Service dogs

[leoemt]

So I was reading this article: http://www.ems1.com/patient-handlin...oman-told-by-operator-she-cant-use-ambulance/

and it got me thinking, what do you do with service dogs if your patient has one? Do they ride in back with the patient? Do you call animal control or family? What if the patient requires invasive ALS procedures that the dog may see as a threat?

I have yet to encounter this but am curious as to what others do.

 

[Aidey]

Step 1, ensure it is a service animal, not an emotional support animal. You can ask two questions. Is it a service animal and what the animal is trained to do. Per the ADA only dogs and small horses can be used as service animals, so if someone tries to tell you they have a service monkey it is BS. Emotional support for animals DO NOT have the same legal protections as service animals. The only benefits an emotional support animal has is being able to live in normally pet free housing and travel in the cabin of an aircraft. They are not allowed in places that don't allow animals like a service dog is.

Just like a business we have the right to refuse access to the service dog if its behavior is aggressive or its behavior is not controlled.

Step 2, ask the patient what they want you to do with the animal, they probably have a back up plan.

As a general rule the dog shouldn't be separated from the pt, however most ambs do not have a way to secure the dog in the back. If the dog is small and has a kennel, you might be able to secure the kennel somehow. Theoretically if the dog is big enough you can buckle them into the front seat.
A lot of service dogs wear harnesses and people commonly buckle the seat belt through the harness. If it is a small horse, you are totally on your own. Luckily they aren't very common.

The exception to trying to keep the pt and dog together is that if the pt is something like a cardiac or stroke activation, and they aren't going to be in the ED long before going to the OR. The animal will not be allowed in the OR, service dog or not, and you don't want it at the hospital without someone keeping an eye on it. In that case it is best to have the dog cared for by someone else, friend, family, pastor...whoever you can get a hold of. I would only call animal control as a VERY last ditch option.

If it is something like an MVC and the dog is also hurt animal control may be the only option to get the dog to an emergency vet, but I would be appealing to our supervisor, the bat chief, or PD to take the dog in before I went to animal control.

 

[Clare]

If it's possible (and I don't see any real reason why it's not) then put the dog in the front passenger seat and problem solved, easy.

I am also not totally adverse to (if possible) the dog sitting at the head of the stretcher in the airway chair.

If neither are possible and somebody else needs to transport the dog to the hospital then I guess I am lucky being in a major urban area we could probably find somebody pretty reasonably easy such as the team manager or rapid response, specialist emergency response team, SPCA, friend or family member, neighbour etc.

Most people who have some sort of on-going healthcare need such as having a disability are usually very clued up on what they need and how best to get it; it's not common that one of these people will call an ambulance as they are usually much smarter than the rest of the population who think it's a big white free ride to hospital. Of course there is the possibility that they will have some sudden medical emergency and need an ambulance so you can never say never.

 

[bigbaldguy]

Step 1, ensure it is a service animal, not an emotional support animal. You can ask two questions. Is it a service animal and what the animal is trained to do. Per the ADA only dogs and small horses can be used as service animals, so if someone tries to tell you they have a service monkey it is BS. Emotional support for animals DO NOT have the same legal protections as service animals. The only benefits an emotional support animal has is being able to live in normally pet free housing and travel in the cabin of an aircraft. They are not allowed in places that don't allow animals like a service dog is.

Just like a business we have the right to refuse access to the service dog if its behavior is aggressive or its behavior is not controlled.

Step 2, ask the patient what they want you to do with the animal, they probably have a back up plan.

As a general rule the dog shouldn't be separated from the pt, however most ambs do not have a way to secure the dog in the back. If the dog is small and has a kennel, you might be able to secure the kennel somehow. Theoretically if the dog is big enough you can buckle them into the front seat.
A lot of service dogs wear harnesses and people commonly buckle the seat belt through the harness. If it is a small horse, you are totally on your own. Luckily they aren't very common.

The exception to trying to keep the pt and dog together is that if the pt is something like a cardiac or stroke activation, and they aren't going to be in the ED long before going to the OR. The animal will not be allowed in the OR, service dog or not, and you don't want it at the hospital without someone keeping an eye on it. In that case it is best to have the dog cared for by someone else, friend, family, pastor...whoever you can get a hold of. I would only call animal control as a VERY last ditch option.

If it is something like an MVC and the dog is also hurt animal control may be the only option to get the dog to an emergency vet, but I would be appealing to our supervisor, the bat chief, or PD to take the dog in before I went to animal control.

All excellent points but I wanted to point out service monkies are service animals as per federal guidelines. Our airline requires them to remain in their carrier at all times, but beyond that all federal service animal rules apply.

