# EMS and taking pictures of incidents...



## nomofica (Mar 18, 2009)

Not too long ago I witnessed an EMS personnel in my city taking pictures of the incident he responded to (car collision, one fatality) with his camera phone. Obviously it wasn't for "evidence", as it's not the EMS' job to collect evidence. I'm pretty sure he snapped a few shots of the casualty as well.

What are your thoughts/opinions on this?

Also, what are the "rules" for these sorts of things in your areas?


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## TheAfterAffect (Mar 18, 2009)

As long as there's no body in sight I don't see what the problem is, We get photographers all the time doing the same thing.


And yes, I mean that as no "Body" not Nobody.


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## nomofica (Mar 18, 2009)

Like I said, I'm pretty sure I saw him snap a few shots of the fatality. This is what I'm talking about.

Taking pictures of two smashed up cars is, well... whatever, who cares? But the body...?


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## artman17847 (Mar 18, 2009)

i have done it myself but only to document mech. of injury for the doc's to see. I would never think of taking a pic of a DOA.


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## Epi-do (Mar 18, 2009)

On EMS runs, I am typically too busy to be taking pictures.  However, I do take pictures at trainings, and if we are on a fire run, I tend to take pictures at those as well, unless there is a patient of some sort.  

I give the pictures to one of the officers at the department, and he uses some of them in the annual banquet video.  Other than that, they just get stored on a disc and are for my personal use, just like my family vacation pictures, or pictures of my son playing in the snow.  I do not typically post pictures of actual incidents from work to facebook, myspace, or anywhere else on the internet.  It isn't worth it to me to risk my job, or at the very least, having to answer an awfully large amount of questions to alot of people I would rather not be talking to.  On the very rare occassion that I do get a picture I want to share for whatever reason, I make darn sure there aren't any visable addresses, patients that can be identified, etc.


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## AJ Hidell (Mar 18, 2009)

As always, if you weren't taught to do something in EMT or Paramedic school, and if it is not in your job description, then you probably should not be doing it in the field.  That goes for photography.


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## nomofica (Mar 18, 2009)

AJ Hidell said:


> As always, if you weren't taught to do something in EMT or Paramedic school, and if it is not in your job description, then you probably should not be doing it in the field.  That goes for photography.



This is exactly what I was thinking when I saw it.


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## mycrofft (Mar 19, 2009)

*Apply Golden Rule*

and follow employers' rules too.


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## BLSBoy (Mar 19, 2009)

nomofica said:


> Not too long ago I witnessed an EMS personnel in my city taking pictures of the incident he responded to (car collision, one fatality) with his camera phone. Obviously it wasn't for "evidence", as it's not the EMS' job to collect evidence. I'm pretty sure he snapped a few shots of the casualty as well.
> 
> What are your thoughts/opinions on this?
> 
> Also, what are the "rules" for these sorts of things in your areas?



Do you KNOW what he was doing, and why?

Do not jump to conclusions without evidence to back it up.


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## flhtci01 (Mar 19, 2009)

Could he have been taking pictures to show the ER?  What one sees and what another one hears from the description may present with two different pictures.  We carry digital cameras on our rigs in order to grab a couple of quick shots for the ER if we think we need them. 

It can help with writing the report also.  I know of one instance where the person (my preceptor) took a picture of an auto after the pt had been extracted.  We were able to look at it and determine things like airbag deployment, etc.

Maybe he was doing the same.  He probably should not have used his personal phone to take pictures but if that was all he had?  He should delete them at the earliest opportunity.

Not saying it was right, just a possibility.


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## medicdan (Mar 19, 2009)

Consider doing a search, and you would see some of the below threads that discuss this issue:
http://www.emtlife.com/showthread.php?t=11520
http://www.emtlife.com/showthread.php?t=7658
http://www.emtlife.com/showthread.php?t=10554
http://www.emtlife.com/showthread.php?t=6213


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## medic417 (Mar 19, 2009)

As I am to lazy to search and see if I or someone else posted this here is my thoughts.  

If pictures were taken to be added to the report or to show the doctor the type of damage etc.  No problem.  Even if taken to be added into the training program no problem.  Many services will have a member do photos as part of the job.  

