# MVA, occupants deny injury.  How do you document this?



## abckidsmom (Sep 28, 2011)

I'm just curious how y'all would document this:

Vehicle off the road on the interstate in a thunderstorm.  Occupants out walking around on arrival, stating they are uninjured.  They say they were restrained, describe how the accident happened, and thank you for your time but deny need for EMS.

If you had to pick from this list, which would you choose:

Treated and released
Patient refused treatment
No EMS needed
Standby only

It seems so clear to me that no EMS needed is the right answer, but that one requires name, demographics, full assessment, etc in order to have a "complete" PCR.  

I maintain that in order for me to need to document a full patient refusal, you have to be a patient in the first place, which uninjured people are not.

What would you do/say?  I am just collected opinions other than my own before I go to address this issue.


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## JPINFV (Sep 28, 2011)

What's the definition of a "patient" in your system?

Is someone who neither called EMS nor as any identifiable complaints a patient? 

What do you have to document if "no patient is found?"


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## WolfmanHarris (Sep 28, 2011)

If I have done no assessment I report it as "no patient found" and P&P says I'm supposed to write a report with just run number and times. Usually we record nothing other than the shift log.

If I've actually done an assessment, then I grab a quick set of vitals, record demographics, do the speech about refusing transport and treat it as a refusal. It sucks, but we have little choice with the way the system is designed.

In the middle is a gray area where I may have done a very, very, minimal assessment and still report it as "no patient found."


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## abckidsmom (Sep 28, 2011)

JPINFV said:


> What's the definition of a "patient" in your system?
> 
> Is someone who neither called EMS nor as any identifiable complaints a patient?
> 
> What do you have to document if "no patient is found?"



The wording on "no patient found" in the multiple choice is "patient gone on arrival."  Not quite applicable.

We don't have an policy that defines the word patient.  That's one thing I hoped to include in this.  Do you have a definition for patient?  Dictionary.com says "a person who is under medical care or treatment."  This could be stretched to include people with a mechanism but without a complaint, I think.


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## BandageBrigade (Sep 28, 2011)

If they called ems I will do a refusal.  If they did not call and deny injury, then no patient found.


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## ah2388 (Sep 28, 2011)

Kind of an odd, although common situation here.

In my mind, it is probably in your best interest to obtain an informed refusal of care, and write it up as "patient refused care"


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## Handsome Robb (Sep 28, 2011)

From the choices and the way it works in my system I would pick "No EMS needed"

The way it works where I work is if we mark on scene and make contact with someone involved in the accident but they refuse any care or assessment we do an "Refused Medical Assistance" or RMA if they have no obvious injuries. If they do have obvious injuries and still refuse care it becomes an AMA with or without an assessment.

Mine would look something like this assuming 2 patients since no number was stipulated:

'I arrived on scene to find a vehicle upright and off the side of the interstate in a heavy rainstorm. Both occupants were ambulatory and walking around the vehicle. Both occupants stated they were restrained at the time of the accident. They were able to describe the accident in detail to myself and my partner. Neither had any complaint or obvious injury. Both were found to be alert, oriented, competent and refused any care or assessment from myself or my partner stating "We don't need any help". I explained the risks of refusing a thorough medical assessment after an automobile accident including the possibility of head or spinal injury and the risk that follow these types of injuries up to and including, full or partial paralysis, coma and/or death. Both occupants acknowledged and stated they understood these risk but continued to refuse assessment and care. We advised the occupants of signs and symptoms to watch for and advised them to call 911 if they felt the need. At this time my partner and I returned to our medic unit, unit ### and advised dispatch that we were back in service.'


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## Shishkabob (Sep 28, 2011)

If they refuse to be checked out, I do "EMS Not Needed", though our PCR doesn't require a full assessment for it.  I make sure I notate in the final narrative that the patient refused to be checked out, but I do note how they looked (ventilatory rate can still be counted, skin color assessed, etc)



If I convince them to let me check them out, then it becomes a "Patient Refusal", with the required assessment and demographics.




Is your ePCR something such as the Zoll style?  I know at my agency if the ground crews find something we think should be different, all we have to do is fire off an email to our supervisors, and if they agree it should be different, they'll get Zoll to change it.  Perhaps you can do the same about "EMS Not Needed"?


