Who can be held liable?

[mfd229]

I am a paramedic within our volunteer ALS ambulance and fire agency. We have fire chiefs that are EMTs that have a take home squad and nearly always beat the ambulance to the scene. A particular chief, who is an EMT, on multiple occasions has told me either "stage in the truck," "you can clear," etc... without allowing me to assess the patient. Literally has forced me off multiple scenes without even seeing the patient. In a scenario like this, if the patient had a real medical situation, later died or got seriously sick, my chief had cleared me earlier, who would ultimately be held liable? If I respond as a higher level of training, am I required to assess all patients or can an EMT clear a higher trained person from the scene?

 

[WyMedic]

I would imagine he would be responsible for disregarding you.

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[Chimpie]

What state are you from?
What do your protocols say?
What does your SOP say?

If I respond as a higher level of training, am I required to assess all patients or can an EMT clear a higher trained person from the scene?

Broadly speaking, no. If said EMT arrives on scene of a call for a large laceration, and finds someone with a bleeding hangnail, does that need to be assessed by a paramedic? Now, if you've arrived at the pt. and made pt. contact, then yes, you've assumed responsibility for them. But again, what do your protocols and SOP state?

 

[planetmike]

Is the chief or other first responder doing a written report on the call? What kind of documentation are you doing of the call? In the system I'm at, as soon as the tones go off, we have to write a report, documenting what happens. If the call a transport, fine, so a complete report i performed. If we get cancelled by dispatch two seconds after the call drops, we still have to document what happened on the call. So in your case, it seems that you should document how you were dispatched, what happened when you arrived on scene, and who cleared you from the call (give name, title, maybe even include quotes (in quotes) what they told you to do.)

 

[EpiEMS]

In a scenario like this, if the patient had a real medical situation, later died or got seriously sick, my chief had cleared me earlier, who would ultimately be held liable? If I respond as a higher level of training, am I required to assess all patients or can an EMT clear a higher trained person from the scene?

Depends on your system - some systems allow EMTs to discontinue an ALS response, others don't. Check your protocols & agency operating procedures.

 

[DrParasite]

did you make patient contact? were you cancelled by an appropriate responder (as defined by your agency) who was on scene? Where you following your agencies operational protocols?

I'd be curious to hear from someone who says a person who is not on scene can be held liable for the actions and directions of a person who is on scene.

 

[SpecialK]

I reckon it's on them, they've made the decision based on their clinical judgement.

 

[WyMedic]

I encounter this in my agency sometimes, there is a local volunteer agency that sometimes will disregard us before we arrive, while personally I have no problems with this I know that some of my co-workers are very resistant to doing this and at times even will just continue their response regardless.

 

[akflightmedic]

To me...to continue on in despite being stood down is a disservice to the rest of the at risk population. You are committing your resources to a scene where you were not needed. Waste of company or tax payer money and taking you out of rotation for the "next one" possibly delaying that response due to a further away unit having to cover. Just how I view it (I note you said you personally do not do this).

 

[WyMedic]

To me...to continue on in despite being stood down is a disservice to the rest of the at risk population. You are committing your resources to a scene where you were not needed. Waste of company or tax payer money and taking you out of rotation for the "next one" possibly delaying that response due to a further away unit having to cover. Just how I view it (I note you said you personally do not do this).

I don't disagree, but there are times when it seems justified to me. I recall one instance where just based on the radio traffic there was a question about weather disregarding was appropriate. The BLS unit on scene advised something along the lines of the pt was "confused but refusing care". I think that in a situation like that you could be liable I assuming that you know that it would be inappropriate to refuse care to someone that was described to you as being confused.

 

[DrParasite]

To me...to continue on in despite being stood down is a disservice to the rest of the at risk population

agreed, unless you have a really good reason. the only time I can recall this happening (in recent memory) while I was at work was when a BLS unit cancelled the ALS unit after stating they gave the patient an epipen, and she was feeling better, so they no longer needed ALS. Suffice it to say, the ALS unit continued to the scene and transported with BLS to the hospital. But that's the absolute rarity, and not the norm.

In that situation, it's not about liability, but rather doing the right thing (and probably saved the BLS crew from getting in trouble for violating state guidelines)