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Patient Question

Discussion in 'Did That Just Happen?' started by daveg, Feb 6, 2008.

  1. daveg

    daveg New Member

    Hello, I am not a paramedic, so i apologize in advance for writing on your forum but it seemed like the only place to have my question answered accurately.

    I am a 17 year old high school student and feel as though I was mistreated and almost abused by paramedics, I'm just wondering if what they did to me is standard protocol or malpractice.

    here is my story...

    I was is class when I suddenly had a seizure. I ended up falling and cutting my head pretty bad and briefly losing consciousness. When I regained consciousness the school nurse and principal were treating me, minutes later paramedics arrived. The paramedics stethed my chest, then put both a neck brace and oxygen mask on me. They then began cutting off my clothing, they cut away my shirt, pants and uderwear. They even removed my shoes and socks. I uderstand that sometimes clothig needs to be removed, but I was fully conscious and able to move all my limbs, and to top it off my school nurse and principal were still in the room. They then strapped me to a backboard and didn't cover me up until they lifted me up onto the stretcher.

    Once i was in the ambulance, the paramedic removed my covers again she gave me a full pysical workup including a pelvic, is this at all needed? She didn't cover me up untill we arrived at the e.r.

    Im not an expert, from what I have read there was no need for all of that to be done, I'm hoping that some of you REAL paramedics can give me insight into whether or not this is proper procedure.

    Thanks for your time.
    Please post back or e-mail me
    Last edited by a moderator: Feb 6, 2008
  2. Emt /b/

    Emt /b/ New Member

    Location:
    Lynn, MA
    EMS Training:
    EMT-Basic
    Yeah...there was really no need to cut off all of your clothes. Or any of them, really.
  3. RavenMaster

    RavenMaster New Member

    Location:
    Santa Barbara, CA
    yeah, i cannot see just cause for that.
  4. TheMowingMonk

    TheMowingMonk New Member

    Location:
    SF Bay Area
    EMS Training:
    EMT-Paramedic
    yeah unless you had some bleeding or tenderness in other areas, they really didnt need to cut you clothes off, c-collar and O2 were find cause you fell and hit your head, but it does seem like them cutting off all your clothes was excessive, specially the underwear, most of the time its a last resort to remove that unless the injury directly affects it.
  5. seanm028

    seanm028 New Member

    Location:
    Arizona
    Do you know if they were EMT-B (Basics) or EMT-Ps (Paramedics)? If you don't know for sure, do you remember if one of them started an IV? Did they put you on a heart monitor?

    I can understand cutting off a shirt, but I'm not positive about the rest. On the other hand, they were probably just trying to be thorough, and they might have had some reason (unknown to you) to suspect further injury. I would like to give them the benefit of the doubt, especially because it can be a little intimidating (especially for a new EMT-Basic) to be making instant decisions that can have huge ramifications.
  6. JPINFV

    JPINFV Gadfly

    Location:
    404: No Meme Found
    I'll second the "cutting off the clothes was not needed" crowd. There probably are cases, though, where new EMTs (B or P) take the "expose" part of the trauma assessment too far.

    Either this thread is a troll and full of BS or there's an EMT someplace that needs to be in jail. To the best of my knowledge, pelvic exams are not taught at any level of EMS and have no use in the prehospital environment.
  7. bstone

    bstone New Member

    Location:
    Cambridge, MA
    EMS Training:
    EMT-Intermediate
    Jail???

    Perhaps she wantes to visualize any injuries. I have never cut away the clothing of any seizure paitients unless there has been tenderness, deformity, bleeding, etc . Perhaps it's their protocols? No harm in being extra careful.

    Surely there was no criminal intent. Why the rush to judgement?
  8. VentMedic

    VentMedic New Member

    How does a male(?) 17 y/o non-medical person define "a pelvic"?

    Do you have a history of seizures?

    Do those around you know you have seizures?

    Do you wear any type of medical alert ID?

    How did the call did phoned in as?

    What did the witnesses say that might suspect other injuries?

    Did they check for signs of a spinal injury by check sensation, movement and asking questions along that line?

    What type of furniture was around you when you fell?

    Since none of us were at the scene with you it is hard to second guess what another medical professional is thinking or seeing when they assessed the area around you. It is also always bad to take a bleeding patient to the ED and find that the obvious injury was a distraction from another injury.

    I see you are posting this on different forums. Is there more to this than curiosity? Do you have any interest in pursuing this further?
  9. TheMowingMonk

    TheMowingMonk New Member

    Location:
    SF Bay Area
    EMS Training:
    EMT-Paramedic
    yeah im feeling the Pelvic exam might just be checking for tenderness, he might be thinking of a pelvic exam like a doctor does and think its the same thing. What did they do for this pelvic exam?
  10. *ofLife

    *ofLife New Member

    Location:
    Madison-ish, WI
    Hmm...

    I am also a 17 year old female from Wisconsin. After being involved in several serious accidents, I decided that being an EMT was my calling and will be attending EMT-B training this summer.

    One of my many terrible experiences was being involved in a head-on collision on a busy county road. A female not much older than myself who was under the influence of some OTC drugs, crossed the centerline and collided with my vehicle going a little under 60 mph.

    My ankle was crushed into over a hundred pieces (my foot was on the break when we collided), the skin on my knee was basically cauterized, and my wrist was dislocated from the air bag.

    The EMTs were from my home town, and I knew half of them on a first name basis, and trusted them with my life. They also stripped me of all my clothing in the middle of the hospital and left me that way for quite some time before finally covering me with a thin sheet. Though I understand it may have been much more appropriate in my situation, I was caught off guard as well, but just happy to be okay and appreciated their help and concern.

