Ever had a partner you can't trust??

[Brandon275]

What everyone said is accurate. the pt had to be placed on the longboard because not only did she have head pain she also had neck and back pain secondary to the assault. As I said, she was hit in the face,thrown against a truck and then kicked in the stomach. Her anxiety alone was a distracting enough factor that made it impossible to assertain where exactly in her back and neck it hurt. Anyhow, yeah I dont trust the guy now unfortunately.

 

[usalsfyre]

Have you asked him why he was so offended by your statement?

 

[Brandon275]

USA, yeah he basically said that we are not the police or FD and we have no right saying those things about people on scene. He also said it makes me seem "dangerous". Whatever the hell that means..

 

[Aidey]

Awesome. So you strapped down a panicked, emotionally traumatized, pregnant patient for no scientifically justifiable reason. Makes perfect sense.

Chances are he doesn't trust you either, so you guys are even.

 

[Brandon275]

Aidey, seriously? We explained everything we were doing once the idiot was removed from the scene. We made sure we padded the appropriate side of the board that way she was not lying directly on her back. We followed our protocol to a T, The hospital left her in the collar for quite a while as well so clearly they were taking precautions to. I hate boarding people, but it is what it is. I attempt to clear C-spine in the field as much as I possibly can. However, there are times when you cannot. This is a case where there is way too much going on, pain all over the back including the midline spine region and the neck region. Also head pain with question a of LOC. She was kicked hard enough to possibly kill the baby and was hit hard enough in the face to batter her up. She was thrown back first into the truck to cause visible damage to the passenger door of the vehicle. You wouldnt take C-spine precautions? Are you asking for a hospital based complaint. You can take that liability if you want, as far as I am concerned that is a patient that needs to be boarded and collared.

Per protocol you cannot clear C-spine if A. The patient has midline back pain upon palpation of the spine, B. The patient has midline neck pain, or C the patient has a distracting injury/condition that makes them an unreliable patient. In this case she failed all three criteria. Therefore she buys a board and collar unless she flips out so bad that she cannot safely be placed on it and in that case you tell the ER. She was fine on the board and relaxed once we got her in the ambulance and away from the idiot who harmed her, so you obviously dont know your protocols.

 

[usalsfyre]

USA, yeah he basically said that we are not the police or FD and we have no right saying those things about people on scene. He also said it makes me seem "dangerous". Whatever the hell that means..

I'm not sure I agree with "dangerous", but I wouldn't have chosen that particular phrasing. I'm not sure this is a reason to mistrust him. He gave you a heads up "don't do it again". A reason to not trust him would be if he smiled, said everything was fine, then reported you.

Everyone I've seen that subscribed to the "what happens on the truck" philosophy had it come back and bite them in the ***. He's doing the appropriate thing. Attempt to handle things at an interpersonal level first, but advising you the behavior wasn't acceptable and he'll move up the chain if needed.

I've seen people falsify charts in an attempt to throw a partner under the bus. This sounds more like a maturity issue on your end.

 

[Veneficus]

he was upset because i referred to the guy who beat up the pregnant woman as a jackass

I see the problem here...

"Jackass" is far too kind for such a creature.

In the future you should use stronger language and put some more emotion in it.


As for partners you can't trust, I have had more than my fill of them. It seems more rampant at agencies with not enough to do, but exists everywhere.

 

[Aidey]

I already told you I'm playing devils advocate.

You broke away from the patient to go yell at a (probably drunk) idiot who was intent on causing trouble. That right there would make me question your judgement if I was your partner.

The hospital very likely left her collared because you guys made the decision to put her in spinal precautions. Once someone has done it, it requires more documentation to undo than it does to never initiate it in the first place.

And go figure she calmed down once you moved her away from the guy who beat her up. Maybe if you had done that in the first place she would have been calm enough to properly assess.

