EMS Patient Care Advocate
Forum Lieutenant
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You are toned to meet a vehicle carrying a passenger involved in a vehicle fire in a POV now driving towards the hospital. Meet POV, man jumps out covered in approx 40% burns, majority 2nd degree and 3rd to hands, arms, shoulders, legs, arms and legs appear to be circumferential. All burned areas of skin peeling, some bleeding to left hand. The Airway is dry, white. All hair on head singed.
Pt states "I was coming down a hill, breaks went out and I crashed into trees. I was unable to get out of the vehicle immediately and it burst into flames"
Unable to stop him he gets into the ambulance and sits on edge of stretcher.
Pt refuses backboard, collar, or sitting back to be secured to transport. Pt is CAOx4 PPTE with 10/10 pain from burns-Id say this counts as distracting injury. Pt states he cannot/will not tolerate anything against his skin, stretcher/backboard/burn blanket. Pt has no midline neck or back pain. Distal Neurological exam somewhat unreliable due to severe burns to arms, legs and hands-However patient is able to move all extremities.
Would you use force and restrain?
Do you allow a patient who had no other contraindications to refusal of care other than a distracting injury? Then discuss this with doctor and document.
You are unable to obtain a BP, alternative placements also burned. All clinical signs of circulation, mentation and distal pulses intact.
No RSI available prehospital.
Pt states "I was coming down a hill, breaks went out and I crashed into trees. I was unable to get out of the vehicle immediately and it burst into flames"
Unable to stop him he gets into the ambulance and sits on edge of stretcher.
Pt refuses backboard, collar, or sitting back to be secured to transport. Pt is CAOx4 PPTE with 10/10 pain from burns-Id say this counts as distracting injury. Pt states he cannot/will not tolerate anything against his skin, stretcher/backboard/burn blanket. Pt has no midline neck or back pain. Distal Neurological exam somewhat unreliable due to severe burns to arms, legs and hands-However patient is able to move all extremities.
Would you use force and restrain?
Do you allow a patient who had no other contraindications to refusal of care other than a distracting injury? Then discuss this with doctor and document.
You are unable to obtain a BP, alternative placements also burned. All clinical signs of circulation, mentation and distal pulses intact.
No RSI available prehospital.