Police Forcing Transport

[Clipper1]

It makes you wonder how many Paramedics already have a diagnosis based on opinion or attitude long before they arrive on scene if they know the call is initiated by the Police. This could explain some of the EMS news articles which are not favorable.

 

[broken stretcher]

in NY state, we have these two gems called Mental Hygiene Law 9.41 and 22.09 .....

Any peace officer, when acting pursuant to his or her special duties,
or police officer who is a member of the state police or of an
authorized police department or force or of a sheriff's department may
take into custody any person who appears to be mentally ill and is
conducting himself or herself in a manner which is likely to result in
serious harm to the person or others. Such officer may direct the
removal of such person or remove him or her to any hospital specified in
subdivision (a) of section 9.39 or any comprehensive psychiatric
emergency program specified in subdivision (a) of section 9.40, or,
pending his or her examination or admission to any such hospital or
program, temporarily detain any such person in another safe and
comfortable place, in which event, such officer shall immediately notify
the director of community services or, if there be none, the health
officer of the city or county of such action.[/SIZE]

and 22.09 is basically the same however it applies to alcohol/drug impairment

 

[Wheel]

How can a person with an altered mental status refuse treatment, of their own volition?

I mean, regardless to AAO status, they are being arrested for suspected intoxication...they can be alert to person place and time, but still have an altered mental status. How can they then refuse treatment? They can't give expressed consent.

Just because you're drunk doesn't mean you can't make your own medical decisions.

 

[nwhitney]

Just because you're drunk doesn't mean you can't make your own medical decisions.

That's how it is in my area.

We also have a "county drunk tank". It's run by a non-profit and is staffed mostly with EMT's. The cops bring people in from within the county and outlying counties as well. We also have a van staffed by two EMT's who are deputized they also bring people to the drunk tank. The people who are brought in don't pay for anything. The county and city fund the program and police agencies from outside the county pay per person. Cheaper than a hospital and cheaper than going through the court system. We decriminalized public intoxication so people aren't facing any legal issues just because they go to the drunk tank.

 

[TransportJockey]

If they are A/O x 4 and have no medical complaint....then we could cancel ourselves and leave the scene. PD can deal with it as it is a common and stupid practice that they seem to employ everywhere...

This is how I work down here. Tends to annoy PD/SO, but heh, life's not perfect. Pd has this Nnoying habit too about leaving when we get there. I tell the guy that if he can answer some questions and walk away safely from the call that I won't force him to go. Amazing how many times I call in as no patient found to dispatch.

 

[mycrofft]

No, arm wasn't broken.

Were the police detaining her to find out if she broke the arm? If it was a true act of violence which results in a broken bone then it is preferable to allow the police to take action and get the kids away from her. The woman with the alcohol intoxication could still possibly be salvaged but not one who breaks her child's arm intentionally.

She had left her abusive husband who called every local motel until he found her and told the manager she couldn't pay, didn't feed their kids that day, etc. She lost it when the manager came and tried to have her leave when she had no ride, very little money, etc. He called the police, they almost came to blows with her. I think her husband had grabbed her arm before she got away and it was bruised, not fractured. But if my partner and I had left them with the police, she'd have been arrested and the kids taken away, etc. Instead they all got a ride to the ER and we told the staff what had gone down. The police didn't follow us.

 

[DrParasite]

I tell the guy that if he can answer some questions and walk away safely from the call that I won't force him to go. Amazing how many times I call in as no patient found to dispatch.

that is not, I repeat, NOT!!! "no patient found". You made patient contact, were requested by another agency on scene, and performed some kind of assessment. saying no patient found doesn't apply, especially when that drunk ends up getting hit by a bus and everyone else testifies that you did talk to him, and your only response was "not patient found."

it can be, however, an RMA by action, which says you did make contact, but the patient walked away from you. Thus they refused to be treated by their actions. This is 100% legal and appropriate.

And before you ask, yes, we have had EMTs and paramedics fired for doing what you are doing.

