Guest guest Posted January 18, 2007 Report Share Posted January 18, 2007 This same thing happened several years ago in a town near Fort Worth. EMS was transporting an intoxicated teenager when he got up, opened the back door and exited the ambulance. He was killed instantly. A long investigation ensued, but ultimately the medics were not found to be at fault. We should all be aware of this possibility and consider the use of restraints for patients with an altered mental status. Gene Gandy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2007 Report Share Posted January 18, 2007 In this case, based upon information I was told, PD did not want to transport the subject because he was vomiting. And there was a question about his BAC being at a high enough level that he needed hospital observation. As I understand it, prior to EMS arrival, he had made some suicidal statments to LE, which they failed to pass along to the medics. There was a grand jury investigation into the matter. The attending medic was in the process of making a radio report to the hospital when the incident happened. He saw the patient before he jumped, but was unable to stop him. Gene Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2007 Report Share Posted January 18, 2007 It has long been my policy not to be between the door and a patient who wants out. ~Bob CCEMTP Bob W. Hargis 2008 Independent Presidential Candidate www.hargis.info <http://www.hargis.info/> bob@... _____ From: texasems-l [mailto:texasems-l ] On Behalf Of wegandy1938@... Sent: Thursday, January 18, 2007 9:23 PM To: texasems-l Subject: Man jumps from moving ambulance This same thing happened several years ago in a town near Fort Worth. EMS was transporting an intoxicated teenager when he got up, opened the back door and exited the ambulance. He was killed instantly. A long investigation ensued, but ultimately the medics were not found to be at fault. We should all be aware of this possibility and consider the use of restraints for patients with an altered mental status. Gene Gandy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2007 Report Share Posted January 18, 2007 Gene, I totally agree with you. I do feel, though, that if the patient has been " medically cleared " from one facility and is being transferred to another, that it be done by law enforcement, or, another more secure means than the back of an ambulance. I know this is open for debate, but it is only my opinion. I have had the (pleasure?) of transporting patients from one facility to another for reasons such as: 1. It took SWAT to get the " person " out of the building. 2. Patients that were threats to themselves, as well as, others. 3. " Persons " that Law enforcement did not want to transfer because of lack of manpower, which, I can understand, sometimes. The list is long, but you know what I'm trying to say(I hope). Yes, we use the stretcher belts and make sure the doors are locked, and are vigilant, but that's not always enough, obviously. If the patient IS violent, I DO NOT believe he needs to go by ambulance. If the patient displayed a violent behavior, but now is calm and says " i won't do anything " ------ they still need to go by Law Enforcement. Again, IF he is medically cleared and does not require to be sedated for the transport. I could go on, but basically--- I feel EMS should not be used for these type of transports. AND when I mean EMS, I also mean transfer services! ALL opinions are welcomed and respected. BUT ! I stand firm on my opinion and don't think I could be swayed to change my mind wegandy1938@... wrote: This same thing happened several years ago in a town near Fort Worth. EMS was transporting an intoxicated teenager when he got up, opened the back door and exited the ambulance. He was killed instantly. A long investigation ensued, but ultimately the medics were not found to be at fault. We should all be aware of this possibility and consider the use of restraints for patients with an altered mental status. Gene Gandy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2007 Report Share Posted January 18, 2007 Gene, Wonder if a well-time brake tap could have helped??? Now with the excited delirium/ " In Custody Death Syndrome " issues that continue to arise mandate that we take these " violent " psych patients more seriously. We had one about 6 months ago that was being held down and restrained by PD and violent is an understatement....because of research I had done on Tasers, and other issues surrounding in custody deaths I suggested we slip a pulse ox probe on his finger...the reading was a VERY frightening 82%... High flow O2 was held in front of the patient while PD freed an arm for an IV and aggressive sedation...which didn't decrease the LOC of the patient but did enable us to establish dialogue and calm the patient enough where we could get him on a stretcher and put the oxygen mask on him.... As violent as he was, it is no mystery that we saved this kid who was zinging along high on cocaine and meth...because if we had left him with PD his end could have been in the paper instead of back at the house. This area needs MUCH more attention and guidance...we truly don't know what we don't know. Dudley Re: Man jumps from moving ambulance In this case, based upon information I was told, PD did not want to transport the subject because he was vomiting. And there was a question about his BAC being at a high enough level that he needed hospital observation. As I understand it, prior to EMS arrival, he had made some suicidal statments to LE, which