PDA

View Full Version : Question about being treated by EMTs at an accident scene



mellymel
01-23-2011, 06:58 PM
Hope someone can give me some info here.

I have a scene where the MC was sort of in a car accident (didn't really collide with anyone, she spun off the road in icy conditions, but ended up with a horrible Migraine headache from using her telekinetic powers). The LI tells them (at her request) that she's fine and doesn't need any help. What would be the normal procedure in this. Would the EMTs insist on seeing her anyway. Talking to her? Would they make her sign anything, like a waiver, that she denies treatment or would they just take the LI word for it that she's okay and not even approach her. Mind you, the LI isn't actually the LI yet. She just met him from the accident because his car was sideswiped by a truck and he too slid off the road. So he's not officially anyone in her life at this point.

thanks,

Mel

alleycat
01-23-2011, 07:05 PM
From the times I've been involved in something like this, the EMTs will want to check out someone and probably take them to the hospital, just in case (there can always be a possible head injury). Of course, someone can refuse if they're conscious. I doubt an officer on the scene would tell them they can't or shouldn't see an accident victim; it would probably even be against regulations because of liability issues.

Cyia
01-23-2011, 07:07 PM
About 6 years ago, I was a passenger in a minor car accident. The EMT's showed up, asked how we were. The driver, who was disoriented and should have been taken by ambulance, said she was fine and wanted to move her car (as she was rattled, she didn't know any better). They had her sign a waiver stating she'd refused an ambulance and sent us on our way (to the hospital), even though getting the car back on the road required someone unbuckling their seatbeat to turn around physically in their seat because she couldn't turn her neck to look behind her or in the mirror.

So, if the EMT's aren't top notch (and these weren't), they're not going to argue if someone says "no thanks" on an ambulance.

mellymel
01-23-2011, 07:16 PM
Ahhh, thanks guys.

That is exactly what I imagined it would be. My character is conscious and didn't collide with anyone or anything. She really does just have a bad headache, but I figured that they would make her sign something, some sort of waiver that she refused to go to the hospital for liability purposes.

Thanks so much. :)

jeseymour
01-23-2011, 07:50 PM
I used to be a ski patroller, and we were taught that an unconscious person gives automatic consent to treatment. However, if the person is conscious and refuses treatment, we had to get them to sign off. And we usually followed them down the hill just in case.

mellymel
01-23-2011, 07:51 PM
I used to be a ski patroller, and we were taught that an unconscious person gives automatic consent to treatment. However, if the person is conscious and refuses treatment, we had to get them to sign off. And we usually followed them down the hill just in case.

Thanks Jeseymour :) You have a crazy job. I've seen way to many accidents on the mountains during my skiing days.

jclarkdawe
01-24-2011, 01:49 AM
Let me make sure I understand the scenario clearly. One person in a minor accident, minimal damage to car, no breakage, starring, or dimpling on the windshield, no obvious trauma on the victim, but she's complaining of a headache. And I'm assuming the seatbelt was on and the airbag deployed.

When the person who called 9-1-1 described the accident, the caller would have had to disclose that there was a possibility of injuries for EMS/Fire/Rescue to be activated. (EMTs do not respond to all accidents.) EMTs arrive to find her walking around. But when asked if she hurts, she complains of a headache and someone says she doesn't want to go to the hospital.

First thing you do is separate the LI from the patient. EMTs are very aware of domestic violence these days, and we don't want our patient giving answers to make the LI happy. This can be done subtly, and if necessary, with police assistance ("Sir, the police officer needs your statement. Meanwhile, I'll be checking out ***.")

We'd take a full set of vitals, check pupil function, and play twenty questions, looking for inconsistencies, memory defects, and strange answers. The question here is going to be whether the refusal to go to the hospital is the result of damage from the accident, or just a questionable choice. You're allowed to make dumb decisions; you're not allowed to make decisions that are a result of brain damage. Trying to figure out which is which is the fun thing here.

Assuming we decide she's making a reasonable decision, and there's no evidence of further problems, we'd have her sign a release saying if she drops dead as we're leaving it's not our fault.