If taken to post on u-tube, idiot space, ugly face or any other site then they should be fired.


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## karaya (Mar 19, 2009)

Unless your employer has specific policies, guidelines, etc. as to the taking of scene photos, you shouldn't take one single image. Especially if you value your employment!

I've authored numerous articles on this very subject including one that appeared in the July 2008 issue of JEMS magazine.

http://www.jems.com/news_and_articles/articles/jems/3307/at_the_push_of_a_button.html

In my article, I cite three incidents in which EMT's and paramedic lost their jobs due to the furor that was created over their on scene photography. After making the attention of the media, EMS administrators and elected officials were quick to react and terminate the camera toting medics even though no privacy laws including HIPAA were violated. All three EMS providers failed to have any policy toward photo documenting incident scenes.

Here are a couple of JEMS.com articles as well:

http://www.jems.com/news_and_articles/articles/Missouri_EMT_Terminated_Over_Photos.html


http://www.jems.com/news_and_articles/articles/Anatomy_of_Florida_Photo_Controversy.html


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## JROD (Mar 19, 2009)

This just goes to show how bad things can get blown out of proportion. I don't condone taking pictures of fatalities, but properly documenting MOI is a part of the job. Its true that what someone sees and what someone hears is different. Snapping a photo to show the ER nurses or docs the MOI should be completely ok and acceptable even if its not taught in Paramedic or EMT school. Sometimes you need to think outside of the box to be a good medic. If you don't then you're just a cookbook medic, which isn't necessarily a good thing.


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## karaya (Mar 19, 2009)

JROD said:


> This just goes to show how bad things can get blown out of proportion. I don't condone taking pictures of fatalities, but properly documenting MOI is a part of the job. Its true that what someone sees and what someone hears is different. Snapping a photo to show the ER nurses or docs the MOI should be completely ok and acceptable even if its not taught in Paramedic or EMT school. Sometimes you need to think outside of the box to be a good medic. If you don't then you're just a cookbook medic, which isn't necessarily a good thing.


 
Your logic, although plausible in its intent, is exactly what is getting medics into trouble. If "documenting MOI is part of the job", then the EMS providers needs to put that in a policy format that clearly spells out just what MOI documentation will take place and the proper chain of custody of the images once they are produced. Lacking this, is a recipe for public embarrassment and destroyed careers.

It was interesting to me the amount of medics that I encountered that have used MOI documentation to justify taking the images; only to have the images still on their cell phone cameras several months or sometimes years later.

Was their intent _really_ MOI documentation?? I often wonder.


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## AJ Hidell (Mar 19, 2009)

JROD said:


> I don't condone taking pictures of fatalities, but properly documenting MOI is a part of the job. Its true that what someone sees and what someone hears is different. Snapping a photo to show the ER nurses or docs the MOI should be completely ok and acceptable even if its not taught in Paramedic or EMT school. Sometimes you need to think outside of the box to be a good medic. If you don't then you're just a cookbook medic, which isn't necessarily a good thing.


Your final sentence is the only thing you said that makes the slightest bit of sense.  And even that is a non-sequitor to the rest of your post.

What purpose does taking pictures of a DOS MOI serve?  Are you transporting them to the ER?

Thinking outside of the box is good.  Making up things as you go, with no intelligent consideration or evaluation of the ramifications, and with no regard for policy, is bad.


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## JROD (Mar 20, 2009)

well I wouldn't necessarily be transporting the DOA but I try to make it a regular occurance to transport any survivors. After all, some car accidents do sometimes on occasion have more than one person involved. This type of accident does happen all the time, wouldn't you agree????? Maybe a drunk driver killed a family while cruising down the road and due to the affects of the alcohol, he isn't reporting any serious pain or injuries. Now in this case, wouldn't you want to show the ER doc what kind of accident this really was? I think this may be a situation that a snapshot of the VEHICLES ONLY may be ok.

I appreciate the constructive criticism Mr. Hiddell, but please understand that I wouldn't document an MOI for a fatality who was the only driver involved. I know you were trying to make me look/sound stupid but your gonna have to try harder than that next time! lol

I also wanted to say that I do agree with Karaya that these photos should be dealt with in a professional manner. Taking pics to show your buddies after works is definately not the way to go.


