Hypothetical MVC...What Would You Do?

[katbemeEMT-B]

This is purely a hypothetical situation that came up the other day at work. I am just looking for input from other people as to what you would do should you be in this situation...

You arrive on scene of a two vehicle mvc. Vehicle #2 t-boned vehicle #1. In vehicle #1 you find a middle aged male with minor injuries. Inside vehicle #2 you find a woman in her early 30's unbelted with airbag deployment, driver side. She has facial trauma and is complaining of difficulty breathing. You note that there is obvious deformation to the steering wheel. In the back seat are two children unrestrained. The male, appearing to be about 7 y/o, is lying on the floor behind the driver. He is complaining of neck and back pain and has an obvious shoulder injury. The female, appearing to be about 10 y/o is sitting in the center of the back seat with minor facial trauma, complaining of neck and head pain. You have already requested additional transport. You tend to the female driver and prepare her for transport as the second truck pulls up. You explain to her that the medics are going to take her to the hospital. She tells you she won't go until her children have been taken care of. You and your partner reassure her that they are fine and you are taking care of them also. You also tell her that they will be in the ambulance right behind her. She is still refusing to go until her children have been loaded into an ambulance and are on their way. You note that her breathing is becoming more shallow with each breath and she is complaining of more head, neck, and back pain. She has pronounced deformity to her face, including the jaw area. A lung check is positive for gurgling telling you that she has aspirated blood. You explain once again the urgency for getting her to the hospital, but she is still refusing. The children's injuries do not appear to be as life threatening.

What would you do? Do you honor the mother's wishes and delay her transport to prepare the children or do you take her against her wishes?

Let me know if you need anymore info.

[akflightmedic]

Meh, its too hypothetical.

I have been in that situation and as bad as she sounds, I dont think she will protest too much longer.

Usually people know when they are bad off and they are not going to jeoaprdize or delay their own care.

You tell her straight to her face, your kids injuries are minor, they are being taken care of. You on the other hand are in worse shape. Do you want to see them off and then die or do you want to get help so you can be there for them another day.

Usually when you explain it like that, they are happy to comply.

[Scaramedic]

That's a whole load reading there m'am, so I might a missed it.

Is she A&O??

Peace,

Marty

Edit: Changed son to m'am.

[511Chief]

Good reply flight medic, Tell her the way it is, agree its too what if..... but then again ya never know

[Dustdevil]

[katbemeEMT-B]

That's a whole load reading there m'am, so I might a missed it.

Is she A&O??

Peace,

Marty

Edit: Changed son to m'am.

Yes she is.

[katbemeEMT-B]

The reason I brought this up was because we had a call involving an 80 y/o mother and her 55 y/o daughter. The daughter was refusing transport unless her mother was taken first. The mother needed to be extricated where as the daughter was packaged and ready to go when the second truck arrived. The daughter was informed that her injuries were she would be transported immediately and her mother would be coming shortly. After some convincing, she accepted that decision.

This brought up the conversation involving the children in the above scenario. I was just curious what you guys thought and how you would handle the same situation. It was the general consensus that we would transport the mother first and children after. One medics answer was to sedate mom. Not gonna happen. He's kind of a smart ass though. I will say that I have had parents tell me to take the kids first. I explained to the parents that their injuries were far more serious than the childrens and that seemed to work. Never had to get ugly though.

[mediccjh]

That's when you say to the one objecting,"Fine. It'll be easier to transport you when you're dead."

That usually works.

[AnthonyM83]

Well, if Dust's idea doesn't work, I'd tell her we have a protocol to follow and her children won't get an ambulance until she gets loaded up, so if she wants her children to get going, she better let us help her or she's delaying treatment of her kids. If she still refuses and she's definitely A/O to make the decision, have her sign AMA to be treated last and go ahead with the kids. They'd probably just go BLS in LA County anyway...

[ERDoc]

Sounds to me like this pt is becoming combative. Maybe a little etomide and sux are in order. :wink: