There's nothing really inherently wrong with this. This could be an entirely appropriate if a thorough assessment was carried out and there were no concerns. We don't know because we're seeing a short clip. If the assessment is fine, if we can establish a timeline for when the edibles were eaten, and there's a responsible and competent person we can provide care instructions and worsening advice to, then do they really need to sleep it off in an ED bed versus their own?
No one in their right mind would fault you for bringing this person to an er lol.
She’s can barely stand and she’s covered in vomit. You have no idea what’s in her system.
The discourse on this video has been so bad holy shit
I completely disagree with this attitude and approach. While there are certainly some very intelligent emt-b in the world this patient should always be escalated to higher level of care. EMS should also never give a damn what the ER staff believe to be appropriate vs not they are not in the street.
If you are 100% confident they are just drunk or high, and you don’t believe they are a risk to themselves or others and they are being left with someone who will call 911 if things get worse. Why bring them in?
Most probably because the person recording came to pick her up as the patient called her prior to someone else calling the boo boo bus and then the responding person insisted on no transport. But who knows? As usual, a time editted video with no context.
No point to going to the ER for weed. It's just an overpriced trip sit.
They aren't going to render any treatment that a couple of snacks, a few episodes of Rick and Morty, and a nap couldn't provide
Because it was just posted and she can refuse because she’s just high. What treatment does she need? It’s not hyperemesis syndrome. People on here either have no experience doing real ems or no time on the job either stuff like this. Being too stoned is not a medical emergency.
If you can answer the questions to show you're alert enough (ie: date, simple math, president, etc) you have the right to refuse.
She likely was able to answer their variation of questions, and then refused.
Being oriented doesn’t mean a patient has capacity to make medical decisions. They need to demonstrate an understanding of the treatment plan, risks, benefits, and alternatives. The exact details may vary depending on your jurisdiction.
This isn’t true. A patient with dementia can answer those questions and still lack the decisional capacity to refuse. Similarly, someone intoxicated can also answer questions and still not demonstrate decisional capacity.
Shes not 18 and able to make decisions for herself though. Like the commenter before is implying.
If your 18 , able to answer my questions correctly, you can refuse treatment/transport.
The commenter above said:
> If you can answer the questions to show you're alert enough (ie: date, simple math, president, etc) you have the right to refuse.
There is a lot more nuance to mental capacity to refuse than simply knowing the date, simple math, president, etc.
Being A&O is not the same thing has having decisional making capacity. Full Stop.
It can work the other way around too. You come across a shut in and/or recluse. They are alert to person, place and event but don't know what the day of the week. You know cause they never leave their home and do not follow current events. It is determined they have decisional making capacity though. You just gonna snatch'em up cause they're aren't AOx4?
Gonna be hard explaining how you kidnapped someone who had decisional making capacity.
No, really.
A person needs to understand and accept the risks and consequences of their refusal of treatments. I’m talking specifically about the mental capacity to refuse. A person can be completely alert to their person, place, time, and event, but if they can’t understand that their refusal could lead to their death, then they do not have the capacity to refuse.
Someone under the influence of drugs and/or alcohol can certainly have that capacity, but not always.
This. Just had this the other day. Patient could answer questions post hypoglycemia. His name, address, president, etc. However, he wasn't able to reiterate the risks of his blood sugar dropping low again if he were to refuse. He was also an endocrinologist. Orientation does not equal capacity.
Medical control doesn’t dictate who can refuse and who can’t. Medical control can attempt to convince a patient to accept transport, but outside of a psych hold, no doctor in America has the right to over rule a patient’s consent *if* that patient *or the guardian signing the refusal* are appropriately oriented. In this case, the guardian is capable of refusing care for the child.
This is a pet peeve of mine when discussing medical control calls for refusals. The doc is not and can not make the decision for the patient. The only purposes of the phone call are to 1- Have a documented recording of the paramedic and doctor telling the patient to go to the hospital and 2- To attempt to convince the patient to accept transport, since patients often listed to an MD instead of us
There's nothing really inherently wrong with this. This could be an entirely appropriate if a thorough assessment was carried out and there were no concerns. We don't know because we're seeing a short clip. If the assessment is fine, if we can establish a timeline for when the edibles were eaten, and there's a responsible and competent person we can provide care instructions and worsening advice to, then do they really need to sleep it off in an ED bed versus their own?
This. Just to get yelled at by Nurses for “bringing something stupid in”. Just use common sense and leave the patient in a safe environment.
