Would you walk this pt out to the truck?

I have put patients on the bench, and airway chair. If I am worried, I will put a blanket down 1st. I clean them all well


I have slept on the cot, when I have had to. Mainly on 24 hour or longer shifts when we had no station. or on the empty leg of long out of town trips (22 hours was my longest). Slept on the cot, bench, airway chair, passenger seat and drivers seat (we were all asleep at that point).
 
if my pt can walk, they walk. End of story. If i feel they are medically unstable to walk for whatever reason, or cannot physically do it due to injury or GCS then they are carried.

But ive had healthy teenage girls with wrist fractures state "oh no, i cant walk".....yes. Yes you can, and you will. And they do!

NOW! thats not to say that im just TRUSTING everyone to walk and i still have myself, a fire fighter or my partner in front and behind the pt extremely close and guiding the pt at all times, ready to catch them if they SHOULD fall or trip or whatever. Safety first. but thats just precautionary as i wouldnt be having them walk if i didnt think they could.
 
every situation is different however, and as a disclaimer ive unfortunately HAD to make pts walk when i REALLY didnt want them to.
Case in point, had a legit diff breather who was in an extremely cramped house and closest gurney could get was front door. Dude was pushing 400lbs and Fire on scene got scared and stated they were gonna "wait in the engine, call us if you need us".....because for them diff breather automatically equals covid.

Dude is Satting in 60's on NRB @ 15lpm i put on and we need to go NOW. I cant wait 10 minutes to go outside, tell fire we need them, have them do a full PPE Covid-19 gear up and THEN come in and THEN carry the guy out....

And me and my partner cant physically carry him.

SO i had to make him walk. And yeah, it wasnt good and made him worse until i was able to get more interventions in place on him at the rig . and i didnt wanna do it but It was the best out of all the bad options that i had available to me at the time. And he was already gonna get C-Pap anyways.
 
mrhunt said:
if my pt can walk, they walk. End of story. If i feel they are medically unstable to walk for whatever reason, or cannot physically do it due to injury or GCS then they are carried.

But ive had healthy teenage girls with wrist fractures state "oh no, i cant walk".....yes. Yes you can, and you will. And they do!

NOW! thats not to say that im just TRUSTING everyone to walk and i still have myself, a fire fighter or my partner in front and behind the pt extremely close and guiding the pt at all times, ready to catch them if they SHOULD fall or trip or whatever. Safety first. but thats just precautionary as i wouldnt be having them walk if i didnt think they could.
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Do you walk grandma with a fractured wrist that you can easily get a cot next to?

I get the sentiment, but this job is also about customer service and making people feel good. As such, some people still get carried that have no medical reason to. Oh well.
 
If i can easily get the stretcher next to them Then they stand with assistance (or not, whatever is required), and transfer over that way.

I understand the customer service aspect but im there for people medically. And FYI, the teenager who broke her wrist was a good half mile away from our ambulance in rough off road terrain with only me and my partner to carry.

So we carry her, And one of us falls causing greater injury to the pt (who inevitebly gets dropped) and injury to me or my partner in order to Make her "feel good"? I dont think so.

Im more than willing to be the bad guy in order to have everyone be safe and have the best outcome.
 
Tigger said:
Do you walk grandma with a fractured wrist that you can easily get a cot next to?
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Why not? is something wrong with her legs? how is she going to get home after the ER discharges her? by ambulance? or by taxi or a friend's car? is she unstable on her feet? can we walk with assistance? is she still in the location where she injured her wrist, or did she walk around the house to get ice, call 911, grab her things, etc.

and, full disclosure, if she slips on the ice outside, there is a 99% chance I am bringing the cot to her (plus that helps me not fall on the ice too). however, I can't bring the cot up to her 2nd floor bed room, with no less than three 90 degree turns to get to here. If Grandma is 90 lbs soaking wet, no biggie; if grandma is 300lbs..... different story.
Tigger said:
I get the sentiment, but this job is also about customer service and making people feel good. As such, some people still get carried that have no medical reason to. Oh well.
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No, it's not: medicine has never been about making people feel good. It's about treating people appropriately. Otherwise, the patient would dictate your treatment path, not their condition; otherwise everyone would get narcotic pain meds. Now, customer service IS important, but it doesn't trump appropriate care, nor should you be providing excellent customer service at the expense of your own health and safety. and yes, you want people to feel good, but that's not the goal of medicine either. You want to deliver appropriate care, and allow the person to get better.

I've carried more people that had no medical reason in my career than I would like to admit (as I'm sure you have too). How many back injuries have you suffered on the job? I can recall one, which knocked me out of work for 2 weeks. I have coworkers who needed back surgery (for one, the second was career ending). Yes, lifting and carrying people is part of the job, but how would you feel if you lost money because you got hurt carrying someone who has no medical reason?
 
mrhunt said:
I cant wait 10 minutes to go outside, tell fire we need them, have them do a full PPE Covid-19 gear up and THEN come in and THEN carry the guy out....
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Why didn't you just get on the radio, tell the engine to gear up and bring in a carrying device, and advice them to hurry because you had a really sick patient?
 
Because we dont have com's with Fire directly. Its 2 differnt dispatch systems. And communication through there is SLOW. Im talking a good 5 minutes slow. Going that route would have actually been a WORSE option than me or my partner running outside.
 
mrhunt said:
Because we dont have com's with Fire directly. Its 2 differnt dispatch systems. And communication through there is SLOW. Im talking a good 5 minutes slow. Going that route would have actually been a WORSE option than me or my partner running outside.
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I had a hunch that was the case... .sadly, it's an all too common occurrence, when fire and EMS can't talk to each other directly.
 
If they seemed stable enough to walk we walk with me on one side partner on the other just in case. If their is any doubt in our minds not theirs ours that they can safely walk then yup stretcher time. As for putting a patient sitting up on the bench seat no thank you. Yes they may be perfectly fine and yes they may be using us as a taxi but two scenarios scare me about letting a patient sit on the bench. 1. If we get in a accident and get sued and we will get sued it may be hard to justify a patient sitting on the bench instead of on the stretcher with all the appropriate safety restraints. Yes the bench has seat belts but still not giving a lawyer a chance to screw me. 2nd what if that calm stable patient suddenly takes a dive and codes or passes out or goes all psycho I rather them be on that stretcher in any of those scenarios.
 
I never really understood this whole concern about walking people to the stretcher if they’re safe to do so. Patients walk in the hospital all the time, why should we be any different?
 
NomadicMedic said:
the quote is, “oh no. The pram is for sick people. You sit on the X”

(Pram is Denver for stretcher... just like litter is Pennsylvanian for stretcher)
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litter....super common around me! Where does it come from...?
 
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