patient with a HR of 200. We had a "stable" BLS patient on board. Had we been close, we would have intercepted that unit, reassessed and traded off patients. That's how it would have worked. Turns out the guy was cardioverted in the ER, etc....No ALS was available.

Same thing would have happened here. "Stable" patient in the back (regardless of age or nature). Come across accident, assess, ask for unit. If ALS intervention is required stay on scene until unit arrives. Switch off if BLS/ALS needed/switch patients, etc....

That is just how it works here from my perspective with a "stable" patient. People simply don't worry about people suing people or lawyers here. I am not saying leave NO ONE with the patient, but at least have someone with a more critical patient.

And you know what, I have had patient's say "maybe you should both help that guy instead, I'll be ok"....

Different mentality I guess...

[fiznat]

I gotta say, it is one of the nice things about working in a city that there is almost always another ambulance nearby. I think it would be extremely tough to keep on driving if faced with a situation like Ruff's, where it is clear that another ambulance is not right around the corner. Extra ambulances nearby in the city makes this decision much easier for me.

If the situation were such that I really thought it was life + death if I stopped for a 2nd patient, and I knew that there were no other available ambulances, and the patient in the back was not critical, I think I would probably stop. I think.

The only think I can say with perfect clarity is that I hope it never happens to me.

[AnthonyM83]

VS-EH, that's criticizing each move again without being there. Did he emerge b/c he hear or saw that something was wrong and was trying to see? He wasn't necessarily abandoning the patient. Who knows how much they "emerged"...the article just decided to use that word. Come on.

[Lone Star]

VS-EH, that's criticizing each move again without being there. Did he emerge b/c he hear or saw that something was wrong and was trying to see? He wasn't necessarily abandoning the patient. Who knows how much they "emerged"...the article just decided to use that word. Come on.

"...how much they 'emerged"? Abandonment is measured in degrees of separation now?

In my area, there's no 'justification' for abandonment, no 'free pass' In the article, it was stated that the driver had the attending stay back...which means they were in the process of abandoning the pt. In for a penny, in for a pound.

Let's be realistic here if you robbed a bank, it wouldn't matter if you only took one dollar, or you took 500 million dollars; either way you're a bank robbing thief and you're going to jail!

If you cease medical treatments without ensuring your patient is in the care of someone of equal or higher licensure, and prepare to leave the pt alone...you are committing abandonment. It doesn't provide that you only get a slap on the wrist if you have one foot out of the room, a kick in the shin if you have one entire leg out of the room......on up to the point that you get a 'time out for leaving the room by 5 feet, and a broken leg for leaving the room by 20 feet. It just doesnt work that way.

[whit72]

Dust Wrote:

You'd think that people would have learned by now that, when Whit and I agree on an issue, there is nothing else to be said about that issue.

It is settled.

I couldnt have said it any better myself.

[EmergencyMedicalTigger]

Our truck was flagged down while transporting a pt once. My partner, who was driving, simply told the people that we had a pt in the back and another unit was being dispatched to them.

How would you feel if you were the parent of the 9 month old and saw the ambulance pulling over to take care of other people when they were supposed to be taking care of your child? Maybe the child wasn't having a sz at that moment, whose to say the child wouldn't start to have another sz at any moment?

Take care of the pt you already have. The medics responsibility at that time was the 9 month old in their care. Call for another unit to take care of the MVA. Their poor judgement could've gotten them or their pt shot in this instance.

[ncmedic309]

Dust Wrote:

You'd think that people would have learned by now that, when Whit and I agree on an issue, there is nothing else to be said about that issue.

It is settled.

I couldnt have said it any better myself.

I really wish I could agree - but I'm just not content...

[Just Plain Ruff]

I see that there are at least three sides of this argument.

side 1- don't stop you already have a patient on board. they are your responsibility

side 2 - stop and render care until the other ambulance gets there

side 3 - stop only to ascertain injuries and notify dispatch as to what injuries.

Which side is correct - some would say side1, others side 2 and even others side 3

Does anyone have access to the law search system not sure what the name of it is.

