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Question to confirm I'm right to my hubby, TY!


smithmbjm

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Damn...I just went from reading this:

I'm guessing she had to perform a sex act that she did not like.

to reading this:

What? You're breaking up! You must be having a major communications breakdown!! :devil:

after skipping all the posts in between...let's just say I expected to see something very different when I went back and read them all... :coool:

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  • 4 months later...

In some states, New Mexico for example, there is law on the books that allows for EMS to conduct a pseudo protective custody in which the patient is a true danger to themselves and the results of refusal is death (Emergency Transportation Act). Though it is expected that any Medic or EMT that is considering this route contact online medical control and have a physician make the final call. Law enforcement agencies would be your best route due to them having legal authority to place an individual into protective custody and force a hospital visit, though there is specific criteria that needs to be met at that time as well.

Generally speaking within the medical field, Prehospital as well as hospital field, if a patient is not under the influence of mind altering medication/drugs/alcohol and there is not reason to believe that the patient has had their cognitive ability changed, and the patient is a competent adult then NO you cannot force the patient to go to the hospital. If you do force a competent adult patient into going to the hospital then you could be reasonably charged with kidnapping, and assault and battery.

Though also remember that we have to acquire consent for everything that we do though it be expressed consent or implied consent it is still consent.

Hope this helps.

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Law enforcement, at least locally, is getting out of the medicine business. They have decided that they cannot make a person go to the hospital, even if the person does not have the capacity to refuse and needs to go. They are putting the burden on EMS, who is not equipped or trained to properly take someone who is violent. It's pretty shitty of LE to do that. They don't want any responsibility. I had an officer get pissy with me on a busy Saturday night once. Guy was arrested for DWI (no accident or any complaints) and was taken to the jail where the jail nurse said he was too drunk to be there so he had to go to the ER. He blew a 300+ but was fully coherent and not altered other than a little swagger when he walked (he probably lived in the 300-400 range on a daily basis). I asked him if anything hurt or if he had any other complaints. He denied everything and had a normal exam. The officer was a little angry when I said we were going to discharge and told me that the guy couldn't go back to jail. He didn't seem to understand it when I said that being drunk is not an acute medical issue and there was no need for the pt to be in the ER, taking up a very needed bed. The charge nurse offered to let the office and pt sit in the waiting room.

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Yes you can legally force somebody to go to the hospital, at least in the Commonwealth of Virginia. Its called a Medical ECO or a Medical TDO, both of which require orders from a magistrate and have time limits. Its a complicated process but at least in VA there is a magistrate on call 24/7

An ECO is only for transport and last for only 4 hours.

A TDO is for when the patient needs to stay at the hospital.

There are restrictions of course but I need to talk to my teacher about those again because my slides are vague. Hope this is interesting and helps the discussion.

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But if LE isn't willing to help you get the pt on your stretcher, are you going to risk being hurt by a violent pt? "If that ambulance driver touches me, I will kill him."

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You're talking about a law enforcement intervention and not something EMS can force. Here's some additional reading on Virginia's Medical ECO and Medical TDO (and more on TDO). While these can be initiated by a physician it needs magistrate involvement to enact. This doesn't mean that EMS can just show up and force someone to go.

I imagine many of these instances are used in the case of psych patients. Most states with which I'm familiar or in which I've worked have some form of involuntary commitment or hold and it's usually related to psych patients. These are all legal interventions and EMS is not included in the decision to detain and transport someone (although they may be drafted into helping transport after the legal process required to commit these individuals has been completed).

That's quite a bit different from what the OP wrote by stating "if they absolutely need medical care then we [EMS] can force them to go".

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But if LE isn't willing to help you get the pt on your stretcher, are you going to risk being hurt by a violent pt? "If that ambulance driver touches me, I will kill him."

you said Ambulance Driver, he he he

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you said Ambulance Driver, he he he

That was a "hypothetical" statement made by a "hypothetical" patient to a "hypothetical" EMS crew that PD refused to help. The pt was "hypothetically" intoxicated with a "hypothetically" significant head wound that needed evaluation.

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That was a "hypothetical" statement made by a "hypothetical" patient to a "hypothetical" EMS crew that PD refused to help. The pt was "hypothetically" intoxicated with a "hypothetically" significant head wound that needed evaluation.

I wonder what hypothetical country and hypothetical state that hypothetical crew and hypothetical patient was in.

And mike yes there are restrictions for our TDO and ECO's we had a crew go through the process a few months ago for a psych patient.

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