Refusal to Abandon...

[mcdonl]

So someone posted a thread regarding FD not wanting to transfer a patient and it I did not want to derail that thread but it does bring up an interesting topic. And not the who FD vs EMS question, that is pretty well played out...

We all know what abandonment is, but can you be held responsible for failure to transfer care?

Let's assume the following

Fire Fighter for a fire company is an EMT and let's assume the call is a basic call according to protocol.

Let's also assume the departments transfer unit is out of town on a transport, or mutual aid or something....

And, let's also assume that the FF/EMT first on scene either has a relationship with the patient of some positive manner, or has built one on scene... maybe a scared child, or someone who just digs firemen....

If dispatch calls for an ALS transport unit for mutual aid, is there a law that says you MUST transfer care to the higher license level?

Can that ALS provider simply but in, and introduce themselves to the patient and force an abandonment issue on their end?

Just thought this was interesting. In our neck of the woods, we pay EMT in our volly environment and medics get $75 for a transport... some of them are money hungry and I could see them doing what they could to get that patient... Just wondering if there was much of this that happens out there.

 

[jjesusfreak01]

The transporting medic is god of their ambulance, but were I the medic, I would let any FF ride if they had developed a good report with the patient. They are probably going to have to find their own way back to their crew. This is a problem with pay per transport systems. You shouldn't run into conflicts when employees are salaried.

 

[emt seeking first job]

I can not answer your question.

However, isnt this issue adressed by your state or department protocols.

It saddens me there is a sytem that pays EMTs or Medics by the job.....

 

[mcdonl]

I can not answer your question.

However, isnt this issue adressed by your state or department protocols.

It saddens me there is a sytem that pays EMTs or Medics by the job.....

The State says you cannot abandon a patient. The department protocols are that when the transporting rescue unit shows up they are transfered the patient. The question was about what happens when that did not take place.

Dont be too sad. We (The department) were doing it for free for many years, but the town decided it would be nice to give us a stipend to cover our expense while we are out of the house and away from our families. I agree, it is nice.

 

[emt seeking first job]

The State says you cannot abandon a patient. The department protocols are that when the transporting rescue unit shows up they are transfered the patient. The question was about what happens when that did not take place.

Dont be too sad. We (The department) were doing it for free for many years, but the town decided it would be nice to give us a stipend to cover our expense while we are out of the house and away from our families. I agree, it is nice.

I am all for stipends. However, I think it should be by time, not nature of the call.

A certain amount of money based on time on duty.

My concern is the possibility if the one bad apple who makes transport decesions based on $.

 

[MMiz]

Enough of the hypotheticals.

In my system once a higher level of care makes contact with a patient it is their patient.

It's clear that your situation all about politics and not about the quality of patient care. The patient deserves the highest quality of care by the most qualified provider.

 

[mcdonl]

It's clear that your situation all about politics and not about the quality of patient care. The patient deserves the highest quality of care by the most qualified provider.

That's not true at all. If the call is a BLS call, and the patient is more relaxed with the basic than THAT is better care. Sorry to have ruffled your feathers. Someone can close this, I didn't mean to start any trouble.

 

[MMiz]

This isn't about me, it's about being a good provider and part of a team.

The patient deserves the EMS provider that is most qualified. If you feel compelled to stick around on the call you can ask to ride along. If the medic says no, then that's something that needs to be addressed after the call or in private.

I've handed many cool calls off to ALS providers, even after I built a rapport and relationship with the patient.

Where I worked the policy was that if a BLS crew felt compelled to go RLS, and it was an emergency, then the patient deserved an ALS crew, and one would automatically be dispatched to intercept. It wasn't about money. It wasn't about paramedics asserting their power and knowledge. It was about the patient.