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Trauma destination legislation

Bjorn, Pret trauma-list@trauma.org
Fri, 4 Apr 2003 08:50:13 -0500


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Jeff,
 
Because all protocols are local, this seems a more appropriate set of
questions for your regional EMS council.  I'm betting your state's informed
consent and trauma triage protocols are already reconcilable.
 
The good news is that criminal penalties must be pursued by the state, which
is rightfully reluctant to file charges against a state-licensed public
servant, unless he's done something utterly and indefensibly inappropriate.
As long as you're following one protocol or the other, such is a tough line
to cross.
 
The bad news is that anybody with the time, resources and inclination can
sue you.  That being the case, your best defense is to a) consistently make
your decisions based on the best medical interests of the patient, and b)
enlist the support of on-line medical control.  
 
In this particular scenario, I'd further suggest that you consider the
consequences either decision: generally it's much easier to defend against
wrongful restraint than preventable death or disability.
 
Pret Bjorn
Trauma Coordinator
EMMC Trauma Program
489 State Street
Bangor, ME 04401
 
207.973.7260 (office)
207.973.7673 (fax)
207.941.5085 (voice pager)


-----Original Message-----
From: medic245@mindspring.com [  <mailto:medic245@mindspring.com>
mailto:medic245@mindspring.com]
Sent: Thursday, April 03, 2003 4:58 PM
To: trauma-list@trauma.org
Subject: Trauma destination legislation


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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<DIV><FONT color=#800000 face=Arial><FONT size=2>Jeff,</FONT></FONT></DIV>
<DIV><FONT color=#800000 face=Arial><FONT size=2></FONT></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial><FONT size=2>Because all protocols are 
local, this seems a more appropriate set of questions for your regional EMS 
council.&nbsp; I'm betting your state's informed consent and trauma triage 
protocols are already reconcilable.</FONT></FONT></DIV>
<DIV><FONT color=#800000 face=Arial><FONT size=2></FONT></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial><FONT size=2>The good news is that criminal 
penalties must be pursued by the state, which is rightfully reluctant to file 
charges against a state-licensed public servant, unless he's done something 
utterly and indefensibly inappropriate.&nbsp; As long as you're following one 
protocol or the other, such is a tough line to cross.</FONT></FONT></DIV>
<DIV><FONT color=#800000 face=Arial><FONT size=2></FONT></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial><FONT size=2>The bad news is that anybody 
with the time, resources and inclination can sue you.&nbsp; That being the case, 
your best defense is to a) consistently make your decisions based on the best 
medical interests of the patient, and b) enlist the support of on-line medical 
control.&nbsp; </FONT></FONT></DIV>
<DIV><FONT color=#800000 face=Arial><FONT size=2></FONT></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial><FONT size=2>In this particular scenario, 
I'd further suggest that you consider the consequences either decision: 
generally it's much easier to defend against wrongful restraint than preventable 
death or disability.</FONT></FONT></DIV>
<DIV><FONT color=#800000 face=Arial><FONT size=2></FONT></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial><FONT size=2>
<DIV><FONT color=#800000 face=Arial size=2>
<DIV><FONT color=#800000 face=Arial size=2><SPAN class=030133519-19052000>Pret 
Bjorn</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN class=030133519-19052000>Trauma 
Coordinator</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN class=030133519-19052000>EMMC 
Trauma Program</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN class=030133519-19052000>489 
State Street</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=030133519-19052000>Bangor, ME 04401</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=030133519-19052000></SPAN></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=030133519-19052000>207.973.7260 (office)</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=030133519-19052000>207.973.7673 (fax)</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=030133519-19052000>207.941.5085 (voice 
pager)</SPAN></FONT></DIV></FONT></DIV></DIV></FONT></FONT><BR>
<P><FONT size=2><FONT face=Arial>-----Original Message-----<BR>From: 
medic245@mindspring.com [</FONT><A href="mailto:medic245@mindspring.com"><FONT 
face=Arial>mailto:medic245@mindspring.com</FONT></A><FONT face=Arial>]<BR>Sent: 
Thursday, April 03, 2003 4:58 PM<BR>To: trauma-list@trauma.org<BR>Subject: 
Trauma destination legislation<BR><BR><BR>Does anyone have knowledge of 
legislation that provides legal protection to<BR>prehospital crews that 
transport trauma victims to trauma hospitals<BR>despite wishes to the contrary 
by family?<BR><BR>Scenario:&nbsp; Prehospital crew responds to trauma victim 
(MVC rollover,<BR>unrestrained, positive loss of consciousness, possible 
hemothorax, varied other<BR>minor injuries.&nbsp; Hemodynamically unstable, GCS 
= 13.)&nbsp; Family on scene<BR>requests crew take patient to small, community 
hospital, while paramedics feel<BR>the patient should be at regional trauma 
center.&nbsp; Transport times are<BR>nearly equal.&nbsp; Despite efforts to 
explain the need for trauma center<BR>capabilities, family does not agree to 
decision.&nbsp;<BR><BR>1.&nbsp; Where does the patient go?<BR>2.&nbsp; Should 
the EMS crew take to trauma center?<BR>3.&nbsp; Legal ramifications for either 
decision?<BR>4.&nbsp; Anyone have state regulations that cover the gluteus 
maximus of the<BR>medics IF they were to transport to the trauma center (what is 
to prevent a<BR>"kidnapping/false imprisonment" charges?)<BR><BR>Any/all input 
is greatly appreciated.<BR><BR>Thanks,<BR><BR>Jeff Brosius,<BR>Paramedic, 
etc.<BR>Atlanta, GA<BR>medic245@mindspring.com<BR><BR><BR>--<BR>trauma-list : 
TRAUMA.ORG<BR>To change your settings or unsubscribe visit:<BR></FONT><A 
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