 

[TransportJockey]

that is not, I repeat, NOT!!! "no patient found". You made patient contact, were requested by another agency on scene, and performed some kind of assessment. saying no patient found doesn't apply, especially when that drunk ends up getting hit by a bus and everyone else testifies that you did talk to him, and your only response was "not patient found."

it can be, however, an RMA by action, which says you did make contact, but the patient walked away from you. Thus they refused to be treated by their actions. This is 100% legal and appropriate.

And before you ask, yes, we have had EMTs and paramedics fired for doing what you are doing.

He's alert and oriented, didn't call me, tells me he doesn't consider himself a patient, and doesn't want me to touch him. So he's not a patient. That's standard practice out here. Third party calls don't obligate the subject of the call to be a patient.
He would sign a 'non-patient' refusal if he hasn't walked off scene. And yes that is a term on the statewide refusal paperwork. Same as your 'RMA by action' except we don't consider them a patient here.

 

[Tigger]

that is not, I repeat, NOT!!! "no patient found". You made patient contact, were requested by another agency on scene, and performed some kind of assessment. saying no patient found doesn't apply, especially when that drunk ends up getting hit by a bus and everyone else testifies that you did talk to him, and your only response was "not patient found."

it can be, however, an RMA by action, which says you did make contact, but the patient walked away from you. Thus they refused to be treated by their actions. This is 100% legal and appropriate.

And before you ask, yes, we have had EMTs and paramedics fired for doing what you are doing.

If someone calls in a traffic accident and you arrive and the occupants of the vehicle state that they did not call an ambulance and do not wish to receive an assessment or other care, do you consider them a patient?

I'm with TJ, if the "subject" says he or she is not a patient, then I am more than inclined to agree with them. Not everyone we come across is a patient.

 

[abckidsmom]

If someone calls in a traffic accident and you arrive and the occupants of the vehicle state that they did not call an ambulance and do not wish to receive an assessment or other care, do you consider them a patient?

I'm with TJ, if the "subject" says he or she is not a patient, then I am more than inclined to agree with them. Not everyone we come across is a patient.

I agree. I say "occupant" or "resident" or "subject".

 

[Medic Tim]

If someone calls in a traffic accident and you arrive and the occupants of the vehicle state that they did not call an ambulance and do not wish to receive an assessment or other care, do you consider them a patient?

I'm with TJ, if the "subject" says he or she is not a patient, then I am more than inclined to agree with them. Not everyone we come across is a patient.

I agree. I say "occupant" or "resident" or "subject".

In my area we report to dispatch the call was unfounded. we talked to the subjects/persons involved/ etc. then request police or a tow if needed. If they are blocking traffic we will sit on scene until the police or tow truck arrive

 

[DrParasite]

He's alert and oriented, didn't call me, tells me he doesn't consider himself a patient, and doesn't want me to touch him. So he's not a patient. That's standard practice out here. Third party calls don't obligate the subject of the call to be a patient.

so when the cops write in their paperwork that they requested EMS for an illness or injury, and turned him over to you, and you said "no patient found" who do you think will be found at fault? the cops who turned the person over to EMS for care, or EMS who lost them?

He would sign a 'non-patient' refusal if he hasn't walked off scene. And yes that is a term on the statewide refusal paperwork. Same as your 'RMA by action' except we don't consider them a patient here.

non-patient refusal? if they aren't a patient, why do they need to sign anything? I'm curious, can you point to a link that shows what this non-patient refusal looks like? I mean, if they aren't a patient, why do they need to refuse anything?

If someone calls in a traffic accident and you arrive and the occupants of the vehicle state that they did not call an ambulance and do not wish to receive an assessment or other care, do you consider them a patient?

This isn't a passerby calling a job in; this is another emergency services agency requesting your service, for a person.

But since you asked about T/Cs, are the cops on scene requesting EMS for multiple injured parties? or the FD? or was it a passerby calling 911 for "possible injuries"? In the first two, you have uniformed personnel requesting EMS for a reason; in the latter, if you want to ask if anyone calls 911, and say no injuries since no one called, that's fine.

