Refusal, still collect vitals?

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noisyone

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I am a new EMT. I work as a volunteer for a local department. I am getting more and more comfortable on calls, but had a question.

We had a call this weekend and as we were walking in to the house, I asked my partner if he wanted me to grab the bags, or see what is going on first. He said lets just see what's going on. We had a feeling it would be nothing. It turned out to be nothing and the patient refused treatment. I grabbed him the tablet out of the ambulance and waited for him as he filled out everything in the house. Then we left.

My question is....should I have collected vitals in a case like this? Keep in mind, we had not brought any equipment in with us, and he never asked me to. I just didn't know if I should have taken it upon myself to go get the bag and start collecting them.

Thanks for the feedback. As I mentioned, I am new, so I'm still trying to sort out the flow of the calls sometimes.
 
I would've it's protocol where I work to have base line vitals on every Pt. If not the chart will normaly get flagged especially if we don't document a good reason.
 
Shoot, I kinda feel stupid now. I guess I figured on a refusal, they were refusing everything and essentially didn't want us to touch them. I'll try to ask the medic next time I see him and see if that was his expectation.
 
If it's a flat out refusal then you may not be able to get vitals. Document it as such.

If it's an AMA then for us we have to get 2 sets of vitals.

I'd question more of the fact of not bringing in any gear to a call
 
If they have no medical complaint then document as such and continue on your way. If they've got a complaint but are refusing transport/treatment I'd push for vitals. If they refuse them, document as such.

False/accidental activations of 911 do happen.
 
You need to be bringing your primary and monitor if you have one on every call. I, and am sure most have showed up somewhere thinking it was BS, turns out the guy is in arrest. Imagine having to run back for equipment? Not a good look and you are making your pt suffer more. You would also probably lose your job.
 
I agree with what everyone is saying. No it is not a common practice, in fact it is the only time I have run a call where we did not bring things inside with us. What should I have told the paramedic when he told me not to bring in anything? Keep in mind, in our chain of command he is above me.
 
noisyone said:
I agree with what everyone is saying. No it is not a common practice, in fact it is the only time I have run a call where we did not bring things inside with us. What should I have told the paramedic when he told me not to bring in anything? Keep in mind, in our chain of command he is above me.
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Don't ask just grab it shouldn't even be a question. If he gets mad what's he going to do write you up for doing your job.
 
There are plenty of calls where it is not be essential to being everything. There are also calls where certain vitals are unnecessary, like ecg for a pediatric skinned knee. Don't worry about it.
 
Chewy20 said:
You need to be bringing your primary and monitor if you have one on every call. I, and am sure most have showed up somewhere thinking it was BS, turns out the guy is in arrest. Imagine having to run back for equipment? Not a good look and you are making your pt suffer more. You would also probably lose your job.
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Kid rounds a corner in his house, runs into a table, cuts self. What use is a monitor?
 
RocketMedic said:
Kid rounds a corner in his house, runs into a table, cuts self. What use is a monitor?
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My vital signs for the county and company like us to get SpO2 along with other vitals. Our SpO2 is in the monitor
 
If we're getting a call for a public assist and fire is already on scene I won't bring anything in generally. They've got all their bags, why do I need mine too? Work smarter not harder. I can think of 3 situations where immediate intervention is warranted and that's arrest, FBAO or severe anaphylaxis. All things I can treat out of fire's bag if I absolutely have to.

In the 3+ years ok 2.5 years since I was out for a while with my shoulder, I haven't walked into something that was dispatched as BS and found it to be one of the above and we run 1500-1800 calls/year each as in each employee.
 
It depends on your agency and their policies. At mine, if the person has no complaint, they don't need vitals. If they have a complaint and want to AMA, we get vitals. If they want nothing to do with us, I document as such and leave.


Now... as for not bringing in gear..ALWAYS BRING EVERYTHING. Just wait until you get bit in the *** for a ''nothing'' call being a cardiac arrest. It happens. There is no excuse for not having your ''first-in'' bag.

Handsome Robb said:
If we're getting a call for a public assist and fire is already on scene I won't bring anything in generally. They've got all their bags... All things I can treat out of fire's bag if I absolutely have to.
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Besides my biggest fire responders being primarily BLS and as such don't have my gear, I'd wager 90%+ of the time they bring in nothing more than a clipboard and pen. It's rather annoying to see them (literally) run out to us when we arrive and tell us to hurry as equipment is needed on a critical patient.
 
Handsome Robb said:
If we're getting a call for a public assist and fire is already on scene I won't bring anything in generally. They've got all their bags, why do I need mine too? Work smarter not harder. I can think of 3 situations where immediate intervention is warranted and that's arrest, FBAO or severe anaphylaxis. All things I can treat out of fire's bag if I absolutely have to.

In the 3+ years ok 2.5 years since I was out for a while with my shoulder, I haven't walked into something that was dispatched as BS and found it to be one of the above and we run 1500-1800 calls/year each as in each employee.
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I used to do this until one day fire didn't have a BVM in their bag on a resp arrest.

Same with urgent care. I was used to bringing in just our monitor and the gurney until they refused to give a patient Epi who was having a severe allergic reaction causing myself to go back out and get the bag.
 
@Handsome Robb I don't see grabbing your primary gear as hard work, sorry. There will be no good excuse if you roll into a call with no primary gear and you end up needing it. That's what it was put on the ambulance for, and 99.9% of the time for the BS calls we don't end up needing it except for grabbing vitals if they want to refuse.

Also @RocketMedic my monitor has our sp02 as well, I'm not thinking every BS call is going to somehow end up be a cardiac arrest in the slightest bit. But it does happen, and I believe "working smarter" means having your primary gear. I didn't say everything, simply a bag and monitor.

Sure fire has their own bags, but am I going to let me job ride on hoping they have everything medically they are supposed to? Nope.

Like the other night when I went to a "priority 4 shooting" (which is our second lowest priority), it changed to a 2 as we rolled up. Police never let dispatch know they were doing CPR. Would of been a real crappy feeling if we walked in there with no gear. No doubt I would have been speaking to brass about it. with no real excuse other than being lazy.

You saying this has never happened to you is probably more reason to start doing it lol. Odds are not in your favor.
 
As a general practice - unless specifically refused by the patient AND documented accordingly ...
I get a set of vitals for every refusal, and multiple sets of vitals on each transport.
 
Chewy20 said:
Like the other night when I went to a "priority 4 shooting" (which is our second lowest priority), it changed to a 2 as we rolled up. Police never let dispatch know they were doing CPR. Would of been a real crappy feeling if we walked in there with no gear. No doubt I would have been speaking to brass about it. with no real excuse other than being lazy.
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What gear do you need for this call besides the stretcher?
 
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