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## reaper (Mar 20, 2009)

Should you not have a good working relationship with the ER Dr's, so they would believe what you tell them about the accident? I have never had a Dr. question me about the description of an mvc. Is it that bad in CA?


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## JROD (Mar 20, 2009)

actually more so with the RNs for some reason, they don't really like us medics out here. I don't recall ever having a problem with the docs.


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## Shishkabob (Mar 20, 2009)

Scene w/o pts= totally fine. 

Scene w/ pts= not fine. 

Don't know how it can be viewed any differently. If you have pts then do your job. But if there are none, and you don't have to do anything, snap away. 

I was at a call where a guy back his truck FULLY into a neighbors house. No injuries, no pts. We were just on stdby just incase an FF got a booboo. Guess what I did?  Snapped the giant truck in the house!!  So did the police, medics, and FFs with their own personal cameras.


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## nomofica (Mar 20, 2009)

Haha, this got a little more heated than intended.


No, you're right I don't have a full picture on the bigger picture of the events. Perhaps he was documenting for professional purposes (which I hope was the case). But still, in my mind, taking pictures of any pts is completely wrong. Especially when the pt has passed...

Thanks for the input, guys.


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## medicdan (Mar 20, 2009)

I'll drop in my $.02. If documenting MOI is the goal of the pictures, take a Polaroid (do they still exist?), attach it to the PCR, and make it a part of the ER chart. Then it stays a part of a protected chart, and it is the hospital's problem re: protection, and you dont hold on to a copy. 

If the goal is training, then the patient should not be identifiable. If possible, a release should be sought, and picture genuinely kept for ONLY official training use.

Really, how often are EMS personnel on scenes where there are no patients. Make that scenes where photographs are indicated. 

There is NO reason for EMTs or Paramedics to keep pictures of patients or scenes on their cell phones.


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## BossyCow (Mar 20, 2009)

MOI pictures need to be taken on agency equipment. NO PICTURES OF ANY KIND.. should ever be taken of actual incidents with personal cameras or cell phones. 

Worse case scenario...  your phone/camera is lost or stolen. What control do you then have over the distribution of that image? None.. however, you will still retain liability for the picture, because you are the one who took it. 

We have a very clear policy regarding pictures of scenes. Taking any personal pictures of any scene, call or drill is grounds for progressive discipline up to and including termination depending on the severity of the event.

People have been sued repeatedly over this. People have lost their jobs repeatedly over this. This is not a gray area as far as the liability goes.


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## EMTCLM (Mar 20, 2009)

AJ Hidell said:


> As always, if you weren't taught to do something in EMT or Paramedic school, and if it is not in your job description, then you probably should not be doing it in the field.  That goes for photography.



i wouldnt do that unless it was for eveidence, just out of respect and courtesy to the pt and the family


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## amberdt03 (Mar 20, 2009)

EMTCLM said:


> i wouldnt do that unless it was for eveidence, just out of respect and courtesy to the pt and the family



i've know quite a bit of people that have taken pics of car wrecks, only so they can show the Dr and nurses a better visual of what the scene looked like and once they were done, they deleted them, or at least said they did.


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## karaya (Mar 20, 2009)

EMTCLM said:


> i wouldnt do that unless it was for eveidence, just out of respect and courtesy to the pt and the family


 
You shouldn't do it at all unless your employer clearly outlines in a policy format that scene photography of any kind is within the scope of your employment.  Without any authorization from your employer, your best bet is to forget the MOI and evidence photography.


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## JROD (Mar 21, 2009)

As a part of this thread, I would like to ask how many of you are planning on going into the fire service???  

If you think properly documenting MOI (including pics when necessary) is wrong because its not outlined in your SOPs then why would you open a door for a woman, greet everyone you see on the street with the utmost respect, helping an old lady load her bags into her car, etc, etc...These may not be outlined in the SOPs word for word, but its common sense....if it needs to be done, then it better get done. Things like this occur every day in the standard EMS system,  but if they aren't outlines in the SOPs, then we shouldn't actually carry out these "procedures," right? I wouldn't want to get fired for opening the door wrong for an old lady...this may be blowing things out of proportion but i think this thread has reached this point...