they failed to pass along to the medics. There was a grand jury investigation into the matter. The attending medic was in the process of making a radio report to the hospital when the incident happened. He saw the patient before he jumped, but was unable to stop him. Gene Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2007 Report Share Posted January 19, 2007 Gene, the NJ case I just posted happened like 3 days ago. Louis N. Molino, Sr., CET FF/NREMT-B/FSI/EMSI Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant Buddhist philosopher at-large LNMolino@... (Cell Phone) (Home Phone) (IFW/TFW/FSS Office) (IFW/TFW/FSS Fax) " A Texan with a Jersey Attitude " " Great minds discuss ideas; Average minds discuss events; Small minds discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) The comments contained in this E-mail are the opinions of the author and the author alone. I in no way ever intend to speak for any person or organization that I am in any way whatsoever involved or associated with unless I specifically state that I am doing so. Further this E-mail is intended only for its stated recipient and may contain private and or confidential materials retransmission is strictly prohibited unless placed in the public domain by the original author. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2007 Report Share Posted January 19, 2007 airmedic51@... wrote: " Yes, we use the stretcher belts and make sure the doors are locked, and are vigilant, but that's not always enough, obviously. " Would you really want to lock the doors alone with a violent or potentially violent patient in the back? Not only will you stop the patient from getting out but you also lock your escape route. With LE present during the transport - maybe, alone I don't think so. AJL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2007 Report Share Posted January 19, 2007 The reason I see to lock the doors is to give you a few extra seconds to get to the person before they exit while the vehicle is in motion...I would think medics know how their doors lock and unlock so the delay in opening the door if you needed to exit should be negligible. For an unruly patient attempting to exit...the extra 3 to 5 seconds it takes for them to realize the door is locked and get it unlocked may allow you to take steps to prevent the exit.... That's my thoughts. Dudley RE: Man jumps from moving ambulance airmedic51@... wrote: " Yes, we use the stretcher belts and make sure the doors are locked, and are vigilant, but that's not always enough, obviously. " Would you really want to lock the doors alone with a violent or potentially violent patient in the back? Not only will you stop the patient from getting out but you also lock your escape route. With LE present during the transport - maybe, alone I don't think so. AJL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2007 Report Share Posted January 19, 2007 If I have any say in it as the lead medic, and, I will for my safety as well as my partner's safety, I WOULD NOT transport a violent or " potentially violent " patient, unles it was medically necessary, AND DEFINITELY NOT ALONE in the back. I would have a second person. (Now I do know some medics who will jump out FIRST, if the Pt. becomes violent (LOL). Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2007 Report Share Posted January 19, 2007 Dudley, If this is the same case I am familiar with the details, it was an old partner of mine who was the medic in the back. The rear door of the ambulance was locked and the guy got off the cot and stepped out the door in blink of an eye. The medic reacted and still was unable to reach the patient before he exited the vehicle at 55 +MPH. The patient up until that point had been cooperative and hadn’t given any indication of what was to take place during the transport. I not sure that anything short of tackling the guy before he got to the door would have stopped him and that would not be a good option because I think the patient would have taken the medic with him, had he gotten in the way. It was truly a very sad situation for the patient and the medic. Bernie Stafford EMTP ________________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of THEDUDMAN@... Sent: Friday, January 19, 2007 10:02 AM To: texasems-l Subject: Re: Man jumps from moving ambulance The reason I see to lock the doors is to give you a few extra seconds to get to the person before they exit while the vehicle is in motion...I would think medics know how their doors lock and unlock so the delay in opening the door if you needed to exit should be negligible. For an unruly patient attempting to exit...the extra 3 to 5 seconds it takes for them to realize the door is locked and get it unlocked may allow you to take steps to prevent the exit.... That's my thoughts. Dudley RE: Man jumps from moving ambulance airmedic51@... wrote: " Yes, we use the stretcher belts and make sure the doors are locked, and are vigilant, but that's not always enough, obviously. " Would you really want to lock the doors alone with a violent or potentially violent patient in the back? Not only will you stop the patient from getting out but you also lock your escape route. With LE present during the transport - maybe, alone I don't think so. AJL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2007 Report Share Posted January 19, 2007 In the case I reported, the driver did in fact apply the brakes vigorously, but it was too late. Gene Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2007 Report Share Posted January 19, 