How to address disabled family members.

[Aidey]

This is kind of a strange scenario my company has run into a couple of times recently, and none of us have been able to come up with a good resolution.

You are called to transport a patient either to or from the hospital. They are accompanied by a family member who is wheelchair bound (specifically the big, heavy electric type.) This family member requests that you also transport them with the patient.

Something to keep in mind is that after hours there are no wheel chair taxis available. In fact, in my area there is only one wheel chair van running after hours, and they are for hospital to home transports only (and the person has to have been the patient). So if the person takes a wheel chair taxi to the hospital, there may not be one available to take them home.

So, what do you do when this person wants to accompany the patient to the hospital?

More complicated, what about if you are taking the patient home from the hospital? It is one thing to leave the person at home, it's another to leave them at the hospital. Is it ethical to take another ambulance out of service to transport the bystander as a courtesy? What then happens to the wheelchair? Is it a violation of the ADA to refuse to transport the family member? Is it reasonable to expect the hospital to store the wheelchair?

Also, keep in mind the person may not be able to use a non-motorized wheel chair for whatever reason, so if they don't have their normal chair, they can't get around.

 

[emt seeking first job]

Sounds like an issue you should bring up during the next meeting, or ask to speak to operations manager and ask for a written protocol on that very issue.

Does you area have access a ride service for people who dont need BLS but cant drive, bus or taxi it?

 

[Sassafras]

My company would transport wheelchair, but we'd also charge them a pretty penny LOL. We don't care when or where though as long as it's medically related somehow.

 

[nomofica]

Too many incidents happened with my service with friends/family members of the patient that we generally don't give them a lift even if they ask for one. Three is already a crowd, four is a sardine can with flashy things and loud things on round things.

Sometimes we'll accommodate given certain circumstances (ATV accident in the middle of nowhere? Sure. If we see the family/friend obviously has a vehicle that runs? Got gas? Good, use it.) Yes I realized that this is in debate about (electrical) wheelchair-bound persons. Sorry, but there's no room for you in the back of our rigs. I'd love to help you out, but you're gonna have to find another way. However where I am, we have plenty of wheelchair taxis that operate after-hours so this is a non-issue for our area.

 

[feldy]

Just had this inncident two days ago. Man was at the hospital after hours (around 11ish at night) and was to be transported back to his nursing home with his wife in a motorized wheelchair. Most of the private ambulance services also have a chair car or too and although they didnt have anyone staffing it at the time, the base wasnt to far from the Hospital so they were able to have an EMT take the chair car to transport while another crew transported the spouse.

 

[MDA]

We simply wouldn't do it.

We have only ALS units (even though we might do a transfer is if County levels are above minimum), and aside that we couldn't transport them anyway due to the gurney/no tie downs for a motorized cart.

There's a couple 24 hour medi-van type companies in the area that could be there to pick them up and taxi them around within 5 minutes of them calling.

 

[somePerson]

If it's a 911 call I wouldn't do it, maybe in severely unusual circumstance like (dad is patient, minor in wheelchair and no other family/friends can take care of minor). If it's important enough for them to think they need to call 911 for their "emergency", I'm not gonna spend another 20 minutes on scene fumble :censored::censored::censored::censored:ing with the wheelchair.

 

[MDA]

If it's a 911 call I wouldn't do it, maybe in severely unusual circumstance like (dad is patient, minor in wheelchair and no other family/friends can take care of minor). If it's important enough for them to think they need to call 911 for their "emergency", I'm not gonna spend another 20 minutes on scene fumble :censored::censored::censored::censored:ing with the wheelchair.

Well yeah, in an unusual circumstance and there's a minor involved either being transported and their parent is, they won't be left alone. Same goes for another family member. I would notify dispatch and either fire (who will show up on scene regardless) or our current mobile supervisor will be with them until their transportation arrives.

I'm not that cold hearted.

 

[BLSBoy]

However that person got to the hospital, should be the way they get home.
If the service is DCed, they should have made arraingements earlier.
Disabled means I make reasonable accomadations for you, not bend over backwards because you are lazy/ignorant.

