To Carry, or Not to Carry, that is the question???

[captainstandup]

How many of you are required to physically carry a patient from the residence, regardless of difficulty or dangers to personnel? To clarify, is anyone permitted to "walk patients to the rig" if they are physically capable of doing so?

[JPINFV]

To the best of my knowledge, my company only required us to carry patients in police custody [we'd get jail transports from time to time] or patients on psychiatric holds on the gurney. There were a hand full of times where a patient was walked to the ambulance, but those generally fell into patients that met the ambulance at the curve. The simple fact was that 99% of the transports were not capable of walking anyways, so it was a mute point.

[fiznat]

Patients should be carried if it is medically or physically necessary that they be carried. Otherwise, remember your ABCs!! Ambulate Before Carrying. lol

I think it is ridiculous that any system would mandate that "every" patient be carried. Why not also mandate that every patient get transported on a priority 1, or that every patient gets oxygen. Its silly.

[scott33]

How many of you are required to physically carry a patient from the residence, regardless of difficulty or dangers to personnel?

I would like to see some public naming and shaming of any EMS system that mandates this.

This is the kind of stupidity that is keeping pockets of EMS in the dark ages, and makes it look even WORSE than a taxi service. It wouldn't surprise me though, if there were some system somewhere, who really think they are going above and beyond, by trying to enforce pitiful practices such as this. ](*,)

I would flat out refuse.

[captainstandup]

Traditionally in EMS we carry people right? A good friend of mine traveled to England three years ago and he actually was allowed to ride along with EMS in London. He said the most interesting thing he witnessed was the fact that medics in Europe rarely carry anyone from the residence. Even patients experiencing chest pain walk to the ambulance. He also said that back injuries are virtually unheard of in European EMS.

I just thought it could be interesting to discuss the benefits vs risk of as fiznat says ABC. Unfortunately patients are conditioned to be so fat and lazy and have a lawyer on speed dial that we carry them in fear of being accused of worsening the patients condition.

We dont have a polcy but i submit that most ems agencies in the US take the stretcher to the patient even when it isnt necessary.

[fiznat]

To be clear, ABC is a joke... I mean, yeah we'd rather not carry patients if we don't have to of course, but when it is necessary for the patient, this is part of our job.

Forcing a patient with ACS, altered mental status, pain, or any other number of medical necessities walk is inappropriate regardless of where you are.

The point is that we should be able to make these decisions ourselves based on clinical presentation, history, and assessment. To say that a patient should never be carried is just as silly as to say that he should always be. It is a case-by-case thing, and a decision that we as professionals should have the autonomy to make.

[captainstandup]

I agree but submit that the decision should be based on clinical judgment as opposed to fear of litigation or stupid policies. we live in a mountainous area where three level stairs are common. 350 pound patients are common as well. There are situations where the patient, even acs patients, simply must walk down the stairs to the front door. The first responders in our county generally suck and wont respond to a medical call. 350 - 400 pound patient 110 demure pound female partner, difficult stairs = patient walks to door or dies

[fiznat]

If that be the case than I might make the (probably unpopular) point that your demure 110 lb female partner should not be doing this job. This is part of the work, and I don't think it is fair to say that patients in pain or at risk of worsening heart conditions be forced to walk so that your employer may say that their hiring practices are fair and equal. In my opinion, this is a misappropriation of priorities.

In addition, if the stairs and large patients are truly that prevalent in your area, your company should invest in those fancy stair chairs with the tracks in order to make your descents easier.

I do agree though that EMSers shouldn't have to constantly worry about litigation from situations beyond their control. If it is not possible to carry a patient, it is not possible and that should be the end of it. Still, this doesn't preclude us from doing the best that we can and avoiding laziness at every turn.

[FormerEMSLT297]

Why would you carry a 35 y/o M patient that accidentally cut his hand with a knife while slicing a bagel and you are taking him to the ED for stitches ????????????

No, carry only when medically necessary.

Now that being said, you should not walk a patient with chest pain or ACS, if they are too big for you to carry, you should get help. Not justify not carrying him/her because of 110 lb partner. Walking an ACS patient is called malfeasance, and you are open to a law suit not to mention just providing lousy patient care.

[zippyRN]

Traditionally in EMS we carry people right? A good friend of mine traveled to England three years ago and he actually was allowed to ride along with EMS in London. He said the most interesting thing he witnessed was the fact that medics in Europe rarely carry anyone from the residence. Even patients experiencing chest pain walk to the ambulance. He also said that back injuries are virtually unheard of in European EMS.

anyone walking a chest pain patient without severe access difficulties would face questions and (if a paramedic or other Health professional ) may face being struck off by the HPC (NMC/ GMC as appropriate) shoudl there be the slightest whiffof a problem

however for most other presentations it's not an issue or unless bed bound they will be moved by carry chair = there are significant numvers of housesi nthe Uk where getting a stretcher into the house is a near impossibility

as for backinjuries- EU directives incoirporated into member state legislation make manual handling operations subject to formal risk asessment and there has to be a documented demonstration that choosing a manual handling operation over an alternative is the only reasonably practicable option ( hence the near universality of mk 6 locking devices ramps /lifts and the associated ferno (UK) trollies on on-road ambulances brought by the NHS and the VASes