Welcome to EMT City
Register now to gain access to all of our features. Once registered and logged in, you will be able to create topics, post replies to existing topics, give reputation to other members, get your own private messenger, post status updates, manage your profile and so much more. This message will be removed once you have signed in.
Sign in to follow this  
Followers 0

Would you stop?

189 posts in this topic

Posted · Report post

Every once in a while a case comes up that provides an opportunity for some learning.

Here's one that may fit that bill:

JEMS story on FDNY EMS unit

It's interesting to see the comments at the bottom of the article. Although I can't believe some people really believe what they were writing.

Personally, I think both providers should get some mandated time off if not fired outright. Not only did they act stupidly but they put more than just themselves in danger.

I'm interested in the discussion this will bring.

-be safe

0

Share this post


Link to post
Share on other sites

Posted · Report post

Stupid stupid stupid stupid.... and downright negligent as well... extreme whackerism.. IMHO

0

Share this post


Link to post
Share on other sites

Posted · Report post

I've always been told, if you see an accident, and or are flagged down and you have a patient you must stop as long as your patient is not critical. Each technician will assume responsibility for one patient.

It's a very hairy situation but thats always what i was told.

Could be wrong though.

0

Share this post


Link to post
Share on other sites

Posted · Report post

I can't believe some of the things that people come up. They were transporting a pediatric seizure patient and decided to stop at the scene of a car accident? And then there's people who believe that they were obligated to stop? Had the child had any negative outcome, and regardless of the medical outcome of the patient they could sue for "emotional trauma" I'm sure due to being placed in that situation while already experiencing an event themselves. To stop for an accident is negligent, regardless of the stability of the patient. I think we should all be able to agree that the appropriate thing that should have been done would be to call for an additional unit.

An ambulance that didn't have a patient on board would have been an entirely different situation however. But that's not the case here...

Shane

NREMT-P

0

Share this post


Link to post
Share on other sites

Posted · Report post

I've always been told, if you see an accident, and or are flagged down and you have a patient you must stop as long as your patient is not critical. Each technician will assume responsibility for one patient.

It's a very hairy situation but thats always what i was told.

Could be wrong though.

This may vary state by state, but once you're dispatched to a call you are committed to that patient and that call until it's completion. This includes arrival at the hospital. If you're on your way to a scene, you can advise dispatch you came across an accident and see if they want to reassign you. But otherwise, you have a "duty to act." Any delay that has an adverse effect on the initial patient is caused by your negligence in responding to their request for assistance. Unless dispatch reassigns you to the car accident prior to making patient contact, you need to see your call all the way to the hospital before initiating another call. What happens when you arrive to find this "critical" patient involved in a car accident and your partner is out there by himself? What if he encounters violence like in this call and you're not there to assist him? One of the golden rules for me is to never leave my partner alone in an unknown scene. Things turn quickly. But back to the critical patient, you're a legal ambulance capable of transport...except you have a patient in the back of your ambulance. This is a different scenario from an intercept medic who routinely responds alone in a vehicle not capable of patient transport. If you notify dispatch so they can send the appropriate resources to the scene of the accident you came across you have met your duty to act. By stopping, you've gone over the line and open yourself to liability with the patient you're responding to, or transporting.

Shane

NREMT-P

0

Share this post


Link to post
Share on other sites

Posted · Report post

I know, personally, that we've passed a car accident or two, where there were injuries, but all we did was radio it in, because we had a patient in the back. Once you stop to check for injuries, you can not leave until someone with the same, or better training has come to relieve you. This is how we do it in my area, however, I do not know what the FDNY EMS's protocols are.

Interesting article, however, thanks for bringing it in to discussion!

0

Share this post


Link to post
Share on other sites

Posted · Report post

wow...our service would not stop...we would use the radio to give the location and call for another ambulance, also why would you stop with a seizing nine month old???

0

Share this post


Link to post
Share on other sites

Posted · Report post

There are too few details included in the "report" to judge what is right & wrong. I wasn't there, I can't say what I would have done, each case is unique and must be judged based on ALL the FACTS. It is foolish (unless you are a whacker) to try and draw any conclusions/judgements based on what is presented.