Then again, I don't do interfacility, so saying no is easy. If I transport, there is a reason why!

 

[Akulahawk]

If I can't safely lift or fit your motorized wheelchair in the back of my rig, you're not going to be going with me. I will attempt to make reasonable accommodations for the wheelchair mobile person wishing to go with the patient. If it's a 911 call and the person needs to accompany the patient to the hospital in some manner, fine. I'll call Law Enforcement or Fire and see if they have some means of making that happen. If the disabled person is a guardian of the patient and refuses care unless they go... I'll have LE take the patient into protective custody, if necessary... and then LE can figure out a way to get the person to the ED.

Basically, it's all about safety. I'm not transporting someone who is NOT a patient, especially as a courtesy, if it's not safe for me to do so.

 

[Aidey]

What about the hospital to home situations? I hate to be like "Sorry, not my problem", and leave the person stranded at the hospital until the WC taxi starts running in the morning.

 

[feldy]

same thing, if they cant fit in with the chair, they cant come. Meet us back at home. We'll call a chair car.

 

[Aidey]

That is the issue though, there is no chair car available. They have no way to get home.

 

[Outbac1]

We do not transport wheelchairs of any sort. We have no place to secure them so they don't go flying around in the event of a mvc. In an severe emergency I don't normaly take family. In non emergent situations if they can get in the front themselves they can come, otherwise they have to find another way. We usually try to accomodate family if we can but it is the individual medics decision whether to take them or not. The family are told just because they went to the hosp. with us does not mean they will be able to go home again with us as well. We also don't transport tons of luggage.

 

[BLSBoy]

you don't take family?
Dude, even in codes I am humane enough to put a family member requesting transport in the front seat.

 

[feldy]

you don't take family?
Dude, even in codes I am humane enough to put a family member requesting transport in the front seat.

I think what they meant is that if the family member is in a wheelchair motorized or needs full help getting in and out, then there isnt any room for them or the chair. Most bls trucks at least in my area are type 2 unless out EMS is from FD then they are usually a 3 or medium duty.

But if family is transported its in the front unless it like a DNR situation where they are just going to the hospital to for palliative care, then fam can sit in the back since care will be fairly minimal.

 

[BLSBoy]

I think what they meant is that if the family member is in a wheelchair motorized or needs full help getting in and out, then there isnt any room for them or the chair. Most bls trucks at least in my area are type 2 unless out EMS is from FD then they are usually a 3 or medium duty.

But if family is transported its in the front unless it like a DNR situation where they are just going to the hospital to for palliative care, then fam can sit in the back since care will be fairly minimal.

Only time I have family in the back is when its a stable pedi.

 

[Akulahawk]

What about the hospital to home situations? I hate to be like "Sorry, not my problem", and leave the person stranded at the hospital until the WC taxi starts running in the morning.

same thing, if they cant fit in with the chair, they cant come. Meet us back at home. We'll call a chair car.

Hospital to home situations... again, in the situation where the motorized wheelchair can't/won't fit in the ambulance, I will not be able to transport the person with the patient. If that results in there not being anyone home to care for the patient, then discharge planning has done an extremely poor job... in that instance, the patient wouldn't be transported.

If calling for a chair car can be done, then I'll do that as well.

 

[abckidsmom]

A service I worked at had a policy against ever transporting electric wheelchairs. We just didn't do it.

In this situation, I may have transported the family member up front, parked the chair and put them in a regular wheelchair at the hospital, but there would need to be some special circumstances to necessitate the transport of the wheelchair-bound person.

 

[ajax]

My service has chair cars, so I imagine if we came across this after hours when the chair car drivers have gone home, we'd call a supervisor and the supervisor would bring the chair car and follow us to the pt's home. In an emergent situation, they're not coming. We can't waste time on scene. I'd call a supe and ask for a car to come bring the parent to the ER, but I'm not waiting on scene for the car to show.