What would you have done?

[medic707]

Get called for a traumatic injury with sheriff on scene. Pulled up and the patient was sitting on the curb with multiple sheriffs around him. It was the typical "we just need you to check him out." Patient wasn't talking to anyone and had no info on him. He was alert and looking at everyone. He looked pissed. He was tased and fell backwards and hit his head on the wall. There was a small laceration on the back of his head with minimal blood loss. Upon arrival one of the sheriffs said that they were going to be transporting him via cop car. I gave them the typical speech of I don't know what's going on inside because I can't do X-rays. I told them that if he isn't talking to anyone then how can I really know whats bothering him. I asked if they wanted me to take the patient and they still wanted to take him via cop car.

So I obviously couldn't tell if he was GCS 15 and had any pain. C-Spine, head injury, drug intoxication, were all being thought of.

Any thoughts?

 

[teedubbyaw]

If you can't confirm that he is A&O then he's your patient, IMO.

 

[MonkeyArrow]

Unless you live in some (imaginary) jurisdiction where you automatically take control of the scene even though the patient is in the sheriff's custody, then there is nothing you can do other then very thoroughly documenting the run. It is the sheriff's ultimate decision what they want to do with their suspect. They take the liability if it goes wrong, not you.

 

[DesertMedic66]

Going to depend on your protocols.

We are never to interfere with law enforcement. We have a good working relationship with the law enforcement agencies in our area and they will normally listen to us.

 

[Medic Tim]

If the pt won't cooperate there isn't much you can do. I wouldn't be too worried. He is going to he ER either way.

Even if he was cooperating no board ... Maybe a collar if there is Cspine pain.

 

[Handsome Robb]

Patients have the right to refuse to provide you information. Was he aware of his surroundings? People don't have to talk to demonstrate that they're oriented. Might be something that comes with experience but this is a pretty common scenario I deal with.

He's retrained and was obviously uncooperative, not exactly someone I want to unrest rain and put in soft restraints. If he doesn't want anything to do with you let them take him by cop car. It's not our job to force ambulances on people.

He's going to the ER anyways, if he takes a crap in the back of the car the cops will call you. Even then if he was in his ambulance not much would be done differently. He's going to the ER either way.

 

[TheLocalMedic]

When cops call you to "check someone out", they're just doing a CYA move. They want you to take a set of vitals and quickly make sure there aren't any immediate life threats that require your intervention. Often anybody who gets hit with a taser or injured in any way will automatically get seen in the ER before heading to jail, but the cops want to make sure that all their bases are covered, that they don't need to go rushing off to the hospital with them.

Give them a once over and grab some vitals, then let the cops deal with them.

 

[Handsome Robb]

I'm trying to remember if a tazing here requires them to go to the ER. I don't think it does. This guy would have to go though either via LE or EMS due to the head strike.

 

[TransportJockey]

I would let him take a ride in the patrol car. Here only taser barbs I cant pull in the field are genitals and face hits.

 

[DesertMedic66]

I would let him take a ride in the patrol car. Here only taser barbs I cant pull in the field are genitals and face hits.

Ouch is all I can really say

 

[nibejeebies]

When I go out to an excited delirium call I always run a strip and vitals. So far I have not run across any one that I felt needed to be transported. Where I am at, we have a decent relationship with the LEOs and we try not to get in the way or stir up issues. However here the LEOs pretty much do the same for us, If the Paramedic on scene thinks that there could be an issue and needs to be seen in the ER they will transfer custody to us and offer to ride in with us if the subject has the potential to be an issue.

In your situation with the not being interactive following a possible head injury, I would feel very concerned and try to assess a bit more thoroughly... (Not saying that you didn't, Im sure you did what I think I would do). Access pupillary response and such, the subject could possibly be a mute, hence the reason that he wasn't saying anything.

At any rate if the LEO pretty much dictated that he was going to be transporting to the ER I would document, document and document and third time verbatim the conversation between myself and the officer on treatment options and then notify supervisor/ medical director of the instant, if I truly believed subject should have been transported via EMS instead of LEO.

Then again that's just my two cents.