Legal question, I was dispatched to transport 2 PT's!!!!!

[Amycus]

I would most likely agree with the decision as well, if it was based on a legitimate pt condition that warranted not taking both pts. It sounds like this was more about not wanting to transport two pts rather than being uncomfortable with it. I don't know anyone that wants to take multiple pts, but we have all done it. It's just part of the job.

I find taking two stable PT's to be quite fun sometimes, lol. Kneeling on the floor taking vitals, getting them both engaged in conversation about each other, their conditions, etc.

 

[EMT11KDL]

I find taking two stable PT's to be quite fun sometimes, lol. Kneeling on the floor taking vitals, getting them both engaged in conversation about each other, their conditions, etc.

whats even more fun, is when you are having two different conversations haha

 

[JPINFV]

If it was new onset of irregular pulse, I'd have some concern, but otherwise, those numbers don't worry me enough that I would consider him unstable by any means.

Unless otherwise stated, I just make the assumption in IFT threads (in contrast to actual practice where more information is readily available) that an irregular pulse is secondary to diagnosed atrial fib.

 

[JPINFV]

I don't know anyone that wants to take multiple pts, but we have all done it. It's just part of the job.

I would personally be perfectly happy to take two related patients who wanted to be transported together provided they have the same origination and destination. Similarly, I'm generally very liberal with my rules regarding transporting family members with my patient.

 

[Amycus]

Unless otherwise stated, I just make the assumption in IFT threads (in contrast to actual practice where more information is readily available) that an irregular pulse is secondary to diagnosed atrial fib.

Oh snap, I entirely missed the fact this was about IFT altogether haha. Well in that case, the info should be at your fingertips in theory anyways. If they have afib I wouldn't bat an eyelash at those numbers, except the prior mentioned diastolic, but still, not something I'd be like "oh crap" about

 

[jrm818]

I find taking two stable PT's to be quite fun sometimes, lol. Kneeling on the floor taking vitals, getting them both engaged in conversation about each other, their conditions, etc.

This would be my major problem with taking 2 patients in a non-emergent setting. There is no possible way for the provider to secure themselves sitting on the freaking floor. :angry: Are we seriously so unconcerned with preserving our lives in an accident that no one bats an eye to a company that is OK with sacrificing safety when there are (apparently) plenty of other ambulances around?

 

[Shishkabob]

This would be my major problem with taking 2 patients in a non-emergent setting. There is no possible way for the provider to secure themselves sitting on the freaking floor. :angry: Are we seriously so unconcerned with preserving our lives in an accident that no one bats an eye to a company that is OK with sacrificing safety when there are (apparently) plenty of other ambulances around?

So there's no airway chair?

 

[jrm818]

While you can usually reach a patient in the stretcher from the airway chair, at least in the ambulances I've been in I don't think I can reach a patient on the bench. I've only been in a vanbulance a couple of times, and maybe you can reach in those, I can't claim any experience. I do think the reality is that most people will be on the floor either way.

 

[Shishkabob]

And who says the patient on the bench seat wouldn't be sitting down, seatbelted themselves, with you sitting next to them?

 

[JPINFV]

To clarify the originating facility, a "board and care" in California (also known as "group homes") is a care facility set up in a house that normally cares for patients more of an assisted living nature than skilled nursing. Even though there are usually no nurses on staff (patients shouldn't require nursing care past what can be provided by a visiting nurse), there should still be a medical packet with the pertinent information available. Similarly, I can see it being more common to have a husband and wife together in a group home than in other care facilities.

 

[Amycus]

To clarify the originating facility, a "board and care" in California (also known as "group homes") is a care facility set up in a house that normally cares for patients more of an assisted living nature than skilled nursing. Even though there are usually no nurses on staff (patients shouldn't require nursing care past what can be provided by a visiting nurse), there should still be a medical packet with the pertinent information available. Similarly, I can see it being more common to have a husband and wife together in a group home than in other care facilities.

Thanks for that clarification JPINFV.

