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paramedicmike

Would you stop?

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What facts are missing? What additional information would you like to see? What do you think based on what's presented?

We know nothing about the seizure patient... beyond the fact it was a seizure patient. Was s/he postictal? Was s/he stable? If s/he was stable is there immediate concern of recurrent seizures? Was s/he still seizing? What was being done to stabilize him/her? Was anything necessary to stabilize him/her? Was transport strictly for observation/investigation or for intervention?

There is no way of conveying how the scene presented to the crew that stopped... it seems apparent that it appeared serious enough to warrant investigation based on the seriousness (or lack thereof) of their seizure patient. If that is the case I'd have to assume they made the right choice (and subsequent decisions) based on the information they had.

Like I said before, I wasn't there to know what they knew or see what they saw so I cannot judge whether it was right or wrong. I need to assume they would use sound judgement based on all the information they have available... until it is proven otherwise; to draw conclusions or pass judgement without all their information is unfair speculation.

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We know nothing about the seizure patient... beyond the fact it was a seizure patient. Was s/he postictal? Was s/he stable? If s/he was stable is there immediate concern of recurrent seizures? Was s/he still seizing? What was being done to stabilize him/her? Was anything necessary to stabilize him/her? Was transport strictly for observation/investigation or for intervention?

Does it matter? Your attention and obligation already belong to one patient. By stopping you're placing yourself in a position where you have to decide between neglecting one and abandoning another. Either way you lose.

There is no way of conveying how the scene presented to the crew that stopped... it seems apparent that it appeared serious enough to warrant investigation based on the seriousness (or lack thereof) of their seizure patient. If that is the case I'd have to assume they made the right choice (and subsequent decisions) based on the information they had.

So what's wrong with grabbing the radio, calling it in and letting an available crew handle the call? That's the thing. This crew was not available. They had a patient. Their attention belongs to that patient regardless of patient acuity from either incident.

Like I said before, I wasn't there to know what they knew or see what they saw so I cannot judge whether it was right or wrong. I need to assume they would use sound judgement based on all the information they have available... until it is proven otherwise; to draw conclusions or pass judgement without all their information is unfair speculation.

Well, you know what happens when you assume things.

I agree with your comments on speculation. However, if even half of this is true, they still need to be fired. But it doesn't seem that many of the primary facts of the story are in dispute.

if you have a patient on board you can't stop for another. If you do, you are neglecting your first patient and putting yourself in a position of potentially abandoning the second. We have all this fancy communications equipment for a reason. What's wrong with using it to call for an available ambulance while you devote your full and undivided attention to the patient you already have?

-be safe

edit: once for missing "]"

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This is a intersting case. I have worked where we stopped at a roll over and had a noncritical patient. The car empty so that did not make a difference. I can see where this would be difficult to not stop. We are trained to provide medical care and it is what we love to do or we would not be in this profession.

I know that my paramedic school made us take the EMS oath. I remember it said something about not inflicking harm. Did they inflick harm on the pt they already had? Nope but the outcome could have been worse. I mean if a stray bullet would have hit that baby or the family that was with them it would have been different story.

People also said that if they did not stop that people would have been calling the news and the 911 center because the ambulance did not stop. If they stop and one of them would have gotten killed they would have been calling the 911 center and the news.

THIS IS A CASE OF THE DAMN IF YOU DO, DAMN IF YOU DO NOT!!!!!

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There are too few details included in the "report" to judge what is right & wrong. I wasn't there, I can't say what I would have done, each case is unique and must be judged based on ALL the FACTS. It is foolish (unless you are a whacker) to try and draw any conclusions/judgements based on what is presented.

