# Attending with Lights on (at night)



## DV_EMT (Oct 22, 2011)

Hi All,

It's been a while since I've posted as I've been super busy, but I'm back for a bit with a questions for all.

I recently started working for an IFT company in LA and there has been some instances where we get some late night calls and its needed to use the lights in back for assessing the patient. In the county I reside in, always uses light on while transporting, but is it always necessary?

So.....

Is it appropriate to just click the lights on in back an leave them on for the duration of the transport? or is it better to click them off so the patient can rest? is it better for the driver? What about HIPAA? Also, what about the use of a reading light/flashlight?


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## JPINFV (Oct 22, 2011)

HIPAA isn't an issue. 

Most patients aren't going to want or need to "rest" during transport, especially depending on the length of the transport.

Depending on the ambulance, you'll have options for which and how many lights are on in back.


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## Akulahawk (Oct 22, 2011)

For me, it's really simple, I use as much light as I need to get the job done. If that means that I turn off the white lights and use a blue or red light, then I'll do that. If I need to turn on all the interior lights, then I'll do that. Whenever I'm in the back with a patient at night, I always will have _a_ light on at all times. No patient? No need for a light back there...


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## Sasha (Oct 23, 2011)

I need the light to write my report. I'll dim them in the back but my handwriting isn't spectacular by itself. Add a moving truck in the dark its kind of crappy. 

Privacy really something that can be helped unless you're gonna cover them head to toe with a sheet the minute you leave the scene til you get them in their room.

Sent from LuLu using Tapatalk


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## MMiz (Oct 23, 2011)

The lights are always on in the back during the night, though often dimmed.  I can't remember a time anyone with the company transported with the lights off.  Even if you're doing an IFT, how would you assess a patient with the lights off?


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## STXmedic (Oct 23, 2011)

If there's a patient in the back, the fluorescents are on. The only exception is if the patient is photosensitive.


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## Shishkabob (Oct 23, 2011)

As far as HIPAA is concerned, it has nothing to do with it.  Still not comfortable?  Look up 'incidental exposures'.  


Personally during the day if it's light enough out I turn off some of the lights just because it's more comfortable lighting, not due to the patient sleeping.


During a 911 call / short distance transport the patient doesn't need to be sleeping anyhow.


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## JPINFV (Oct 23, 2011)

MMiz said:


> The lights are always on in the back during the night, though often dimmed.  I can't remember a time anyone with the company transported with the lights off.  Even if you're doing an IFT, how would you assess a patient with the lights off?



One time I just had the counter light on. This was a hospital to hospital transport, by patient request, and following assessment. The light gave me enough light to keep an eye on the patient.


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## Akulahawk (Oct 23, 2011)

JPINFV said:


> One time I just had the counter light on. This was a hospital to hospital transport, by patient request, and following assessment. The light gave me enough light to keep an eye on the patient.


I've never transported at night with the lights off. I do, however, use dimmer lighting options when possible if my patient wants to rest. I won't, however, start off with dim lighting. I put it on full bright to assess, get things situated, and the like. I pretty much also explain to the patient that I may have to use full lighting at times, but I'll warn first before turning them all on. Then I begin to adjust lighting to what's comfortable for the patient _and_ is what I need for monitoring the patient. Sometimes that means moving equipment around... Of course, having equipment that could be positioned almost anywhere was a bonus.


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## abckidsmom (Oct 23, 2011)

JPINFV said:


> One time I just had the counter light on. This was a hospital to hospital transport, by patient request, and following assessment. The light gave me enough light to keep an eye on the patient.



I usually get all my work done, IV, meds, etc, then just leave the counter light on.  This is how we worked in the hospital, too.  The main ER we transport to keeps its lights dimmed at night too.


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## Tigger (Oct 23, 2011)

I turn the interior lights on when I get out of the truck so it's easier to load the patient/climb in. Once I've finished my assessment I usually just ask the patient if they want lights out. If they do, the counter light is bright enough for writing the PCR.


