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<P>I initially started out in medicine on an ambulance. While your comments are of course correct, this is one of the hardest responsibilities an EMT has. Having to determine mental competnecy on an individual the EMT has just met! Damn, sometimes even Psychiatrists may disagree on an individual patient.</P>
<P>And God forbid the EMT makes the wrong decision! Either by transporting a 'competent' individual against their wishes or failure to transport an 'incompetnet' individual who then injuries themselve or another individual!</P>
<P> </P>
<P>~doug~<BR></P></DIV>
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<DIV></DIV>From: <I>"Ronald Gross" <rgross@harthosp.org></I><BR>Reply-To: <I>"Trauma &amp; Critical Care mailing list" <trauma-list@trauma.org></I><BR>To: <I><trauma-list@trauma.org></I><BR>Subject: <I>Re: Consesnt vs. Responsibility;</I><BR>Date: <I>Sun, 05 Nov 2006 14:01:18 -0500</I><BR>>The only one who can "cancel" the ambulance is the patient, who does<BR>>have the right to refuse treatment/transport. The only caveat is that<BR>>the patient needs to be deemed competent, and given the circumstances,<BR>>the medics could have made an argument for transport against the<BR>>patient's wishes if they felt that the patient was NOT mentally<BR>>competent. Tough decision - but that is why they pay us the big<BR>>bucks.....<BR>><BR>> >>> "oded private"
<tangentcarrot@hotmail.com> 11/04/06 2:05 PM >>><BR>>Young Man (mid 20's),thin and healthy appearing, working in night club,<BR>>crashes at the club. He is unressponsive to voice or pain (GCS score=3),<BR>>but<BR>>has a patent airway, is breathing Spontaneuosly and has a strong pulse<BR>>at<BR>>around 70 bpm. According to friends, he didn't take drugs or drink<BR>>excessive<BR>>alcohol, but might have been hurt by another clubber. I order the<BR>>activation<BR>>of the EMS. within ~1 min. he starts waking up and vomits. We take him<BR>>outside, where I learn his boss canceled the bus since "his Ok now". He<BR>>keeps on vomiting, has a thready pulse, is shivering, and has retrograde<BR>>and<BR>>antegrade amnesia. Claims are he had been stuck in the head. Finaly,I<BR>>manage<BR>>to convience him to take the bus to hospital. When
the bus comes, the<BR>>boss,<BR>>once again, insissts that the owner will take him to the hospital.<BR>>Ambulance<BR>>personnel don't even argue and get away, inspite of my attempts. Finaly,<BR>>we<BR>>get to the hospital by car, at least 40 min post injury (?).<BR>><BR>>The first dillema is- should EMS personnel (EMT-B'S, in this case)<BR>>insist<BR>>with such pateints? I tried conviencing them to "talk some sense" into<BR>>him,<BR>>but they refused,despite my description of coma and amnesia, saying they<BR>><BR>>couldn't force him and that "he looks fine now", and left the scene.<BR>><BR>>What are your thoughts?<BR>><BR>>_________________________________________________________________<BR>>Express yourself instantly with MSN Messenger! Download today it's
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