I guess the whole "fire service" thing  applies to the "getting a cat out of a tree" scenario. Although you may not actually be getting a cat out of a tree, you might be asked by an old lady to do something just as ridiculous in your point of view...but if its not outlined in your SOPs, would you do it?


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## reaper (Mar 21, 2009)

Because none of your examples can be illegal! Try again and come up with better examples to make your argument.


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## JROD (Mar 21, 2009)

so what if i help an old lady with her grocery bags and accidently bump in to her while loading them...techincally thats battery...should I be sued?????? is this an "illegal" enough example??? I feel like the fact that you would even argue that these are legal actions and documenting MOI is illegal is retarded in itself.


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## reaper (Mar 21, 2009)

Well, considering that I have never had to take a photo to document MOI in 20 years, tells me that this is a none argument. You should be able to write a pcr that documents MOI. If you can not write it out, then you may need to learn how.

Taking a picture for training, is one thing. Taking to show the ED the wreck, is another. As I stated before, your ED's should be trusting what you tell them about an accident scene. If they are not, then you have more serious issues to deal with.


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## AJ Hidell (Mar 21, 2009)

JROD, If your fire department does not have written policies regarding treating the public with dignity and respect, ladder operations, and animal rescue, then your department sucks.  Poor examples.


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## JROD (Mar 21, 2009)

So your telling me that your department actually has SOPs for rescuing cats from trees???? In most big cities, thats considered animal control's job. If you actually have SOPs regarding that procedure, then your dept has way to much time on there hands...As for the other examples, I felt like this thread was becoming way too literal and needed to have some literal examples introduced. If you think this is wrong, then I appologize for disagreeing.


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## AJ Hidell (Mar 21, 2009)

JROD said:


> So your telling me that your department actually has SOPs for rescuing cats from trees????


I have been a firefighter with two professional departments and yes, both had written policies regarding animal rescue, as well as the ladder ops necessary to effect them.  Yours doesn't?


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## JROD (Mar 21, 2009)

lol, being that we are a rather large city with a rather large volume of calls per month, we designate animal rescue to the qualified professionals, that being animal control. Wouldn't you agree that there training and experience would be better suited for that type of operation?? We also don't outline forced entry into a hostage situation in our SOPs becuase thats left up to the SWAT team...


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## Scout (Mar 21, 2009)

So what your saying is your non existant written SOP outline the standard proceedure as recieve call pass it on?



Woudl that not indicate you have a SOP written down, how else would you know what to do?


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## AJ Hidell (Mar 21, 2009)

I worked in one of the ten largest cities in the United States, so it was certainly no small, suburban agency (although I worked one of those too).  Animal Control would not be allowed to scale an aerial ladder.  Animal Control has no high angle rescue team.  Animal Control has no water rescue team.  Animal Control has no trench rescue team.  Animal Control has no protective equipment with which to enter a burning structure or property.  Animal rescue will always be a responsibility of the fire RESCUE service.  In fact, Animal Control should probably be merged with the fire service since you guys are so interested in rescue.

As for the hostage situation, any fire department worth a darn has written policies addressing both forced entry and hostile operations.  Again, I'm really surprised that your agency does not.  I would have very little confidence in a department that did not have the competent management to provide for them.


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## JROD (Mar 21, 2009)

I'm not really sure what you're asking me there, or if your qestion is even directed toward me...if you're asking if we have a "non-written procedure" for dealing with calls pertaining to animal rescue then my answer would be that we have no SOP regarding animal rescue. It seems to be common sense between all dispatchers to refer any calls pertaining to ANIMAL rescue to ANIMAL control, seeing as they are best suited/trained for the job. We also occasionally refer people to outside companies after an overhaul, seeing as they are better fitted for the reconstruction job than we are...


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## JROD (Mar 21, 2009)

So AJ, what your telling me is that you have SOPs for a high angle rescue team to respond to a 86 year old lady who is calling about a stranded animal. You also seem to write SOPs for hostage situations that have not been properly secured by a competent/well trained Police department in your area. If you have procedures for breaching a building during a hostage situation, then I'm not so sure I want to work for your city...Especially since I don't have the proper training to deal with that kind of situation in the first place.


