Pat Downs

[CAOX3]

What's everyones view on Outer Pocket/Clothing 'Pat Downs' on patients suspected of having needles or sharp objects on them?

I know that LEO's are the ones who can legally pull things out of peoples pockets, I'm not talking about any drastic 'Pat Downs' just precautions prior to having to lift someone either out of a house, up a hill/down a hill, or out of a car and onto a stretcher...

Unconscious patients with suspected drug use/overdose should get their pockets cut.

We dont reach in anyones pockets.

Police can pat down the conscious ones or they may cut them too if deemed neccesary.

 

[ZVNEMT]

Any pt not coming from a nursing home, we'll flag down security at the hospital to use the wand. If i have to search pockets for ID i use my shears as a probe, if needed I'll just cut the pocket open.

 

[Trayos]

Could cutting the pockets be covered under the same standards as removing other articles of clothing? It seems like the best option at this point, at least to me,

 

[DrParasite]

If you are suspicious and the pt refuses a pat down, refuse to treat them, its that simple. Your safety comes first and if you have reason to believe you may be endangered dont touch them. It never usually comes to that but its good to just ask politely if they might have any sharps on them etc, most of the time they know you want to help them and will cooperate.

+1. if they don't want you to check them for weapons, then they obviously don't need an ambulance. it's either an RMA by action or unsafe scene your call. lets PD know to call you back when they get on scene and the patient has been properly searched.

Unconscious patients with suspected drug use/overdose should get their pockets cut.

very simple thing, but it never even occurred to me to do this. good call!

 

[JPINFV]

+1. if they don't want you to check them for weapons, then they obviously don't need an ambulance. it's either an RMA by action or unsafe scene your call. lets PD know to call you back when they get on scene and the patient has been properly searched.

I'm sorry, I didn't realize that I surrendered my constitutional protection against unreasonable search and seizure because I'm having a medical emergency. You better have a better reason than 'because I wanted to' if you want to pull the scene safety card.

 

[ah2388]

I'm sorry, I didn't realize that I surrendered my constitutional protection against unreasonable search and seizure because I'm having a medical emergency. You better have a better reason than 'because I wanted to' if you want to pull the scene safety card.

i understand the argument that paranoia is what creates the majority of issues related to this type of thing, but with that being said...would you agree that EMS providers are kind of between a rock and a hard place. Ensuring personal safety without violating the rights of patients. And truthfully, in theory "scene safety" is probably over drilled into peoples heads the majority of the time, but in practice..safety of the provider must be the first priority on scene.

 

[AlphaButch]

I'm sorry, I didn't realize that I surrendered my constitutional protection against unreasonable search and seizure because I'm having a medical emergency. You better have a better reason than 'because I wanted to' if you want to pull the scene safety card.

I don't find it unreasonable to ensure that a pt has no sharps, weapons, etc. before treating them. If they won't consent, then they don't get treated. Part of treating a patient is removing them from harm.

So other than scene safety.. there's "removing clothing in order to do a proper assessment", "removing harmful or dangerous objects/substances which may result in self-injury or injury to others", "searching a pt for information relevant to the emergency", etc.

Always have a witness and never be alone with a patient while the risk of a behavioral emergency is present.

 

[Shishkabob]

I'm sorry, I didn't realize that I surrendered my constitutional protection against unreasonable search and seizure because I'm having a medical emergency. You better have a better reason than 'because I wanted to' if you want to pull the scene safety card.

Civilians are not bound by the 4th amendment >_<

 

[JPINFV]

i understand the argument that paranoia is what creates the majority of issues related to this type of thing, but with that being said...would you agree that EMS providers are kind of between a rock and a hard place. Ensuring personal safety without violating the rights of patients. And truthfully, in theory "scene safety" is probably over drilled into peoples heads the majority of the time, but in practice..safety of the provider must be the first priority on scene.

Yes, it's a rock and a hard place with the paranoia of EMS providers. Reference any of the "EMS called to treat someone with a CCW" threads because the mentality of many providers is "gun=police or bad guy."

 

[JPINFV]

Civilians are not bound by the 4th amendment >_<

Except:

1. The text of the 4th Amendment doesn't limit it to law enforcement.

2. In all most all cases 911 services is either a municipal service (be it 3rd government or EMS based fire suppression) or a contracted service.

