Hello everyone.
I'm fairly certain I made a mistake by protocols. Fairly sure I did. However, in the idea of doing no additional harm to a patient, I don't feel my actions were uncalled for. I just want others opinions, even if they are collectively "You made a mistake"
Tonight we got called for a PT, obvious ETOH. Had a good size bump on the head, a lac, and probably broken nose. The guy doesn't fully recall how it happened, just that he walked like 1-2 miles and police found him where we picked him up. PT VERY uncooperative. Doesn't want EMS help, pulls away when I try to assess, I dress/bandage the wound, he rips the dressings off, try to give him an ice pack, throws it away, so on and so forth. This guy adamantly DID want to go. My partner and the PD convinced him he HAD to go get looked at. Here's the thing though-a thought process went through our heads. This FULLY indicates c-spine precautions. He obviously fell, and he's under the influence. However, he's staunchly throwing back any intervention/treatment right back at us, and besides his name, won't give any real relevant information. We opted that the best bet is to keep him cooperative as we possibly can, load him up and keep him as immobile as possible all the way to the ER (about 3 minutes away). Staff was informed the situation and lack of c-spine, and they seemed to agree. He was not c-spined by staff either at this time. Found out he was very uncooperative with staff also.
I'm starting to drill my brain about this. I've been under the mindframe that while this called for C-Spine, and technically when intoxicated, implied consent kicks in- this guy was already very combative toward EMS and did not want our help, but we convinced him to go anyways. I feel that at the end of the day, keeping him as calm as possible and getting him to go in for evaluation was the right thing to do. He was alert and oriented to the present events, but the ETOH attitude was still kickin around
My coworkers feel the proper course would have been to restrain him, force the collar and board on him, and take him in like the regardless of how he acted. I think that's probably the proper course, but maybe I'm wrong in thinking this- couldn't forcing that on him compromise c-spine even further, if you have to be fighting with him to immobilize him? The guy obviously needed medical attention and was under the influence of something- but would that really have been the best course? I'm here to help people, even if I'm a bit of a softy, not to make them suffer/get agitated worse.
Naturally, I documented the living HELL out of the situation, but I just figured I'd get opinions of more seasoned folks, even if the opinions are "protocol is law"
Thanks.
Signed,
An EMT still learning =X
I'm fairly certain I made a mistake by protocols. Fairly sure I did. However, in the idea of doing no additional harm to a patient, I don't feel my actions were uncalled for. I just want others opinions, even if they are collectively "You made a mistake"
Tonight we got called for a PT, obvious ETOH. Had a good size bump on the head, a lac, and probably broken nose. The guy doesn't fully recall how it happened, just that he walked like 1-2 miles and police found him where we picked him up. PT VERY uncooperative. Doesn't want EMS help, pulls away when I try to assess, I dress/bandage the wound, he rips the dressings off, try to give him an ice pack, throws it away, so on and so forth. This guy adamantly DID want to go. My partner and the PD convinced him he HAD to go get looked at. Here's the thing though-a thought process went through our heads. This FULLY indicates c-spine precautions. He obviously fell, and he's under the influence. However, he's staunchly throwing back any intervention/treatment right back at us, and besides his name, won't give any real relevant information. We opted that the best bet is to keep him cooperative as we possibly can, load him up and keep him as immobile as possible all the way to the ER (about 3 minutes away). Staff was informed the situation and lack of c-spine, and they seemed to agree. He was not c-spined by staff either at this time. Found out he was very uncooperative with staff also.
I'm starting to drill my brain about this. I've been under the mindframe that while this called for C-Spine, and technically when intoxicated, implied consent kicks in- this guy was already very combative toward EMS and did not want our help, but we convinced him to go anyways. I feel that at the end of the day, keeping him as calm as possible and getting him to go in for evaluation was the right thing to do. He was alert and oriented to the present events, but the ETOH attitude was still kickin around
My coworkers feel the proper course would have been to restrain him, force the collar and board on him, and take him in like the regardless of how he acted. I think that's probably the proper course, but maybe I'm wrong in thinking this- couldn't forcing that on him compromise c-spine even further, if you have to be fighting with him to immobilize him? The guy obviously needed medical attention and was under the influence of something- but would that really have been the best course? I'm here to help people, even if I'm a bit of a softy, not to make them suffer/get agitated worse.
Naturally, I documented the living HELL out of the situation, but I just figured I'd get opinions of more seasoned folks, even if the opinions are "protocol is law"
Thanks.
Signed,
An EMT still learning =X
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