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MidTech

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My partner and I were txp'ing a discharged pt from an er to his NH. En route we get flagged down by a police officer at a MVA. 2 cars, 4 pt's, 1 critical.
The pt we were already txp'ing was stable and so we decided to stop and render aid until 911 got there. Driver (me) and tech (partner) extract the critical pt and provided aid until 911 showed up and took all the pts from the MVA.
We get back in bus and continued txping our stable pt to his NH.

Did we do anything wrong? Should we have even stopped? Did we have a duty? Did we abandon our pt? Or did that not fall under definition of abandonment?

Our oversight chewed us out for even stopping!
 
MidTech said:
My partner and I were txp'ing a discharged pt from an er to his NH. En route we get flagged down by a police officer at a MVA. 2 cars, 4 pt's, 1 critical.
The pt we were already txp'ing was stable and so we decided to stop and render aid until 911 got there. Driver (me) and tech (partner) extract the critical pt and provided aid until 911 showed up and took all the pts from the MVA.
We get back in bus and continued txping our stable pt to his NH.

Did we do anything wrong? Should we have even stopped? Did we have a duty? Did we abandon our pt? Or did that not fall under definition of abandonment?

Our oversight chewed us out for even stopping!
Click to expand...

Did someone stay with the pt in your ambulance?
Most places I have worked it is up to the crew but someone had to stay with the original pt at all times.
 
You cannot leave a patient, no matter how stable you believe them to be, unattended.

As it has been explained to me (on this board no less), if you are patient loaded you do not have a duty to stop in many states as you already are rendering patient care.

If you do stop, the driver could provide aid, but you cannot leave your patient unattended.
 
Medic Tim said:
Did someone stay with the pt in your ambulance?
Most places I have worked it is up to the crew but someone had to stay with the original pt at all times.
Click to expand...

No... we both assisted at the MVA. But I dont believe its abandonment if pt gives consent.
 
MidTech said:
No... we both assisted at the MVA. But I dont believe its abandonment if pt gives consent.
Click to expand...

Imagine your "stable" patient tanked while you were gone. You'd be in a load of trouble. You don't know internally what's wrong with your patient so never assume they are stable and leave them unattended.

I personally would have left my driver with the patient, do a quick scene size up and radio to dispatch for another truck.

My service usually runs with 3 people so I would of left someone on scene and continued with our previous transport.
 
Your responsibility is to the patient currently in your care, not all the potential patients out there in the world. Whether calls are pending, you drive past calls, or the hospital is slow you stay with and take care of your patient until you transfer care to someone else.

I wouldnt have stopped. There are jurisdictional agencies who are probably already enroute and will handle the scene. Very few patients require that kind of immediate attention that you would need to abandon your patient
 
With or without patient consent, in event that something happened to your original pt you would be in huge trouble. What are you going to say in court? "She told me we could leave her unattended"? All she has to do i say "No I didn't" and you're down two points.

Leaving your patient unattended is like playing with fire. 99% of the time nothing is going to happen, but there is always that damn 1% which could get you in some HOT water.

Driver stop to help...sure...attendant too? No way.
 
This was a question on a test in EMT Basic school. Yes, that's abandonment. You can't leave a pt who's already under your care, no matter how stable they are. Even if they say "Go ahead".

One of you (you inparticular) should have stayed with the patient while your partner did a survey.

Better yet, if EMS was already en route, you should have just kept going unless there was a true need for immediate extrication and aid.

Just my thoughts.

Take care
 
I would have been chewed out for leaving a patient alone in the ambulance too!

You are never to leave your patient unattended while in your care. Yiu just either transfer care to someone of equal or greater training .
You also said NH? Nursing home? Courts could argue he is unable to care for himself.

Never, ever leave your patient!
I would have had driver jump out and done a quick primary leaving one in back
 
Last edited by a moderator:
Ya, there is much confusion as to what exactly constitutes 'abandonment' in the ems field. Can it be possible for the tech to leave the pt in the ambulance for any amount of time and they still be properly monitored? Hospitals leave the pt's that are being discharged in their respective rooms completely off monitor for who knows how long.

How often do you monitor your stable pt? Every 15 minutes?
 
Do no harm.

Was there a possibility of doing harm to a patient? I think yes.
 
MidTech said:
Ya, there is much confusion as to what exactly constitutes 'abandonment' in the ems field. Can it be possible for the tech to leave the pt in the ambulance for any amount of time and they still be properly monitored? Hospitals leave the pt's that are being discharged in their respective rooms completely off monitor for who knows how long.

How often do you monitor your stable pt? Every 15 minutes?
Click to expand...

If I were you I would admit I was wrong and move on.

You might take vitals every 15 minutes but that is not synonymous with monitoring. When you're transporting the patient do not eve look at them until 15 minutes has elapsed? No of course not.
 
MidTech said:
Ya, there is much confusion as to what exactly constitutes 'abandonment' in the ems field. Can it be possible for the tech to leave the pt in the ambulance for any amount of time and they still be properly monitored? Hospitals leave the pt's that are being discharged in their respective rooms completely off monitor for who knows how long.

How often do you monitor your stable pt? Every 15 minutes?
Click to expand...

I don't think you can compare hospital medicine with EMS and come up with a clear answer.

No matter how educated or smart EMS providers are, in the US they are still techs.

By comparison, those in the hospital are under the care of high level professionals who are not just providing transport. They are permitted by both environment and education to make decisions on who can wait and who cannot.

This practice is only extended to EMS in the form of triage.

Now whether or not I agree is a different matter, but it is a different discussion.

The issue being discussed here is that of abandonment, but it could also be an admission of fraud.

Ambulance transfer to a nursing facility requires a medical need in order for it to be paid. If you decide your patient does not need continuous medical attention you may have either ignored the physicians order or inadvertantly admitted they did not need ambulance transport.

Either way, it is very thin ice to be on.

I doubt anyone at your agency would say "yea, we were fraudulently billing medicare, our guy was not abandoning his patient."
 
Most places LE can flag you down and direct you to help them. You already have an extant duty, explain that to the officer. Radio for backup and permission or denial from your boss. Do not leave your patient alone.
 
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