Another Patient Jumps from Ambulance

[Dustdevil]

This is becoming epidemic.

http://www.foxnews.com/story/0,2933,587649,00.html

Teen Dies After Highway Jump From S.C. Ambulance

Monday, March 01, 2010

Associated Press

GREENVILLE, S.C. — A teenager has died after jumping out of a moving ambulance on an interstate highway in South Carolina.

Multiple media outlets reported the 16-year-old boy died shortly after the leap near Greenville while be was being driven to a psychiatric hospital in Columbia

Coroner Mike Ellis says the teen was restrained on a gurney in the back of a Greenville Hospital Systems ambulance when he loosened his restraints, moved past an emergency technician, opened the door and jumped.

Emergency workers treated the teen before taking him back to the hospital in Greenville, where he was pronounced dead minutes later.

An autopsy was planned Monday.

[maverick56]

This is becoming epidemic.

Really? This is happening a lot? I'm not being sarcastic, honestly, I'm just new to the civilian EMS scene and live in a small town. Is it a problem with psych patients? It can't be that easy to open the door and jump out of a moving rig on a highway. How was he not stopped? Now I'm curious...

[Chief1C]

Seems only like they are psych patients. Maybe persons being transported to psych hospitals, need to be fully restrained until they are with in the facility?

[spenac]

Really? This is happening a lot? I'm not being sarcastic, honestly, I'm just new to the civilian EMS scene and live in a small town. Is it a problem with psych patients? It can't be that easy to open the door and jump out of a moving rig on a highway. How was he not stopped? Now I'm curious...

Yes easy. Unbuckle seat belts. Stand up. Walk to door pull handle. Step out. If door is locked ad unlock door.

As to stopping them, my safety first, in other words I ain't fighting with you. Now should this patient have been sedated or secured with handcuffs, in hindsight I bet they think so.

[joesph]

musta saw the bill

[Richard B the EMT]

Really? This is happening a lot? I'm not being sarcastic, honestly, I'm just new to the civilian EMS scene and live in a small town.

It happens, unfortunately. It is, at least where I am looking from, infrequent.

1) Working an Inter-Facility Transfer ambulance, I once transported a patient from the Manhattan (NY) Veterans Administration Hospital to the Montrose (NY) VA facility. Montrose specialized in substance abuse "dry outs", and had an extensive psych lock down area. The ambulance I was on was an open design type 2, no interior walls between the cab and cabin.

This call was different than most that I had previously transported on this run. First off, most of the patients the VA had me pick up for this run were already in the ER area. Most are walking. Not so this time. We had to go upstairs to the MnVA's lock ward, where the staff took our stretcher from us, took it inside the "lock-ward", and put an apparently partially sedated man in a straitjacket onto the stretcher, and put a locking restraint onto his ancle and a bar on the stretcher. They then brought the device back out to us, handed me a large manila envelope, and the key to the locks, and bade my partner and me a safe journey. The envelope was sealed shut, and I made no attempt to open it.

I rode the front passenger seat in a side saddle position, that I could watch the patient, and talk with my partner during the roughly 90 minute run. Abouy 10 minutes from our destination, my partner and I suddenly smelled cigarette smoke. Neither of us smoked, so I turned to see the patient, with one arm free, calmly smoking a cigarette!

After an uneventful (except for the cigarette) trip, while processing the patient in with the admissions officer, he asked me if I had read the paperwork, which I had not, and told him so. "Brother, next time, better look at the papers!" he said, almost evilly.

It turned out that this patient was a suicidal/homicidal patient!

We got the patient to his ward, let the staff release him with the key in our possession, got handed back the restraints, and started back down to NYC.

I can assure you, after that, any paperwork going with a patient will at minimum, be visually scanned by me, and anything like that standing out, will be heavily scrutinized by me, and advised to my partner.

2) There seems to be an "Urban Legend" within most IFT ambulance services in existance for more than 25 years. The story is the crew is transporting a seemingly cooperative psych patient going to a somewhat distant facility. The EMT riding "Shotgun" is a bit sleepy, and allows the patient to sit on the crew bench while the EMT takes a short nap, on the stretcher.

