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Trauma destination legislation

trauma-list@trauma.org trauma-list@trauma.org
Thu, 03 Apr 2003 23:22:02 -0500


I would think that in the patient described (GCS = 13, hemodynamically
unstable) it would be much harder to show that any decision was made
with the best interest of the patient in mind if you did not go to a
trauma center.

I go out of my way to honor the requests of competent patients and family
members. Based on what you wrote, there does not appear to be an
understanding of the risks in not going to a trauma center. Without that
understanding how can the family make an informed decision?

With the unstable patient how much time is available to discuss this with
the family. You did not mention the age of the patient.

You might ask police (on scene already?) to intervene.

Given the circumstances I would be surprised if a District Attorney would
prosecute (Guiliani would have, but he just doesn't like EMS). I expect
the laws vary by state, but there may be something federal that addresses
this. I do not know about civil law suits.

Tim Noonan.


On Thu, 3 Apr 2003 16:58:02 -0500 (EST), medic245@mindspring.com said:
> 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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