Refusal, still collect vitals?

RocketMedic said:
You can and probably should obtain the monitor for that.

I chuckle when I see people carrying Lifepacks onto MVCs "to get the refusal!"
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For us it's a mix of reasons we take our monitor to TCs/MVCs. Our BP cuff and a steth is stored in it. Our SpO2 is also stored in it. And if we are going to pronounce someone they have to be PEA <40
 
Most wrecks don't involve dead people. If you're pronouncing enough people at roadside to need a monitor on every wreck. I submit you need better roads. As for pulse ox, it is what it is. Do you also need an ECG, capno and sugar for a refusal, and permission?
 
I'll submit that carrying your gear in on every call is the best way to form a habit. At SCEMS, we were required to bring BOTH bags and the monitor on every call. If we were a single medic, one bag and the monitor. Not bringing gear in to a house or to the treatment area of an MVC or active incident would result in discipline. (At least a supervisor talking to... If it was a chronic thing, a write up)

The feeling of the brass was, if this call requires a paramedic assessment, you better have paramedic tools at your fingertips. Better to have and not need, than to need and not have.

And I'm not so lazy that I can't carry a statpack and monitor in to the house with me.

And we wrote a full chart on refusals, documenting that we asked and they refused treatment and/or transport three times.
 
Chewy20 said:
@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.
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That's your opinion. Call me lazy all you want. There's a method to my madness. You also don't know my system, co-responders or my policies.

Let me know how it is with a back injury after needlessly carrying 100lbs of gear in and out of houses when it can very easily be left on the gurney at the front door and available rapidly.
 
Handsome Robb said:
That's your opinion. Call me lazy all you want. There's a method to my madness. You also don't know my system, co-responders or my policies.

Let me know how it is with a back injury after needlessly carrying 100lbs of gear in and out of houses when it can very easily be left on the gurney at the front door and available rapidly.
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100lbs? lol more like 25 maybe. and we never said about leaving stuff at the front door. that's a little different then leaving in the box all together.

Luckily we have auto loaders and power stretchers :p cut down on those back injuries.
 
RocketMedic said:
Most wrecks don't involve dead people. If you're pronouncing enough people at roadside to need a monitor on every wreck. I submit you need better roads. As for pulse ox, it is what it is. Do you also need an ECG, capno and sugar for a refusal, and permission?
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I'm not a fan of having to walk back to the ambulance for items. So if I have a patient in a TC who has no pulse I am now required to go back to the ambulance and get the monitor to check the patient, which may take several minutes depending on obstacles. Much easier to take the monitor with us.

Depending on the patient we may not need to contact base. However we do require vitals on all AMAs which for us requires the monitor. Once again much easier if it is all brought on scene with us.
 
Ok I have not read what everyone has put. here is my view on it. If you do not touch the patient and he/she does not want any medical attention and you do not see anything that is concerning IE GCS 15 Alert and Oriented and no signs of distress/trauma. that is a NO Patient Found type chart.

If you do an assessment and he does not want to be transported than it is a refusal, and you need vitals. If the patient refuses vitals, document that the patient refused and write that on your refusal form and have the patient initial the line.
 
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