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???

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Permalink Reply by anne potter on November 12, 2008 at 3:21pm
In the same aspect who wants to work for a CO who is suppose to be in a field of transport who does not know that this was wrong.... I agree with Floyd contact a lawyer as far as job back.. Not for sure these people know what their job is to begin with...
Permalink Reply by Jason Koontz on February 19, 2009 at 11:29am
Do what your training and protocols require. Your rig, your patient, your job, your tail on the line. As for us, the kid gets c-spine, backboard, and a traction splint if appropriate. One parent may get to ride along, if they can control themselves, but not both.
Permalink Reply by FETC on February 19, 2009 at 11:49am
Jason,

If you had read the previous posts you would realize this was an inter-hospital transfer to a peds ortho facility under the direction of a MD in the ER to a MD in the recieiving hospital.

Totally different than transporting from a private residence....
Permalink Reply by Jared Ryker on February 20, 2009 at 4:28pm
i would have to say that you and your partner were right. since the fall was 3 times the pt's height C-spine is a major major factor in making sure that there are no further injuries. but also keep in mind that with a one year old a car seat, placed in the airway seat in the back would be the safeist and you can use towls to hold C- spine so as far as what u did was great u took there own intrest first and did what u new was right.
Permalink Reply by David on April 28, 2009 at 6:30pm
Since this was a Hospital pick up and you where told to do C-spine, you should have contacted your MC and viced your concerns with them and let them tell you what to do, Id sue your service for wrong ful termanation ,the hospital and DR.
Permalink Reply by Cody W. Nelson on May 8, 2009 at 10:40pm
If you were transporting from a facility, chances are they probably cleared c-spine. I don't know for sure, because I wasn't there. However, if I were there and if they had cleared c-spine, I would have requested that the kid be put in traction and made him comfortable by position and chemical means.
Daniel EfawPermalink Reply by Daniel Efaw on May 27, 2009 at 2:12am
Ummm wow....that would be my first response considering the idea that 5 feet for a child like that is a Significant MOI. I mean it goes without saying the FX more then likely isnt the only possibly injury. you had it right playin by the protocols and boarding and immobilizing. and at this stage ALS isnt just a possibility its nessary.
Permalink Reply by Jason Koontz on May 27, 2009 at 3:30am
Nope, read all the posts. Same thing applies. I'm going to be bouncing the poor kid down the highway, and because of his size, I'm guessing most don't carry traction splints that small. So the leg needs to be immobilized, and usually a KED works awesome, but will end up making it a total immob. It depends on what the hospital had done thus far. If the leg was splinted, it would be an ALS run for pain management, and we transport in position of comfort. If the hospital has nothing in place, we treat like the kid is fresh from a scene. Based on the fracture being mid-shaft, a car seat seems to be contraindicated simply because the strain it puts on the leg by having the lower leg unsupported. If the kid was brought in full c-spine and removed, orders from the doc to that effect would be in hand, otherwise I'm not hauling an injury like that with someones "Word", I dont care if its my Medical Director himself. The docs know this, and if they don't it needs to be politely explained, even if you have to use the "its company policy, I'm sorry" line. Most highways are pretty unforgiving, especially in the back of a bus for close to an hour. I've done many of these, and the docs were mostly always on the ball. the few that weren't, we had to repackage the kids and do what we could for them in the rig during the trip. If the sending doc tells you something you disagree with, talk it over with him. If he still argues, call the recieving doc, explain your concern, and clear what your planning with him. if they both absolutely refuse to budge, request the orders in writing, for no other reason than to make sure everything is clear. Its always worked for me in the 6 years I've been doing it. Granted thats not long, but running 15-20 transports a shift gets me a little experience.
Permalink Reply by Amber on June 20, 2009 at 10:19pm
This was an ALS transfer. The kid had a line in his foot with NS running TKO. It was a standard carseat that put the kid in a 90 degree position. This is what confused me. They said that C-Spine had been cleared... BUT the also said that we needed to maintain C-Spine. When we arrived at the hospital the kid was lying on the bed with his head taped down to the mattress to keep him inline. When they decided on everything and we went to move him to the carseat they UNTAPED his head put him in the carseat and then RETAPED his head in the carseat. I felt that all of it was completely unnecessary being as soon as we moved him from supine to fowler's we are automatically breaking the C-Spine immobilization. As far as the femur immobilization... they didn't have proper equipment as it was a freestanding ER and they had a towel wrapped and taped to his leg... Like I've said previously it was all in all just a very messed up situation. I DID lose my job as did my partner. But neither of us decided to sue etc etc or take any action being as we didn't have any support on the issue and the company pulled that... "you weren't fired for that".... Which all of you know is one of the Private Ambulance BS schemes!!!! >./body>
Permalink Reply by Bill Anderson on July 12, 2009 at 6:06am
That's the joy of working for a private service. Facilities are always right. They call that customer service. No matter how well you followed protocol/procedure you will always be in the wrong if a facility complains. Even if you prove you were in the right you will still be wrong. Been there, told them where to put the T-shirt....That's why if i get a conflicting order I'll call my supervisor and follow his direction, which is usually call Med Control. This also gives them a heads-up that there may be a problem on the call. Then if the doc still want's it his way, wait until you get in the truck and follow protocol or the MC doc's order. Then document your azz off. Still may not make the bean counters happy but you can be satisfied that you did the right thing for the patient.
Permalink Reply by Michael J Burke on August 8, 2009 at 10:26am
You are correct Amber. Any time you run into a question like that it is good to pass it up to higher authority. A God Doctor should have known better. Did you transport the pt? Sounds like you and your partner used good judgement. Strong work.
Permalink Reply by Jared Ryker on February 27, 2010 at 12:42am
but would u put that pt in the car seat and transfer them if u new it was wrong. i would have told them i wasnt transporting thim in the car seat if i felt it was the wrong thing to do

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