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## abckidsmom (Sep 28, 2011)

Linuss said:


> If they refuse to be checked out, I do "EMS Not Needed", though our PCR doesn't require a full assessment for it.  I make sure I notate in the final narrative that the patient refused to be checked out, but I do note how they looked (ventilatory rate can still be counted, skin color assessed, etc)
> 
> 
> 
> ...



It's the software offered by the state, that is supposed to meet the minimum data set.  The multiple choice language is determined by the state.  

So, I looked it up (go figure!  Looking it up!) and I was off on what the choices were:

treated and released (full documentation required)
no treatment required (full documentation required)
patient refused care (full documentation required)
cancelled
no patient found

I believe that we could have been covered under any of the last 4.   

http://www.nhtsa-tsis.net/ems/state/VA/PPCRTechManNEMSIS[1].pdf

This issue is addressed on page 10 of the pdf.


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## JJR512 (Sep 28, 2011)

Here in Maryland, it the alleged patient is not the person who called 911, and my initial impression is there is nothing wrong with the person, then it's reported as "no patient" and no documentation is needed.

When the incident is an MVC, I would also need to consider mechanism of injury. If there are indicators present (intrusion, rollover, bent steering wheel, etc.) for a significant mechanism of injury, then regardless of how fine (uninjured) the occupants appear and say they are, I can't treat it as "no patient" and I'm supposed to try to persuade them to go by ambulance to a trauma center. They can still refuse, of course, in which case it's documented as a patient refusal. We document what if the patient refuses transportation, treatment, or an exam (any or all of those).

If the patient refuses even just an exam then we indicate we have no vitals or exam findings because the patient refused an exam. In my experience, I haven't seen any patient refuse an exam, but I'm still fairly new at EMS.

Obviously, if the vehicle is merely "off the road" that, by itself, doens't constitute a significant mechanism of injury. It doesn't even indicate an MVC at all, they could have just had a reason to stop and pulled waaaay off the road to minimize the risk of being hit by 80 mph cars on the highway. It actually seems to happen a lot around here that anytime someone is out of their vehicle on a highway, or anytime a vehicle is further off the road than just being on the shoulder, someone driving by inevitably calls 911 to report an accident.


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## VCEMT (Sep 28, 2011)

We just cancel, there's no medical. If fire wants to play, let 'em play. I gotta get back to my nap.


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## shfd739 (Sep 28, 2011)

If there is damage to the vehicle and it was more than a simply driving off onto the shoulder Ill still talk to them and ask to do an assessment. Ill document the findings and that patient reported no complaints along with getting a refusal signed and doing a full report.

Anytime we go onscene with a patient we have to do a full report. Very CYA.


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## jjesusfreak01 (Sep 28, 2011)

If you arrive onscene and the "patient" reports that they did not call 911 and have no complaints or injuries and they will not let you assess them, you have a "no patient found". If they have visible injuries then its in everyone's best interest to try to convince them to let you assess them.

If they have visible injuries, they are technically a patient at that point, however if I was totally unable to assess, i'm probably still going to write it up as a "no patient found", because we can't write up an AMA without demographics. It would be pointless because we wouldn't have any way to follow up and there is nothing legally tying them to our report.

I will write on my NPF reports that the individual for whom EMS was called denied all complaints and does not wish to be assessed.


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## Akulahawk (Sep 29, 2011)

The way I'd document the run would depend upon specific circumstances. The people involved in the crash may or may not have called 911 to report the crash and have LE come out and take a report, they may have concerns that their vehicle is now a hazard and need Fire to mitigate that hazard... EMS may have been simply called out as part of a standard response to such an event. So, I really don't care who called. 

If I have a NPF type of event, I'll document as much as the software will allow. If it's paper-based, then I'll describe the event, number of persons there, all refused exam/care verbally, and attempt to get someone from another agency to countersign my report attesting simply to the above and nothing further. If someone OK's a quick check-out, I'll have to get demographics, document my findings, and either their refusal of care or document as a no identifiable medical need, or something similar. If LE is on scene and the person wants to refuse, LE can simply cancel us on scene prior to patient contact...