 

[Aidey]

No, they aren't anymore. The ADA updated the rules within the last 2 years or so and restricted it to dogs and small horses under certain circumstances. I don't know if monkeys et al were grandfathered in through. I'll get the info off the ADA site once I'm off my phone.

 

[Aidey]

I just double checked the ADAs guidelines are separate from the Air Carriers Access Act, and the ADA changes don't affect the ACAAs rules.

 

[Jon]

No, they aren't anymore. The ADA updated the rules within the last 2 years or so and restricted it to dogs and small horses under certain circumstances. I don't know if monkeys et al were grandfathered in through. I'll get the info off the ADA site once I'm off my phone.

I've never seen a "small horse" service animal. I can only imagine.

I've heard a couple of options. Best being work with PD to see if a car w/ a K9 cage can be pressed into service. I know of a couple of options in my neck of the woods - one would be calling county Sheriff office and asking if one of their K9 officers can come assist from the courthouse in town.

 

[Aidey]

I haven't either, but the miniature horses aren't much bigger than your average medium-large dog, so I don't think they are to hard to handle.

 

[Bullets]

We used to have a resident with a horse, no bigger then a golden retriever, just more cumbersome. I cant take a horse, i can take a dog. We carry a dog harness on the truck for large dogs, the typical service breeds. ALS calls the PD will handle the animal. the horse doesnt come in the truck as it cant be secured.

 

[Tigger]

I don't think I'd want the dog up front with me. If the dog does anything unusual it might affect my driving and we don't want that. You're not supposed to have your pet in the front seat of your POV either. Ideally some sort of seatbelting solution would be found, probably with the captain's seat since the six point harness might not work to well with an animal.

I've transported a patient and dog before, it was not a service animal and the toughbook probably weighed more, so we just let the patient hold it (hospice transfer).

 

[bigbaldguy]

http://www.jaunted.com/story/2012/6...w+One+Little+Horse+Flew+on+Southwest+Airlines

This is a service horse we had.

 

[bigbaldguy]

I just double checked the ADAs guidelines are separate from the Air Carriers Access Act, and the ADA changes don't affect the ACAAs rules.

Very interesting I didn't know this. Thanks.

 

[Aidey]

I don't think I'd want the dog up front with me. If the dog does anything unusual it might affect my driving and we don't want that. You're not supposed to have your pet in the front seat of your POV either. Ideally some sort of seatbelting solution would be found, probably with the captain's seat since the six point harness might not work to well with an animal.

I've transported a patient and dog before, it was not a service animal and the toughbook probably weighed more, so we just let the patient hold it (hospice transfer).

We can turn the passenger air bag off in most of our ambs now, and that is supposed to be one of the issues with animals up front. With service dogs there is a very low risk of them doing something unusual/unexpected. True service dogs are VERY well trained.

I honestly don't think I would use the captains seat...it is vinyl/plastic. I could totally see a dog sliding right off the thing...In fact if I tried this with my dog I guarantee he would find a way to try and hang himself by sliding off the airway seat.


I've also just thought of something else. Autism service dogs can be taught to keep the child in sight, to prevent them wandering off. Separating the dog from the patient could result in the dog trying to find the pt. In theory there should be a command the dog knows that will tell the dog it is ok that the patient is somewhere else, but it probably will have to be given by someone who the dog knows.

 

[Aidey]

Very interesting I didn't know this. Thanks.

I didn't know there were separate guidelines either. Here is a link to the updated ADA rules.

It is kind of interesting how strict they defined the rules. I know there have been increasing issues with service animal fraud as emotional support animals have become more popular and I suspect that is part of the reason why. I have a friend with a seizure dog, and she has had tons of problems in businesses because of people bringing in their untrained poorly behaved "service animals".

 

[Tigger]

We can turn the passenger air bag off in most of our ambs now, and that is supposed to be one of the issues with animals up front. With service dogs there is a very low risk of them doing something unusual/unexpected. True service dogs are VERY well trained.

I honestly don't think I would use the captains seat...it is vinyl/plastic. I could totally see a dog sliding right off the thing...In fact if I tried this with my dog I guarantee he would find a way to try and hang himself by sliding off the airway seat.


I've also just thought of something else. Autism service dogs can be taught to keep the child in sight, to prevent them wandering off. Separating the dog from the patient could result in the dog trying to find the pt. In theory there should be a command the dog knows that will tell the dog it is ok that the patient is somewhere else, but it probably will have to be given by someone who the dog knows.

I'm just not comfortable driving with a dog in the front seat at any time. I guess come to think of it the dog is probably best off just lying down on the bench next to me, there's plenty of room.