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Cameras are prohibited and pictures will get you fired


DFIB

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During my EMT training our instructor stressed that crash scene photography would lead to disciplinary action and the loss of employment for EMS workers. In short, “Cameras are prohibited and pictures will get you fired”

Newgard, Martens & Lyons have some very interesting studies that seem to indicate the usefulness and validity of crash scene photography as a diagnostic guide for ER physicians.

I would extend the assertion that photographic evidence is useful in describing many incidents other than trauma. It could be useful to describe both MOI and NOI to ER physicians without violating HIPPA so long as the patient’s image or likeness or otherwise recognizable personal traits are not recorded in the images. So, what is the problem with photography?

What is your service policy in relation to photography?

Do you take pictures at the scene?

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No pictures with us. The docs in our system rely on our assessment of the vehicle damage.: Intrusion, extent of damage,restraints, airbags, windshield intact, wheel bent, speed of vehicles, location of patient in relationship to damage on vehicle. etc. That information is generally enough to tell how much kinetic energy was in play, and the types of injuries they should suspect.

I know some systems DO utilize photos as an aid for the ER docs to see MOI, and I'm sure they have strict guidelines as to how they handle PHI issues.

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I took a few photos once in a Train vs. car MVC. Showed them to the attending @ in the ED as it was somewhat difficult to explain. Said photos were immediately deleted from my phone afterwards. Only 1 picture showed the pt., the others were all MOI pictures.

We don't have a policy regarding photo taking. It really hasn't been an issue. We leave that to the FD.

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This is yet another great topic.

It has long been the idea that providers taking pics of crash scenes and making statements to the press is some sort of violation of a law that no one can put thier thumb on except to say "HIPAA" or "FOIP".

The reality is, to provide pictures of an accident to the recieving Doc is a great asset! I do, and will continue to, snap a pic with my iphone, and email it to the recieving physician at the trauma centre.

Now there is a moral/ethical dilemma one must face before spreading said pic to all his friends.... but hey, we are professionals, so that should not be a problem. However, if you do not show a license plate, patient, or give a name.... it is just a smahed up car!

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we tried that here the supervisors here would show up and photo the scene and take it to the hospital to show the doc. cameras were property of the service and only used for such ... but it quickly went away

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I routinely take pictures of things that I think I would want to see if I were a receiving Dr.

For example: Patient with hematemesis 600 - 800 ml. Compensated shock. BP 80/40 RR 26 SPO2 92

HR 120. Picture was taken of vomitus.

Arrive at hospital. Doc is writing a report. I report I have a patient with a hemorrhage. He ask Trauma? before I could continue with vitals? He seems distracted by his report. Hematemesis I said about his much and show him the camera he glances at the picture, left his report and began doing the things that make ER Docs Rock Stars.

Pictures have been very useful to me

.

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we are allowed to take pictures as long as it does not display the PT. Our county ER docs like to have pictures of a crash if the MOI is great enough to need a visual aid would help them.

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During my EMT training our instructor stressed that crash scene photography would lead to disciplinary action and the loss of employment for EMS workers. In short, “Cameras are prohibited and pictures will get you fired”

Without qualifying that statement with something along the lines of "personal use," your instructors are idiots.

So, what is the problem with photography?

Systems that lack appropriate and enforced policies for on-scene photography and providers who lack self control.

To drive home this point, here's a case from two idiots over at the California Highway Patrol.

http://en.wikipedia.org/wiki/Nikki_Catsouras_photographs_controversy

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In my former region (Greater Munich) the air-ambulances both carry cameras for "vehicle-photos" to explain the MOI and educational purpose. Some services do enforce a strict "no photos" rule, others don't.

In my current region we have our own "photographer". Got his own pager and decides if a call "needs him"...then he will show up on scene, take a few photos (which some will be sent to the press after controlled by a supervisor), handle all other media on scene....

The photos will be "uploaded" to a secure server from a mobile device. So when we're at the hospital we can access the photos from the hospitals PC and show the doc the MOI if needed. LE and FD sometimes use those photos as well when they don't bring their own photographer on scene.

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We have a demand by state police to not taking pictures on scene because of personal right issues. It wasn't forced into a department order, only hangs on the blackboard. It even is not a clear denial, just a beg for profeesionalism. This obviously is a reaction to some TV channels issuing cameras to fire dpeartments to get early in-scene pictures. Some fire departments got a bit exhausted in getting pictures on-scene, even doing their own "press service" (which is a bit over the edge for a one-unit vollie fire dept,). At least in EMS all staff is fully aware of patient rights (it's part in every step of education, beginning with advanced first aiders).

Some EMS fellows are taking pictures, sometimes I did. Not to show around, but to use in training and even for public relations - making sure, no identifying is possible. And, important, never before taking care of the patient.

We recently decided to buy a department camera for this things, so no personal camera/phone has to be used and the pictures are under full department control. Scene commanders already have cameras, but mainly for documenting own ambulance accidents. However, they are used to document scenes much more.

Personally I never showed a picture to the ER doc, but I know several incidents that happened. Not sure, what exactly they're taking from them beside a general impression. Such things like accident mechanics we're documenting on the call reports anyway.

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