Stetcher drop-What would you do

[DaveTFD 0]

not saying this incident happend, but ime curious

you get a call for a mva involving a motorcycle. u get on scene to a 27 yr old male, compound fracture to L-femur, broken L-arm/R-wrist, helmet on and not badly damaged but strap is choking pt slightly. LOCx4 minutes reportedly going in excess of 80 mph in street race with other motor cycle and hit concrete barrior. - lung sounds on left side.

spo2 68, pulse 120, bp 86/72, resps 26 labored.

we all know wut to do with that so far. ALS was on board... we get to trama center

heres where i wanna know wut your would do-

unloading the patient from the back there is a newer guy who might have been rushing a little bit and he did not let the legs of the stretcher lock, the pt and the entire stretcher hit the ground.

you are the crew chief, how do u write that up?

[mikerabbit 2]

you are the crew chief, how do u write that up?

Honesty is the best policy. Accidents happen and this is one that probably wouldnt affect the paitent.

Mike

[roeems87 0]

probably shouldn't happen, but these things do...

instead of writing "txp w/out incident to ###" at the bottom of your PCR, change it to something like, "while unloading pt. at ###, the stretcher legs were not fully locked and pt. and stretcher fell to the ground..." At that point, I would describe what happened to the patient and what you do to rectify the situation. Likely (hopefully) it caused little (if any) damage to the patient, but should something happen to him (even in the future), you bet your bottom dollar that someone will be coming after "that ambulance crew" that "dropped him on the floor." Your only saving grace in court two years from now is a well documented PCR that can replay the event for you and everyone else involved that way you look both credible and honest with what happened...

[tbendick 27]

This has to be documented for many reasons. One this will need to be forward to the DOH. Two, this could be a problem with this equipment, and if it goes unreported maybe the problem will not get resolved. As well as a Agency you need to take responsiblity for your actions and the results of them.

This should be documented on the end of the PCR as well as needed reports being filed. I would even go as far as taking the equipment out of service for inspection.

This way you did you part to resolve and prevent another occurrence.

800.21.q

upon discovery by or report to the governing authority of the ambulance service, report to the Department's Area Office by telephone no later than the following business day and in writing within 5 working days every instance in which:

1. a patient dies, is injured or otherwise harmed due to actions of commission or omission by a member of the ambulance service;

2. an EMS response vehicle operated by the service is involved in a motor vehicle crash in which a patient, member of the crew or other person is killed or injured to the extent requiring hospitalization or care by a physician;

3. any member of the ambulance service is killed or injured to the extent requiring hospitalization or care by a physician while on duty;

4. patient care equipment fails while in use, causing patient harm

800.21.r

On or in a form approved by the Department, maintain a record of all unexpected authorized EMS response vehicle and patient care equipment failures that could have resulted in harm to a patient and the corrective actions taken. A copy of this record shall be submitted to the Department with the EMS service's biennial recertification application.

[Guest]

Funny,

This happened to us two years ago with the patient in full arrest. The tube was lost and had to be done again, but they were going into the ambulance to transported to the hospital.

As far as reporting goes, tell the truth! It's an accident or a problem with the stretcher like others have stated.

After it was all said and done every member was re-trained on the use of our stretchers because of operator error.

Do The Right Thing- which may not be doing the right thing according to popular opion!

Stay Safe,

G

[cas2383 22]

"Gravity took a stronger hold of the patient while unloading him from the ambulance"

[Guest]

I must admit that I had a similar situation except it was in the middle of a very crowded emergency room. My partner was doing his paperwork while I was preparing the patient to be transferred from the ems stretcher to the hospital bed. I lowered the bar and undid two of the three straps. As soon as I undid the last belt, I quickly found out that all her weight was resting on that one strap and she fell to the ground. I managed to catch her head and shoulders, so it could have been worse. But the THUD and blood-curdling scream this little old lady let out were shocking. We wrote a detailed and truthful report and submitted it to my employer. The patient was not hurt, but she was not satified by the care she got for her original problem and wrote a letter to the state to complain about this place and also happened to mention that she was dropped. The state was quite interested because they had never recieved any reports about a patient being droppped and came to investigate (one year after everything happened)! The moral of the story is that the only thing that kept us out of trouble was the fact that we had thoroughly documented what happened. Also, I would encourage you all to be extremely careful when transferring a patient...stretcher and bed must be touching, with EMTs pushing them together from either side, only then do you unclip the belts! The end.

[DaveTFD 0]

good post jl008h, thanks

[HCFRFF 0]

Ive been on a crew that has dropped pts before......and oopps accidents happen. Apoligize to the pt. theres nothing else you can do. Have a little strecher training class when you get back to the station and get on with your day. I tend to notice that most of theses accidents happen with people that arent use to using a strecther or dont know how to use it "the new guy". Everybody makes mistakes......

