# Responding to your own sons emergency. Could you?



## EMTIsee (Oct 28, 2014)

This story blew me away.Threw discussion today, I learned from the EMS chief's daughter "EMT-I", and granddaughter. That the EMS Chief " Responded to a drowning of a teenage boy. She found it was her own son, as I was told she worked him all the way to the hospital, doing all things possible. He lived and is still alive to this day. I am unsure of exact details; nor did I ask. The only other details I know is it was some time ago in the early 80's I thought I would share this amazing story.


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## MonkeyArrow (Oct 28, 2014)

I know that is it unethical to do so. A provider's judgement would be impaired and [he] would not be able to make the right decisions in a situation like this.


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## STXmedic (Oct 28, 2014)

MonkeyArrow said:


> I know that is it unethical to do so. A provider's judgement would be impaired and [he] would not be able to make the right decisions in a situation like this.


Yeah, good luck keeping me from treating my son.

I know of two similar situations. Two years ago, one of my coworkers responded to an MVC. When he got there, his 19yo son was one of two involved (the other was DOA). He treated his son on the way to the ED, but his son ended up being pronounced in the ED.

The other incident was one of the ED docs my brother works for. EMS brought in a 20 or 21 year old cardiac arrest drowning patient. Ended up being the doc's son. He pronounced his son after 20min.


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## MonkeyArrow (Oct 28, 2014)

STXmedic said:


> Yeah, good luck keeping me from treating my son.
> 
> I know of two similar situations. Two years ago, one of my coworkers responded to an MVC. When he got there, his 19yo son was one of two involved (the other was DOA). He treated his son on the way to the ED, but his son ended up being pronounced in the ED.
> 
> The other incident was one of the ED docs my brother works for. EMS brought in a 20 or 21 year old cardiac arrest drowning patient. Ended up being the doc's son. He pronounced his son after 20min.


That's the problem with treating family members. Sure, when you are the only one there, treat your son. When EMS comes, hand over care. You're not going to make the right decisions. You're going to give the wrong medications or work it for too long or break protocol.


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## EMTIsee (Oct 28, 2014)

MonkeyArrow said:


> That's the problem with treating family members. Sure, when you are the only one there, treat your son. When EMS comes, hand over care. You're not going to make the right decisions. You're going to give the wrong medications or work it for too long or break protocol.



Also the lasting emotional damage.


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## STXmedic (Oct 28, 2014)

MonkeyArrow said:


> That's the problem with treating family members. Sure, when you are the only one there, treat your son. When EMS comes, hand over care. You're not going to make the right decisions. You're going to give the wrong medications or work it for too long or break protocol.


That's a lot of assumptions you're making. Having had to treat my own wife for a medical emergency she experienced while we were at home (albeit not a cardiac arrest), I can personally attest that that blanket statement has no bearing. If you feel that you personally couldn't handle the stress of treating a loved one, then don't. Don't paint everybody with your own personal brush, though. Some of us actually handle stress well.


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## STXmedic (Oct 28, 2014)

EMTIsee said:


> Also the lasting emotional damage.


What about the lasting emotional damage of _not_ treating. If the outcome was poor, and I had let some other medic assume care, I would spend the rest of my life dwelling on the possibility that I would've done something different/better and the outcome would have changed.


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## teedubbyaw (Oct 28, 2014)

Pfft I couldn't even deal with my dying dog.


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## MonkeyArrow (Oct 28, 2014)

Summarizes my thoughts in a nutshell. I don't think you could classify the AMA as "your [my] own personal brush". http://www.ama-assn.org/ama/pub/phy...l-ethics/code-medical-ethics/opinion819.page?
You know, there is this branch of study called medical ethics. It's kinda important to the whole first, do no harm mantra et al.

Could you deal with the fact that *you* made a mistake while treating a family member because you had clouded judgement (as opposed to handing over care)? Having a family member die is a traumatic experience. You will nitpick any decision that you make. Did I do everything right? Should I have just handed over care? Should I have stayed with my son today because of that gut feeling I had?


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## STXmedic (Oct 28, 2014)

Thank you, I've never heard of this medical ethics thing. I appreciate you learning me and my unedumacated self.

"May" is the key phrase in that entire article. As I stated previously, I'd like to see you try to prevent me from treating my son or wife. Good luck- you'd better have PD already on scene with you. And considering my partner isn't going to call PD on me, that won't be the case.