0

Share this post


Link to post
Share on other sites

Posted · Report post

What facts are missing? What additional information would you like to see? What do you think based on what's presented?

0

Share this post


Link to post
Share on other sites

Posted · Report post

I would not say I would never stop or that I would always stop; it would depend on the situation. In this case it is not clear just how stable or unstable their 9-month-old patient was and it was not clear how serious the MVA was. Those that say they would never stop with a patient on board, here is scenario to consider. You are transporting an elderly patient from a care home, they had a fall from standing and their only complaint is hip pain, vitals are normal and the only injury seen is shortening and rotation of one leg. Enroute to hospital you witness a 10-year-old pedestrian who is thrown 20 feet, lands on his back and is not moving. Do you stop to assess, or continue on and radio for another unit?

0

Share this post


Link to post
Share on other sites

Posted · Report post

What facts are missing? What additional information would you like to see? What do you think based on what's presented?

We know nothing about the seizure patient... beyond the fact it was a seizure patient. Was s/he postictal? Was s/he stable? If s/he was stable is there immediate concern of recurrent seizures? Was s/he still seizing? What was being done to stabilize him/her? Was anything necessary to stabilize him/her? Was transport strictly for observation/investigation or for intervention?

There is no way of conveying how the scene presented to the crew that stopped... it seems apparent that it appeared serious enough to warrant investigation based on the seriousness (or lack thereof) of their seizure patient. If that is the case I'd have to assume they made the right choice (and subsequent decisions) based on the information they had.

Like I said before, I wasn't there to know what they knew or see what they saw so I cannot judge whether it was right or wrong. I need to assume they would use sound judgement based on all the information they have available... until it is proven otherwise; to draw conclusions or pass judgement without all their information is unfair speculation.

0

Share this post


Link to post
Share on other sites

Posted · Report post

We know nothing about the seizure patient... beyond the fact it was a seizure patient. Was s/he postictal? Was s/he stable? If s/he was stable is there immediate concern of recurrent seizures? Was s/he still seizing? What was being done to stabilize him/her? Was anything necessary to stabilize him/her? Was transport strictly for observation/investigation or for intervention?

Does it matter? Your attention and obligation already belong to one patient. By stopping you're placing yourself in a position where you have to decide between neglecting one and abandoning another. Either way you lose.

There is no way of conveying how the scene presented to the crew that stopped... it seems apparent that it appeared serious enough to warrant investigation based on the seriousness (or lack thereof) of their seizure patient. If that is the case I'd have to assume they made the right choice (and subsequent decisions) based on the information they had.

So what's wrong with grabbing the radio, calling it in and letting an available crew handle the call? That's the thing. This crew was not available. They had a patient. Their attention belongs to that patient regardless of patient acuity from either incident.

Like I said before, I wasn't there to know what they knew or see what they saw so I cannot judge whether it was right or wrong. I need to assume they would use sound judgement based on all the information they have available... until it is proven otherwise; to draw conclusions or pass judgement without all their information is unfair speculation.

Well, you know what happens when you assume things.

I agree with your comments on speculation. However, if even half of this is true, they still need to be fired. But it doesn't seem that many of the primary facts of the story are in dispute.

if you have a patient on board you can't stop for another. If you do, you are neglecting your first patient and putting yourself in a position of potentially abandoning the second. We have all this fancy communications equipment for a reason. What's wrong with using it to call for an available ambulance while you devote your full and undivided attention to the patient you already have?

-be safe

edit: once for missing "]"

0

Share this post


Link to post
Share on other sites

Posted · Report post

This is a intersting case. I have worked where we stopped at a roll over and had a noncritical patient. The car empty so that did not make a difference. I can see where this would be difficult to not stop. We are trained to provide medical care and it is what we love to do or we would not be in this profession.

I know that my paramedic school made us take the EMS oath. I remember it said something about not inflicking harm. Did they inflick harm on the pt they already had? Nope but the outcome could have been worse. I mean if a stray bullet would have hit that baby or the family that was with them it would have been different story.

People also said that if they did not stop that people would have been calling the news and the 911 center because the ambulance did not stop. If they stop and one of them would have gotten killed they would have been calling the 911 center and the news.

