cameras in trucks?

Everyone's situation is different, and some may allow for pictures. Mine never has. And I don't like the liability nor do I want to be associated with a subpoena of any pics I have. I prefer to be under everyones radar.
 
I like taking pictures. Mostly for myself. Its an easy way of getting the info for my paperwork in a quick way.

-number plate
-pillar damage
-airbag deployment
-level of cabin instrusion

And a few other things I can't remember until I actually look at the ePCR which is why I like the photos.

Its good for case studies too. If you can add a photo to the text for students.

As far as the trauma team, I don't have a great deal of experience with them, but they like to know what happened and I find it easier and quicker to explain with a picture to help.

I'm not terribly concerned about privacy. Its reasonably common to take photos, usually for learning purposes, usually with the pt's permission. I'm not emailing the photos around the place. If I use them in anything remotely public (case studies), I'll de-identify the location and markings. If someone stole my computer and got the photos, they haven't got anything they couldn't have found in the newspaper.
 
If an accident is on a highway or a main street, for example, then it is in open view and pictures are allowed. When in public, people have almost no expectations of privacy. Doesn't mean we shouldn't give them some rights of privacy in pictures, but by law, it wouldn't be violating any laws.

Friend of mine was working on a documentary that made it pretty big, and they shot some footage in an airport terminal. A hasidic jewish man was sitting in plain view of the camera. He did not want his picture taken, but his picture was used in the film itself and the trailer. He sued the production companies and distributors, and lost, because he was in a public space. The fact that he was staring into the lens of the camera for a good 10 seconds didn't help his case either.
 
It's not even close to a HIPPA violation to take pictures of the vehicles (no patients.) There is no expectation of privacy when the accident occurs in a public place. If you're worried about the picture ending up on facebook or someone's phone, use a polaroid. Pictures get dropped off in the ER, end of story.
 
There is nothing about it in my squad's by-laws/protocols. I will of course be courteous as to not take pictures of the patient or the license plate. If I can't get a picture without the license plate, I will be sure to block it out and delete the original. My instructor likes to incorporate new pictures in his slideshows all the time so he asks us if we could get pictures, if allowed, to send to him. I love the one I went to which was a motor vehicle versus a house. The car went over an 8" curb, about 30 yards on their lawn and hit the side of a concrete house.
 
Company policy states that no one is to take pictures on scene without a supervisors permission, this includes the use of camera phones. We do carry a digital camera on every truck, but it's in a sealed accident reporting kit. In the event of an MVC involving the ambulances, we are to take as many pictures (relevant of course) of the ambulance and whatever we were hit by/what we hit (the latter being more common as of late).
 
I can recall one time when a picture was used from a cell phone to convince a doctor that something might be going on.

dispatched to a car vs tree, car was on the high way, ended up going off the roadway and hitting a few tree, and collided on the passenger side of the car causing about 3 feet of intrusion. driver was drunk as a skunk, which is probably how he walked away with barely a scratch. the car was destroyed.

anyway, we took the patient to the trauma center, instead of the local hospital, and the trauma attending asked us why we took him there, if he had minor injuries. two photos of the car convinced him that the patient deserved a trauma work up, even if he presented with minor injuries.

now, if you can't control yourself from posting the pics to FB, that's another issue. I have a couple cool MVA pics, some even cooler fire pics that have made it to FB (and the news paper), but they were all taken off duty.

besides, if a pictures is worth a thousand words, and your goal is to paint a picture for later, isn't a picture a very valuable piece of documentation?
 
My thoughts:

How many pictures were in your powerpoint presentations during school with proper changes to eliminate pt identification? I'd love someone to tell me how, with proper screening, that a picture is a violation of HIPAA.

Next. If your using a service issued camera how is that going to make it on the internet? How is it violating HIPAA by showing it to the trauma team? They are providing pt care so they should be privy to the information.

Next. It may lead to tunnel vision, if your not doing a good assessment/being a good clinician. It can give you or the trauma team an idea of what they may be dealing with. Don't withhold care to take photos but if there is a set of extra hands how is it going to hurt? If a trauma surgeon/MD is getting tunnel vision from a photo they see they shouldn't be in the position of power and definitive care that they are.

