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Trauma destination legislation

trauma-list@trauma.org trauma-list@trauma.org
Thu, 03 Apr 2003 22:58:25 -0500

Seems as if the law eliminates some flexibility that might work in the
patient's best interest. Does "major trauma victim" include those who
meet mechanism criteria only?

How does informed consent work there? You may be seen in a hospital, but
ONLY those that are approved. If you wish to be seen in another hospital
you shall not go by ambulance.

If you are taken to another hospital and there is any complication this
is entirely on EMS and medical command (since any input from the patient
is clearly a violation of the State Code of Regulations).

Trauma triage criteria are expected to overtriage to the trauma center.
Why not allow the patient to have some input in their care (other than
the all or nothing option)? Will the alert and oriented patient be
expected to give informed consent in the hospital?

Limiting options in patient care does not sound like good patient care.

What if they want to bypass Eden to got to Highland?

Tim Noonan.

On Thu, 3 Apr 2003 16:41:47 -0800 (PST), "caesar ursic"
<cmursic@yahoo.com> said:
> In California it is written into state law that patients meeting
> regional EMS "major trauma victim" criteria be transported to the
> nearest designated trauma center whenever possible.  I believe it's
> covered under Title 22 of the State Code of Regulations.  Neither
> family nor patient have the authority to divert the ambulance anywhere
> else, unless they refuse transport altogether.
> C.M. Ursic, M.D. Dept. of Surgery UCSF-East Bay Oakland, California
> --- medic245@mindspring.com wrote:
> > Does anyone have knowledge of legislation that provides legal
> > protection to prehospital crews that transport trauma victims to
> > trauma hospitals despite wishes to the contrary by family?
> >
> > Scenario:  Prehospital crew responds to trauma victim (MVC rollover,
> > unrestrained, positive loss of consciousness, possible hemothorax,
> > varied other minor injuries.  Hemodynamically unstable, GCS =
> > 13.)  Family on scene requests crew take patient to small, community
> >    hospital, while paramedics feel the patient should be at regional
> >    trauma center. Transport times are nearly equal.  Despite efforts
> >    to explain the need for trauma center capabilities, family does
> >    not agree to decision.
> >
> >  1.  Where does the patient go?
> >  2.  Should the EMS crew take to trauma center?
> >  3.  Legal ramifications for either decision?
> >  4.  Anyone have state regulations that cover the gluteus maximus of
> >      the medics IF they were to transport to the trauma center (what
> >      is to prevent a "kidnapping/false imprisonment" charges?)
> >
> > Any/all input is greatly appreciated.
> >
> > Thanks,
> >
> > Jeff Brosius, Paramedic, etc. Atlanta, GA medic245@mindspring.com
> >
> >
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