THIS IS A CASE OF THE DAMN IF YOU DO, DAMN IF YOU DO NOT!!!!!

0

Share this post


Link to post
Share on other sites

Posted · Report post

There are too few details included in the "report" to judge what is right & wrong. I wasn't there, I can't say what I would have done, each case is unique and must be judged based on ALL the FACTS. It is foolish (unless you are a whacker) to try and draw any conclusions/judgements based on what is presented.

You are kidding right? There really are no other facts needed in this case. You have a patient in the back of your ambulance that is being transported to the hospital. You are committed to that call. The best thing you can do is to call for another unit and continue transport. I don't think anyone is disputing that there was a patient being transported and that's really the only pertinent fact to this case.

here is scenario to consider. You are transporting an elderly patient from a care home, they had a fall from standing and their only complaint is hip pain, vitals are normal and the only injury seen is shortening and rotation of one leg. Enroute to hospital you witness a 10-year-old pedestrian who is thrown 20 feet, lands on his back and is not moving. Do you stop to assess, or continue on and radio for another unit?

As much as this scenario sucks, I would notify dispatch and request additional support. Notify a supervisor of the incident. However, stopping is not a viable option due to the duty to act incurred by having a patient in the back of my ambulance that's being transported. However, by requesting resources I have fulfilled my duty to the struck patient. It's a difficult thing to do, but stopping is NOT the right answer.

Shane

NREMT-P

0

Share this post


Link to post
Share on other sites

Posted · Report post

People are actually condoning this???? They had a patient, period. That is their focus. There was no reason to stop, as others have said, pick up the damn radio and call for another unit. These two should be fired immediately, with no questions asked. Glad to see a good outcome for the baby who deserved a lot more than received.................

I have passed numerous MVA's over the years and have NEVER stopped at any of them if we had a patient on board. If it could be safely done, I would slow down long enough to advise that another unit was notified and/or en route (and tell bystanders to stop CPR on a decapitated body on one occasion) and then continued on with our call..........

0

Share this post


Link to post
Share on other sites

Posted · Report post

I am not sure if this is local, provincial, or canada wide, but we are not allowed to stop with a patient in the unit transfer or unstable. If we have a patient we are not "for hire". However if we do not have a pt. we are obligated to stop.

Morals say one thing law says another.

0

Share this post


Link to post
Share on other sites

Posted · Report post

You never stop. That's abandonment. I don't what anyone says.

That first pt was sick and requested transport to the hospital. They expect to be transported. If the ambulance was involved, then that'd be different. But in this case, they should have radioed it in and kept driving. The only time I've ever stopped, was on the way to the call. Never after a pt was on board.

0

Share this post


Link to post
Share on other sites

Posted · Report post

If you stop, I hope you have alot of money, after the lawsuits and unemployment you will need it.

You are abandoning your paitent by stopping plain and simple. And not only that, you are also offering both paitents a decreased level of care. Top it off with placing the original patient possibly in harms way, and there is the Hat Trick.

Use the radio, slow down open the window, and explain the situation to a bystander if you have to.

Don't stop.

0

Share this post


Link to post
Share on other sites

Posted · Report post

I'm confused, 1 EMT is in the back with the patient during transport, 1 is driving, how does the driver stepping out affect the patient in the back with the 1 tech.

In this case there is 1 EMT-P, 1 EMT-B/P student With the seizure patient, and the driver stepped out to check for life threats on the accident patient.

Where is the neglect or abandonment? The only thing I can see is perhaps the slower transport time, but this argument seems to be negated by everyone's argument of " it's NYC, how far away is another unit" its probably the same as the distance to the nearest ER.

Both are pretty quick, but, I do believe if the accident patient needed ALS it would have taken a bit longer then a BLS unit. Also if you see the list of personnel who were on scene it was all ALS, maybe its relevant maybe not. I'm strumming through my protocols and reference guides to get a definitive answer but I'm not having any luck right now.

0

Share this post


Link to post
Share on other sites

Posted · Report post

If you stop, I hope you have alot of money, after the lawsuits and unemployment you will need it.