[WAS967 97]

Only time I ever dropped a patient was when we were wheeling the stretcher sideways and we hit a crack in the asphalt. Don't ever do it. Always wheel the stretcher parallel with an invisible line drawn through the stretcher from head to toe. There is much less chance of it toppling that way.

Also, after the last investigation I saw after a dropped patient, it was determined that most people wheel the "one and half man stretchers" in the highest position it will go. According to the manufacturers this is incorrect. These stretchers should only be at the top (or loading position) when being loaded into the ambulance. (You can tell because instead of being flush with the ground, the head end will be higher than the feet end.) Minor nit-pick on the part of management, but an interesting point none the less.

[IzzyEng4 427]

If you don't write it down, it didn't happen according to the report. Soo needles to say if it is brought up and you didn't write it down and you were found that it did, you are in big trouble up here.

Every little thing has to be documented otherwise your setting your self up for a potential lawsuit. Make sure you write it down and you tell the ER crew as well reguarless if it hurt the paitient's condition or not.

Can't be to sure these days with everyone sue crazy.

[COMMANDCHIEF 4]

What accident? Enough said

The guy just came off of a motor strapped between two wheels going 80MPH. a 3 foot drop isn't going to put him over the top.

[WAS967 97]

The guy just came off of a motor strapped between two wheels going 80MPH. a 3 foot drop isn't going to put him over the top.

How can you be so sure? The lawyers might see it differently. They'll try to pin death and disabiliuty on anything and anyone, no matter how far fetched it is. CYA!

[Guest]

you have to document cover your butt make sure you document the fact that the patient never hit the floor and that there was NO injury ,maybe even have the patient sign an rma so you can show in writing that there were NO injuries and that there was no potential for injuries if you lie and get caught it is worse in the long run...................

[Jybehofd 85]

What accident? Enough said

The guy just came off of a motor strapped between two wheels going 80MPH. a 3 foot drop isn't going to put him over the top.

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WOW I can't belive you would do something like that. I know my firehouse got pist when the ambulance was coming back and stopped at a MVA. My fire chief told me to destory the RMA and that it never happend. I refused and got suspend for a week. After the commisioners did some investigating one of them just came up to me a few months back and told me that I was in the right.

There has to be more sharing of knowlegde between fire and ems. Espicailly when they are combined in one house.

[Guest]

WOW I can't belive you would do something like that.  I know my firehouse got pist when the ambulance was coming back and stopped at a MVA.  My fire chief told me to destory the RMA and that it never happend.  I refused and got suspend for a week.  After the commisioners did some investigating one of them just came up to me a few months back and told me that I was in the right.

There has to be more sharing of knowlegde between fire and ems.  Espicailly when they are combined in one house.

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you got suspended??? dosent he know about having "A DUTY TO ACT" not knocking anyone but fire suppresion should be left to firefighters and EMS left to EMS providers, i hope something was done about you being suspended you should talk to your medical director that wasn't right, if he saw a fire would he pass it bye and then destroy a LEGAL DOCUMENT oh yeah i forgot that is a crime to destroy a PCR....................

[Guest]

you got suspended??? dosent he know about having "A DUTY TO ACT" not knocking anyone but fire suppresion should be left to firefighters and EMS left to EMS providers, i hope something was done about you being suspended you should talk to your medical director that wasn't right, if he saw a fire would he pass it bye and then destroy a LEGAL DOCUMENT oh yeah i forgot that is a crime to destroy a PCR....................

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Suppresion left to firefighters and EMS left to EMS providers because one person says something stupid? Why didnt you(meaning the guy who got suspended) educate the dinosaur as to the procedure so what if he has 5 bugles if he is any kind of officer he should listen to what his people say. People should not sterotype all people are different and should be treated as such

[Guest]

you got suspended??? dosent he know about having "A DUTY TO ACT" not knocking anyone but fire suppresion should be left to firefighters and EMS left to EMS providers, i hope something was done about you being suspended you should talk to your medical director that wasn't right, if he saw a fire would he pass it bye and then destroy a LEGAL DOCUMENT oh yeah i forgot that is a crime to destroy a PCR....................

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As far as i know, there is no duty to act unless you are paged out and or are flagged by FF/PD. I know up until recently, the ambulance district where i volly never had flagging protocol, we actually had to request a page so that it was recored over the PD channel for insurance purposes. I dont want to sound harsh, but i never stop when i see an accident on the highway, its a liability i dont want to shoulder.

Edited December 15, 2005 by 66Alpha1