    Was it a necessary act? Probably not. But it can be justified. The important thing is that you're okay, and I'm sure your well-being is the only thing that remains on the mind's of the individuals that may have gotten a glimpse of your bare-ness.

    I hope that helps ;)
    Don't hesitate to message me if you have any questions about my experience(s)
  11. Asclepius

    Asclepius New Member

    EMS Training:
    EMT-Paramedic
    Sounds like they did their job and was being thorough. You had a seizure and hit your head and lost consciousness. The paramedic or emt has no way of knowing the full extent of your injuries unless they expose. A = Airway, B = Breathing, C = Circulation & C-spine, D = Deformity, and E = Expose.

    It's never fun to have your body exposed, but sometimes it is necessary to discover injuries you may not even have been aware of having. Sounds like to me you're very lucky for having had such a good team. Also, not covering you until they lifted you up to the stretcher is not uncommon. Having the sheet getting tangled up in the process of moving can be an issue sometimes.

    See, the flip side of this is that if they didn't do a thorough examination and because of that missed something...then they face the wrath of the angry patient or medical director. Having lost consciousness after having struck your head is good cause to believe that you may have an injury that you're not even aware of.

    As for the pelvic exam...we are, in fact, taught that part of the assessment is to visually inspect the genitalia. If that is all that happened, than that is not out of the norm. However, if they did a gynecological pelvic exam, then you were indeed violated.
  12. EMT19053

    EMT19053 New Member

    Location:
    south dakota
    EMS Training:
    EMT-Basic
    In a trauma situation the clothes are usually cut off at the scene to allow a visual of dcap-btls during the rapid trauma assessment. For a seizure I would not have cut the clothes off unless the patient complained of pain in a certain area. A fall from a standing position or sitting in a chair is not a significant mechanism of injury to be deemed a "trauma" even though you can sustain an injury. I was taught to respect the patient's privacy by keeping them covered.
  13. firecoins

    firecoins IFT Puppet

    Location:
    Nyack, NY
    what are you talking about? We certainly are trained to check for pelvic fractures and look for signs and symptons on internal bleeding into the pelvis are. This may or may not have bneen appropriate for the original post but it is certainly in the training.
  14. Asclepius

    Asclepius New Member

    EMS Training:
    EMT-Paramedic
    It is indeed a significant MOI...especially since the patient lost consciousness as a result of it. Sometimes removing clothing is appropriate even outside a multi-system trauma. I wasn't there, so I don't know. But so far, nothing sounds like it was that far from the norm.
  15. bstone

    bstone New Member

    Location:
    Cambridge, MA
    EMS Training:
    EMT-Intermediate
    Checking pelvic stability and visualizing genetalia are standard parts of a trauma assessment. People can die from pelvic fractures.
  16. Ridryder911

    Ridryder911 EMS Guru

    Okay, let's use something called common sense. Do you actually think you will find a pelvic fracture or abdominal evisceration on a seizure call? Ever heard of medical examination versus trauma?

    Now, if this a combination or a trauma induced seizure I could understand.

    Since I was not there I believe the post to be a little vague and question the integrity of the initial poster.

    Do I strip every seizure patient...NO. There is no reason to. Do I toally strip chest pain or diabetic patients..on medical calls.. NO! Again, for what reason? Do I strip them if they have been involved in trauma? Yes! (again within reason).

    For those so big on stripping patients, (in which I for on true trauma patients, do you really assess all the lower quadrants as well as the symphysis pubis.. probably not.

    So strip when appropriate and need be. For as checking for pelvis? Why if the patient was conscious and denying pain. From what I have seen most pelvic fractures are symptomatic and will inform you if they are hurting in that area. Since pelvic fractures are always symmetrical (never isolated).

    R/r 911
  17. Asclepius

    Asclepius New Member

    EMS Training:
    EMT-Paramedic
    I don't strip all of my patients either. However, I am saying that none of this seems to be malpractice. I, without having any other knowledge of this call, side with the medics on this. They likely had a good reason for performing a detailed assessment and then a detailed secondary assessment. I also believe in doing too much in caring for my patients as opposed to doing too little...again with in reason. It doesn't sound like the school nurse or principle saw anything that alarmed them, because if they had, I believe the poster would have added that to insight even more doubt in his care.
  18. VentMedic

    VentMedic New Member

    To those ASSUMING a trauma pelvic exam, the phrase "a pelvic" was used by a 17 y/o non-medical person which could be read as a genitalia exam or a pelvic fx exam.

    Patients also deny a lot of things if they were doing something they weren't supposed to be doing or if they are embarrassed by their medical condition especially as a teenager.

    Since the patient was in high school and 17 y/o, another adult who is a representative of the school should be present to provide information either for the school or who will contact the family. The nurse is the medical professional at the scene until the paramedics assume care.

    We also do not know the intent of the person posting this thread.
  19. Ridryder911

    Ridryder911 EMS Guru

    This was my main thinking too!..

    R/r 911
  20. JPINFV

    JPINFV Gadfly

    Location:
    404: No Meme Found
    Sorry people, but to me someone saying 'full medical exam including a pelvic' does not fully equate to my mind as 'checking for pelvic instability,' especially after a patient has been fully stripped. I won't rule out that I'm reading too far into it, but with how it was worded came across with giant red flags, shiny red lights, and noise makers.
    Last edited by a moderator: Feb 6, 2008

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