There's just so many ways to go at this... Given the lack of choices that abckidsmom posted, if the person wants to refuse all care, including any initial exams, I'd have to go with NPF, with a note that states how many people were found on-scene and that they were advised that if they want EMS, all they have to do is ask... and leave it at that.


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## usafmedic45 (Sep 29, 2011)

> Vehicle off the road on the interstate in a thunderstorm. Occupants out walking around on arrival, stating they are uninjured. They say they were restrained, describe how the accident happened, and thank you for your time but deny need for EMS.



In Maryland, it would be documented as "Called for Trooper 2 due to mechanism of injury/damage to vehicle".


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## Handsome Robb (Sep 29, 2011)

usafmedic45 said:


> In Maryland, it would be documented as "Called for Trooper 2 due to mechanism of injury/damage to vehicle".



:rofl:


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## usafmedic45 (Sep 29, 2011)

NVRob said:


> :rofl:



It's not really all that funny. One of the two patients died, along with the two EMS providers and the helicopter pilot (a friend of mine).


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## JJR512 (Sep 29, 2011)

The idea that you would say this...


> About 10:45 p.m. Saturday, Charles County authorities said, Wells was driving a 2003 Ford Taurus on Smallwood Drive in Waldorf when the car crossed the median, hit several trees, veered into oncoming traffic and collided with a Honda CRX.
> 
> Wells and her passenger, Younger, suffered serious injuries. Authorities said yesterday that the accident is under investigation.


(http://www.washingtonpost.com/wp-dyn/content/article/2008/09/28/AR2008092800416.html)
...is the same thing as this...


abckidsmom said:


> Vehicle off the road on the interstate in a thunderstorm. Occupants out walking around on arrival, stating they are uninjured. They say they were restrained, describe how the accident happened, and thank you for your time but deny need for EMS.


...and then say this...


usafmedic45 said:


> In Maryland, it would be documented as "Called for Trooper 2 due to mechanism of injury/damage to vehicle".


...is revolting and in bad taste, especially given the fact that one of your friends was killed.


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## feldy (Sep 29, 2011)

No Ems if we did not even assess the pt. (we dont have to do a PCR). If we do a quck assessment and pt. does not want to go, its a refusal but we still have to fill out a PCR. If we feel that the pt needs to go and they dont want to, AMA from med control and fill out PCR.


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## dixie_flatline (Sep 29, 2011)

JJR512 said:


> ...is revolting and in bad taste



Have you met usaf?


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## usafmedic45 (Sep 29, 2011)

> Wells and her passenger, Younger, suffered serious injuries.



During the course of the investigation it came out that both patients were walking around and talking on their cell phones after the crash.  Neither of them was seriously injured and Wells' attorney has publicly stated that all of the life-threatening and crippling injuries see suffered were as a result of the helicopter crash.  Of course, MSP said it was "serious injuries" because according to state protocol at the time (and more or less, today) they did meet the criteria for that based on antiquated and misguided supposition about the predictive nature of damage to vehicles.  They were flown because of bad protocols and the lack of a desire of the ground EMS providers to be inconvenienced by driving to a hospital.


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## usafmedic45 (Sep 29, 2011)

dixie_flatline said:


> Have you met usaf?



You haven't so let me Google that for you


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## dixie_flatline (Sep 29, 2011)

usafmedic45 said:


> You haven't so let me Google that for you



I'm confused.  I didn't mean "meet" as in face to face.  I just meant that I thought it wasn't a big secret that you don't hold much sacred/nor care when other people are shocked, offended, or otherwise bewildered by your position on a given issue.


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## JPINFV (Sep 29, 2011)

dixie_flatline said:


> I'm confused.  I didn't mean "meet" as in face to face.  I just meant that I thought it wasn't a big secret that you don't hold much sacred/nor care when other people are shocked, offended, or otherwise bewildered by your position on a given issue.



Life is more fun that way, or else I'd feel really bad about laughing at the Downfall parodies.


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## usafmedic45 (Sep 29, 2011)

dixie_flatline said:


> I'm confused.  I didn't mean "meet" as in face to face.  I just meant that I thought it wasn't a big secret that you don't hold much sacred/nor care when other people are shocked, offended, or otherwise bewildered by your position on a given issue.



