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Where there's a plan, there's a way

EMS1.com News

September 16, 2010


EMS News in Focus
by Arthur Hsieh

Where there's a plan, there's a way

Editor's note: An Ill. ambulance company owner is calling a Fire Department unprofessional and insensitive after the department refused to help move a 700-pound patient into her home after being discharged from the hospital. Our Editorial Advisor Art Hsieh takes a look at this type of patient transport all EMS crews may face.

An interesting dilemma is posed in this report. On one hand, I can see the argument that a city department could assist in this case, especially since these situations are unique and the fire department might have the tools and staffing necessary to assist the EMS crew in moving the patient back into her home.

On the other hand, the interfacility transfer is a private enterprise that ought to have put together an internal resource plan to move the patient.

Based on the facts reported in this article, the department had decided prior to the incident that the risk of injury to its staff outweighed the desire to provide service in a nonemergency setting.

One point was made by the Deputy Chief of the department that I do agree with: Moving a bariatric patient takes significant planning, tools and lifting techniques to reduce the risk of real injury to both the patient and staff.

Fifteen minutes is no where near enough time, especially in a nonemergent situation like this one. Having been involved with two of these operations, it easily took over an hour to lift a very heavy patient from a house to a unit, and vice versa. To rush it would be unsafe.

As for the concern of the ambulance company for additional financial charges to the call, that's simply annoying. The vast majority of patient transports are uneventful and handled without difficulty.

On occasion a call like this will require more than normal resources, which the company should be able to absorb, if planned for ahead of time. At the very least, consider having prearranged assistance from the department, or from a nearby EMS company, or send additional crew to help. There are ways to avoid these unpleasant situations, with a little bit of forethought.

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.
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