Is It Ever Our Job to Inform the Family

MicahW

MicahW

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I have heard a couple of different opinions on this topic and I was wondering about all of your opinions. Is it ever our job to call the family?

What if it is a pediatric and it would be benificial if the hospital could get parental consent immediately? What if you find a patient unresponsive and you see the patient's phone ringing and the call is from "Mom" or "Dad". If it were your child, wouldn't you want to know immediately. If a patient is dying, it could be the difference between the family getting to say goodby and not. Also, is it a HIPPA violation (and if it is, would it still be considered so if a patient asked "could you please call my family for me?")?

One of the reasons that I ask is that a couple of months ago, as a student, I signed up to take an all night shift at a music festival. The company with which I was training was running EMS there and we also had a medical tent set up. At about 2030, two guys walked up to the front of the tent and told me that they had lost their friend who was a little too drunk. I told them that this wasn't really an ems matter, but that there was a security tent just a couple of hundred feet over. He said that that wasn't necessary and that he just wanted us to let him know if the friend came in as the result of his ETOH. I asked him if he were sure that that was all that he had had (no drugs) and he said yes. Again, I told him that he was probably looking in the wrong place, and that being slightly drunk doesn't really get you a trip to the medical tent, (if it did, most of the people there would have been in the medical tent). Still, I told him to leave a description and number and that I would call him if his friend showed up.

It is now about 2315. A patient comes in, carried off of a golf cart that we were using to transport patients throughout the concert ground. GCS of 3. We throw him on a cot and I start to hook him up to the 3 lead as a medic starts his assesment. I move down to the ankles to place the leg leads and all of the sudden, this guy wakes up an tries to kick me in the face. It takes about 10 big guys to restrain him. My friend, also a student, runs in and looks at the guy and asks if that is the guy who was described by his friends earlier. I told him there was no way: that guy was drunk, this guy a little too screwed up to be a mere ETOH (it was later revealed that he was ETOH, on molly, acid, mushrooms, and had smoked some weed). After being chemically restrained, we transport him to the hospital. I have the peoce of paper with the description on it in my pocket. I realize that this is the guy. I ask my medic if we should call the friends. He tells me that it is the hospital's probelem and to leave the number with them. I wasn't really in any mood to help a guy who had tried to kick me in the face and was now swearing at me while heavily sedated and tied to a stretcher. After we drop him off and start to head back, O get a text from my friend. The friends had stopped in to check if we had seen him. My friend had given them the story and they were pissed at us for not calling them.

Did my friend break any HIPPA regs?
Would I have been in the wrong to call?
 
They didn't break HIPPA but they did break HIPAA. You can always pass on any information to the hospital and let them decide, but once their buddy comes in as a patient then you can't tell them that they are there. If you happen to have had security informed about the missing person, and they happen to be in the tent and notice that the patient looks an awful lot like the description of a missing person; there is nothing that you could do to prevent security from calling the friends of the patient. But over all yeah it would be wrong to call the friends, according to HIPAA. If the patient ends up pissed that they were called without his permission there could be fines involved.
 
Dude...no. It's our job to treat the patients, not be playing telephone with family members.

A minor in emergency situations would fall under implied consent.

If a patient asks me to call their family, I'll tell them that there's a phone at the ER and I'll bring it to them when we get there so they can call them.

Say you find a minor down unresponsive. Was he hit by a car? Does he have a seizure Hx and is now postictal? Maybe he's diabetic and had a syncopal. The possibilities are endless. You're going to remove yourself from the assessment and treatment of this patient to talk on the phone?

Sure, maybe we could learn some Hx that would be pertinent, but we treat plenty of adult patients without getting on the blower to their family. We use our assessments and on scene clues to make the best decisions for the patient's care and to get them to the appropriate higher level of care.

If it's a scenario where it may mean the difference between the family being able to say goodbye or not, you've got way more important things to be doing than playing 20 questions with the family. Toss that phone to the nearest police officer and continue doing your job. Which is exactly what I'd do in most scenarios. "Hey Deputy, this kids mom keeps blowing up his phone. Here you go."

The family will be contacted by either law enforcement or hospital and can come down to the ER and say their goodbyes. I've done CPR in the ER until the family arrives to say goodbye. I've had them come by after everything was over and say goodbye. It's heartbreaking everytime.

The Medic is right. Im assuming the dude at the music festival is an adult. He's a grown man and partied too hard. I'm not going to be calling up his friends and telling them their friend is an idiot. They already know that. He's safe in the hospital. They'll treat him and when he comes around he can start making phone calls. If he's really far gone, the hospital will call his family. His friends can call his family. You can't release information about him without his consent.
 
There is nothing wrong with calling and saying "hey guys, we found John. He is at blank hospital right now".

I have called family and friends several times on calls with zero issues. Just state who you are and ask them for information that you need. Thank them for their help and then state what hospital the patient will be at.
 
GCS of 3!! Holy crap...No painful stimuli at all? Just curious since the others addressed the rest.
 
Yeah, that's what the incident report said, I didn't check the GCS, we had an EMR student do it and throughout the night, we discovered how incompetent he was. So on second thought, that number is probably incorrect, it's just what I remember him saying. Didn't even think about that number, good catch!
 
He was swearing at them. Think Think Thinking I've him a 5 on verbal for verbal for that.
 
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