3. Without some sort of reasonable suspicion that the patient is both carrying something dangerous and is dangerous (you don't need a knife or a gun to be dangerous. Also, are we separating, say, a butterfly knife and a pocket knife?), denying care could easily fall under abandonment.

 

[DrParasite]

I'm sorry, I didn't realize that I surrendered my constitutional protection against unreasonable search and seizure because I'm having a medical emergency. You better have a better reason than 'because I wanted to' if you want to pull the scene safety card.

because my safety comes first? I don't plan on using anything I find in your pockets against you in a court of law. but I would rather find it and have it thrown out when you get arrested than not find it and have it used against me in the back of the ambulance. and remember, I am not the cops, so search and seizure rules don't apply the same way (look at school searches for a comparable example).

Except:

1. The text of the 4th Amendment doesn't limit it to law enforcement.

actually, the 4th amendment is completely about law enforcement and the courts. Just like your mother can search your room and use what she finds against you (and the 4th amendment won't save you), or your boss can search your cubicle, as long as a LEO doesn't do the search, for the purposes of using it against you in a court of law, you should be ok.

2. In all most all cases 911 services is either a municipal service (be it 3rd government or EMS based fire suppression) or a contracted service.

WRONG. volunteer EMS systems are often independent from the government, or hospital based. and if they are contracted, they aren't part of the government at all. so yeah, either way, they aren't law enforcement.

3. Without some sort of reasonable suspicion that the patient is both carrying something dangerous and is dangerous (you don't need a knife or a gun to be dangerous. Also, are we separating, say, a butterfly knife and a pocket knife?), denying care could easily fall under abandonment.

you ever been hit in the head by grandma's cane? damn thing can hurt. are you saying a pocket knife isn't dangerous? I have a pocket knife with a locking blade, which is about 4 inches long while closed and about 8 while open (yeah, it's pretty big). I am pretty sure I can do quite a bit of damage if i sucker stabbed you. and If I slip it into the back pocket of my jeans, you won't even know I have it.

and you never, ever deny anyone care. that is abandonment. however, if you leave an unsafe scene, and wait to PD to arrive and secure it, well, that isn't abandonment. now if he says "you ain't checking me for anything dangerous" doesn't that raise a flag in your brain? what is he hiding? maybe something to hurt you? so you clear the scene until PD arrives to ensure it is safe. not really rocket science.

 

[JPINFV]

because my safety comes first? I don't plan on using anything I find in your pockets against you in a court of law. but I would rather find it and have it thrown out when you get arrested than not find it and have it used against me in the back of the ambulance. and remember, I am not the cops, so search and seizure rules don't apply the same way (look at school searches for a comparable example).

So if I have a pocket knife, you're going to throw it out? There are objects that are legal to have that can be considered "dangerous," however the presence of a "dangerous" object doesn't mean it can be thrown out or that it should be taken away.

actually, the 4th amendment is completely about law enforcement and the courts. Just like your mother can search your room and use what she finds against you (and the 4th amendment won't save you), or your boss can search your cubicle, as long as a LEO doesn't do the search, for the purposes of using it against you in a court of law, you should be ok.

Depends. As a child, she is the actual "owner" of everything. If I am an adult in a renter situation, then she doens't have a right to enter my room as a land lord. Granted, this ignores the entire family member vs complete stranger going through my things difference.

WRONG. volunteer EMS systems are often independent from the government, or hospital based. and if they are contracted, they aren't part of the government at all. so yeah, either way, they aren't law enforcement.
you ever been hit in the head by grandma's cane? damn thing can hurt. are you saying a pocket knife isn't dangerous? I have a pocket knife with a locking blade, which is about 4 inches long while closed and about 8 while open (yeah, it's pretty big). I am pretty sure I can do quite a bit of damage if i sucker stabbed you. and If I slip it into the back pocket of my jeans, you won't even know I have it.

I'm saying that I wouldn't confiscate a pocket knife or granny's cane for the sole reason that they have it. However I'm not so paranoid to think that everyone with a cane or a pocket knife are going to stab me or bonk me over the head. If the volunteer ambulance is dispatched by means of the 911 system, then it is acting as a government service.

and you never, ever deny anyone care. that is abandonment. however, if you leave an unsafe scene, and wait to PD to arrive and secure it, well, that isn't abandonment. now if he says "you ain't checking me for anything dangerous" doesn't that raise a flag in your brain? what is he hiding? maybe something to hurt you? so you clear the scene until PD arrives to ensure it is safe. not really rocket science.