 

[EMT11KDL]

This would be my major problem with taking 2 patients in a non-emergent setting. There is no possible way for the provider to secure themselves sitting on the freaking floor. :angry: Are we seriously so unconcerned with preserving our lives in an accident that no one bats an eye to a company that is OK with sacrificing safety when there are (apparently) plenty of other ambulances around?

So its ok to put our safety at risk in a emergency situation but not in a non emergent situation?

I know when I am transporting a patient, non emergent or emergent I am rarely secured in the back.

 

[Aidey]

The condition of the patients was not exaggerated, it was his real condition.

Systolic of 160 and pulse of 110 is squarely in the "meh" column. The diastolic of 100 is a bit concerning, but not a "this patient is going to die" thing. Similarly, what signs and symptoms were leading you to think that the other patient was at significant risk of crashing?

That was my point. His actual vitals may be legit, but unless you are leaving something significant out, he wasn't that sick.

 

[jrm818]

And who says the patient on the bench seat wouldn't be sitting down, seatbelted themselves, with you sitting next to them?

True, I assumed that both patients were going to be lying down, and that may not be the case. I think when you hit the level of acuity where you need no care and can sit up then an ambulance may not be the best use of resources, but thats a separate issue....

That said, I think I have a problem with a patient secured only by a lap belt sitting sideways (or even in the airway chair, although that's a bit safer). I don't like that as employees we have to sit like that, but I'm not OK with putting a patient into that situation, probably without their even realizing the risks.

Obviously this isn't the case everywhere, but where I've worked in the past it's been against policy to have a patient anywhere but in the stretcher with all straps in such a way to prevent movement in all three planes. I like that policy.

 

[JPINFV]

Obviously this isn't the case everywhere, but where I've worked in the past it's been against policy to have a patient anywhere but in the stretcher with all straps in such a way to prevent movement in all three planes. I like that policy.

[sarcasm]Hehe, you'll be pleased to know that, at least when I was working in LA and OC, most ambulances weren't outfitted with shoulder straps.[/sarcasm]

 

[EMS49393]

I worked in an urban arena for a few years and we transported multiple patients often out of need. I'm not waiting around for 20 or more minutes for another ambulance to come available when I could have long been to the ER.

The maximum amount of patients I've transported at once was five. One on the stretcher, three on the bench, one in the captains chair. I wedged myself down in the door well during transport. The ER was five minutes away and they were all walking wounded pre-litigation examination patients. I'm not taking another ambulance out of service for that when there could be a chance they are truly needed and the only unit available.

It's not a violation. You really need to read the law and take the training again so you understand the HIPAA laws and regulations.

 

[jrm818]

So its ok to put our safety at risk in a emergency situation but not in a non emergent situation?

I know when I am transporting a patient, non emergent or emergent I am rarely secured in the back.

No, it's not "OK," but in non-ideal situations the reality is you do what needs to be done. However, if there is a way to avoid multiple pt. transport, I think it should be avoided. If you're in the sticks with no other ambulances, then you may be stuck.

There is a possible justification for being a bit more risk tolerant during a single emergent situation....not so much for a systematic allowance of exposure risk simply to get grandma nunu and papa jack to the doctors without taking more than one crew out of service for dialysis runs.

Personally I'd much much rather see us go to forward facing crew seats with only room for one patient, but that's not reality in most places.

 

[jrm818]

[sarcasm]Hehe, you'll be pleased to know that, at least when I was working in LA and OC, most ambulances weren't outfitted with shoulder straps.[/sarcasm]

lovely. I can't imagine why you chose a different career path.....

 

[JPINFV]

lovely. I can't imagine why you chose a different career path.....

Multiple reasons, but that honestly wasn't one of them.

 

[jrm818]

Multiple reasons, but that honestly wasn't one of them.

Admissions: So JPINFV, tell me a bit about yourself. What motivated you to dedicate the next decade of your life in rigorous training 1000 hours a week without ever seeing the sunlight just to become a highly trained and deeply in debt new doctor who will be compensated at pennies on the dollar and lectured about medicine by a bunch of government bureaucrats.

JP: Well, I heard you guys had some of the best shoulder straps around and...well....that if I work real real hard I might even be able to pick out the color next time you buy new ones...sir.