Oh, OK....I thought you were trying to be snide.  My apologies.  It's been a rough couple of days.


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## dixie_flatline (Sep 29, 2011)

JJ:



> Ashley Younger called her mother just before 11 p.m. and calmly explained that she and Wells had just been in an accident. Her mother rushed to the scene with her best friend and Younger's grandmother. Ashley seemed fine, her mother recalled: no bleeding, no broken bones, just some chest pain.





> Bill Rudolph, another medical technician, began helping the two girls. Ashley Younger complained that her head and chest hurt but Jordan Wells, who was also in pain, seemed more worried about the damage to her father's car.



MOI ShmemOI.  Yes, the girls could have been in shock, but by all accounts they did not need to be flown.  They could have gone to Ft Washington, which is less than 15 miles away.  The only thing that said they needed to go to the Level 1 trauma center at PG was the MOI script.  The bit about "authorities" saying that both of them suffered serious injuries is suspect at best.


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## JJR512 (Sep 29, 2011)

If that's the case then perhaps they didn't need to be flown.

Nevertheless, as a provider functioning in Maryland, I detest and reject the notion that we're all a bunch of mindless idiots who automatically call for a helicopter on every MVC.

Stereotyping is stupid and ignorant.


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## dixie_flatline (Sep 29, 2011)

JJR512 said:


> Stereotyping is stupid and ignorant.



Although they're working to change it (slowly), one could argue that Maryland's formula for establishing trauma priorities and codes is stereotyping, when it should at best be a loose guideline for the provider to build his own conclusions from.


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## usafmedic45 (Sep 29, 2011)

> Nevertheless, as a provider functioning in Maryland, I detest and reject the notion that we're all a bunch of mindless idiots who automatically call for a helicopter on every MVC.
> 
> Stereotyping is stupid and ignorant.



The only people stereotyping Maryland EMS providers and harming the patients as a result are the MSP and MIEMSS by assuming that ground providers are unable to provide quality care.  The people I am stereotyping as incompetent tools are the leadership of MSP Aviation and the leadership at MIEMSS.  Bass can suck my left nut and I have told him such to his face. 

Remember, I used to live in Maryland and one of the major reasons I left was because of the lack of respect the leadership has for rank and file providers.  I am too smart and too driven to function in a system that is predicated around keeping the status quo at the time of the death of R. Adams Cowley (circa 1991) around for as long as freakishly possible. 



> Although they're working to change it (slowly),



It's not changing anymore than your average addict does.  They scaled back the flights immediately after Trooper 2 to get the press and everyone off their asses and made some grand proclamations about how people would be endangered by not flying them (thank you Tom Scalea for not being concerned about being burdened by trivial matters such as, you know, evidence) and went right on with the same ol'  "It puts the patient on the MSP helicopter or else it gets the hose again" approach they have had since the powers that be at MSP realized they could bump up their budgets and otherwise overcompensate by having the most overworked HEMS operation in the nation.


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## JJR512 (Sep 29, 2011)

usafmedic45 said:


> The only people stereotyping Maryland EMS providers and harming the patients as a result are the MSP and MIEMSS by assuming that ground providers are unable to provide quality care. The people I am stereotyping as incompetent tools are the leadership of MSP Aviation and the leadership at MIEMSS.


 
You say you're not stereotyping anyone, that it's MSP and MIEMSS.



usafmedic45 said:


> In Maryland, it would be documented as "Called for Trooper 2 due to mechanism of injury/damage to vehicle".


 
For MSP (and MIEMSS) to stereotype me as a provider unable to provide quality care, they first have to get on scene. And they don't get on scene unless I, or some other provider on the ground, call for them. So you _are_ perpetrating a stereotype here. You're indicating that the ground providers, which includes me, are going to automatically call MSP on every trauma call regardless of if there's an actual need.


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## Akulahawk (Sep 29, 2011)

usafmedic45 said:


> During the course of the investigation it came out that both patients were walking around and talking on their cell phones after the crash.  Neither of them was seriously injured and Wells' attorney has publicly stated that all of the life-threatening and crippling injuries see suffered were as a result of the helicopter crash.  Of course, MSP said it was "serious injuries" because according to state protocol at the time (and more or less, today) they did meet the criteria for that based on antiquated and misguided supposition about the* predictive nature of damage to vehicles*.  They were flown because of bad protocols and the lack of a desire of the ground EMS providers to be inconvenienced by driving to a hospital.





dixie_flatline said:


> JJ:
> 
> 
> 
> ...