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## AJ Hidell (Mar 21, 2009)

JROD said:


> I'm not really sure what you're asking me there...


I'm asking you if your department has written policies for the situations I listed.  And do you really need a written policy to know to bring the dog out of the burning house?

Do dispatchers run your department?  Sooner or later, Animal Control encounters a scenario that they are not trained or prepared for.  Typically, those scenarios are those that professional firefighters have been trained for, so you get the call.  If you haven't received any of those calls, then you're not in a very big department.


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## AJ Hidell (Mar 21, 2009)

JROD said:


> So AJ, what your telling me is that you have SOPs for a high angle rescue team to respond to a 86 year old lady who is calling about a stranded animal.


Who called us is irrelevant, isn't it?  Who or what you are rescuing is also irrelevant.  You should have written policies and procedures addressing high angle rescue.  Period.



> You also seem to write SOPs for hostage situations that have not been properly secured by a competent/well trained Police department in your area.


You're going out of your way to overcomplicate this.  Do you not have an SOP telling you whether or not you may enter unsecured hostile scenes?  If you have a tactical rescue team, do they not have SOPs for their operations?



> If you have procedures for breaching a building during a hostage situation, then I'm not so sure I want to work for your city...Especially since I don't have the proper training to deal with that kind of situation in the first place.


You should have an SOP for forced entry.  You should have an SOP for hostile scenes.  You should have an SOP for assisting law enforcement.  You do not have to have one SOP that addresses all three at the same time.  And if you have not been trained on all three of those scenarios, then your training was horribly inadequate.  Your SOP and training may be as simple as "don't do it", but it should still exist.


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## JROD (Mar 21, 2009)

I'm not in dispatch, so I can only report what I've hard...We received hundreds of calls in regard to animals being stranded...these calls are then forwarded to animal control. 

Being an ALS responder in the EMS system, we typically respond to emergency calls that involve human life...I haven't reviewed the animal section lately, but I'm pretty sure thats how it goes...We don't call someone else for a situation we never encountered before (keep in mind this doesn't include high angle/low angle rescue, HAZMAT, or any other type of emergency response team that works with a fire dept.), so we don't expect animal control to call us for an animal situation they may have not seen before (although we would respond to help if necessary, although if animal control doesn't have an SOP for a given situation, odds are we don't have one either). After reading some of your prior posts, especially the one regarding never taking pics to document MOI, I would think you strongly believe in not doing anything without a strict policy stating its legitimacy. If this is correct, then running in to a burning building to retrieve a dog would probably be against your SOP, unless you have a SOP directly relating to that Emergency situation.

 As far as responding to hostage situations go, we consider Scene Safety a priority. If the scene is not safe, then we will not enter...Or at least I won't let me crew enter...I'm big on scene safety...


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## ffemt8978 (Mar 21, 2009)

Get back on topic and stay there.


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## nightstar22 (Apr 6, 2009)

like the others have said, it could be for the moi. there is an amendment about taking pictures, bascially if it is in the public, then you can take a picture of it. however, there are moral issues of taking pictures of the patient. to me, this is wrong. i have always taken pictures of wreck scenes, but this has been after the patient is loaded. i am now the unofficial photographer for the volunteer fire department that i am on. my cheif has instructed me to get anywhere i possibly can, as long as i am not a danger.. lol.. 
if you are still curious why they took the pictures, just ask them. but do not do it in an accusing way.


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## fortsmithman (Apr 6, 2009)

Last year after I joined my service we were providing coverage for a snowcross race.  One of the other members was video taping the event when one of the racers wiped out right in front of the rig.  The member video taping it caught the incident on video.  The doctor got to see the accident on tape so he new what happened.  Other than that we don't take pictures.


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## WarDance (Apr 6, 2009)

I am on a SAR team and camera phones are really useful (if there is service).  Sometimes the IC can't see what is going on at the scene of an avalanche, for example, so sometimes a picture can be taken and sent back down.  The IC can then make suggestions on what should happen for the evac.  The guys up there generally know what is the best thing to do but it always helps to have the IC's input since they are usually one of the most experienced team members.  It can even be useful to take pictures of injuries and relay it to EMS at the base so they can make treatment suggestions or get ready for whatever we are bringing down.