Depends on the situation. Maybe I just don't want you feeling me up because you're paranoid that I might be carrying a legal tool and if you deny care because of some unreasonable paranoia, you can bet that that would be considered abandonment. Sorry, but I can just see plenty of people here refusing to care for, say, a construction worker because they have a box cutter unless police are on scene. Yes, I think that a jury would find that sort of refusal to provide care unreasonable.

 

[AlphaButch]

If a person is presenting with ALOC, or any signs of becoming a hazard to myself or others (this includes agitation, prior hx of violence, etc) or becoming a behavioral patient, then a search is justified and related to the scope of why I was called on scene.

If I ask someone if they could "bunny ear" their pockets so I don't get an unwanted surprise and they deny the request, they have just denied treatment as I will not assess them without ensuring my own safety. They can sign a refusal and I'll be on my way, or I will wait for PD to secure the scene.

The construction guy with a box cutter..yep, he's giving it up (he can get it back later at the hospital or after I've left).

Granny's cane? she won't need it, if she needs to be moved, we'll move her. If she wants it brought with us, I have no issue with putting it and/or any other belongings (within reason) together in a bag and tossing it in the truck.

I understand that you may be playing devil's advocate on this one. Here's an example of an unreasonable search;

If I get on scene and the patient does not present with ALOC, or any signs of becoming a hazard to myself or others (this includes agitation, prior hx of violence, etc) or becoming a behavioral patient; If a patient does not have any injuries or complaints which require assessment or treatment, or refuses treatment; and anyone (LEO, parent, etc) asks for me to search a pt (reason regardless), then it may be construed as an illegal search as the search did not meet justification within my scope of treatment. If I am given consent by local LEOs (the person is in their custody), they can pat them down first and get stuck, then I'll assess and treat.

 

[JPINFV]

Let's take this to the extreme. Police officer is shot. Would you refuse to treat the police officer until someone else removed all of the weapons on their duty belt and any/all backup weapons? I can give plenty of examples of police officers being untrustworthy (University of Maryland student beating, Seattle detective stomping on a person mistakenly ID'ed as a suspect who was proned out on the ground while using racially hateful language, East Palo Alto PD officer threatening to murder civilians, and off duty Baltimore murdering (and shockingly charged with murder even) another person at a bar) in just the last few months, so I don't want to hear the, "but it's a police officer" argument.

 

[AlphaButch]

Let's take this to the extreme. Police officer is shot. Would you refuse to treat the police officer until someone else removed all of the weapons on their duty belt and any/all backup weapons? I can give plenty of examples of police officers being untrustworthy (University of Maryland student beating, Seattle detective stomping on a person mistakenly ID'ed as a suspect who was proned out on the ground while using racially hateful language, East Palo Alto PD officer threatening to murder civilians, and off duty Baltimore murdering (and shockingly charged with murder even) another person at a bar) in just the last few months, so I don't want to hear the, "but it's a police officer" argument.

Yes. If they are unable to maintain positive control of their weapon (or will be unable to, due to pain management, etc) or they meet the ALOC/behavior standard, they give up their belt and tools to their partner/superior, etc. It's happened a few times down here over the last year, I may start treatment but there is always someone there who will be responsible for their gear. If I'm doing a combined response, I'll secure their gear away myself until their CO meets me and signs it all out or I sign it all over to the PD at the ER.

I also expect that should I be the one as a patient, that my weapons get locked away. I don't want to come out of a medicated state and informed that I shot the medic treating me or that my weapon was lost somewhere because no one knew I had one and it fell out somewhere (wasn't secured by the medic on scene).

 

[CAOX3]

I'm sorry, I didn't realize that I surrendered my constitutional protection against unreasonable search and seizure because I'm having a medical emergency. You better have a better reason than 'because I wanted to' if you want to pull the scene safety card.

Unconscious parties imply consent whether it be to search or treatment.

I'm not going to be stuck by some junkie who decided to go to his happy place and didn't have the common courtesy to empty his pockets before hand.

Just as I assume if your shot there is someone in the general vicinity with a gun, if you have overdosed I'm assuming there's a needle close by until proven otherwise.

I have the utmost respect for your constitutional rights it isn't granted at the risk to my safety.

We can go to court and argue about it there, I have no problem with that but on scene its my way or the highway. Your also entitled under your constitutional rights to arrange other means of transportation to the hospital.

