brentoli Posted May 28, 2007 Author Share Posted May 28, 2007 What would that 17yro be refusing exactly? AMA is usually refusing to transport or refusing treatment. The reason being that we as "medical professionals" believe they need medical tx. If they have no medical problem, what medical treatment or evaluation are you trying to get them to accept? What medical advice are they going against? If a 17yro had a papercut approached you while on shift and asked you for a bandaid and showed you her finger, would you need her to sign out AMA? I don't see what you are getting at Anthony? If a 17 year old's mom tells me to transport their child, I have to do it barring orders from MD or law enforcement. It doesn't matter the situation. I can try and talk them out of it all I want to, but in the end I have to have orders from someone on high to refuse the transport. Aside from that, in your analogy there is true visible injury to her. I don't see how that has relevance to the discussion. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted May 28, 2007 Share Posted May 28, 2007 Sorry, I might not have connected my post with the discussion at hand well enough. I was taking the logic that an AMA is needed for any release after tx to an extreme to see if you guys felt the logic still held, since logic used needs to hold for all situations. The scenario of me walking through a shopping mall and being approached by someone for a bandaid with a SUPER minor papercut (or as extremely minor thing you can think of in your head...) popped to mind. We were trained in Santa Clara County not to require AMA for minor things that we didn't think any transport was necessary and in Los Angeles County where I now work, it's also the system we use (so giving you examples of two places, not geographically close to each other, that use the same system). It's not assumed that the 17yro's parents would want their daughter transported for an already bandaided papercut when we don't have medical justification for such transport. We assume it with small children because 1) They can't decide on simple decisions for themselves and 2) They need a guardian to be released to, but if we feel this is a decision this 17yro is capable of, then we can allow her to make it. At least how I was taught. But if you're in a system like DustDevil described, then I guess my scenario doesn't make the point I wanted, because you guys need AMA for literally everything, no exceptions, if a minor. Link to comment Share on other sites More sharing options...
brentoli Posted May 28, 2007 Author Share Posted May 28, 2007 That does make more sense, but here we are required to make parental contact whenever a minor is involved. If the parent says go, then we have to go. If we can't get ahold of the parent, we have to keep trying or fall back on PD assuming it is a minor situation. Of course we still go by implied consent for major problems. Link to comment Share on other sites More sharing options...
MedicRN Posted May 28, 2007 Share Posted May 28, 2007 To sum it all up, treat/transport/AMA according to YOUR LOCAL policies/procedures/regulations. What is policy for me is probably not policy for you. Link to comment Share on other sites More sharing options...
JCicco345 Posted May 28, 2007 Share Posted May 28, 2007 I disagree with was Dust said here, she would be a patient about her being a non-patient. Maybe some systems are diffrent but even in school we've had the debate about what constitutes a patient. If you were called to the scene to evaluate someone, wouldn't that make them a patient. Granted the trooper didn't need to call the ambulance but once he did that makes her a patient. Its a gray area though, if a passer-by calls 911 for the accident, on your arrival all parties are ambulatory and denying injuries, there is minor damage, ect. Do you obtain refusals, in our system we do, but i don't think we should need to. However if police or fire on scene request for the eval then that makes the person a patient. Or if you arrive on scene and they do complain about something, IE neck or back. Link to comment Share on other sites More sharing options...
spenac Posted May 28, 2007 Share Posted May 28, 2007 What would that 17yro be refusing exactly? AMA is usually refusing to transport or refusing treatment. The reason being that we as "medical professionals" believe they need medical tx. If they have no medical problem, what medical treatment or evaluation are you trying to get them to accept? What medical advice are they going against? If a 17yro had a papercut approached you while on shift and asked you for a bandaid and showed you her finger, would you need her to sign out AMA? Based on all the comments I got when I asked if you transport the guy thats only hungry, most would transport your papercut, much more serious than just getting lunch. We don't have AMA form for this we just have a form that adults can sign that say's basically they do not want treatment or transport. If we feel they need treatment transport then we use AMA. The benefit of a signature is when papercut gets infected and they don't treat it then a month later they lose the entire arm and try to sue you have something showing you were there and offered your services. CYA ( Cover Your A.. ) Link to comment Share on other sites More sharing options...
AnthonyM83 Posted May 28, 2007 Share Posted May 28, 2007 If a 17yro had a papercut approached you while on shift and asked you for a bandaid and showed you her finger' date=' would you need her to sign out AMA?[/quote'] Based on all the comments I got when I asked if you transport the guy thats only hungry, most would transport your papercut, much more serious than just getting lunch. The difference is that the guy who is only hungry wants to go. We wouldn't refuse him transport, either. But I guess I'm lucky in my system, b/c we'd be tied up for hours each day if we needed parental signatures without exceptions. It's about the only good thing in our county... Link to comment Share on other sites More sharing options...
brentoli Posted May 28, 2007 Author Share Posted May 28, 2007 I am sure volume does have a play in this. You have how many calls a shift? We have 2 calls a day, and are the 2nd busiest township in the county. Heh. I think there is just a little too much CYA on the law enforcement side going on here. And alot of it comes from the troopers, and the older officers who dont want to deal with whats going on. Link to comment Share on other sites More sharing options...
spenac Posted May 28, 2007 Share Posted May 28, 2007 Based on all the comments I got when I asked if you transport the guy thats only hungry, most would transport your papercut, much more serious than just getting lunch. The difference is that the guy who is only hungry wants to go. We wouldn't refuse him transport, either. But I guess I'm lucky in my system, b/c we'd be tied up for hours each day if we needed parental signatures without exceptions. It's about the only good thing in our county... So you would refuse treatment to the 17 year old papercut while transporting the hungry guy makes no sense to me. She asked for help and you provide a bandaid she becomes your patient, so you have provided treatment therefore you should get a signed refusal for further treatment. Some states recognize 17 year olds as adults and she would then be able to sign refusal. Also is she pregnant if so she's an adult. If not then your stuck with her. Don't like that idea either but more sense than transporting the hungry guy. I still think it makes more sense to deny the hungry guy. I am glad I have that right here, such a waste of resources. Paper work is a CYA item. Sorry I'm trying to fight the urge to go into a rant. deny the patient deny deny bye for now Link to comment Share on other sites More sharing options...
spenac Posted May 28, 2007 Share Posted May 28, 2007 Whats wrong with the qoute machine? Looks like anthonys comments are mine. Deny the the hungry guy, deny deny It's adding another qoute went back edited and fixed my post but acting up. Deny deny deny I say. Link to comment Share on other sites More sharing options...
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