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## MonkeyArrow (Oct 28, 2014)

Did I hurt your feelings? I do truly apologize for my use of the words "You know, there is this branch of study called medical ethics." 
And no, this is the key phrase in the article. Independent of whether your judgement is clouded or better than its ever been, this is the AMA's official opinion on the matter. 





> In emergency settings or isolated settings where there is no other qualified physician available, physicians should not hesitate to treat themselves or family members *until another physician becomes available*.


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## STXmedic (Oct 28, 2014)

MonkeyArrow said:


> Did I hurt your feelings? I do truly apologize for my use of the words "You know, there is this branch of study called medical ethics."
> And no, this is the key phrase in the article. Independent of whether your judgement is clouded or better than its ever been, this is the AMA's official opinion on the matter.


Yes, my feelings are crushed right now. Thanks. 

And when a physician is available, they had damn well better take over. I'm certainly not going to stand in the way of the ED doc. Before we get to the hospital, though, they're going to be in my hands.


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## EMTIsee (Oct 28, 2014)

STXmedic said:


> Yes, my feelings are crushed right now. Thanks.
> 
> And when a physician is available, they had damn well better take over. I'm certainly not going to stand in the way of the ED doc. Before we get to the hospital, though, they're going to be in my hands.



I'm unclear what you are both getting at. What is the finial call to help or to not help? Both of you have well backed opinions.


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## STXmedic (Oct 28, 2014)

EMTIsee said:


> I'm unclear what you are both getting at. What is the finial call to help or to not help? Both of you have well backed opinions.


My opinion: If I respond to a call, and it ends up being a family member that's critically sick/injured, I will be the one to assume patient care on the way to the hospital. 

Monkey seems to disagree, citing impaired judgement and poor ethics.

Final call is whatever you personally decide to do when put in that situation. It's going to be dependent on you and what you feel comfortable with.


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## DesertMedic66 (Oct 28, 2014)

If I get called to a 911 call there is a good chance I am going to be the only paramedic on scene. For my area the paramedic is the only one who can attend a 911 call. So I'm not really going to have a choice as to hand over treatment to someone else or call for another unit.


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## STXmedic (Oct 28, 2014)

DesertEMT66 said:


> If I get called to a 911 call there is a good chance I am going to be the only paramedic on scene. For my area the paramedic is the only one who can attend a 911 call. So I'm not really going to have a choice as to hand over treatment to someone else or call for another unit.


I always forget that single medics are more the norm than what I'm used to. Many of the 911 EMS systems around here run dual medics.


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## DesertMedic66 (Oct 28, 2014)

STXmedic said:


> I always forget that single medics are more the norm than what I'm used to. Many of the 911 EMS systems around here run dual medics.


We only have a handful of departments that are BLS so it doesn't happen too often but it's a possibility.


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## Tigger (Oct 28, 2014)

Saying that it "violates ethics" is not really accurate. To an extent we all make decisions based on our personal ethics and so long as it does not negatively impact patient care it is not a big deal.

Also note the last section of the link posted:



> would not always be inappropriate to undertake self-treatment or treatment of immediate family members. In emergency settings or isolated settings where there is no other qualified physician available, physicians should not hesitate to treat themselves or family members until another physician becomes available. In addition, while physicians should not serve as a primary or regular care provider for immediate family members, there are situations in which routine care is acceptable for short-term, minor problems. Except in emergencies, it is not appropriate for physicians to write prescriptions for controlled substances for themselves or immediate family members. (I, II, IV)
> 
> 
> 
> ...


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## joshrunkle35 (Oct 31, 2014)

MonkeyArrow said:


> That's the problem with treating family members. Sure, when you are the only one there, treat your son. When EMS comes, hand over care. You're not going to make the right decisions. You're going to give the wrong medications or work it for too long or break protocol.



Bear in mind that you "might" do those things, or that you "may" have a higher likelihood of making mistakes, but nothing is definite. Some people don't react the same way that others might. Also, bear in mind that the majority of the U.S.' EMS is volunteer, and that getting another responding unit may not be an option.

ETA: that being said, if you have the option of allowing someone else to take over at the same (or greater) provider level, then you should.


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## Angel (Oct 31, 2014)

easy, dont work where you/close family members live...
my system is also BLS fire, and medic/emt so...calls mine either way.


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## cruiseforever (Oct 31, 2014)

MonkeyArrow said:


> That's the problem with treating family members. Sure, when you are the only one there, treat your son. When EMS comes, hand over care. You're not going to make the right decisions. You're going to give the wrong medications or work it for too long or break protocol.


