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Question for anyone who's done Private Transport!!!!!!!!
Ok... I just have to ask... I had a situation with a patient and am curious as to whether my partner and I may have.... "Over reacted" maybe? We were asked to transport a 1yr old kid with a Femur Fx. It was a complete break positive rotation, edema, shortening... THE WORKS!!! They wanted us to take the kid from lying on the bed and sit him up into a car seat, AND maintain C-Spine. Are my partner and I TOTALLY wrong thinking that this was NOT A GOOD IDEA by any means???
Replies to This Discussion
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Permalink Reply by Aaron Siller on
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ok my first question was it as a result of an MVC?
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Permalink Reply by Jason Brooks on
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Who is they? What was the mechanism of injury? We tend to treat kids with much more lattitude to prevent further upsetting them anyhow. If that was the only complaint, why aggravate the situation by putting a toddler in a papoose board or pedi-pak? Make them as comfortable as possible an transport. As far as the car seat goes, what was that going to do?
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Permalink Reply by Amber on
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No... but it was a trauma. According to the parents he was sitting on a 5 ft countertop and fell.
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"They" being the transfering facility. As I stated in the above reply he fell off of a 5 ft countertop. We just didn't feel comfortable with that kind of injury sitting the kid in a 90 degree position being as the leg had NO support or splint. Especially because it was a 45 min ride to the receiving facility.
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Permalink Reply by Matt on
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seeing that the moi was a fall of approximately 5 feet, and the pt suffered an injury of that magnitude, i would not have sat him up in a car seat. i would have followed protocols of full c-spine immobilization, to prevent, and or protect any other injury. i dont know details, but it seems like he must have fallen in a procarious way, and another serious injury in my eyes would be more than likely. as far as being comfortable goes... not one of my priorities. kids are more tolerable to some forms of pain, and i believe that mom or dad riding along could have corrected that... cause after the day is done... its your behind that gets it. and i would not be comfortable with myself laying in bed later that night contemplating if i did everything i could and the correct way... just do what you know.. do what you were taught. ya know!
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ok fall victim always always always take c-spine procautions that is what we are tought c3 4 5 keep a man alive
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Permalink Reply by Joe Stoltz on
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You and your partner are totally RIGHT in thinking that a child seat wasn’t appropriate.
My thinking is this: Fractured femur – do we want this kid to walk again? Immobilize it first, starting with C-spine if MOI so indicates.
Patient lying in bed – move to pediatric immobilizer or short board as gently as possible with spinal precautions.
Treat for shock, call for ALS for IV and sedation/pain management
Transport to pediatric trauma center.
My personal philosophy: Once “they” call us, then “we” are in charge of the patient and our protocols will dictate treatment. “They” step back and don’t interfere, or else we call law enforcement to come and explain the facts of life to them.
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Permalink Reply by Beth on
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Remember that it is CYA - Cover Your A**. You and your partner must take the proper actions. Your company WILL NOT back you up if you didn't follow your protocalls. Your private company operate under a set of protocalls and a doctor's license. You need to find your company's SOP's, By-Laws and protocalls. Read them carefully. If unsure go back to what you were taught.
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Just so you guys know the REST of the story.... My partner and I were both FIRED following this incident because we expressed our concerns. The doctor at the transferring facility jumped down our throats because the receiving doctor had ordered this patient to be transferred in a car seat. Granted, I have only been doing this for 2 yrs... but in that 2 yrs I was ALWAYS told that as the crew on scene, it is OUR decision for the transport method. We DID transfer the patient in the car seat AS TOLD.... but we documented that we were VERY UNCOMFORTABLE in doing so!!! But... either way... we BOTH got fired 2 days later because the transferring facility felt we were "stepping on the docs toes" so to speak. But that's why I REALLY wanted opinions on this... is because I lost my job standing up for what I felt was BEST for the health of my patient. I guess I just wanted to make sure that OUR decision was one that others may have ALSO made, in feeling that the method of transport was inappropriate. I thank EVERYONE for adding in their views on this situation... it eases my mind a bit!!!! Stay Safe & Have Fun!!!
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Permalink Reply by Capkurt on
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So did the transferring facility clear the C-spine? X-rays, etc? If so I can see where you would not need full spinal immobilization. But not splinting/hare traction on the femur? That seems a little out of the ordinary just from Pt. comfort. Follow your protocols and you won't be wrong. The firing part needs to brought up to your state medical board. the Doc's dropped the ball on this one!
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Permalink Reply by Vicki Harvey on
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Well Geez.....sounds like they wanted to torture the poor kid..My gosh--of course it was a bad idea..Can you even imagine the pain that baby was going through?? I hope yall didn't transport the child in that carseat.
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Permalink Reply by Paul Montpetit on
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First off....Who was "they"....?? Second ....once you were on scene you (or rather the highest trained) were in charge....Not bystanders or others....This is where things get difficult sometimes...with good pt/family teaching we can most often avoid problems......NO, any trauma should have FULL immobilization and not just C-Spine....thats like putting a bandade on an amputation.....I am sure that if further damage had occurred that you would be liable not the family member that made the request......(Good Samaritan law useless in negligence)... Stay safe and keep the faith...........Paul
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