# Ruined by IFT - Three 911 Pts; One Answer?



## SurfEMT (Feb 23, 2014)

I recently took a pre-employement test for a 911 provider and, because I've been doing IFT's for so long, my brain was unable to correctly answer questions about field protocols in the 911 universe. One question I got wrong was one I thought I got RIGHT:

"You and your partner get on scene of a traffic accident, and there are three patients who have noticeable minor facial injuries. Two patients refuse treatment, but the third lets you treat him. What do you do?"

One of the possible answers was to "have your partner get [AMA] releases from the other two, while you treat the third patient." Which is the answer I picked.

The other was to "treat all three, and ignore the two patients protests." And I don't recall the third and fourth possible answers. 

So based on California, LA County, protocols of 911 EMS what would you do? Does the fact they are facial injuries (but minor) make the answer different? I thought it was an attempt at misdirection. 

Thoughts? Thanks.


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## LACoGurneyjockey (Feb 23, 2014)

I'd do a more thorough assessment of the other two, and rule out any further injuries other than their apparent minor facial injuries. Can't just AMA them and have them walk off without a further assessment, can't treat them anyway and ignore their protests. But usually with good people skills and persuasion you can convince them to allow a more complete assessment, if you clearly explain the realistic worst-case scenario, etc. If you find anything else, try to convince them to let you treat and transport, if not then you can have them sign AMA with a better chance it doesn't come back to bite you.


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## chaz90 (Feb 23, 2014)

Eh. If you get on scene to find two people with minor facial lacs from an MVA who did not call EMS and don't want to be evaluated, they're not patients. Really no different than if you drive by a PD only accident and try to spring into action and backboard everyone who witnessed it. You don't have to get a refusal on a patient unless they were a patient in the first place. Clearly these definitions will vary, but unless they were actually evaluated for some reason I don't go throwing refusals around.


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## exodus (Feb 23, 2014)

It's probably for a private company so you tell them they might die and that they need to listen to the scientific validity of your poke test and that they shouldn't doubt your knowledge because you went to one semester of EMT school so they really need to go. And by helicopter.


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## chaz90 (Feb 23, 2014)

exodus said:


> It's probably for a private company so you tell them they might die and that they need to listen to the scientific validity of your poke test and that they shouldn't doubt your knowledge because you went to one semester of EMT school so they really need to go. And by helicopter.



My freshly laminated "Not a Doctor" card says I can.


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## exodus (Feb 23, 2014)

chaz90 said:


> My freshly laminated "Not a Doctor" card says I can.



Trust me, I'm like basically a doctor. We do everything they do, but doing 75MPH backwards in the snow, and then sometimes on the roof too.


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## mycrofft (Feb 23, 2014)

exodus said:


> Trust me, I'm like basically a doctor. We do everything they do, but doing 75MPH backwards in the snow, and then sometimes on the roof too.



Don't get me started.(The "Ginger Rogers description of EMS*).


OP, I don't know how we can answer your question without giving you the answer to the test, and we don't know the test. In real life, the answer would be more complex and fluid theory time (patients change their minds, or you can persuade them to at least get assessed). 

One person treating while the other talks to the others and documents is what I'd want done on my rig, as long as scene safety is preserved.


*Ginger Rogers had to dance as well as Fred Astair, but in highheels and backwards while in a long tight dress.


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