While the tech sleeps, the patient releases the stretcher from the moorings, opens the ambulance door, and, while the ambulance is still travelling at 60 MPH, pushes the stretcher and tech out, and jumps out, himself!

What is left of the 2 is taken off the highway roadway with a spatula.

[maverick56]

Wow, that's crazy

[Dustdevil]

Really? This is happening a lot?

I honestly don't know the statistics. I just know that we get a story posted about it several times a year. It raises some very serious questions, like:

1. Why the Hell are we being used to transport people who need no medical services that we offer? What's wrong with a police car?

2. Do not the cops have both the authority and the responsibility to take these people?

3. Do we not have the right to refuse the cops and/or ERs request to transport them?

4. Why is any medic allowing this to happen without the patient being properly restrained and accompanied?

5. What laws and/or policies are hindering us in dealing with this problem?

6. What lack of laws and/or policies is hindering us in dealing with this problem?

7. Would you personally physically engage a patient to prevent him from taking a dive out of a fast moving ambulance?

[FireMedic65]

I honestly don't know the statistics. I just know that we get a story posted about it several times a year. It raises some very serious questions, like:

1. Why the Hell are we being used to transport people who need no medical services that we offer? What's wrong with a police car?

2. Do not the cops have both the authority and the responsibility to take these people?

3. Do we not have the right to refuse the cops and/or ERs request to transport them?

4. Why is any medic allowing this to happen without the patient being properly restrained and accompanied?

5. What laws and/or policies are hindering us in dealing with this problem?

6. What lack of laws and/or policies is hindering us in dealing with this problem?

7. Would you personally physically engage a patient to prevent him from taking a dive out of a fast moving ambulance?

1. Cops can be lazy. They don't want to deal with such things. If they are't under arrest, they don't bother. If the patient is violent, you can request a cop come with you, but likely won't happen. There are often special services that will come and pick up the patients, but it is usually some poor sap that works for a company that deals with screwed up kids. They come in a car, usually their POV.

2. Yes, and yes. Refer to above.

3. Where I work, yes. I have every right to refuse a transport. If the patient is uncontrollable, I will not transport without sedation. And I can't transport a sedated patient in most cases due to protocols/standing orders. I would need an RN to tag along, and they won't do that for a number of reasons.

Also, many ambulances companies have contracts with these facilities, where you cannot refuse the transport. It sucks. I pray for a 911 call.

4. Usually, don't have a choice because of contracts with the facilities. Sedating a patient and restraining them will vary depending on what area you live in. Again, it sucks. These crazies I'd like to vec and vent. (can't transport a patient with vecuronium on board)

5. No idea, I should look into it. As should everyone else.

6. Same as above. Knowing the law always helps when you want to change it

7. Depends on the situation. Generally speaking though, no. I will inform the driver to stop the vehicle ASAP though. Contact PD and hopefully they will do their job. As a side note though, I can tie a damn good knot, and I would be impressed to see someone escape from them.

[maverick56]

I honestly don't know the statistics. I just know that we get a story posted about it several times a year. It raises some very serious questions, like:

1. Why the Hell are we being used to transport people who need no medical services that we offer? What's wrong with a police car?

2. Do not the cops have both the authority and the responsibility to take these people?

3. Do we not have the right to refuse the cops and/or ERs request to transport them?

4. Why is any medic allowing this to happen without the patient being properly restrained and accompanied?

5. What laws and/or policies are hindering us in dealing with this problem?

6. What lack of laws and/or policies is hindering us in dealing with this problem?

7. Would you personally physically engage a patient to prevent him from taking a dive out of a fast moving ambulance?

Those are all very good points/questions. And no, I don't believe I would do much to restrain someone myself. I guess I was more wondering how he was restrained in the first place that allowed him to break free. I definitely think the whole concept of transporting unstable, possibly dangerous psych patients falls (or should fall) outside EMS purvue and is rather obsurd. I understand these people need help and proper care, but not the type of care EMS provides and it placed undue risk on crews.