Do you allow riders?

[Shishkabob]

Not enough new topics, so....




Do you allow riders, family / friends, when you're transporting patients?


I used to, but several weeks ago I stopped allowing them. Now it's more the exception than the norm that I allow someone. Many reasons as to why I switched, but the most PC one being I don't trust people around my expensive personal belongings in the truck while my attention is elsewhere. Wouldn't be the first time something was stolen or someone rifled through stuff looking.

 

[Veneficus]

When I worked on a truck I encouraged it.

Rider sits in back with me and the patient. My gear sits in the front with my partner.

 

[Shepard]

Working IFT: If there's family in the room I usually ask if someone want to ride with us. It makes the patient calmer and it's generally good for customer service. If there is any reason I suspect something might go wrong with the patient or if the transport is longer than 15-20 minutes (most aren't). The rider goes up front with my partner.

Working 911: If it's a "routine" pedi or someone who speaks a different language someone is riding with my medic (usually). If it's "routine" and a situation where were just doing vitals then someone can go if they want.

 

[EpiEMS]

Working 911 in an urban/suburban area

If the patient is pediatric, the parent/guardian/caretaker rides in back (unless they're interfering with EMS or are "agitated")
If the patient is an adult, nobody rides in back unless:
-- Requested by the patient (the rider must be calm and not interfere with EMS care)
-- Needed for translation
-- Needed to keep the patient calm
If a psych patient, PD may ride (if EMS requests it or if PD suggests it, say)
If the patient is not stable, there's no riders in back (or in front).

Riders must be seat belted on the squad bench. They are often helpful, and rarely are a hinderance.

 

[Veneficus]

If the patient is not stable, there's no riders in back (or in front).

Why?

 

[Merck]

I have no issue with people ridining along with a friend/family member. Of course each situation is different. Say a shooting with 2 or even three medics in the back and police accompanying there is likely no room/time but for the most part I encourage it.

I consider it to be part of an approach to health care not unlike how cardiac arrests are run. I always talk to the family and ask if they'd like to watch the call and encourage questions. With riding along you have the chance to fill the family in at the same time as the patient. If you've ever been on the other side you know it can be frustrating and that the source of frustration is the lack of knowledge. I think it helps the patient as well.

When we transport a post-arrest it isn't always feasible to take the family but usually a PCP stays behind while the other PCP drives in the ACP crew. That PCP that stays behind generally cleans/disposes of anything left out and sweeps for sharps then offers a ride to the hospital.

 

[rescue1]

I took riders all the time. Like others have said, stable pediatric patients will have the parent in the back with them, and some patients may have LE ride (though usually they just follow).
Almost everyone else I'll allow to ride in the front, especially if they have no other way to see their loved one/friend at the hospital.

I usually don't let riders in the back with an adult patient, since they tend to either get in the way or keep trying to talk to the patient during assessments. However, sometimes I'll need a translator, and once I had someone's boss ride with us in the back to help us hold the patient down (he was AMS and combative migrant worker, and ALS was a solid 20 minutes away).

Keep in mind though that I never have personal belongings in the front of the unit, since we're station based, not SSM. My last job was also in a nice-ish suburb, so petty theft from the unit was basically unheard of (though petty theft OF the unit was startlingly more common). My volunteer gigs were in poor-ish rural areas, but I never had an issue with riders. Sometimes they give some good patient history during transport too.

If I did SSM in a high crime urban area, this may be different, but I have no experience with that so I can't really comment.

 

[EpiEMS]

Why?

Oh, I meant in the context of an unstable adult whose family isn't going to be useful (or necessarily take it well to see their loved one in distress). Almost like not letting family into the resus room. Though, apparently, it's common to let them in now, no?

 

[Veneficus]

Oh, I meant in the context of an unstable adult whose family isn't going to be useful (or necessarily take it well to see their loved one in distress). Almost like not letting family into the resus room. Though, apparently, it's common to let them in now, no?

It is preferred to let them watch resus. Especially in peds.

 

[EpiEMS]

It is preferred to let them watch resus. Especially in peds.

I guess my concern is that it would lead to the family being (more) upset to watch. But if that's not an issue, space certainly is. If, say, it's an arrest, there's a medic and at least 1 EMT in back. That's a bunch of people already in a Type III rather than a medium duty ambulance, say.