You are kidding right? There really are no other facts needed in this case. You have a patient in the back of your ambulance that is being transported to the hospital. You are committed to that call. The best thing you can do is to call for another unit and continue transport. I don't think anyone is disputing that there was a patient being transported and that's really the only pertinent fact to this case.

here is scenario to consider. You are transporting an elderly patient from a care home, they had a fall from standing and their only complaint is hip pain, vitals are normal and the only injury seen is shortening and rotation of one leg. Enroute to hospital you witness a 10-year-old pedestrian who is thrown 20 feet, lands on his back and is not moving. Do you stop to assess, or continue on and radio for another unit?

As much as this scenario sucks, I would notify dispatch and request additional support. Notify a supervisor of the incident. However, stopping is not a viable option due to the duty to act incurred by having a patient in the back of my ambulance that's being transported. However, by requesting resources I have fulfilled my duty to the struck patient. It's a difficult thing to do, but stopping is NOT the right answer.

Shane

NREMT-P

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People are actually condoning this???? They had a patient, period. That is their focus. There was no reason to stop, as others have said, pick up the damn radio and call for another unit. These two should be fired immediately, with no questions asked. Glad to see a good outcome for the baby who deserved a lot more than received.................

I have passed numerous MVA's over the years and have NEVER stopped at any of them if we had a patient on board. If it could be safely done, I would slow down long enough to advise that another unit was notified and/or en route (and tell bystanders to stop CPR on a decapitated body on one occasion) and then continued on with our call..........

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I am not sure if this is local, provincial, or canada wide, but we are not allowed to stop with a patient in the unit transfer or unstable. If we have a patient we are not "for hire". However if we do not have a pt. we are obligated to stop.

Morals say one thing law says another.

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You never stop. That's abandonment. I don't what anyone says.

That first pt was sick and requested transport to the hospital. They expect to be transported. If the ambulance was involved, then that'd be different. But in this case, they should have radioed it in and kept driving. The only time I've ever stopped, was on the way to the call. Never after a pt was on board.

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If you stop, I hope you have alot of money, after the lawsuits and unemployment you will need it.

You are abandoning your paitent by stopping plain and simple. And not only that, you are also offering both paitents a decreased level of care. Top it off with placing the original patient possibly in harms way, and there is the Hat Trick.

Use the radio, slow down open the window, and explain the situation to a bystander if you have to.

Don't stop.

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I'm confused, 1 EMT is in the back with the patient during transport, 1 is driving, how does the driver stepping out affect the patient in the back with the 1 tech.

In this case there is 1 EMT-P, 1 EMT-B/P student With the seizure patient, and the driver stepped out to check for life threats on the accident patient.

Where is the neglect or abandonment? The only thing I can see is perhaps the slower transport time, but this argument seems to be negated by everyone's argument of " it's NYC, how far away is another unit" its probably the same as the distance to the nearest ER.

Both are pretty quick, but, I do believe if the accident patient needed ALS it would have taken a bit longer then a BLS unit. Also if you see the list of personnel who were on scene it was all ALS, maybe its relevant maybe not. I'm strumming through my protocols and reference guides to get a definitive answer but I'm not having any luck right now.

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If you stop, I hope you have alot of money, after the lawsuits and unemployment you will need it.

You are abandoning your paitent by stopping plain and simple. And not only that, you are also offering both paitents a decreased level of care. Top it off with placing the original patient possibly in harms way, and there is the Hat Trick.

Use the radio, slow down open the window, and explain the situation to a bystander if you have to.

Don't stop.

I think that sums it up. You shouldn't be stopping. Regardless of weather someone stays with the patient you're transporting, you're now committed to that scene you stopped at since you've started to render care. You've delayed transport to definitive care. And you've provided less than the acceptable standard for a transporting ambulance since you have only one set of hands available and a patient already in the back of your ambulance from another call. Again, the right answer is not to stop. You're committed to a call from the time you're dispatched until the conclusion. You cannot get yourself involved in another call while you're on one. That's abandonment and negligence. You would have zero legal defense if you were to do this. Notify dispatch and continue to the destination hospital. There really isn't another answer that works.

Shane

NREMT-P

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