Guest guest Posted November 1, 2003 Report Share Posted November 1, 2003 There are a couple of things I heard in the past and assumed to be fact because they were told to me by more " experienced " paramedics. The more I think about it, the more I wonder. Item #1...when asked " Can I ride in back " the paramedic replies " No, You have to sit up front. " Assuming you have a stable pt and proper seat restraints, is there any reason a family member can not ride in the back of the unit? Item #2...If you suggest to a pt that does not want to be transported to the ER that they take an OTC medication, is this considered " practicing without a license " or just advice? Are there any issues to be considered? Dennis P. Lee EMT-P Training Officer Cy-Fair VFD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2003 Report Share Posted November 1, 2003 Dennis- #1 Some services may have a rule against extra civilians in the back, mine does not, and if I feel the persons presence will not interfere with treatments, be beneficial to the patient, help secure patient co-operation, lower patient stress, or just because I feel like it, I will invite the person to ride there. I generally give them the " Paramedic " seat at the patients head and seat belt them in to it myself. I do not like to separate young children from Mom or my old folks from each other if I can help it. #2 Suggestions like that will get your a@@ in a sling. Unless your Medical Director is particularly freewheeling, wait until you have completed medical school and your family practice residency as well as your state licensing examination before suggesting or performing any procedure or dispensing any drug not covered by your medical protocols. I limit such " Free " medical advice to suggesting a visit to their PCP, ER " Fast Track " , or local " Doc-In-The-Box " for if they do not have a current relationship with a MD, or to call us back if the condition exacerbates and they cannot safely drive to seek treatment. I deliver our " Refusal of Treatment or Transport " protocol (we call it the EMS " Miranda Form " ) and obtaining their informed signature insulates us from most forms of liability if their indigestion at 7 pm turns into a cardiac complication at 10 pm and they call EMS again..... Regards- Terry Dinerman EMTP DM (Dinosaurus Medicus) Fact or Fiction? >There are a couple of things I heard in the past and assumed to be >fact because they were told to me by more " experienced " paramedics. >The more I think about it, the more I wonder. Item #1...when >asked " Can I ride in back " the paramedic replies " No, You have to sit >up front. " Assuming you have a stable pt and proper seat restraints, >is there any reason a family member can not ride in the back of the >unit? >Item #2...If you suggest to a pt that does not want to be transported >to the ER that they take an OTC medication, is this >considered " practicing without a license " or just advice? Are there >any issues to be considered? > >Dennis P. Lee EMT-P >Training Officer >Cy-Fair VFD > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2003 Report Share Posted November 1, 2003 I am of two minds about having family members riding in back. Terry makes good points about reducing the anxiety of children, mothers and the elderly. However, as long as the percentage of serious injuries and fatalities incurred by EMS personnel in the back of units from MVCs (see the accident study on the NHTSA EMS website), I have a problem with any additional risk to citizens. Terry makes a good point about buckling up the riders in the 'paramedic' seat. But, think of this: how many of us 'in the back' buckle ourselves in, and how much equipment can fly free in an accident? A Zoll or LP 12 could really ruin your day. How many of you leave an oxygen flowmeter installed in the starboard (passenger) built-in oxygen connection? Think for a moment what that could do to your face/head as your forward motion continues into the front of the box during a wreck. Sometimes, Mr. Newton is NOT our friend! " Destiny is not a matter of chance, it is a matter of choice. It is not a thing to be waited for; it is a thing to be achieved. " - W.J. Larry RN LP EMSI Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2003 Report Share Posted November 1, 2003 lanelson1@... wrote: > > Terry makes a good point about buckling up the riders in the 'paramedic' > seat. Except that it now leaves the medic without a position of safety in the back of the unit. This of course violates rule number one of EMS, which is scene safety. You do nobody any good if you go through the windshield while your patient and his/her parent or significant other remains safely bolted to the floor. > But, think of this: how many of us 'in the back' buckle ourselves > in, After breaking my neck -- literally -- in an ambulance crash, I darn sure did. Every time. Don't wait for the same reminder that I needed. > and how much equipment can fly free in an accident? A Zoll or LP 12 > could really ruin your day. Been there and done that too. LifePak 5 took out my left knee at about 70 mph (at the same time the wall was breaking my neck) and I still feel it, thirteen years after the fact. " Comforting " somebody is not sufficient reason to jeopardize them, their family, or your own life and safety. When it comes down to it, I feel there is practically NO defendable reason to allow a civilian to ride in the back of my unit. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2003 Report Share Posted November 1, 2003 Dennis, My opinion may differ somewhat from others on the list, but here goes. Item #1 That is my pat answer, " No you may not ride in the back " , and even with small children, I still have the parents ride in the front. After 14 years of dealing with screaming small children, only a miniscule percentage continue to scream once the parent is out of sight. Most are screaming because their parents are screaming and spastic. Quite honestly, I don't see the need for any riders at all, aside from maybe answering a question or two, what good is it to have them in the unit? Would they not be better off taking a car to the hospital as many of our patients are leaving and needing a ride home before we clear? I am not an a**hole, but having an untrained, spastic family member in the back does not help me do my job at all, I spend more time trying to keep them AND the patient calm. Item #2 This will depend on the judge that is hearing your malpractice suit... Seriously though, you are much better off with the answer of " Follow up with your PMD, etc. " Fact or Fiction? There are a couple of things I heard in the past and assumed to be fact because they were told to me by more " experienced " paramedics. The more I think about it, the more I wonder. Item #1...when asked " Can I ride in back " the paramedic replies " No, You have to sit up front. " Assuming you have a stable pt and proper seat restraints, is there any reason a family member can not ride in the back of the unit? Item #2...If you suggest to a pt that does not want to be transported to the ER that they take an OTC medication, is this considered " practicing without a license " or just advice? Are there any issues to be considered? Dennis P. Lee EMT-P Training Officer Cy-Fair VFD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2003 Report Share Posted November 1, 2003 > Fact or Fiction? > Item #1...when > asked " Can I ride in back " the paramedic replies " No, You have to sit > up front. " Assuming you have a stable pt and proper seat restraints, > is there any reason a family member can not ride in the back of the > unit? Yeah, I don't want them back there. Unless it's a parent of a small child, I don't want them in the front neither. Ken Musick > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2003 Report Share Posted November 2, 2003 Rob- What was the root cause of your accident? TD Re: Fact or Fiction? >lanelson1@... wrote: > >> >> Terry makes a good point about buckling up the riders in the 'paramedic' >> seat. > > >Except that it now leaves the medic without a position of safety in the >back of the unit. This of course violates rule number one of EMS, which >is scene safety. You do nobody any good if you go through the >windshield while your patient and his/her parent or significant other >remains safely bolted to the floor. > >> But, think of this: how many of us 'in the back' buckle ourselves >> in, > > >After breaking my neck -- literally -- in an ambulance crash, I darn >sure did. Every time. Don't wait for the same reminder that I needed. > >> and how much equipment can fly free in an accident? A Zoll or LP 12 >> could really ruin your day. > > >Been there and done that too. LifePak 5 took out my left knee at about >70 mph (at the same time the wall was breaking my neck) and I still feel >it, thirteen years after the fact. > > " Comforting " somebody is not sufficient reason to jeopardize them, their >family, or your own life and safety. When it comes down to it, I feel >there is practically NO defendable reason to allow a civilian to ride in >the back of my unit. > >Rob > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2003 Report Share Posted November 2, 2003 Terry Dinerman wrote: > Rob- > > What was the root cause of your accident? Civilian vehicle ran a red light, causing us to t-bone them in a highway intersection. We were running priority with lights and siren at night. Clear visibility and weather. No visual obstructions. No other traffic at intersection besides us and the car. EMT-I Driver - Seat belted. No injuries. Paramedic - Standing in rear of ambulance. Broken neck. Broken arm. Broken wrist. Broken ribs. Head/facial lac and concussion. Torn knee. EMT Student - Standing in rear of ambulance. Broken hip. Concussion. Patient - Strapped to stretcher. No injuries. Civilian car driver - DOS. Massive trauma. Civilaian car passenger - DOS. Broken neck. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2003 Report Share Posted November 2, 2003 Rob- I am so sorry that you received such grievous injuries in the line of duty...... More ammunition for me when I gripe my drivers out to slow down..... TD Re: Fact or Fiction? >Terry Dinerman wrote: > >> Rob- >> >> What was the root cause of your accident? > > >Civilian vehicle ran a red light, causing us to t-bone them in a highway >intersection. We were running priority with lights and siren at night. > Clear visibility and weather. No visual obstructions. No other >traffic at intersection besides us and the car. > >EMT-I Driver - Seat belted. No injuries. >Paramedic - Standing in rear of ambulance. Broken neck. Broken arm. >Broken wrist. Broken ribs. Head/facial lac and concussion. Torn knee. >EMT Student - Standing in rear of ambulance. Broken hip. Concussion. >Patient - Strapped to stretcher. No injuries. > >Civilian car driver - DOS. Massive trauma. >Civilaian car passenger - DOS. Broken neck. > >Rob > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2003 Report Share Posted November 2, 2003 Hatfield wrote: > > ...I have to say, " No Ma'am/Sir, I am sorry, but I don't > allow riders in the back, if you really feel the need to go with us, then > the only available seat is in the front " Or, " You may be a lot better off > bringing your car and following along behind us, you will need a ride home, > and if " X " is not admitted, they will need a ride home as well. " That brings up a whole nother can of worms. I *ALWAYS* advise family or friends that they should go ahead and start towards the hospital AHEAD of us while I stabilize the patient. I make it very clear to them that under NO circumstances are they to follow my ambulance, regardless of how slow, fast, or otherwise it is travelling. Allowing persons to follow your unit is just inviting trouble. You don't have to be running hot for them to decide to run a red light to catch up with you. And you don't need a stressed out person, who is probably talking on a cellphone nonstop, riding your bumper. VERY bad practice to allow this. Stop it before it starts. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2003 Report Share Posted November 3, 2003 Rob, Excellent point, I saw an article through TEXASEMSFACTOR about a woman in Ocala who had an accident while following an ambulance which carried her infant son. Mike Re: Fact or Fiction? > Hatfield wrote: > > > > > ...I have to say, " No Ma'am/Sir, I am sorry, but I don't > > allow riders in the back, if you really feel the need to go with us, then > > the only available seat is in the front " Or, " You may be a lot better off > > bringing your car and following along behind us, you will need a ride home, > > and if " X " is not admitted, they will need a ride home as well. " > > > That brings up a whole nother can of worms. I *ALWAYS* advise family or > friends that they should go ahead and start towards the hospital AHEAD > of us while I stabilize the patient. I make it very clear to them that > under NO circumstances are they to follow my ambulance, regardless of > how slow, fast, or otherwise it is travelling. Allowing persons to > follow your unit is just inviting trouble. You don't have to be running > hot for them to decide to run a red light to catch up with you. And you > don't need a stressed out person, who is probably talking on a cellphone > nonstop, riding your bumper. VERY bad practice to allow this. Stop it > before it starts. > > Rob > > > > > > > Quote Link to comment Share on other sites More sharing options...
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