Would you walk this pt out to the truck?

DragonClaw

DragonClaw

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About 19: long story short, guy is altered and might be on something, locks himself in the gas station bathroom

Cop notes he's altered, diaphoretic, stumbling, weak. Pt claims sickle cell.

This is not to attack any of the medics, but I mean, doesn't that open you up for liability if you walk the pt and they fall, injuring themselves?

I mean, the guy took some verbal nudging to get up but followed commands and answered questions after a second.

But at the same time, he seemed kinda unfit to walk as it is an unnecessary risk.

I don't think I would, but then again, I've heard a lot of medics use the "Airway, Breathing, Can you walk to the ambulance", because they're not waiters and aren't gonna just baby every pt.

There was a medic from NY I knew and worked with a few times that I didn't like. Once we had to take a Bari discharge an hour and a half or so from ED to home. We were told someone would be there for the pt. On arrival, we find out, that person is sick and cannot take care of our pt.

It was a basic call and we were assist. The primary crew was BLS. I know them, they're a good team. Us basics all agree there's no way we can leave her. She can't walk or feed herself or anything, she's too weak.

The medic on the other hand threw a hissy fit. Saying we just need to leave her there by herself and she'll be fine, blah blah blah. He goes, "Back in newyork, we would have just yeeted her" abd he gets up on one leg and pulls the other up abs does that basketball throw pose and shoots his arm to indicate he'd just toss the pt in and leave.

He gets kinda mad but we're all firm, we're taking her back. He's mad the whole time back, but he drives our unit.

I learn later that he tried to blame the primary crew for trying to leave her.

As for the second, is there really any defense for getting to leave her? If she was AOX4 GCS15 and wanted to, having no idea when she'd get help, would you?
 
If the patient is alert and oriented, and can understand and explain back to you the risks of being left alone, then you might be justified in leaving the patient. If the patient is weak and can't take care of herself, leaving the patient probably isn't the right path to take.
 
DragonClaw said:
This is not to attack any of the medics, but I mean, doesn't that open you up for liability if you walk the pt and they fall, injuring themselves?

I mean, the guy took some verbal nudging to get up but followed commands and answered questions after a second.

But at the same time, he seemed kinda unfit to walk as it is an unnecessary risk.
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I didn't watch the entire video, how did he get to the bathroom? I'm assuming he walked, right? I did see him walking out to the ambulance, so I am assuming he was able to walk.

Truth be told, I probably walk more people than the majority of my coworkers; if they can walk, even with some assistance, they should, as it's safer for all involved. And if they do get woozy, then you can safely lower them to the ground, and plan an alternative. But if they have a clinical reason not to walk (cardiac/respiratory issue, every time they sit up they pass out, etc), I have no issues carrying them to the truck.

That being said, if you are doing a discharge, and the patient can't care for themselves, and their caretaker isn't able to care for them, why on earth would you leave them there? it's a recipe for disaster. your medic was wrong. Yes, the person will need to have a plan to take of themself, but if their plan (the caretaker) is unable to, then things will be bad, the patient will go downhill, and you will be dragging the bari patient out on a 911 call. There is no defense to making the decision leave a bed-confined person at home, when they have no ability to care for themselves. Not even in NY.

However, if she was AOx4, GCS 15, understands the risks... well, people have the right to make stupid decisions about their healthcare. But before I left, I'd be on the phone with my supervisor, and if they didn't give me an answer I liked, I would call my director/administrator, and document who I spoke to, and what they said, because it's not going to end well.
 
DrParasite said:
I didn't watch the entire video, how did he get to the bathroom? I'm assuming he walked, right? I did see him walking out to the ambulance, so I am assuming he was able to walk.

Truth be told, I probably walk more people than the majority of my coworkers; if they can walk, even with some assistance, they should, as it's safer for all involved. And if they do get woozy, then you can safely lower them to the ground, and plan an alternative. But if they have a clinical reason not to walk (cardiac/respiratory issue, every time they sit up they pass out, etc), I have no issues carrying them to the truck.