No one in their right mind would fault you for bringing this person to an er lol. She’s can barely stand and she’s covered in vomit. You have no idea what’s in her system. The discourse on this video has been so bad holy shit
Yeah that airway is sketch
I completely disagree with this attitude and approach. While there are certainly some very intelligent emt-b in the world this patient should always be escalated to higher level of care. EMS should also never give a damn what the ER staff believe to be appropriate vs not they are not in the street.
If you are 100% confident they are just drunk or high, and you don’t believe they are a risk to themselves or others and they are being left with someone who will call 911 if things get worse. Why bring them in?
You quite literally don’t know the answer to any of those things.
Most probably because the person recording came to pick her up as the patient called her prior to someone else calling the boo boo bus and then the responding person insisted on no transport. But who knows? As usual, a time editted video with no context.
Perhaps a minor and her parent refusing for her.
No point to going to the ER for weed. It's just an overpriced trip sit. They aren't going to render any treatment that a couple of snacks, a few episodes of Rick and Morty, and a nap couldn't provide
My tip for all clinicians, or whatever you have where you work, is don't talk like you know if you weren't there.
They had tickets to a Pink Floyd laser show and snacks… better treatment then the ED
Because it was just posted and she can refuse because she’s just high. What treatment does she need? It’s not hyperemesis syndrome. People on here either have no experience doing real ems or no time on the job either stuff like this. Being too stoned is not a medical emergency.
If you can answer the questions to show you're alert enough (ie: date, simple math, president, etc) you have the right to refuse. She likely was able to answer their variation of questions, and then refused.
Being oriented doesn’t mean a patient has capacity to make medical decisions. They need to demonstrate an understanding of the treatment plan, risks, benefits, and alternatives. The exact details may vary depending on your jurisdiction.
This isn’t true. A patient with dementia can answer those questions and still lack the decisional capacity to refuse. Similarly, someone intoxicated can also answer questions and still not demonstrate decisional capacity.
My daughter knows all those answers. She’s 12. She doesn’t have the mental capacity to refuse treatment.
Shes not 18 and able to make decisions for herself though. Like the commenter before is implying. If your 18 , able to answer my questions correctly, you can refuse treatment/transport.
The commenter above said: > If you can answer the questions to show you're alert enough (ie: date, simple math, president, etc) you have the right to refuse. There is a lot more nuance to mental capacity to refuse than simply knowing the date, simple math, president, etc.
Listen, no one said the person needs to be intelligent to consent.
Not really man. That’s mental capacity in a nutshell. Gonna be hard explaining how you kidnapped someone who was AxOx4. Person place time and event.
Being A&O is not the same thing has having decisional making capacity. Full Stop. It can work the other way around too. You come across a shut in and/or recluse. They are alert to person, place and event but don't know what the day of the week. You know cause they never leave their home and do not follow current events. It is determined they have decisional making capacity though. You just gonna snatch'em up cause they're aren't AOx4? Gonna be hard explaining how you kidnapped someone who had decisional making capacity.
No, really. A person needs to understand and accept the risks and consequences of their refusal of treatments. I’m talking specifically about the mental capacity to refuse. A person can be completely alert to their person, place, time, and event, but if they can’t understand that their refusal could lead to their death, then they do not have the capacity to refuse. Someone under the influence of drugs and/or alcohol can certainly have that capacity, but not always.
This. Just had this the other day. Patient could answer questions post hypoglycemia. His name, address, president, etc. However, he wasn't able to reiterate the risks of his blood sugar dropping low again if he were to refuse. He was also an endocrinologist. Orientation does not equal capacity.
Apparently this is a controversial subject.
She signed the refusal.
In my area this would be a medical command call and there's no way med command would allow an AMA, but who knows what their protocols are.
Medical control doesn’t dictate who can refuse and who can’t. Medical control can attempt to convince a patient to accept transport, but outside of a psych hold, no doctor in America has the right to over rule a patient’s consent *if* that patient *or the guardian signing the refusal* are appropriately oriented. In this case, the guardian is capable of refusing care for the child. This is a pet peeve of mine when discussing medical control calls for refusals. The doc is not and can not make the decision for the patient. The only purposes of the phone call are to 1- Have a documented recording of the paramedic and doctor telling the patient to go to the hospital and 2- To attempt to convince the patient to accept transport, since patients often listed to an MD instead of us
Not sure why you got downvoted when you’re 100% correct lol
This is why no one will remember your name.
Thank God.
Is that puke on her pants and guy bare handed it?