 

[Handsome Robb]

Geez, I must have lucked out because my partner and I are like two peas in a pod. Every day at work is a damn good day and we spend plenty of time drinking beer, watching football and talking :censored::censored::censored::censored: to each other on our days off.

Sounds like this call could've been handled better on both ends. I'm going to have to agree with Kyle on this one...if he had acted like it was fine and thrown you under the bus that's a reason not to trust him but the fact that he talked to you before tossing you under the wheels would almost make me lean TOWARDS trusting him... Just my two cents.

One thing I will say is I agree with Aidey, move yourself and your patient away from the situation that's causing the distress or ask PD to get the guy out of there. Maybe I'm spoiled but the cops here are smart enough to separate the parties involved in a domestic violence prior to our arrival so A) no further problems occur and B) I don't have to listen to some drunk guy run his mouth while I take care of my patient.

 

[Brandon275]

Aidey, what dont you understand about this? You cannot move the patient until they are boarded and collared if they fail the C-spine protocol. What is so hard to understand about this? Your a medic, arent you? I didnt turn my attention away to yell at a drunk. I informed my partner the story was hard to get because the person who assaulted my pt was being a "jackass". Im not going to physically remove this guy from the scene, he is handcuffed, that is the PD's job, not mine and your wrong about the hospital keeping in the colloar on If the hospital does not feel the pt needs c-spine precautions and the doc clears the c-spine when we show up then they take the board and collar off. She clearly failed the c-spine clearance protocol that the hospital has, so they kept her in the collar. You cant play devil's advocate if it makes you sound like a fool. I guess your smarter than the doc and me and my partner. LOL...I wouldnt want you treating me.

 

[Handsome Robb]

Aidey, what dont you understand about this? You cannot move the patient until they are boarded and collared if they fail the C-spine protocol. What is so hard to understand about this? Your a medic, arent you? I didnt turn my attention away to yell at a drunk. I informed my partner the story was hard to get because the person who assaulted my pt was being a "jackass". Im not going to physically remove this guy from the scene, he is handcuffed, that is the PD's job, not mine and your wrong about the hospital keeping in the colloar on If the hospital does not feel the pt needs c-spine precautions and the doc clears the c-spine when we show up then they take the board and collar off. She clearly failed the c-spine clearance protocol that the hospital has, so they kept her in the collar. You cant play devil's advocate if it makes you sound like a fool. I guess your smarter than the doc and me and my partner. LOL...I wouldnt want you treating me.

You want our help and advise? Watch who you talk to like that. From the story you are telling I'd be willing to bet everyone in this thread is smarter than you and your partner, combined. Did you ask her where she hurt or did you ask her if her neck hurt and nodded your head at her while you asked it? Ever heard of leading a patient? I'd bet that's what happened in this situation.

This women didn't need to be backboarded. Anxiety is not a "distracting injury". Many would argue it is relatively contraindicated.

She's right about the ER and the collar. You started the process now they have to deal with it and finish it.

For what it's worth I'd take aidey as the attending paramedic if I ended up in a box any day of the week over many medics that I know. I know I wouldn't want you treating me, that's for damn sure.

 

[Aidey]

Do you not understand the concept of devil's advocate? The point is to argue the opposite side. And yes, you can, lightening will not come out of the sky and strike you down. If they have already been ambulatory there is no good reason to leave them in a bad situation. Current PHTLS guidelines allow for the pt to self extricate and then having a standing take down performed. Shockingly they've found that a person can move AND protect their own spine much better than we can protect their spine. And the fact still remains that you walked away from you patient to go and yell at someone else.

And before you call me a fool do some research on spinal precautions. They are less than worthless. They have no proven benefit and have only been proven to be harmful. The only reason it is common practice is because not enough people have stepped up to call for an end to it.

 

[Aidey]

Did you ask her where she hurt or did you ask her if her neck hurt and nodded your head at her while you asked it? Ever heard of leading a patient? I'd bet that's what happened in this situation.