 
It's not that rare in rural areas.  Treated a couple of family members and close friends.  I was part of the EMS crew.  What should I do call for another ambulance that is over an hour away, while the hospital is 30 minutes.


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## johnrsemt (Nov 11, 2014)

Change the question around:  could you NOT treat your family member in an emergency?


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## lifeway (Nov 21, 2014)

johnrsemt said:


> Change the question around:  could you NOT treat your family member in an emergency?


 I completely agree with you. Being an EMT and having that training has allowed me to assist my family and friends on multiple occasions.


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## doc610 (Nov 23, 2014)

I feel that it really depends on the person. A person who took an EMT course just for college credits/ had nothing else to do would be of little help in an actual emergency. However, a good EMT or Paramedic with a fair amount of field of experience would probably be able to keep their cool to a certain degree and be able to help their loved one.


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## DrParasite (Nov 23, 2014)

Would I want to?  no.... could I?  sure.  

would I turn them over to another crew to treat?  absolutely.  would I leave their side before they made it to the ER, especially if it was a crew I didn't know or trust?  probably not.


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## johnrsemt (Nov 24, 2014)

IF you were the first crew in,  or first provider to the scene or first ALS; and it was a family member; you don't get a choice till help shows up.  Can't let them die, "Because it is my son".


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## Handsome Robb (Nov 24, 2014)

I'm with @STXmedic on this one. 

Over my dead body would I let someone else care for my loved one, especially knowing the standard for the majority of EMS providers in this country.


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## Carlos Danger (Nov 26, 2014)

Interesting topic. I know in rural areas it's not at all unheard of for this to happen.

Assuming we are talking about a critical situation and assuming we aren't the only person around who can provide treatment, I think it's clearly best avoided, personally. 

This is the type of stress that is well known to decrease cognitive function and performance substantially. Memory doesn't work as well, we are more likely to make mistakes or forget something important, we fumble with things we are normally smooth at. Same exact reason that protocols and checklists are becoming more commonplace in EM and anesthesia. 

I imagine that I would *probably* perform just fine in this scenario, but I can't count on it. I wouldn't want to take the chance. Let someone else handle it who doesn't have the emotional investment that I do.


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## MonkeyArrow (Nov 26, 2014)

^^^^^^Exactly what I was trying to say in my earlier posts more eloquently worded.


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## EMT11KDL (Nov 26, 2014)

Just to add my 2 cents, Could I treat a family member, YES, would I want to in a critical situation, NO.  But I do have a job to do, and if I am the highest level of care on scene, than it is my job to treat until I either get relieved by someone at my level or higher, or Hand off to the ER.  If you are in a system that allows another unit to come take the call, or if you have a field supervisor in a sprint unit, than Ill let that unit treat, and I will have to become a family member and not participate.  It might kill me not being able to help, but I know that my judgement would be impaired.


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## RocketMedic (Dec 6, 2014)

I saw a comment earlier regarding "breaking protocol". I find it laughable that a protocol that I and my family know to be detrimental or ineffective would be followed in the care of my family member. Running a family member may be dangerous to employment depending on what's wrong with them, but the medical care would be stellar.


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## johnrsemt (Dec 8, 2014)

I have never seen a protocol or SOP that makes "it dangerous to your employment" to treat a patient.   and that is exactly what the situation would be  A PATIENT.  Doesn't matter if it is family or not;  it is your patient.


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## Joey DeMartino (Dec 27, 2014)

I can honestly say that I am closer to the members of my crew and have a stronger love for them than any of my natural family members. This was/is often the case in the military, law enforcement, even ems and many other occupations where we develop a strong bond through adversity and trial by fire. For me there is a sort of toggle switch that may be a natural-not too sure- (gift?) that literally shunts that emotion of fear of failing from my immediate existence.   This "toggle" seems to be there to provide the best care possible for my "loved ones" as if they were total strangers.  I feel much more confident not passing care on unless I am sure the medic / doc etc. has not only the experience/expertise  but the tools and meds available and is not afraid to use them. Often I don't have that option.    I prefer to stay on board to assist- and I do so when possible- but it's an eerie feeling watching from the tail rotor or tail light (respectively) end as you stand up, and begin cleaning up the remnants of the last incident.  I don't consider the likelihoods of possibilities of dangers due to emotional ties - I'm usually too busy.    But a mom working on her son?  I guess she gave him life and she'll be damned if she lets it be taken away.    The ultimate in patient care.


