So while thumbing through articles about paramedics making diagnoses I came across yet another blog article about another lawsuit filed against the Washington DC Fire and EMS Department regarding medical malpractice. You can find it here, read it and come back.
Welcome back. So did you fully understand the situation? Let me summarize. Basically the fire dept was called to a private residence for a sick child with trouble breathing. From what I gather they did an incomplete examination and refused to transport the child for treatment. When they returned 8 hours later the child was septic and later died from pneumonia. Reading further down the page, I found another article regarding this tragedy that had 2 links to DC newspapers. Reading those articles, I found that there wasn’t even a care report filled out and the parents left with instructions to use home remedies. Further reading revealed this was in the middle of a snowstorm in Feburary.
Now, here’s the commentary. I can’t say much due to lack of other information, but based on DC’s track record this is not surprising. The fact that the EMS crews didn’t complete a PCR for this little girl demonstrates the lackadaisical manner in which care was provided. Not only does it reflect poor attention to detail that we must possess in EMS, but a detailed legal document would have allowed the providers to tell their side of the story. Without a document now the patient’s family can dictate the scene as they see fit.
I believe that the child should have been transported initially, we should never refuse to care for someone but we should make them aware that if they happen to have a non-emergency condition that they should probably seek some form of alternate medical care. People always like having options I’ve found when handling those types of patients. I’ve seen many minor cuts and scrapes, bruises, broken fingers and toes, and even arthritic joint pain I’ve referred to other modes of treatment and transportation. Just because we show up doesn’t mean that they have to come with us, but we would like them to since we’re already there.
If you have been following the last couple podcast episodes you’ve heard me talk about refusals and making diagnoses and education. I see the issues linked (hence the timing) in that with better education we can make better decisions with field triage and diagnoses. You should always… wait, let me repeat that: ALWAYS complete a patient care report when you contact a patient. I often times end up documenting a situation even when there is no patient found just so that there is a record I was there and what happened. If you have electronic reporting, be as detailed as possible. If you’re still on paper, be brief but detailed. These are important things to keeping you out of court and if you end up in court, how to reduce your liability.