Should all patients have clothing removed?

[spenac]

Just a bit dramatic there, don't you think? :roll:

With that amount of time you should be able to perform a thorough assessment and still allow for some degree of modesty for your patients. Time/distance is not a determining factor of forcefully disrobing someone. Remove the clothing that is required an no more.

Your OB patient should probably have undergarments removed if they are in active labor. Otherwise it is assault. Potential for injury is a poor excuse for doing anything. Sometimes it is the only reason we have, but that does not make it a good one. Bilateral IV's--could be bleeding internally, spinal precautions--could have a cervical/vertebral fracture.

Nope, in 90 minutes person can go from bad to worse even die if not properly treated. One poster said only treat CC. CC may only be a symptom of something more serious, as I asked so just give aspirin for the headache let the doctor figure out it was a CVA?. Doing that could be very harmful for the patient. Can most make it to the hospital with nothing being done, yes just like in your system, but when something dramatic is happening missing something literally can lead to death. In the field we have very limited ways to examine a patient, the key ways are our eyes, ears, and fingers, if you rely only on the machines you can not be a very good medic. In my part of the world there is no golden hour they are still with me way past that hour. Ten minutes to hospital missing something probably will not drastically change the outcome, missing something serious 90 minutes out you may have just let your patient die.

While I have said I think having all patients change into a gown could be beneficial I have never said force them. We do not require them to do it. One great thing about the USA is all compentent patients have the right to refuse any and all medical care, so if patient says no when we need to look we do not force it we just document their refusal for that part of the treatment. As you mention we to only remove what is needed to take care of that patient. To properly assess any OB patient in labor requires visual exam failure to expose that patient would be neglecting your patient. Sense none of us are doctors we all have to work with the idea that there is potential of something and proceed accordingly.

Again can we get back to the question should we have all patients in hospital gowns, maybe you can include criteria of when you would feel this is good and when you feel it is bad. Let's forget about any of the above scenarios and discuss possible times we should consider it, or if we feel all patients discuss why. I am sure there are many lines of thinking based on the types of areas you work in. Thanks for input.

[spenac]

I have been a patient on an ambulance twice. When I consider all the moving of clothes up down, sideways etc while having lung, heart, abd sounds, and ECG hooked up I personally think I as the patient would have found it easier to have just removed my shirt.

So do I feel it would maybe better to have all patients remove clothing at least pants and shirts yes I do. I feel it would allow me to be sure I am not missing a clue that could lead to better treatment of the patient. I personally feel that if I can improve the outcome for one patient w/o harming the other patients I see makes a method worth while. Are there legal issues to consider probably. Could you forcefully remove nope. I do not feel a lone medic could decide to make it the standard to have all patients asked to remove clothing while the rest of the medics leave the clothes on. If it were implemented it would require in my opinion the medical director deciding it was the way it should be done. So for now will keep doing as always have the clothes that I deem needed removed to treat each individual patient. I am a firm believer in the look, listen, and feel method of patient care, my equipment is used as a means assist evaluation. I do not treat the machine I treat the patient. Just a little of my thinking probably not even worth $0.02 in somes mind but oh well.

[Sassafras]

If I were to break my ankle by stepping in a hole in my yard or something (assuming I would call an ambulance for that) and the responding paramedics attempted to remove my clothing, I would have a definite problem with that.

[akroeze]

If I were to break my ankle by stepping in a hole in my yard or something (assuming I would call an ambulance for that) and the responding paramedics attempted to remove my clothing, I would have a definite problem with that.

Quoted for truth.

[spenac]

Thanks for all the replys. It is interesting the way each person looks at each question and the thoughts it brings out. Have a great day.

And the winner is Keep the clothes on the majority of the time.

[Just Plain Ruff]

So Wink, tell em what they win

so what did I win other than some really nice parting gifts.

[spenac]

Do to an error all contest info is void and all gifts are sent to charity. Thank you for playing we appreciate your support. Catch ya'll next time on lost causes.

[AnthonyM83]

Coming into this late, but I'd say modification of procedure (as long as it won't get you in legal trouble) should be looked at in a case by case basis. If there'ds abd. pain and pt really wants you to keep her covered (being seen might not mean much to us, but the world to that woman, for religious reasons...she might be tainted, afterwards having been exposed...the only way I can compare it in my mind is comparing it to how girl might feel about her virginity...we might not care, but her culture sure might), then keep covered.

If it's a trauma, it's a life immediately at stake. What mom thinks doesn't matter one bit, because in this case preservation of llife wins out.

[nremtp]

I vote NO - only the females :wink:

[Laura Anne]

MY TURN, MY TURN!!!!! :twisted:

OK..... as professionals(most of us anyways), being able to determine if/what treatment is going to be rendered is part of our job. It's common friggin sense. If someone took my mother's clothes off for a twisted ankle and she had no other compaints/injuries/illness, I'd take part of their anatomy off, plain and simple. But hey, I am fair...I'd let the person who took the clothes off pick which part of their body(doesn't mean I'd agree, mind you).

When it comes to elderly and/or children, their modesty and/or fear plays a big role on how you assess someone. When it's kids, I normally want a parent or care provider there with me while I assess the ENTIRE patient. Now, here comes a big shocker.....I can do this WITH the clothes on! :shock: Yes, it's true. Just lift the shirt, pull down/up the pants, and check legs/buttocks for any other signs of injury/illness. Kids a lot of times won't tell you they're hurt due to not knowing you and/or fear of you or the care provider that may have caused the pain. Sometimes it's out of pure shame cause they got hurt doing something they're not allowed to IE: climbing the tree in the backyard, standing on a chair to reach the countertop, etc.

Elderly may be old fashioned/modest and/or have other reasons for not being capable of telling you every injury/illness they have had now or recently in the past IE: the bruises from recent falls, the pacemaker box in their chest, etc. PSST, this too can be assessed w/o the clothes needing to come off, just expose the body regions. 8)

So my answer is 'no'.