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## sop (Apr 7, 2009)

Epi-do said:


> On EMS runs, I am typically too busy to be taking pictures.  However, I do take pictures at trainings, and if we are on a fire run, I tend to take pictures at those as well, unless there is a patient of some sort.
> 
> I give the pictures to one of the officers at the department, and he uses some of them in the annual banquet video.  Other than that, they just get stored on a disc and are for my personal use, just like my family vacation pictures, or pictures of my son playing in the snow.  I do not typically post pictures of actual incidents from work to facebook, myspace, or anywhere else on the internet.  It isn't worth it to me to risk my job, or at the very least, having to answer an awfully large amount of questions to alot of people I would rather not be talking to.  On the very rare occassion that I do get a picture I want to share for whatever reason, I make darn sure there aren't any visable addresses, patients that can be identified, etc.



How would you have time to take pictures if you are doing your job?


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## curt (Apr 7, 2009)

I'll say that using a personal or digital device is probably not the best course of action. The best idea I've seen in here is the Polaroid instant-photo statement since it's not stored on the camera, there's no copies unless you pocketed it, and it stays with the chart, meaning that it cannot possibly be used for anything besides documentation and reporting. You could probably even use your own personal Polaroid for it, just make sure that your employer will back you on that. It's easily defensible in court and if the media asks anyone involved or with half a brain, they're not going to be able to take it and run with it. It functions even better if you can avoid photographing identifying information or features. 

 As for written documentation of MOI facts, that's okay, but a picture works better in my opinion. People can interpret words differently, but there's only one way to interpret a photo.


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## CAOX3 (Apr 7, 2009)

You should be able to describe mechanism, you dont need a picture.


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## rmellish (Apr 7, 2009)

CAOX3 said:


> You should be able to describe mechanism, you dont need a picture.



Don't need it necessarily, but we've snapped a couple pics of car wrecks before for the doc at the ER. Sometimes if it's a lengthy extrication you've got time.


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## DR_KSIDE (Apr 7, 2009)

If we have a full crew (two EMTs and a driver), if there is the time, or we might ask one of the officers of FF to snap a photo or two of the car itself that our pt is coming out of and one of the scene, our ER docs have requested these if possible so that they might have a better understanding (picture) of what the person might have been through. Since our docs have been seeing these, I have noticed more interventions being done, some as preventative measures.


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## CAOX3 (Apr 7, 2009)

Why dont we just drag the wreckage to the ER with us?


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## Juxel (Apr 7, 2009)

AJ Hidell said:


> As always, if you weren't taught to do something in EMT or Paramedic school, and if it is not in your job description, then you probably should not be doing it in the field.  That goes for photography.



I strongly disagree.  Ever had a patient who by mechanism of injury fits the serious or critical categories but is refusing to go?  These are the patients that even if you talk into going to the hospital will downplay the severity of the accident to the hospital staff, potentially missing something because they don't have a good scope of the mechanism.

You can document all you want, but a picture is worth a thousand words. The last accident scene that I took a picture of my partner wanted to sign the patient, I talked him into going.  Got back to the hospital 3 hours later and the doctor thanked me for taking the picture because that was his basis for CTing the patient and finding a liver laceration.  This isn't to say they wouldn't have found the liver lac without my picture, but thanks to the picture they found it before the patient exhibited serious signs and symptoms.


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## AJ Hidell (Apr 7, 2009)

Congratulations if you work in a system where the hospital staff even listens to your report, much less wants to look at your pictures.


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## CAOX3 (Apr 7, 2009)

Mechanism of injury in an auto accident held more water ten years ago.  With todays improvement in safety technology, automobiles are supposed to come apart, crinkle and basically dismantle themselves.  They are directing the force of the MVA away from the passenger compartment.  Even minor MVA's today will usually have significant damaged to the shell of the vehicle.  I am much more concerned with intrusion then exterior damage.

I guess if your MD's enjoy the pictures, then what the heck.  We are forbidden to take any picture at an EMS scene.