The thing people need to remember about MOI is while it _is_ predictive of injury, it's _not_ predictive in the way people _think_ that it is. MOI can not predict _actual_ injury, however, if you know the MOI, you can determine where an injury is _likely_ to be. In other words, if I set about busting your arm up with a baseball bat, chances are pretty darned good that you didn't get a head, neck, or back injury from me whaling away on your arm with said bat. Now if you have a particularly tough arm or I have a particularly weak swing, you might not actually have a busted-up arm... it might not even show a bruise, let alone actually have damage.

So, MOI can tell you where to look, but it won't tell you if actual injury occurred. No mechanism, no injury because no injury happens without a mechanism, but the reverse is clearly not the case.


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## usafmedic45 (Sep 29, 2011)

JJR512 said:


> You say you're not stereotyping anyone, that it's MSP and MIEMSS.
> 
> 
> 
> For MSP (and MIEMSS) to stereotype me as a provider unable to provide quality care, they first have to get on scene. And they don't get on scene unless I, or some other provider on the ground, call for them. So you _are_ perpetrating a stereotype here. You're indicating that the ground providers, which includes me, are going to automatically call MSP on every trauma call regardless of if there's an actual need.



Suffice to say that I'm not maligning the rank and file providers- regardless of what you want to believe- but rather the archaic and harmful system they are forced to work in.  If they were the pinnacle of EMS, like MIEMSS so often likes to claim, then they would have standards at least approaching the progressive services in the nation and not have some of the most restrictive protocols around.  They don't have to be on scene to render you hobbled because all they have to do is put it on paper out of fear, distrust, disrespect, sincere ignorance and conscientious stupidity. 

If I get a full ride to Johns Hopkins or even a faculty appointment there, I will live in Pennsylvania and commute in every day to avoid funding the system that endangers its patients and the very personnel it relies upon.  Maryland's EMS programs are broken beyond repair and must be scrapped and all those responsible for the current circle jerk sacked.


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## epipusher (Sep 29, 2011)




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## JJR512 (Sep 30, 2011)

usafmedic45 said:


> Suffice to say that I'm not maligning the rank and file providers- regardless of what you want to believe- but rather the archaic and harmful system they are forced to work in. If they were the pinnacle of EMS, like MIEMSS so often likes to claim, then they would have standards at least approaching the progressive services in the nation and not have some of the most restrictive protocols around. They don't have to be on scene to render you hobbled because all they have to do is put it on paper out of fear, distrust, disrespect, sincere ignorance and conscientious stupidity.


 
You can keep saying you're not, that it's just what I want to believe...I tend to believe what I see. Earlier you said this MVC, the one described at the opening of this thread, would be documented as a medevac call. Why would it be documented as a medevac call? For it to be a medevac call, the ground provider has to make it one. They don't come because they feel like it, they don't listen to the dispatches and say, "Hey, that sounds good, let's go land at that call!"

You can say it's MIEMSS hobbling the ground provider, you can say this happens because of what MIEMSS puts it down on paper, but that's just not true. Nowhere in the Maryland Medical Protocols does it say, to my knowledge, that the ground provider _must_ call for a medevac. On our trauma decision tree, in the two worst cases, it says, "Consider helicopter transport if quicker and of clinical benefit." There's other language in there as well but none of it says a helicopter _must_ be called.

So when you say that Maryland likes to fly all traumas regardless of the benefit, you're not attacking MSP or MIEMSS. They don't automatically send the helicopter nor do they require us to call. You're attacking the ground providers, implying they lack judgement and just always call for a helicopter.