That being said, if you are doing a discharge, and the patient can't care for themselves, and their caretaker isn't able to care for them, why on earth would you leave them there? it's a recipe for disaster. your medic was wrong. Yes, the person will need to have a plan to take of themself, but if their plan (the caretaker) is unable to, then things will be bad, the patient will go downhill, and you will be dragging the bari patient out on a 911 call. There is no defense to making the decision leave a bed-confined person at home, when they have no ability to care for themselves. Not even in NY.

However, if she was AOx4, GCS 15, understands the risks... well, people have the right to make stupid decisions about their healthcare. But before I left, I'd be on the phone with my supervisor, and if they didn't give me an answer I liked, I would call my director/administrator, and document who I spoke to, and what they said, because it's not going to end well.
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He walked there, as far as I know. It's not shown in the video but the store manager says he used the bathroom and locked himself in, so I assume he got there fine enough on his own.

Their caretaker didn't even live with them and was at their home. If that wasn't clear.

I was pretty appaled by his demand.

She was like "Oh you have to take me back? Okay"

She wasn't chomping at the bit to stay. She was just bummed.

The hospital was displeased at our return.
 
Anyone who can walk, walks. If they need an assist, give it. Especially some of the larger people who are mobile (we have one psych that has to be 400+), I am not at all interested in lifting them. Especially with the weather we have been having.

Use good judgment and utilize your resources as appropriate. For most of what EMS does, a large percentage are perfectly capable of taking some initiative in their care and walking. A fairly significant portion of my patients ride the bench seat.
 
StCEMT said:
Anyone who can walk, walks. If they need an assist, give it. Especially some of the larger people who are mobile (we have one psych that has to be 400+), I am not at all interested in lifting them. Especially with the weather we have been having.

Use good judgment and utilize your resources as appropriate. For most of what EMS does, a large percentage are perfectly capable of taking some initiative in their care and walking. A fairly significant portion of my patients ride the bench seat.
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I've actually never ever had anyone ride on the bench or seen it.

Hmm.
 
DragonClaw said:
I've actually never ever had anyone ride on the bench or seen it.

Hmm.
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I'm all for moving people when they need it. But the people using us as a taxi will not be getting lifted by me or my partner if they're physically capable. I have no desire to get hurt for some ******** complaint.
 
Our EMS will happily walk people to the ambulance all day long.

They'll usually get belted into the gurney anyways once in the ambulance versus a special spot on the bench though.
 
DragonClaw said:
Is this a joke or literal?
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Literal. If you search and find that old Paramedics show from the early 2000's/ late 90's on TLC, there's an episode or two with Denver EMS that shows them on a call. I think it was a shooting, IIRC.
 
VentMonkey said:
Literal. If you search and find that old Paramedics show from the early 2000's/ late 90's on TLC, there's an episode or two with Denver EMS that shows them on a call. I think it was a shooting, IIRC.
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Why not just have them sit anywhere and belt them in?
 
DragonClaw said:
Why not just have them sit anywhere and belt them in?
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1. Sanitary reasons
2. Safety reasons

I personally have plenty of pts I don’t want sitting where I sit. It doesn’t matter if I clean the area afterwards.
 
DragonClaw said:
As for the second, is there really any defense for getting to leave her? If she was AOX4 GCS15 and wanted to, having no idea when she'd get help, would you?
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If a patient has demonstrated the capability to make decisions, you respect those decisions. You can educate, but you don't get to decide for the patient.

As for walking a patient like that? I dunno. Maybe hold on to them if you're concerned. The bed does not solve all problems.
 
Tigger said:
If a patient has demonstrated the capability to make decisions, you respect those decisions. You can educate, but you don't get to decide for the patient.

As for walking a patient like that? I dunno. Maybe hold on to them if you're concerned. The bed does not solve all problems.
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I don't remember if she was in our case, tbh. But she didn't want to stay alone particularly.
 
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