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## BossyCow (Apr 10, 2009)

CAOX3 said:


> Why dont we just drag the wreckage to the ER with us?



I've actually done that.. but it was attached to the pt.


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## ErinCooley (Apr 10, 2009)

I think its incredibly tacky and in poor taste personally!

And, our company does not allow it.  No questions asked, its a terminable offense.

And honestly, does a picture of wreckage help a doctor treat a patient more than briefly describing the incident??  Am I missing something here??


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## VentMedic (Apr 10, 2009)

ErinCooley said:


> I think its incredibly tacky and in poor taste personally!
> 
> And, our company does not allow it. No questions asked, its a terminable offense.
> 
> And honestly, does a picture of wreckage help a doctor treat a patient more than briefly describing the incident?? Am I missing something here??


 
Taking pictures (Polaroids) was a common practice in the 1980s and early 1990s where mechanism of injury was heavily studied and emphasized. Many good articles came out of some of those pictures but as technology and automobile engineering progressed, so did the knowledge about mechanism of injury.


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## ErinCooley (Apr 10, 2009)

VentMedic said:


> Taking pictures (Polaroids) was a common practice in the 1980s and early 1990s where mechanism of injury was heavily studied and emphasized. Many good articles came out of some of those pictures but as technology and automobile engineering progressed, so did the knowledge about mechanism of injury.




I get that, and I get taking pics for training and/or evidence purposes.  However, I see very little reason why an EMT or Paramedic would have use of a cell phone picture... other than to put them on the internet which I personally think gives our industry as a whole a bad name.  For instance, look at what John Travolta just went through when his son died (granted it wasnt the exact same scenario).

I find it hard to believe that showing a doctor a picture of a squished car in the year 2009 would help them treat the patient more effectively than just saying "rollover w/ X'  of intrusion on driver side" or "ejection following 3 rollovers at a high rate of speed."  If a doc treating ME needed to see a picture to give me proper care, I would question his adequacy as a medical professional.


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## JAM-EMT (Apr 10, 2009)

I agree Hospitals do like to see what happened, as well as other medics who like to discuss the incidents and what we did and could've done.


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## Mountain Res-Q (Apr 10, 2009)

nomofica said:


> Not too long ago I witnessed an EMS personnel in my city taking pictures of the incident he responded to (car collision, one fatality) with his camera phone. Obviously it wasn't for "evidence", as it's not the EMS' job to collect evidence. I'm pretty sure he snapped a few shots of the casualty as well.
> 
> What are your thoughts/opinions on this?
> 
> Also, what are the "rules" for these sorts of things in your areas?



I have a few problems with why s/he needs to take pictures.  What are they gonna be used for?  I have two different perspectives on this.

I haven't worked Ambulance in 3+ years (AMR).  But the company training manual specificlly said that Cameras were not allowed to brought to work at all.  The problem was that the amnual also spoke of the need to use our personal cell phones while at work to caontact dispatch and our supervisor.  Obviously the rules were writen prior to Cell Phones all having cameras.  but I do believe that it is helpful for the hospital to be able to see the MOI.

I currently work Search and Rescue, which follows a more "Law Enforcement set of rules.  We are encouraged to carry cameras with us.  If we see "clues" like tracks, etc. we are told to record them before disterbing them.  Beyond that. we routinely take pictures of the operations for memory sake.  Also, we commonly deal with the recovery of dead bodies.  So, we are taking "crime scene" photos for the coroners and investigators.  We give copies to the officals, but since we are sworn members of the Sheriff's Office, we often hold on to the originals for educational and memory purposes.  However, if we were dealing with the care of a live patient I, as Medical Team Leader, would be pissed if one of my people were taking photoes instead of doing their job.


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## BLSBoy (Apr 10, 2009)

ErinCooley said:


> I think its incredibly tacky and in poor taste personally!
> 
> And, our company does not allow it.  No questions asked, its a terminable offense.
> 
> And honestly, does a picture of wreckage help a doctor treat a patient more than briefly describing the incident??  Am I missing something here??



Right. Lets never take pictures during an incident to learn how we can do things better, or to document any strange and unusual happenings. 
Let's just describe it in detail.


