Legal question, I was dispatched to transport 2 PT's!!!!!

[strangerdude88]

Okay, It was near the end of my shift earlier this week. Our unit got radioed and asked to call dispatch via cell phone. I call dispatch and was sent to pick up a husband and wife from a boarding care with a chief complaint of "flue like symptoms" I immediately question the dispatcher about the legality of transporting two patients. The dispatcher responds with, " oh it's okay we had a meeting about this the other day, it's perfectly legal." I still protest and am advised to call a supervisor.

So, I call my supervisor and let him know that I am not comfortable with attending two patients and will not do it. He then advices to do a complete assessment of both patients and if they're both stable to take them. If assessment reveals that at least one is not stable take one. So me and my partner find any reason not to take both. We took one(tachycardic, HTN, hot to the touch, and vomited earlier that day) and advised dispatch to send another crew for the wife(we waited till the crew got there).

So can someone please let me know what protocols, laws are being broken? This happened in Los Angeles County. I really did lose respect for this company after this, the way I see it is that our company is money oriented not patient oriented. I just really need advise, did I do the right thing?

 

[Shishkabob]

Perfectly, 100% legal to take more than one patient. They don't even have to be related.


Each box ambulance I've ever seen is built to hold 2 backboarded patients.




How else do you think MCIs are handled, especially in rural areas?

 

[strangerdude88]

We are an IFT company, MCI's are the last thing we will ever do. There was at least three other rigs available. I do not see how this doesn't violate HIPPA.

 

[brentoli]

Its husband and wife, you had to "search" for a reason to make one "unstable". Sounds like you did a disservice to them. I've taken more than one patient several times, who weren't related. What was your hangup with it? Why did you not want to do it? If you were taking a man from room twelve and a woman from room thirty, that's a better arguement. But it was a husband and wife, take em both.

 

[brentoli]

We are an IFT company, MCI's are the last thing we will ever do. There was at least three other rigs available. I do not see how this doesn't violate HIPPA.

HIPAA - Health Insurance Portability and Accountability Act

And don't be so sure about MCIs. If I have a greyhound bus flip ill be calling all the ambulances, including IFTs, hell, they have the best setups to transfer green patients if you don't have a school/commuter bus available.

 

[Aidey]

It is legal, I've done it several times, with MVC patients mostly.

I honestly don't see why it was such a big deal that you and your partner had to exaggerate how sick a patient was to get out of taking 2 people.

As for HIPAA there are exceptions, how do you think that hospitals get away with having curtains between beds instead of sound proof walls?

 

[Epi-do]

I am in Indiana, so I can't speak about protocol or laws in CA, at least here, there is nothing illegal about transporting two patients. As long as you have the equipment you need to treat both pts, and there isn't something major going on, it isn't a huge deal. Also, you would want to take into consideration the circumstances. For instance, you wouldn't want to transport both drivers from a 2 car MVC, but two family members from the same car would be ok.

It is never ideal to transport 2 pts and I don't know anyone that likes to do it. However, it does happen. It's not an ideal situation, but it isn't the end of the world either.

 

[Amycus]

I am not from the LA County, so unfortunately I cannot speak to your laws/regulations, which make my post mostly useless.

However, in my area- transport of up to 2 PT's is perfectly allowed if A.) They are both stable, B.) No HIPAA violations, and C.) Both PT's can be properly secured. In my case, I've transported, multiple times actually, two people in the same motor vehicle during an MVA- both spineboarded, one secured to the main stretcher, and one to the bench seat. Two people from DIFFERENT vehicles would be totally taboo.

That's just one example. We may have different definitions of stable though- without seeing the whole picture, only the given information, I would have considered the male stable enough. Sounds like flu like symptoms. Unless he's VERY tachy and VERY htn, if he's a bit over 100 and say, 140-150ish sys, I'd consider him stable. If he was well above that, I'd be more worried about getting a possible ALS intercept than finding reason not to transport both. Although I do totally understand, the idea of taking 2 people at once seems very dodgy to begin with.

 

[Akulahawk]

Perfectly, 100% legal to take more than one patient. They don't even have to be related.