Plus there is that whole pregnant woman chronic back pain thing...

 

[Veneficus]

You cant play devil's advocate if it makes you sound like a fool. I guess your smarter than the doc and me and my partner. LOL...I wouldnt want you treating me.

Easy there killer. You seem rather new at this to be leveling such accusations.

I can't help but wonder if the reason you are having partner trouble is because of this same attitude?

If you have never been in a fight, win or lose, if you take a couple of shots, it's going to hurt.

Do you really think a person possesses enough strength to throw somebody against a car and break their spine?

Do you know that while it still hurts, landing flat against something is the best way to prevent serious injury? There is even a martial art technique called Ukemi devoted to it.

Now that we have discussed injury mechanics, I will say that I would not have been inclined to board or collar this patient and I am rather smart.

I am more than confident in Aidey's ability to take care of me or anyone I know.

You tried to interview an abuse patient in the presence of her abuser. Fail.

You followed the letter of a protocol because you do not have enough knowledge about trauma to make a reasonable clinical decision.

You also have no idea why that patient was left in a collar. Do you think every patient who gets an IV needs one?

Medicine is not absolute. It is not follow the protocol and you are always right and everything turns out ok.

 

[Handsome Robb]

/thread

 

[VFlutter]

I walked over to him and told him to shut up because he was upsetting my patient.

I didnt turn my attention away to yell at a drunk. I informed my partner the story was hard to get because the person who assaulted my pt was being a "jackass".

From the sound of your first post you did turn your attention away to yell at a drunk....

How far along was the patient? Backboarding would have been the least of my worries. Did you transport her flat on her back or did you tilt the backboard? You probably did more harm then good.

I can't say I would go to management but I would lose all respect for you as a health care professional (from your attitude in these posts I doubt I would have much to begin with) . It sounds like you lost your cool and let your emotions take over. You should have never engaged the guy, did you think he would have actually listened to you when you told him to shut up? And regardless if the person deserved it or if you are talking to your partner referring to someone as a jackass or other obscenity on scene is unprofessional. Be mature about it

 

[usalsfyre]

Redacted

 

[Veneficus]

How far along was the patient? Backboarding would have been the least of my worries. Did you transport her flat on her back or did you tilt the backboard?

As strange as it sounds, if I actually suspected an abrupted placenta, flat on her back on a board may actually be the best way prehospital to control hemorrhage from it.

Definately not perfect, but life is imperfect sometimes.

 

[VFlutter]

As strange as it sounds, if I actually suspected an abrupted placenta, flat on her back on a board may actually be the best way prehospital to control hemorrhage from it.

Definately not perfect, but life is imperfect sometimes.

That would make sense however I was thinking more along the lines of an intact placenta. She had ABD pain but said she could not feel any movement when with an abrupttion there is usually intense continuous contractions and bleeding. But some can be asymptomatic. (I could be wrong, OB was not my strongest subject). In a patient with normotensive, non-tachycardic, pregnant trauma patient with no visible bleeding would you advise a 15* tilt or flat?

 

[Veneficus]

That would make sense however I was thinking more along the lines of an intact placenta. She had ABD pain but said she could not feel any movement when with an abrupttion there is usually intense continuous contractions and bleeding. But some can be asymptomatic. (I could be wrong, OB was not my strongest subject). In a patient with normotensive, non-tachycardic, pregnant trauma patient with no visible bleeding would you advise a 15* tilt or flat?

For routine treatment, I would go with the tilt.

If I reasonably suspected a traumatic abruption, even without blood from the vagina, because sometimes the center can seperate instead of an edge early on which can lead to a life threatening occult hemorrhage, I would be inclined to try to keep her on her back on the board to use it to put indirect pressure on the abd. Obviously if she started to have deletorious effects it would have to be changed.

You can actually see this work in some patients with pelvic fractures. (particularly "donorcyclists")

Side note:

Statistically, pregnant women are the most abused cohort in the world.