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## Mountain Res-Q (Apr 10, 2009)

ErinCooley said:


> I think its incredibly tacky and in poor taste personally!
> 
> And, our company does not allow it.  No questions asked, its a terminable offense.
> 
> And honestly, does a picture of wreckage help a doctor treat a patient more than briefly describing the incident??  Am I missing something here??



Have you ever been on the scene of a realy horrible MVA where the vehcile is so twisted that you couldn't believe that it was once a car?  And have the pateint literally walk away and without a scratch.  Could he be lucky as sin.  Usually.  But even if I can't see anything wrong with him, I know the the MOI was there to kill him.  I want him to go to the hospital, as any good pateint advocate would.  When I get ther the Hospital staff may look at this as a BS deal, and it may be.  But as an advocate for my patient I might want to show the Doctors exactely what he survived in the hope that if something is wrong wiht the patient, the hospital staff would look at the scene, take it seriouosly, and be able to catch any problems.  Some Doctors, in fact, have become used to pictures and like to know what happen to there pateint.  This is an extreme case, but others exist as an argument for cameras on scene, not that I advocate it or would be taking pictures when I have patient care to focus on.

On teh other hand, I understand why many companies disallow it.  Howevr, consider that all the insider pictures that grace the inside of EMT and other medical tesxtbooks came from somewhere.


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## CAOX3 (Apr 12, 2009)

Mountain Res-Q said:


> Have you ever been on the scene of a realy horrible MVA where the vehcile is so twisted that you couldn't believe that it was once a car?  And have the pateint literally walk away and without a scratch.  Could he be lucky as sin.  Usually.  But even if I can't see anything wrong with him, I know the the MOI was there to kill him.  I want him to go to the hospital, as any good pateint advocate would.  When I get ther the Hospital staff may look at this as a BS deal, and it may be.  But as an advocate for my patient I might want to show the Doctors exactely what he survived in the hope that if something is wrong wiht the patient, the hospital staff would look at the scene, take it seriouosly, and be able to catch any problems.  Some Doctors, in fact, have become used to pictures and like to know what happen to there pateint.  This is an extreme case, but others exist as an argument for cameras on scene, not that I advocate it or would be taking pictures when I have patient care to focus on.
> 
> On teh other hand, I understand why many companies disallow it.  Howevr, consider that all the insider pictures that grace the inside of EMT and other medical tesxtbooks came from somewhere.




 Strong relationships are needed between EMS providers and ER staff so that when you transport someone into the ER you can convey to them the severity of damage.

As far as the pictures in medical text, im not sure but I believe they might need the patients permission.


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## Ridryder911 (Apr 12, 2009)

Years ago Polaroid actually had a "EMS" documentation kit. It had fell out of popularity due to privacy laws and confidentiality. Can one be sure that they focus on one patient per camera angle? Is there detailed protocols & procedures to ensure that the photographs are embedded only into the patients chart and then original destroyed. 

As well, who has the time to take the pictures when care should be performed? Kinda hard to show how the patient was before tx. and explain that a pic was taken before tx was given. 

I believe we have outgrown the pic phase. Most physicians can understand "high speed" MVC. 

R/r 911


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## EMTDave (Apr 12, 2009)

I think as long as there is no patient in the picture and that taking the picture does not interfere with caring for any patient(s),  then I think that it is alright to do.


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## karaya (Apr 13, 2009)

EMTDave said:


> I think as long as there is no patient in the picture and that taking the picture does not interfere with caring for any patient(s), then I think that it is alright to do.


 
Think so?? Here is one EMT who lost his job and there was never a patient in the photo!! EMS providers need to establish very clear policies that govern the taking of any scene photos. Without it... don't take it!

http://www.jems.com/news_and_articles/articles/Missouri_EMT_Terminated_Over_Photos.html


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## EMTDave (Apr 13, 2009)

I understand what you are saying and agree completely. I need to just clarify what i meant by my previous post. Im not saying at every scene take a picture, im just saying when it may be appropriate in help determining what exactly happened then you should be allowed to take a picture with certain restrictions. I dont think that any of the pictures should be used for humor use with friends or be placed on facebook or sites like that, just to be used with your fellow crew members, nurses and doctors.


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