Would you stop?

[missa4816]

I personally feal they should have never gotten out they should have called the sceen in especially with a 9-month old in the back of the ambulance.

[Lone Star]

I personally feal they should have never gotten out they should have called the sceen in especially with a 9-month old in the back of the ambulance.

That's exactly the point that most of us are trying to make here. Once you've got a patient on board, you're bound to treat that patient and that patient only.

Splitting crews delays the transport of the original patient, while waiting to arrange for a second unit to come to the scene. If you assess that the second patient is 'stable enough' or uninjured enough to continue on with your first patient, you've abandoned the second patient, and either way, you're in so much deep shit that hip waders arent going to help you!

The only way that the 'legally bound to stop' even makes any sense is if you're on your way to a call, and you are an 'empty unit'. In Michigan, the law is clear. Patient on board, you're committed to that call, and even if flagged down by a police officer, you are NOT to pick up or even assess a second patient.

If you're an 'empty unit' even if you're responding to a priority 3 patient (lowest priority), you get flagged by law enforcement, you notify dispatch, and the either hand the call off to another unit, or another service. Obviously, no law enforcement officer is going to try to flag down an unit running code 3 to another call!

Common sense would dictate that the 'legally bound to act' clause only applies to an 'empty unit', and is suspended or ceases to be applicable once you stop being an 'empty unit'.

Moral/ethical duty to act only applies if you can do so without endangering the life of someone you've already started treating!

[Dustdevil]

THE PLOT THICKENS!

I recently spoke with the paramedic-attorney who writes the medico-legal column for JEMS about this issue. She had already written one article on abandonment for JEMS, but it did not specifically address the issue of stopping while loaded. She said she would write a column addressing this issue soon, and now it is out.

EMS and the Law

W. Ann Maggiore, JD, NREMT-P

2008 Feb 7

The state EMS office in Massachusetts recently sent a reminder out to its EMS services indicating that an ambulance with a patient on board may not stop at the scene of another medical emergency. The notice states that the office has received information that some EMS services have policies that instruct them to stop at the scene of a crash even if they are transporting another patient, and that such policies are "invalid and without legal force." This issue has also arisen in the context of EMS units who, while responding to calls, encounter another emergency en route or who may be en route to a low priority or "alpha" call when they find themselves the closest unit to a higher priority call. What should EMS do in these situations?

For once, it sounds like Massachusetts may be doing something right.

[tniuqs]

This is cut, copy, paste in the closing statements in the article that you so kindly provided a link.

Gosh: I sure hope that there is no copyright laws (sarcasm intended)

ps yes something is getting thick but I don't believe its the plot :twisted:

If you're en route to a non-emergency transfer call, and the patient you're called to transport is in a medical facility, it would be reasonable to stop at another scene to triage and have another unit dispatched to the transfer call. Delay in patient transfers may cause a different set of problems, and should be avoided whenever possible. Some EMS services have taken the position that a contract exists between the transfer patient and the service that renders the EMS unit unable to stop at an emergency they encounter en route, or that the presence of one call creates an unwritten contract between the first patient and the EMS unit enroute to that call. However, it cannot be understated that the EMS system as a whole has a duty to do what's best for the most people it can in every situation, and the patient’s acuity level -- not the financial interests of the EMS service -- should always dictate how these situations are handled.

I believe an addition no fear of legal reprisal of the "unwritten contract" should also be included in this statement. One cannot legislate common sense or write in a protocol what the suposed action (s) should be, but back to the protocol vs. guideline controversy once again, and fear of litigation ... hmmm.

I truly believe in the Pirates Code: (tis more of a guideline my dear)

[Dustdevil]

However, it cannot be understated that the EMS system as a whole has a duty to do what's best for the most people it can in every situation...

Ah, well if you want to make this a mathematical problem, you've just made my job easier.

In your ambulance you have one (1) patient who needs your immediate care and transportation.

Outside your ambulance, you have a banged up car on the side of the road. Inside this car, you don't even know if there are people, much less patients. So, at the time you stopped, you had one (1) patient in your vehicle, and zero (0) patients in the wrecked car. Potential patients do not count as patients, for you have no patient relationship with them until you make contact.

You lose, 1 to 0. Now maybe in Kanuckistan, you do the math differently, but in America, abandoning an existing patient to go fishing for potential patients is not doing the most good for the most people. It's just whackerism.

[tniuqs]

Math:

Lets see here the use of less than respectable teminology and lack of grasp of the Queens English :twisted:

Whackerism - 1 for gibberish (you made that word up) not in my Funk and Wagnals (sp?)

Fishing -1 for gross assumptions, and a term used for baiting and catching of fish.

Attacking the credibility of a crew on a "based news release" - 4 for disrespecting EMS Brothers and lack of solidarity within the community.

Attempting to impose/ dictate others ethics of moral views in the face of a direct quote: = priceless

Perhaps we should use Chemistry because Law is not necessarily RIGHT its just the Law and subject to change with the voted in politicians (subject to change based on a whim)

- 2 for absolute blind faith in a system that is flawed (by your own words)

So on to chemistry:

H2O + dust = MUD :shock:

[RaceMedic]

Non emergent transports that have yet to be picked up usually do and as far as im concerned will always take the back seat to Emergent calls or unreported accident scene's

A loaded ambulance with PT. If you stop that ambulance and "abandon" that PT in the back ( and that is what it is if you leave them alone) is just not the smart thing to do. your crew and ambulance is already rendering care to an individual.

[Eydawn]

You let your dispatcher tell you where to go.

If you've got a patient in the back, you never stop. Point, blank, end of story.

If you have no patient, and are enroute to a dispatched high priority emergency (cardiac incident, respiratory distress, etc.,) you should be the closest unit to that scene. If you're not for some reason, and another unit realizes they are closer, go through dispatch and get the vehicle that's most able to quickly respond there.

If you are enroute to a "BS" call, and you hear another more emergent call come in and you're closer to it, same deal. Dispatch has the final say in where you should be ending up.

If you are enroute to an emergent call and pass a car wreck, call it in! Dispatch will handle it.

If you are enroute to a BS call, and the car wreck you just passed is getting called in as emergent, let dispatch know you're close to it so they can reassign priorities.

See a theme here? You go where dispatch tells you to go (be nice, Brent) and follow protocols. You don't self activate unless there's a major communication screwup, you're totally free of other obligation, and you let someone (dispatch?) know where you're going and why.

Easy enough?

Wendy

CO EMT-B

[tniuqs]

I personally feal they should have never gotten out they should have called the sceen in especially with a 9-month old in the back of the ambulance.

Are you suggesting that a 9 month old LIFE has more importance than an adult or are you just biased towards a this smaller person ?

please note: Febrile siezures are "in most cases" are self limiting and medical based evidence suggests that very few have long term damage, I am not suggesting that it is a NOT a scary and emotional event for the Parent as well, but should it be "emotional" for the professional providing care ?

Just wondering out loud is all.

[RaceMedic]

In most cases that prolly works, however unfortunitly my dispatch is in another state, they have no clue what things are like on our streets not to mention they have 4 dispatchers for several counties in several states ... so we end up telling them what we're going to do ... right or wrong that how we do it.