Question for all

[nycemt89]

New member here (and new EMT), posting with a question for any who'd like to respond...

The call is multi vehicle accident with two patients. One car has the right side completely smashed in and the other is front end into a nearby store. The driver of the car in the store is still in the vehicle, conscious. The other driver is walking around dazed, with no apparent serious trauma. When you question the walking driver, she says she doesn't know whether she's lost consciousness or not.

What do you do?

I ask this question because my mother was in such an accident yesterday, where she was the patient wandering dazed after the accident. The paramedics that responded did not board her (though they briefly collared her), and transported her seated (!!!!) in the ambulance with the driver of the car that hit her. It could be my lack of street experience speaking, but it seemed to me that this is a gross violation of procedure. Am I right? Thoughts?

 

[Chimpie]

Explain dazed.

 

[rescuecpt]

Based on how you described the cars, with at least one car travelling fast enough after the collision to leave the road, I would have done a standing takedown - full spinal immobilization procedures.

As far as transporting them together, that's ok, so long as no one talks about the accident or fault. It is not ideal for insurance/lawsuit purposes, but sometimes it's the best you can do (if you have enough personnel to handle 2 patients but a second ambulance is too far out or on another job).

 

[TTLWHKR]

In the world of Triage, anyone who can walk and is conscious is an automatic class 3, Priority Green. If she had no complaints, no pain, no injuries, I would see no problem transporting in such a manner. As long as she is collared and KED in place, that's fine. Unless she did not want to be in a KED, on a board or in a collar, then I would have her sign a refusal of care or treatment. Not to be confused with a refusal of transport. People who cannot walk, or are confined to a vehicle are automatically a class 2, yellow priority. I usually board everyone, unless they are 'walking wounded' with no complaints, then they get to sit in a seat, belted in. If they get transported at all. Can't make people follow our procedures, if the patient doesn't want to be treated, that is their right.

gross violation of procedure. Am I right?

No. All you are getting is one side of a story, heresay, is the term. You're in text book shock.

 

[Flight-LP]

Based on the MOI described, she should have been c-spined, no questions asked. If the patient wishes to decline treatment, thats their choice, have sign a refusal of treatment and transport them. Otherwise, a collar, CID, and LBB is indicated...

 

[Jon]

based on your version of the story, she should have been fully immobilized.

Many providers I've worked with will accomplish this by collaring the patient and having the patient sit on the strecher with the board on the strecher. The feeling is that "the patient is alreday up and walking"

I don't agree with this, but when I'm not in charge, I can't really "make them do it my way"

Even worse is making them get up out of the car and sit on the strecher, while wearing a collar.

I usally do a rapid extrication on MVA's... I'd have no problem using the ked, but someone on my crew would throw a temper tantrum over it...

 

[Ridryder911]

Generally speaking she should had been immobilized, unless they have procedures to clear c-spine. But, since they applied a c-collar I doubt that. Yep, sounds like a mistake.

Be safe,
Ridryder 911

 

[rescuecpt]

Standing takedown! Standing takedown!

Man, I love standing takedowns. Can you tell???

(PS - that's not me or anyone I know, I linked it from emstraininginc.com)