2007 Well I think we should all get dart guns for the violent patients. we simply ask them " Do ya really want to continue acting this way? " if they say yes. well then ..... Just kidding THEDUDMAN@... wrote: Gene, Wonder if a well-time brake tap could have helped??? Now with the excited delirium/ " In Custody Death Syndrome " issues that continue to arise mandate that we take these " violent " psych patients more seriously. We had one about 6 months ago that was being held down and restrained by PD and violent is an understatement....because of research I had done on Tasers, and other issues surrounding in custody deaths I suggested we slip a pulse ox probe on his finger...the reading was a VERY frightening 82%... High flow O2 was held in front of the patient while PD freed an arm for an IV and aggressive sedation...which didn't decrease the LOC of the patient but did enable us to establish dialogue and calm the patient enough where we could get him on a stretcher and put the oxygen mask on him.... As violent as he was, it is no mystery that we saved this kid who was zinging along high on cocaine and meth...because if we had left him with PD his end could have been in the paper instead of back at the house. This area needs MUCH more attention and guidance...we truly don't know what we don't know. Dudley Re: Man jumps from moving ambulance In this case, based upon information I was told, PD did not want to transport the subject because he was vomiting. And there was a question about his BAC being at a high enough level that he needed hospital observation. As I understand it, prior to EMS arrival, he had made some suicidal statments to LE, which they failed to pass along to the medics. There was a grand jury investigation into the matter. The attending medic was in the process of making a radio report to the hospital when the incident happened. He saw the patient before he jumped, but was unable to stop him. Gene Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2007 Report Share Posted January 19, 2007 Bernie, I sure hope he is doing okay...I have been fortunate that only a couple of my patients have made any attempt to get up off the stretcher. I cannot imagine this happening.... My thoughts were in response to other posts and not directed at this particular incident. This is probably the 3rd or 4th case of this similar thing happening over the last several months...no matter what the circumstances, it is a horrible event that I hope very few of us would ever have to experience ourselves. Dudley RE: Man jumps from moving ambulance airmedic51@... wrote: " Yes, we use the stretcher belts and make sure the doors are locked, and are vigilant, but that's not always enough, obviously. " Would you really want to lock the doors alone with a violent or potentially violent patient in the back? Not only will you stop the patient from getting out but you also lock your escape route. With LE present during the transport - maybe, alone I don't think so. AJL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2007 Report Share Posted January 19, 2007 Dudley, My comments were to clarify the circumstances of the incident and to make everyone take a little closer look at a patient that might have that potential to jump out the back of the ambulance. The medic that was in the back was cleared after a very intensive investigation and is now a RN and working in the DFW area the last time I saw him. I have had a couple of patient over the years make an attempt to escape, most allow me to have the ambulance pulled over before they exited, much to my relief. I also had one that just kicked my butt instead.lol The point is you have to be aware all the time, try not to concentrate on doing the patient report rather give you full attention to your patient no matter what their complaint or condition. Bernie Stafford EMTP _____ From: texasems-l [mailto:texasems-l ] On Behalf Of THEDUDMAN@... Sent: Friday, January 19, 2007 6:56 PM To: texasems-l Subject: Re: Man jumps from moving ambulance Bernie, I sure hope he is doing okay...I have been fortunate that only a couple of my patients have made any attempt to get up off the stretcher. I cannot imagine this happening.... My thoughts were in response to other posts and not directed at this particular incident. This is probably the 3rd or 4th case of this similar thing happening over the last several months...no matter what the circumstances, it is a horrible event that I hope very few of us would ever have to experience ourselves. Dudley RE: Man jumps from moving ambulance airmedic51@sbcgloba <mailto:airmedic51%40sbcglobal.net> l.net wrote: " Yes, we use the stretcher belts and make sure the doors are locked, and are vigilant, but that's not always enough, obviously. " Would you really want to lock the doors alone with a violent or potentially violent patient in the back? Not only will you stop the patient from getting out but you also lock your escape route. With LE present during the transport - maybe, alone I don't think so. AJL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2007 Report Share Posted January 20, 2007 I always think of my safety and my crew's safety. I never transport a potentially violently patient alone, whether it's me or my partner in the back. Since I am usually the senior partner I always insist on LE or at least FD to go with. Two against one makes the odds better for us all. Take care and stay safe Anita NREMTP/LP Quote Link to comment Share on other sites More sharing options...
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