If you do maybe you could do a search as to are there any lawsuits that fall under one of the three sides of this argument. What is the legal precedent to not stopping or for stopping??

If you have a medic in the back of the ambulance taking care of the patient and the driver gets out to check on injuries is that a bad thing? The patient is not suffering for the delay unless it's a long delay. (this does not include critical patients because no one will argue that you stop with a critical patient.). The emt or medic driver checks on injuries and the patient still has the same level of care that they started out with.

I personally don't see the harm in stopping.

let's put this on the other foot, many are saying that if they were the parents of the 9 month old and you stopped that you would sue.

how bout there is a patient in the car and you stopped long enough to get the address and call it to dispatch and you told the bystanders that you have another ambulance coming. Would you not be pissed off that the ambulance stopped but then kept on going??

Just curious how you'd feel or if you would sue the ambulance service for not rendering care???

What if you are the patient in that car and you saw the ambulance drive on by and not stop? You know it was one of the ambulances that service your town. What would you do? Would you sue them for not stopping.

[vs-eh?]

let's put this on the other foot, many are saying that if they were the parents of the 9 month old and you stopped that you would sue.

how bout there is a patient in the car and you stopped long enough to get the address and call it to dispatch and you told the bystanders that you have another ambulance coming. Would you not be pissed off that the ambulance stopped but then kept on going??

Just curious how you'd feel or if you would sue the ambulance service for not rendering care???

What if you are the patient in that car and you saw the ambulance drive on by and not stop? You know it was one of the ambulances that service your town. What would you do? Would you sue them for not stopping.

People are so paranoid in the US about suing and such.

Working for several years in the largest system in Canada, hundreds of thousands of calls a year, I can't even recall ONCE a person stating they would "sue" regarding an issue in EMS. I'm sure it has happened, but I can't recall any specific instance. Truly amazing the mentality of people...

The fact of the matter is that here, assuming that you have a "stable" patient on board and are not leaving them by themselves, people stop.

People can come up with all the scenario's they want. As long it is reasonable to assess the patient after witnessing/being flagged down (i.e. the are observable from the ambulance) and your current patient isn't being left alone, people stop. In the end, it is a form of triage. Your knee pain can probably wait if you are flagged down and see a person doing chest compressions to someone on the street...

In the end, all of this is going to be fairly rare and will be at the digression of the crew, the acuity of your current patient, and the reasonable nature of assessing the patient you are stopping/being stopped for.

[flight-lp]

What if my car caught on fire in front of the fire station. I see the engine through the window, but its a volunteer station, not manned. Do I sue them because THAT engine that was RIGHT there didn't immediately respond???????

Sorry, too many what ifs.......................

Bottom line is you can't save the world, most need to stop trying and focus on the job at hand. That little 9 month old is entitled to the best that can be offered by by the medics. The baby didn't receive that, delivery to definitive care was delayed, and the patient was placed in harms way, both physical and psychological. O.k. maybe this is policy and then yes they followed policy, but it was still wrong and the child is entitled to a payed education courtesy of NYC. My belief, take it or leave it..................

Since we are discussing this to some depth, let me throw a couple other scenerios at you....

1. You are at the ER with your asthma patient. The ER is currently full and you are awaiting a bed along with several other ambulances. An MVC with a confirmed pinned victim is toned 2 blocks from the hospital. Your nearest ambulance is responding from the other side of the district and will take over 10 minutes to get there. While you are enjoying holding up the wall awaiting your room assignment, a young lady bursts in to the ER screaming that her 8 month's pregnant sister is trapped in the car, bleeding profusely, and is unconscious. What do you do?

2. You are now a flight medic and are flying an AMI pt. from the outlying, podunk ER, to the tertiary cardiac care center. While flying over a rural area, you witness a school bus get t-boned by a logging truck. The bus flips over, then catches fire. It is 3p.m. and you suspect that children may be on the bus. You are familiar with this rural area and know that it will take almost 30 minutes to get an ambulance on scene. You do not see movement coming from inside the bus. Do you land?

Interested in hearing your opinions..........................