Just my 0.02

If your posting them all over the net via facebook/myspace/twitter/whatever your flavor is then that is inappropriate. If used for pt care I feel they can be another type of tool used to steer the treatment in the correct direction.
 
NVRob said:
Next. It may lead to tunnel vision, if your not doing a good assessment/being a good clinician. It can give you or the trauma team an idea of what they may be dealing with. Don't withhold care to take photos but if there is a set of extra hands how is it going to hurt? If a trauma surgeon/MD is getting tunnel vision from a photo they see they shouldn't be in the position of power and definitive care that they are.
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I disagree. A picture has absolutely ZERO bearing on what your exam will reveal. You will not rule out any test, exam or procedure based on a photograph. You will still maintain a high index of suspicion. So based on that, what does a picture offer? Absolutely nothing.
 
akflightmedic said:
I disagree. A picture has absolutely ZERO bearing on what your exam will reveal. You will not rule out any test, exam or procedure based on a photograph. You will still maintain a high index of suspicion. So based on that, what does a picture offer? Absolutely nothing.
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I just re-read my original post and I think I was not completely clear. It was obvious to me that the nurse assessing the patient was about to put her at the end of the line in the hallway. The picture of the car clearly made a difference in her immediate treatment. Yes OUR index of suspicion was very high, but we weren't otherwise able to convey that to the nurse (which you are free to argue is also our fault).
 
akflightmedic said:
I disagree. A picture has absolutely ZERO bearing on what your exam will reveal. You will not rule out any test, exam or procedure based on a photograph. You will still maintain a high index of suspicion. So based on that, what does a picture offer? Absolutely nothing.
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A good quality photograph will let the trauma team see the results of the accident. You never know, they may see something you might have missed at the scene because of your focus on the patient. If you have the time, like during an extrication where you can't access the patient, then yeah, grab a few shots. If your patient's condition dictates that they need that trauma team 2 minutes ago, then don't wast your time with photos.

If you're standing around doing nothing at a scene, you never know, snapping a few photos of the scene could prove to have been a couple seconds well spent.
 
Simusid said:
I just re-read my original post and I think I was not completely clear. It was obvious to me that the nurse assessing the patient was about to put her at the end of the line in the hallway. The picture of the car clearly made a difference in her immediate treatment. Yes OUR index of suspicion was very high, but we weren't otherwise able to convey that to the nurse (which you are free to argue is also our fault).
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The yes, if you are willing to assume the blame for not conveying how serious your patient truly was, then sure...it is your fault and you did a poor assessment.

Again, showing the picture to a nurse and having her change her treatment based on a photograph is poor form on her as well--ON HER.

But with your explanation, the original issue started with your inability to relay how serious your patient was.
 
Cup of Joe said:
A good quality photograph will let the trauma team see the results of the accident. You never know, they may see something you might have missed at the scene because of your focus on the patient. If you have the time, like during an extrication where you can't access the patient, then yeah, grab a few shots. If your patient's condition dictates that they need that trauma team 2 minutes ago, then don't wast your time with photos.

If you're standing around doing nothing at a scene, you never know, snapping a few photos of the scene could prove to have been a couple seconds well spent.
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You can not enter a debate and have your one fact or main statement as "You never know". That is not how we perform within medicine.

Please tell me exactly what a "good trauma team" is going to see in a picture which is going to change their assessment, treatment or exam???

Hint: Absolutely nothing.
 
akflightmedic said:
The yes, if you are willing to assume the blame for not conveying how serious your patient truly was, then sure...it is your fault and you did a poor assessment.

Again, showing the picture to a nurse and having her change her treatment based on a photograph is poor form on her as well--ON HER.

But with your explanation, the original issue started with your inability to relay how serious your patient was.
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So if I try to relay to the hospital staff the acuity of the situation, and they don't want to listen, it's MY fault?

Absolutely not. I am an advocate for my patient, and do everything within my power to paint as accurate of a picture as possible to the receiving staff. The fact that you place the hospital personnel's screw ups on the EMS provider is insulting. I work with a trauma center/university tertiary care center that routinely discounts EMS accounts of initial acuity of the patient. Photos have been used more than once to back up the assessments of the EMS providers.

Just like one single test or one single part of the assessment rarely makes the diagnosis, but are a part of the entire assessment and workup, photos have a similar place of importance.
 
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