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## Rin (Jan 5, 2015)

Parents take care of their children through all sorts of injuries and ailments.  What parent has never seen their child bleeding or unconscious, in respiratory distress, or wailing with an injury?  I think it's reaching to say a parent can't remain calm and treat their child.  Parents get a lot of practice putting aside their emotions in the midst of chaos and focusing on what's best for their child.


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## Calico (Jan 6, 2015)

Around here, everyone pretty much knows everyone and who they're related to and where they live, so if a call came through that someone's kid was having a life-threatening emergency, they would generally try to swap out medics before even leaving the station, or just letting it go to city/metro and eat the consequences later.  Of course this posed a problem once when the victim of a car accident was a friend of the entire station (had to call in a station from the next county to take care of it).

Now if someone's kid broke their leg at school and we got paged out, yeah, so what?  Mama's gonna break the other one, too, when she takes him home.

My husband and I don't have kids, but I did end up taking care of him when he got run over by a tractor until help arrived.  Nothing serious, thankfully, and he'd pretty well already recovered from shock and his altered mental status by the time help got there.


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## Giant81 (Jan 6, 2015)

You have to think, I live in a very small community (1 rig, 500 people) and our RS responds to a very large area (amy other communities around only have first responders with not transport capability so we are their ALS/transport).  Couple that with everyone knows everyone + accidents happen < 20mi from home, and chances are if there is a 1050, someone knows them.


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## DesertMedic66 (Jan 7, 2015)

Calico said:


> Around here, everyone pretty much knows everyone and who they're related to and where they live, so if a call came through that someone's kid was having a life-threatening emergency, they would generally try to swap out medics before even leaving the station, or just letting it go to city/metro and eat the consequences later.  Of course this posed a problem once when the victim of a car accident was a friend of the entire station (had to call in a station from the next county to take care of it).
> 
> Now if someone's kid broke their leg at school and we got paged out, yeah, so what?  Mama's gonna break the other one, too, when she takes him home.
> 
> My husband and I don't have kids, but I did end up taking care of him when he got run over by a tractor until help arrived.  Nothing serious, thankfully, and he'd pretty well already recovered from shock and his altered mental status by the time help got there.


Wait, so for serious conditions and car accidents where people you know are involved you guys will not respond and will have a unit from further away respond? That sounds safe..


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## Calico (Jan 7, 2015)

DesertEMT66 said:


> Wait, so for serious conditions and car accidents where people you know are involved you guys will not respond and will have a unit from further away respond? That sounds safe..



There was a huge debate on policy afterwards regarding safety vs. trauma.  Do we force the guys to pull out a body of one of their closest friends (who I believe was either a former firefighter of the station or a station we usually work with) or call it on scene and stick to traffic control and get them into debrief until help arrives? (And for the record, we're only about three miles from the county line, and it might be another two to the station that responded).


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## DesertMedic66 (Jan 7, 2015)

Calico said:


> There was a huge debate on policy afterwards regarding safety vs. trauma.  Do we force the guys to pull out a body of one of their closest friends (who I believe was either a former firefighter of the station or a station we usually work with) or call it on scene and stick to traffic control and get them into debrief until help arrives? (And for the record, we're only about three miles from the county line, and it might be another two to the station that responded).


How about a debate on safety vs. trauma vs. patient care. 5 miles can make the difference between life and death for critical patients (i.e. major bleeding, resp arrest, cardiac arrest, etc).


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## Calico (Jan 7, 2015)

Self, partner, patient.  If you can't do the job, step aside for someone who can.  A bumbling medic is worse than a level-headed EMR.


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## DesertMedic66 (Jan 7, 2015)

Calico said:


> Self, partner, patient.  If you can't do the job, step aside for someone who can.  A bumbling medic is worse than a level-headed EMR.


Until it comes down to lawsuits about why the closest capable unit was not sent to a patient that they can handle. If someone is to the point of not running a call on someone they know they should not be working anywhere near where they or family live.

A level headed EMR isn't going to be able to do anything for the severe anaphylaxis who you can't ventilate with a BVM..
or the hypoglycemic unresponsive patient...


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## Tigger (Jan 7, 2015)

Calico said:


> Self, partner, patient.  If you can't do the job, step aside for someone who can.  A bumbling medic is worse than a level-headed EMR.


Errrr no.


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