I dont pat everyone down, if your conscious the cops can deal with you if your not then I will do everything in my power to ensure the safety of everyone involved.

 

[CAOX3]

Let's take this to the extreme. Police officer is shot. Would you refuse to treat the police officer until someone else removed all of the weapons on their duty belt and any/all backup weapons? I can give plenty of examples of police officers being untrustworthy (University of Maryland student beating, Seattle detective stomping on a person mistakenly ID'ed as a suspect who was proned out on the ground while using racially hateful language, East Palo Alto PD officer threatening to murder civilians, and off duty Baltimore murdering (and shockingly charged with murder even) another person at a bar) in just the last few months, so I don't want to hear the, "but it's a police officer" argument.

If anyone is shot I dont go anywhere near them until the police have arrived and cleared the scene.

I dont know if you have ever been on a call where a police officer is injured, but in a matter of minutes every cop within a fifty mile radius will be there in the blink of an eye, on duty, off duty, retired, state, marsharls anyone who holds a badge, you name it. You wont even have your gear out of the truck and you will be surrounded by cops, they will have a route planned to the hospital, a helicopter on standby and a hospital escort that would rival the presidents. They dont mess around with injured cops.

Me securing his weapon wouldn't be a problem as this will be done before I even have the opportunity to lay eyes on him.

 

[1badassEMT-I]

If you are suspicious and the pt refuses a pat down, refuse to treat them, its that simple. Your safety comes first and if you have reason to believe you may be endangered dont touch them. It never usually comes to that but its good to just ask politely if they might have any sharps on them etc, most of the time they know you want to help them and will cooperate.

AGREE Your safety comes first!!!!! PERIOD!!!!!

 

[Shishkabob]

I ram on five ODs last night...half of them conscious. I went through the pockets of each one of them, looking for id, prescription meds, and the offending drugs to know what I was working with.

If I'm taking you to the hospital against your will, any claims of assault and/or battery will fall on deaf ears, as I'm already doing something against you're wishes so it doesn't matter if you refuse to let me search your pockets.

 

[DrParasite]

So if I have a pocket knife, you're going to throw it out? There are objects that are legal to have that can be considered "dangerous," however the presence of a "dangerous" object doesn't mean it can be thrown out or that it should be taken away.

my safety comes first. you as a fellow provider should not argue this fact. and no, I am not going to throw it out. I will, however, confiscate it for the duration of the transport. it will be turned over to security, and they can return it when you leave the ER. oh, and just for the record, you have the right to carry a pocket knife, because it's legal. but the TSA has an amazing collection of pocket knives, nail files, and nail clippers. try arguing with them that your search and seizure rights are being violated, and you have a right to keep your legal items. let me know how far you get, and unless i am mistaken, they are not considered law enforcement officers either.

I'm saying that I wouldn't confiscate a pocket knife or granny's cane for the sole reason that they have it. However I'm not so paranoid to think that everyone with a cane or a pocket knife are going to stab me or bonk me over the head. If the volunteer ambulance is dispatched by means of the 911 system, then it is acting as a government service.

I hope for your sake you never get stabbed or bonked on the head by a demented patient because of your careless thinking.

Depends on the situation. Maybe I just don't want you feeling me up because you're paranoid that I might be carrying a legal tool and if you deny care because of some unreasonable paranoia, you can bet that that would be considered abandonment. Sorry, but I can just see plenty of people here refusing to care for, say, a construction worker because they have a box cutter unless police are on scene. Yes, I think that a jury would find that sort of refusal to provide care unreasonable.

are you a cute blond? maybe a playboy bunny? maybe you got a great rack? I mean, not that I would ever feel up any patient, but unless you meet the above 3 qualification, then the thought won't even cross my mind.

you can see a construction work being refused care because he has a box cutter? I don't blame 'em. solution? take the box cutter away and give it to one of his coworkers. Then he can get all the treatment he wants. or, he can refuse to give it up, which tells me that he doesn't want my help that much. RMA by action, unsafe scene, you chose, if you want my help, you follow my rules. otherwise, if you are sick, i will wait until you pass out, then remove any and all items in your possession that can hurt me, and treat you accordingly. not all that complicated.

why stop at a construction worker? what about a butcher? would you let a butcher carry his favorite knife with him (an 8 inch cleaver) that he just cut his thumb off with to the hospital? after all, it's legal for him to have. or what about a hunting accident? are you going to let the hunter keep his loaded shot gun while you transport him? after all it's his legal right to have.