 

[Veneficus]

I guess my concern is that it would lead to the family being (more) upset to watch. But if that's not an issue, space certainly is. If, say, it's an arrest, there's a medic and at least 1 EMT in back. That's a bunch of people already in a Type III rather than a medium duty ambulance, say.

Was never a problem for me, i just sat them on the bench closest to the door and belted them in.

 

[EpiEMS]

Was never a problem for me, i just sat them on the bench closest to the door and belted them in.

I'll give it a try!

 

[NomadicMedic]

I try to take a family member when I can. It hasn't been a problem yet.

 

[VFlutter]

It is preferred to let them watch resus. Especially in peds.

Our hospital just did a lengthy trial with encouraging families to be present in ICU codes. Family satisfaction went up, complaints and lawsuits went down, and futile codes were called much sooner. Not anything new since there is a lot of data already out there supporting it.

 

[the_negro_puppy]

Why?

Do they normally let relatives stand in the trauma or resus room in a hospital and watch? Generally no. Shouldn't the same consideration be given for the working space in the back of an ambulance with a critical patient?

Not only this but the extra risks like unrestrained medics, sharps, bodily fluids etc etc.

I rarely deny riders.

Having a friend or relative can be comforting to the patient.

I am getting less tolerant of it though, particularly like when you pick a up EtOH pt's from nightclub districts and their gaggle of 5 drunk friends all want to come up. I will usually let one friend accompany as long as they are well behaved.

I find it funny how some people see it as their right to be in the ambulance. As the qualified medic its my call based on the safety of myself, other crew, the patient and our ability to do our job.

 

[FLdoc2011]

Our hospital just did a lengthy trial with encouraging families to be present in ICU codes. Family satisfaction went up, complaints and lawsuits went down, and futile codes were called much sooner. Not anything new since there is a lot of data already out there supporting it.

That's been our experience here as well. Too many times have we coded a patient multiple times, each time on the phone with family who was determined to have everything done until the finally worked there way in to the hospital and saw the futility of it. If family is around we try and get them in to observe if feasible, if not around then I'm calling them and asking them to come in.

 

[DesertMedic66]

Generally not. I prefer to have them drive to the hospital so that they have a way to get back home.

 

[Epi-do]

deleted

 

[Epi-do]

Our hospital just did a lengthy trial with encouraging families to be present in ICU codes. Family satisfaction went up, complaints and lawsuits went down, and futile codes were called much sooner. Not anything new since there is a lot of data already out there supporting it.

This is exactly why I am trying to become more lax about allowing family watch in serious situations. I was originally taught, way back when, to keep family away, and have done it that way for years. Therefore, it is a difficult thing for me to start doing the opposite now.

I used to only allow parents of minors who were patients, family members who had no other mode of transportation (primarily in situations where the patient was elderly), or special circumstances such as a patient with autism, needing an interpreter, etc. to ride in the ambulance to the ED, and rarely in the back of the ambulance unless it was a small child or there was a communication issue. Now, I am trying to let more people in the back, if that is where they want to be, but like I already mentioned, I find it difficult to change my way of thinking.

Even though I am working on allowing more family/friends to accompany my patients, I will still absolutely refuse to do so if it is someone that is upsetting the patient or does/says anything to make me feel as if they are/could become threatening. Ultimately, my safety and the safety of everyone else in the ambulance is more important to me than letting a family member or friend ride into the hospital with us.

 

[BeachMedic]

It is dependent on the situation. Especially in an urban EMS setting.

I am usually pretty lenient when it comes to riders as long as..
1. They are immediate family.
2. There aren't any hygienic concerns.

Definitely not on stat returns. As far as cardiac arrest is concerned, transport is rare. I generally work all codes on scene. In ROSC, I wouldn't take a rider. A lights and sirens return puts me at enough risk as it is, I wouldn't put someone else at risk.

Yes, I've had multiple riders be a hindrance to patient care. It is not fun to try and calm down a yelling, screaming, and crying family member while trying to provide optimal care for their loved one.

A hospital setting is completely different from a field setting. It is far more controlled and there are more people, including security, present. We all know that much of what goes on there is not applicable to the field.