What would you do?...

[Ridryder911]

yep, The police do not want the responsiblity. and also as many peolpe have mention acting drunk doesn't mean you are drung. too many DM have died in jail because they didn't get medical treatment. And according to MA, Achoiclism is a diease and has to be treated that way. so that makes it a medical problem.

So is spelling ; do a glucose to determine their level. Inmates are supposed to be checked upon. If the patient is alert and cognitive then taking against their will would be kidnapping. Inform them of the risks and dangers with them repeating and acknowledging them with a witness.

R/r 911

 

[emtfarva]

So is spelling ; do a glucose to determine their level. Inmates are supposed to be checked upon. If the patient is alert and cognitive then taking against their will would be kidnapping. Inform them of the risks and dangers with them repeating and acknowledging them with a witness.

R/r 911

I never said I could spell and this was an answer to a question from our friends up north. He was asking why we tooked the Pt from my orignal question.

 

[Aidey]

I think this is an area where the laws/regulations need to be clarified. I've yet to get a clear, straightforward answer about whether someone who is intoxicated can refuse treatment or not.

 

[exodus]

Why don't you use soft restraints? Restrain the pt's feets, and have their right arm restrained next to them, then take the left arm and bend it above their head, and bend the elbow 90 degrees, and restrain that wrist on the right side as well. Now they have no movement at all and you can still check vitals pretty quickly without loosening. Also, because their left arm is bent above their head (not on top, above), they are unable to try to loosen the restraints with body movement.

And spelling is very, very important!

 

[exodus]

My partner and I (Sharon) responded to a call for injurys after the assualt a couple of months ago. When we got there we find about 7 police crusiers. We found a very drunk Pt sitting in the back seat. PD was telling this guy he had to go to the hosp. We got him out of the crusier and started to try to get him on our stretcher.

At this point the Pt became very uncoop. and started to swing wildly. He even hit me in the face a couple of times. Not hard but he hit all the same. It took about 5 of us to get him straped down. We didn't restrain him due to the fact he wasn't try to really hurt anybody, just swinging really. We were hoping PD was going to cuff him but that didn't happen. My partner is a medic and I am a basic. I am a male and my partner is a female. When we finnaly got the guy into the back of the truck I asked Sharon, "Are you going to do anything for him?" She replied No and I told her to drive us to the hosp. Now what would you do in that situtation? Would you let the medic tech? would you tech? Would you take PD along? Would you go solo?

The drive to the hosp was about 3 mins long. In that short amount of time the Pt's condition didn't change. We took PD with us. We didn't have any problems and we also had Hosp security meet us at the door. we got him to a rooma nd security took over. No problem there either. Another question is what should we have done if the transport would have been 30 mins to an hour or longer?

We didn't even know the guy's history he wouldn't even really talk to us. PD told us that his friends told them that they were at a party and they had the same amount to drink. PD said they were fine. I think he took something else and his friends just ditched him. I haven't really found out what happened either. I think we made the right choice what do you think?
Oh, PD also doesn't think he was assaulted either.

For your specific scenario, I would have had PD hold him down at all extremities and throw a face mask on him real quick to stop spitting, and while PD is holding down the extremities, I would have restrained wrists and ankles. Then had PD ride with us in the ambulance and have the other officers partner follow us. But the reason I would keep one officer in there is in case the patient gets a lot more combative, or something breaks, the officer is trained in take down and can do a whole lot more than I can.

EDIT: Not sure where you're from, but if I recall correctly, ETOH isn't under implied consent for NREMT. It's late and I don't remember for sure, if you want to look it up that's be awesome

 

[vquintessence]

Aidey, here's my answer: I kidnap drunks

I think this is an area where the laws/regulations need to be clarified. I've yet to get a clear, straightforward answer about whether someone who is intoxicated can refuse treatment or not.

Does opinion count as an answer? No, a truly intoxicated person will never get me a refusal. (I'm not talking about the smell of booze, but someone who is slurring, incontinent, belligerent, swaying, or at least slow to respond).

Some cities I work in are wonderful, the police don't tolerate the BS and the guy goes in the cruiser. Some towns however, the police like to use ABC (ambulance before cruiser) simply because they are short staffed and don't want to PC and babysit. Apparently the one dedicated ambulance is an unlimited resource compared to the five cruisers on patrol... but that's another issue.

Anyways, back to the point Aidey. Myself and my employer can defend (probably quite well) in the court of law "kidnapping" charges for an intoxicated pt. Myself and MAYBE my employer, will find it much harder to defend me against abandonment charges should ANYTHING happen to the pt after we leave him/her with a refusal, or even worse, a "no EMS needed". Sure, that means occasionally we'll get stuck hauling off the violent drunk, but at least we are protected. Secondly, perhaps the most important part to consider, is a lot of alcohol/polysubstance abusers have a good chance of underlying medical problems, that may never have been addressed, until you hauled them "against their will" to the hospital.

Almost nobody will ever sue a cop for not arresting them. How many people will sue an ambulance for not "helping" them?

 

[BossyCow]

The answer we got from our MPD was if the pt is alert to person, place and time, all though intoxicated, they have the right to refuse treatment. This is different from a LEO request. The cops have already determined the intoxication and need what is called in our area.. a clearance for incarceration. This is to rule out possible blood sugar or other medical issues masked by the intoxication.

 

[brice]

--restraints-- sounds like a good idea.

 

[DT4EMS]

The answer we got from our MPD was if the pt is alert to person, place and time, all though intoxicated, they have the right to refuse treatment. This is different from a LEO request. The cops have already determined the intoxication and need what is called in our area.. a clearance for incarceration. This is to rule out possible blood sugar or other medical issues masked by the intoxication.

Yep. It's called a "Fit for confinement" very regular occurrence. Even on "routine" DWI's if a person is above a .25 they have to be medically cleared for some agencies.

 

[Medic946]

This pt absolutely needed to be restrained. In addition to his striking you, the whole flailing around the ambulance would fall into the potential to harm himself....IMO.