You are abandoning your paitent by stopping plain and simple. And not only that, you are also offering both paitents a decreased level of care. Top it off with placing the original patient possibly in harms way, and there is the Hat Trick.

Use the radio, slow down open the window, and explain the situation to a bystander if you have to.

Don't stop.

I think that sums it up. You shouldn't be stopping. Regardless of weather someone stays with the patient you're transporting, you're now committed to that scene you stopped at since you've started to render care. You've delayed transport to definitive care. And you've provided less than the acceptable standard for a transporting ambulance since you have only one set of hands available and a patient already in the back of your ambulance from another call. Again, the right answer is not to stop. You're committed to a call from the time you're dispatched until the conclusion. You cannot get yourself involved in another call while you're on one. That's abandonment and negligence. You would have zero legal defense if you were to do this. Notify dispatch and continue to the destination hospital. There really isn't another answer that works.

Shane

NREMT-P

0

Share this post


Link to post
Share on other sites

Posted · Report post

I'm confused, 1 EMT is in the back with the patient during transport, 1 is driving, how does the driver stepping out affect the patient in the back with the 1 tech.

It doesn't affect the tech. It affects the patient. The patient to whom you already have an obligation. The patient to whom you have promised to provide not only top notch care but also expedient transport to a hospital. Remember the patient? The ones for whom we do this job?

Where is the neglect or abandonment? The only thing I can see is perhaps the slower transport time, but this argument seems to be negated by everyone's argument of " it's NYC, how far away is another unit" its probably the same as the distance to the nearest ER.

You've just answered your own question. It's neglect because you have purposefully increased your transport time neglecting the patient to whom you've already initiated care.

I don't know that this meets the criteria for abandonment. But I think it certainly meets the demand for neglecting your current patient and endangering his/her life.

-be safe

0

Share this post


Link to post
Share on other sites

Posted · Report post

Think about it from another standpoint as the obvious reasons aren't apparent to you. In Texas, an ambulance is required to have a minimum of two certified or licensed personnel on it. When the driver presents himself on scene and his / her partner is in the back, you are no longer a legal unit as you do not have the required components to be a licensed inservice unit. Plus, what happens if, while you are farking around on the MVA scene, your partners patient crashes after you make contact with a new MVA patient. Then your screwed..........

I honestly can't believe this is even being debated, at least its not as bad as the morons on Jems.com who actually believe these dumb#@$es were heros.............

0

Share this post


Link to post
Share on other sites

Posted · Report post

I honestly can't believe this is even being debated, at least its not as bad as the morons on Jems.com who actually believe these dumb#@$es were heros.............

No kidding! That's the first thing that struck me about this article! That's just how clueless JEMS is. That's why you can never get anything of substance out of JEMS. They exist only to feed into the whacker element. A.J. Heightman is an idiot. WTF is so heroic about throwing your partners and patients into a dangerous situation through your own stupidity, and then running like a little bitch when the $hit hits the fan? Heroic? Had Dutton kept right on driving, like he should have, there would never have been any need for his "heroics."

FDNY is not a little mom & pop transfer service. It's the biggest EMS provider in the U.S. They have policies addressing everything. What is their policy on this? If their policy is to not stop, then Dutton needs to be fired. If their policy is to stop, then they need to change it. If they have no policy, then heads need to start rolling from the top down, and hopefully Dutton has learned a lesson from this. But I doubt it. All this hero worship BS has just reinforced his bad judgement, and probably strengthened his resolve to be an even bigger whacker in the future.

Where the heck is Asys when you need him? I bet he'd like to bitch slap this guy.

0

Share this post


Link to post
Share on other sites

Posted · Report post

Where the heck is Asys when you need him? I bet he'd like to bitch slap this guy.

No doubt, I'd love to hear his take on it..........

Did you notice in the Jems.com comment's the comment made by their editor??? Unbelievable!!!!

BTW - Mike, I enjoyed your comment............Kid could be set for life..............

0

Share this post


Link to post
Share on other sites

Posted · Report post

This is hilarious... you all want to lynch a man based on a magazine article, not in inquiry or an investigation... but a dang magazine article!

0

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now
Sign in to follow this  
Followers 0