Sent from my out of area communications device.


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## mycrofft (Oct 23, 2011)

*As much light as you need for job and safety.*

It will be inexcusable to miss something because you were "trying to let the pt rest".
(gavel)"BAM, fifty years"...


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## usalsfyre (Oct 23, 2011)

mycrofft said:


> It will be inexcusable to miss something because you were "trying to let the pt rest".
> (gavel)"BAM, fifty years"...



Let's be realistic, assuming you do a GOOD assessment and continually monitor the patient how likely are you to "miss" something because the lights are dimmed? Most of the time if your surprised by a patient deterioration you overlooked something anyway.


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## exodus (Oct 23, 2011)

I transported all of my IFT 5150's to the psych facility with the lights off when I worked nights. This allowed them to stay asleep the whole time making it safer for me and them.


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## Sasha (Oct 23, 2011)

exodus said:


> I transported all of my IFT 5150's to the psych facility with the lights off when I worked nights. This allowed them to stay asleep the whole time making it safer for me and them.



I would NEVER EVER make it to where I couldn't clearly see a psych patient. They are tricksy little :censored::censored::censored::censored::censored::censored::censored:s.


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## exodus (Oct 23, 2011)

Sasha said:


> I would NEVER EVER make it to where I couldn't clearly see a psych patient. They are tricksy little :censored::censored::censored::censored::censored::censored::censored:s.



Policy required all 5150's to be restrained to the side of the gurney and from the captains chair, I could see both restraints and hand at all times. So all good


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## mycrofft (Oct 24, 2011)

*Leaking IV, and, yes, missed eval points...*

Like posterior incision or stab that clapped shut and didn't start bleeding until the Ringer's stated in.


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## usalsfyre (Oct 24, 2011)

There's a difference between the unstable/potentially unstable patient and taking grandma back to the SNF after being discharged from the ED.


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## mycrofft (Oct 24, 2011)

*Ok*

Point taken, a judgment call.


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## firecoins (Oct 25, 2011)

Stable dialysis patients, discharges to snf and similiar non emergencies are my call. ER trips ihave some light on. 


---
I am here: http://maps.google.com/maps?ll=41.071848,-73.922635


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## lawndartcatcher (Oct 26, 2011)

And of course no patient would ever accuse you of getting up to any hanky-panky with the lights off back there? Doesn't matter if they can't prove it; damage is done once they scream "j'accuse!".

In that situation, would you _really_ want to have to answer the question, "Why were the lights turned off in the back of your rig if you were both in there?"


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## akflightmedic (Oct 26, 2011)

All of the ambulances I worked in had tinted windows, so there was never a privacy issue concern. Family and bystanders could not see in when on scene, drivers behind you could not see in, it was a very nice feature.

During transport, lights always stay on. They can rest when they get to wherever we are going. There are two options, one bright and one dim, but whichever is chosen, they stay on.

By keeping lights on at all times it reduces many potential negative situations, some already listed.


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## rescuepoppy (Oct 26, 2011)

exodus said:


> I transported all of my IFT 5150's to the psych facility with the lights off when I worked nights. This allowed them to stay asleep the whole time making it safer for me and them.



   Asleep,restrained or not never ever underestimate what a psych patient is capable of. You could find they are very clever in ways to slip out of restraints. also one of the fastest to yell they have been abused in one way or the other. Better to leave lights on than to have to explain. Just to add in most cases if a patient is deemed as a risk for self injury inside a facility they are required to have lights on wherever they are 24-7.


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## DV_EMT (Oct 27, 2011)

Thanks everyone for you're responses. 

I know that on our rigs, there isn't really a "dimmed light" except for low vs high. On one of them, we have a "less bright" interior light that I use so it's not directly in the patients eyes which is more convienient for the patient and It allows me to assess the patient. I also have my trusty mini mag which is bright as all getout if worse comes to worse.


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