The call isn't unfounded; a traffic accident did occur, and you found it. The request for injuries is unfounded (yes, i will agree), but the incident isn't unfounded (as in you couldn't find any crash at all). It's all about documentation, and poor documentation can and will bite you in the *** (and yes, people at my agency have been bitten, hence the reason we operate as we do).

 

[TransportJockey]

I'll post a picture of my paperwork with the non patient refusal when I go to work tomorrow. And I'll reply more when I get to a conputer

 

[Tigger]

This isn't a passerby calling a job in; this is another emergency services agency requesting your service, for a person.

But since you asked about T/Cs, are the cops on scene requesting EMS for multiple injured parties? or the FD? or was it a passerby calling 911 for "possible injuries"? In the first two, you have uniformed personnel requesting EMS for a reason; in the latter, if you want to ask if anyone calls 911, and say no injuries since no one called, that's fine.

The call isn't unfounded; a traffic accident did occur, and you found it. The request for injuries is unfounded (yes, i will agree), but the incident isn't unfounded (as in you couldn't find any crash at all). It's all about documentation, and poor documentation can and will bite you in the *** (and yes, people at my agency have been bitten, hence the reason we operate as we do).

If the party is capable of making his own decisions and does not want us there and did not call for use, then he is not a patient. I don't care who called on his behalf. I never said that the call would be unfounded, just that no patient was found. Law enforcement calls us all the time for TAs with possible injuries and we often arrive to the parties involved stating no injuries. Just because the cops want to cover themselves doesn't mean I need to get a refusal.

 

[Jim37F]

In my area police can write a 5150 hold, which is a mandatory 72hr hold for psychiatric evaluation for danger to self or others. Once your under a 5150 hold you cannot refuse transport, nor can we refuse or just drop them off a block later

 

[TransportJockey]

In my area police can write a 5150 hold, which is a mandatory 72hr hold for psychiatric evaluation for danger to self or others. Once your under a 5150 hold you cannot refuse transport, nor can we refuse or just drop them off a block later

Those are different. Just like when someone is in custody the police can force them to receive treatment. But those are the exceptions

 

[DesertMedic66]

Police call us to "check a person out" that they got in an altercation with. We arrive on scene. The subject is AOx4 and doesn't want our help, then the subject is not a patient.

Arrive at a TC that was called in (doesn't matter if its by FD/LEO/citizen), all parties involved are AOx4 and not injured/don't want our help, then it gets reported as "non injury TC" or "no patient found".

 

[Anonymous]

so when the cops write in their paperwork that they requested EMS for an illness or injury, and turned him over to you, and you said "no patient found" who do you think will be found at fault? the cops who turned the person over to EMS for care, or EMS who lost them?

If the person is able to refuse care and is doing so why would you be held liable if something were to happen to them after your contact?

Either the police turn the person over to you and the individual refuses care:

or

The individual is in police custody and the officer leaves the individual with you.

not sure how either scenario would make me liable?

Now on the flip side. Police make contact with me, I am not under arrest, they request EMS for whatever reason. I refuse treatment and you refuse to accept that. Now who is going to be liable when I decide to sue?

 

[joshrunkle35]

Just because you're drunk doesn't mean you can't make your own medical decisions.

Must be a weird state law or something. Nearly everywhere else, legal documents signed when someone is drunk are invalid; when a drunk person gives consent to have sex with someone, the consent is still considered invalid and is date rape. There is tons of existing case law on a drunk person's inability to give expressed consent, regardless of whatever they say and regardless of protocols. Can you point to a contrary law that does allow a drunk person to give consent for their release?

 

[Tigger]

Must be a weird state law or something. Nearly everywhere else, legal documents signed when someone is drunk are invalid; when a drunk person gives consent to have sex with someone, the consent is still considered invalid and is date rape. There is tons of existing case law on a drunk person's inability to give expressed consent, regardless of whatever they say and regardless of protocols. Can you point to a contrary law that does allow a drunk person to give consent for their release?

Without a breathalyzer or blood alcohol testing how can we determine if someone is legally drunk? If the patient has had one drink, are they intoxicated? For some patients yes, others no. I can suspect intoxication but if the person is still alert and oriented and answering questions appropriately then I am not going to force treatment or transport on them.