Each box ambulance I've ever seen is built to hold 2 backboarded patients.




How else do you think MCIs are handled, especially in rural areas?

Yep. Perfectly legal to transport 2 patients. However, usually, they must be transported to the same destination. Where you take them depends upon who is the sickest or meets a specific transport policy. The exception is MCI events where you are directed to transport your patients to separate destinations. This would, however, be rare.

All of the ambulances I have ever worked on had the capability to transport 2 patients flat. One ambulance had the ability to transport 4 flat. One on gurney, one on bench, 2 hanging from ceiling. That was interesting, but we never had to take more than 2 in that unit. B)

 

[strangerdude88]

It is legal, I've done it several times, with MVC patients mostly.

I honestly don't see why it was such a big deal that you and your partner had to exaggerate how sick a patient was to get out of taking 2 people.

As for HIPAA there are exceptions, how do you think that hospitals get away with having curtains between beds instead of sound proof walls?

The condition of the patients was not exaggerated, it was his real condition.

 

[EMT11KDL]

I am not in Cali. So I do not know your local or state code for EMS.

Off the top of my head, I believe my agency says if one patient is a Green Patient, and the other is a yellow or green you can. But if one of the patients is a Red than NO, only transport 1.

With that being said I have transported 2 patients by myself a few times. My transport agency that I work for is completely volli, and sometimes we cant get a second unit for 25+ mins. Each Situation is different, and sometimes we get put into difficult situations where do dont have any other option but to take multiple patients. If that happens, rondevu (If available) with another unit while en-route to the hospital.

If I remember correctly from my class and the NREMT, they would like to have one provider for each patient.

I agree with your decision on this particular call, you didnt feel comfortable transporting 2 patients, and you called ur supervisor and advised him of this also.

Hope this helps

 

[JPINFV]

I do not see how this doesn't violate HIPPA.

Did you ask if the husband and wife wanted to be transported together?

 

[Shishkabob]

We are an IFT company, MCI's are the last thing we will ever do. There was at least three other rigs available. I do not see how this doesn't violate HIPPA.

IFT doesn't matter, point still stands, you can take more than one at a time.


You also need to look up HIPAA. Incidental release of PHI while discussing it with a patient, with safeguards taken, is not punishable.

 

[JPINFV]

The condition of the patients was not exaggerated, it was his real condition.

If he was hypertensive and tachycardic, what was the pulse and blood pressure?

 

[strangerdude88]

Did you ask if the husband and wife wanted to be transported together?

Yes they did. But I also didn't want to take both in case they both deteriorated en route. I only have two hands.

 

[strangerdude88]

If he was hypertensive and tachycardic, what was the pulse and blood pressure?

160/100, 110 strong/irregular

 

[Shishkabob]

160/100, 110 strong/irregular

That's really pushing the limits of "He needs my undivided attention".

 

[Amycus]

160/100, 110 strong/irregular

This still, in my opinion, and please do not take this the wrong way- is something I would be comfortable BLSing in, even 2 PTs at a time. I don't know what you guys run for a setup out there- if all trucks are I/B, I/I, P/I, etc. If it was new onset of irregular pulse, I'd have some concern, but otherwise, those numbers don't worry me enough that I would consider him unstable by any means.

 

[JPINFV]

160/100, 110 strong/irregular

Systolic of 160 and pulse of 110 is squarely in the "meh" column. The diastolic of 100 is a bit concerning, but not a "this patient is going to die" thing. Similarly, what signs and symptoms were leading you to think that the other patient was at significant risk of crashing?

 

[Epi-do]

I immediately question the dispatcher about the legality of transporting two patients...

So, I call my supervisor and let him know that I am not comfortable with attending two patients and will not do it...

So me and my partner find any reason not to take both.

I agree with your decision on this particular call, you didnt feel comfortable transporting 2 patients, and you called ur supervisor and advised him of this also.

I would most likely agree with the decision as well, if it was based on a legitimate pt condition that warranted not taking both pts. It sounds like this was more about not wanting to transport two pts rather than being uncomfortable with it. I don't know anyone that wants to take multiple pts, but we have all done it. It's just part of the job.