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## dixie_flatline (Sep 30, 2011)

JJR512 said:


> You can keep saying you're not, that it's just what I want to believe...I tend to believe what I see. Earlier you said this MVC, the one described at the opening of this thread, would be documented as a medevac call. Why would it be documented as a medevac call? For it to be a medevac call, the ground provider has to make it one. They don't come because they feel like it, they don't listen to the dispatches and say, "Hey, that sounds good, let's go land at that call!"
> 
> You can say it's MIEMSS hobbling the ground provider, you can say this happens because of what MIEMSS puts it down on paper, but that's just not true. Nowhere in the Maryland Medical Protocols does it say, to my knowledge, that the ground provider _must_ call for a medevac. On our trauma decision tree, in the two worst cases, it says, "Consider helicopter transport if quicker and of clinical benefit." There's other language in there as well but none of it says a helicopter _must_ be called.
> 
> So when you say that Maryland likes to fly all traumas regardless of the benefit, you're not attacking MSP or MIEMSS. They don't automatically send the helicopter nor do they require us to call. You're attacking the ground providers, implying they lack judgement and just always call for a helicopter.



JJ - you are also in Howard County, which has the luxury of not needing the helo's all that much.  State-wide, things are different.  Other counties rely on the choppers _extensively_.  Dispatch has been known to pre-alert the helo as well - I have been on a number of calls (in Howard County) where the chopper was already in the air en route before I had done a full assessment and called them off.  

Considering the only time I am more than 30 minutes from a Trauma Center (be it Shock Trauma, Hopkins, or Sinai) is during a football game or a blizzard, I have never had a patient that required flight.  Between ETA, packaging, and flight into Baltimore, it rarely makes sense to use HEMS in Howard County outside of extenuating circumstances (it took me 15 minutes to drive Priority 1 from the Mall to the Hospital on July 4th - total trip 1.8 miles)


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## Epi-do (Sep 30, 2011)

From the choices you listed, I would select "no EMS needed."  We would actually hit dispatch on the radio and advise it is a "property damage only" incident, mark back in service, and complete a unit report in the station log.  No need to do a PCR.


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## abckidsmom (Sep 30, 2011)

Epi-do said:


> From the choices you listed, I would select "no EMS needed."  We would actually hit dispatch on the radio and advise it is a "property damage only" incident, mark back in service, and complete a unit report in the station log.  No need to do a PCR.



Virginia requires a PCR on incident where the ambulance marks on scene.


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## dixie_flatline (Sep 30, 2011)

abckidsmom said:


> Virginia requires a PCR on incident where the ambulance marks on scene.



That sounds like a ridiculous requirement.


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## abckidsmom (Sep 30, 2011)

dixie_flatline said:


> That sounds like a ridiculous requirement.



Not really.  It's a short little times, brief narrative and incident number if there's no patient, and more indepth if there is a patient.

They are collecting data, so they can actually see how many times their EMS system is used, whether there is patient contact or not.  Thus, all of those choices for incident disposition that refer to incidents that had no patient contact.


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## dixie_flatline (Sep 30, 2011)

abckidsmom said:


> Not really.  It's a short little times, brief narrative and incident number if there's no patient, and more indepth if there is a patient.
> 
> They are collecting data, so they can actually see how many times their EMS system is used, whether there is patient contact or not.  Thus, all of those choices for incident disposition that refer to incidents that had no patient contact.



Don't you guys fill out RMS-type reports? (Rescue Management Software from Zoll is what we use).  That is what the county uses to track types of calls, units that respond, etc.  Every call that is dispatched requires an RMS report to be filed, whether it's a Fire, Water Rescue, MVC, Refusal, or cancellation en route.  

We only fill out an MIR/ePCR if there is a patient refusal (or transport obviously).  We don't fill out a PCR for an assist (lifting grandma into her chair) or if we roll up and don't have a patient - whether that means there is no patient to be found, or any possible patient found on-scene is agreed to not need medical services.  If they don't want medical services and we agree there is no need, a refusal isn't usually obtained.


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## Trashtruck (Sep 30, 2011)

*What to do?*

Non-Patient form.
Collect name, DOB, sex, and race. Then they sign our 'Non-Patient' form saying they don't need us, don't want us, never called for us, aren't injured/ill, don't want to go to the hospital, and some other lawyer-speak saying we're not liable for anything if we leave. No exam. No call to docs.


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## Epi-do (Sep 30, 2011)

dixie_flatline said:


> Don't you guys fill out RMS-type reports? (Rescue Management Software from Zoll is what we use).  That is what the county uses to track types of calls, units that respond, etc.  Every call that is dispatched requires an RMS report to be filed, whether it's a Fire, Water Rescue, MVC, Refusal, or cancellation en route.
> 
> We only fill out an MIR/ePCR if there is a patient refusal (or transport obviously).  We don't fill out a PCR for an assist (lifting grandma into her chair) or if we roll up and don't have a patient - whether that means there is no patient to be found, or any possible patient found on-scene is agreed to not need medical services.  If they don't want medical services and we agree there is no need, a refusal isn't usually obtained.



We use 24/7 instead of RMS, but it is essentially the same thing.  The station log is also maintained within the same program, so it's all linked.


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## usafmedic45 (Sep 30, 2011)

dixie_flatline said:


> JJ - you are also in Howard County, which has the luxury of not needing the helo's all that much.  State-wide, things are different.  Other counties rely on the choppers _extensively_.  Dispatch has been known to pre-alert the helo as well - I have been on a number of calls (in Howard County) where the chopper was already in the air en route before I had done a full assessment and called them off.
> 
> Considering the only time I am more than 30 minutes from a Trauma Center (be it Shock Trauma, Hopkins, or Sinai) is during a football game or a blizzard, I have never had a patient that required flight.  Between ETA, packaging, and flight into Baltimore, it rarely makes sense to use HEMS in Howard County outside of extenuating circumstances (it took me 15 minutes to drive Priority 1 from the Mall to the Hospital on July 4th - total trip 1.8 miles)



I've also personally witnessed a few cases where MSP troopers called for the helicopter without consulting the EMS personnel, including one literally three minutes by ground from a hospital (Level II trauma center if I remember).


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## Jon (Oct 3, 2011)

abckidsmom said:


> I'm just curious how y'all would document this:
> 
> Vehicle off the road on the interstate in a thunderstorm.  Occupants out walking around on arrival, stating they are uninjured.  They say they were restrained, describe how the accident happened, and thank you for your time but deny need for EMS.
> 
> ...



Not sure why No EMS Needed asks for patient info - seems counter-intuitive. Around here, I'm able to use that choice and it goes straight to the narrative screen. 

And every service I work with (PA) requires a PCR/run sheet for every dispatch, including recalls/cancels/no service calls.




dixie_flatline said:


> Have you met usaf?


Yup. I have.
I also got to see him discuss this, and similar cases, at a recent conference. And have lunch with him, too. He is almost as sexy in person as in his avatar.



dixie_flatline said:


> JJ - you are also in Howard County, which has the luxury of not needing the helo's all that much.  State-wide, things are different.  Other counties rely on the choppers _extensively_.  Dispatch has been known to pre-alert the helo as well - I have been on a number of calls (in Howard County) where the chopper was already in the air en route before I had done a full assessment and called them off.
> 
> Considering the only time I am more than 30 minutes from a Trauma Center (be it Shock Trauma, Hopkins, or Sinai) is during a football game or a blizzard, I have never had a patient that required flight.  Between ETA, packaging, and flight into Baltimore, it rarely makes sense to use HEMS in Howard County outside of extenuating circumstances (it took me 15 minutes to drive Priority 1 from the Mall to the Hospital on July 4th - total trip 1.8 miles)


And?
Because it hasn't shown up in this thread yet, I present, for your veiwing pleasure, _The One With the Mechanism of Injury_ 
[YOUTUBE]YzYxz_uvtSI[/YOUTUBE]


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## dixie_flatline (Oct 3, 2011)

Jon said:


> And?
> Because it hasn't shown up in this thread yet, I present, for your veiwing pleasure, _The One With the Mechanism of Injury_



I was trying desperately not to completely derail the original question with this video.:rofl:


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## Jon (Oct 3, 2011)

dixie_flatline said:


> I was trying desperately not to completely derail the original question with this video.:rofl:


Thank you for your discretion. And allowing me the opportunity to share such a gem.


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## usafmedic45 (Oct 3, 2011)

> I also got to see him discuss this, and similar cases, at a recent conference. And have lunch with him, too. He is almost as sexy in person as in his avatar.



Kat says "Get it right.  He's much sexier in person.  Oh, and tell Jon he can't flirt with you because you're mine."


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