Best of luck,

Jim Clark-Dawe

mellymel
01-24-2011, 06:56 AM
Let me make sure I understand the scenario clearly. One person in a minor accident, minimal damage to car, no breakage, starring, or dimpling on the windshield, no obvious trauma on the victim, but she's complaining of a headache. And I'm assuming the seatbelt was on and the airbag deployed.

When the person who called 9-1-1 described the accident, the caller would have had to disclose that there was a possibility of injuries for EMS/Fire/Rescue to be activated. (EMTs do not respond to all accidents.) EMTs arrive to find her walking around. But when asked if she hurts, she complains of a headache and someone says she doesn't want to go to the hospital.

First thing you do is separate the LI from the patient. EMTs are very aware of domestic violence these days, and we don't want our patient giving answers to make the LI happy. This can be done subtly, and if necessary, with police assistance ("Sir, the police officer needs your statement. Meanwhile, I'll be checking out ***.")

We'd take a full set of vitals, check pupil function, and play twenty questions, looking for inconsistencies, memory defects, and strange answers. The question here is going to be whether the refusal to go to the hospital is the result of damage from the accident, or just a questionable choice. You're allowed to make dumb decisions; you're not allowed to make decisions that are a result of brain damage. Trying to figure out which is which is the fun thing here.

Assuming we decide she's making a reasonable decision, and there's no evidence of further problems, we'd have her sign a release saying if she drops dead as we're leaving it's not our fault.

Best of luck,

Jim Clark-Dawe

hahaha...thanks Jim. Your scenario for my story is a bit off as I didn't give full details of the situation, but this is REALLY good info to know for future reference. Just curious how you know this stuff? Is it from your own research/learning or did you work in the field? :)

Thanks again,

Mel

jclarkdawe
01-24-2011, 07:30 AM
hahaha...thanks Jim. Your scenario for my story is a bit off as I didn't give full details of the situation, but this is REALLY good info to know for future reference. Just curious how you know this stuff? Is it from your own research/learning or did you work in the field? :)

Thanks again,

Mel

I was a volunteer EMT/firefighter for many years.

Best of luck,

Jim Clark-Dawe

blackrose602
01-24-2011, 06:16 PM
Around here the EMT response seems to vary dramatically.

1) My dad was in a really severe accident many years ago. He was in a tiny car, T-boned by a big pickup that ran the light. No question...they got him out with the Jaws of Life and he was in emergency surgery within an hour. EMTs saved his life, and I'm very thankful.

2) I was 17 and my 19 yo boyfriend was driving. We were rear-ended by a tow truck. I was fine, he had some neck pain. He consented to transport, I tried to refuse. But I was under 18 and my parents weren't there, so the EMTs told me I had no choice. I was right, I was fine, but I understand why they were cautious.

3) I was 15 and on a learner's permit. My passenger was 19, so I was driving legally in FL at the time. It was around midnight, and I ran off the road into the woods. Spun around several times, bounced off a bunch of trees, completely trashed the car. Passenger was thrown out. I got myself out of the car and went to a nearby house. Homeowners had already called 911. I called my parents, who were less than five minutes away. Parents got there after police, before EMTs.

I had scrapes and bruises, but I had remained conscious, didn't hit my head, nothing felt broken or injured. EMTs were distracted finding my passenger in the woods and getting him transported (he was okay, miraculously nothing worse than a concussion). When they finally got around to me, I was finishing up with the police report and just wanted to go home. I got a couple of questions about how I felt, the EMT shined a flashlight in my eyes, and they told me I could go home. I *think* my parents signed something, but I'm not sure. Nobody took vitals or anything.

So it really just depends. I would have thought that with the severity of that last accident, they would have strongly encouraged transport. And with the minor nature of the second one, they wouldn't have insisted. But I'm not an expert, so I don't know how it all works.

I would expect they'd at least say hello to her, but beyond that I think you're safe writing it however you want.

jclarkdawe
01-24-2011, 07:01 PM
Around here the EMT response seems to vary dramatically.

1) My dad was in a really severe accident many years ago. He was in a tiny car, T-boned by a big pickup that ran the light. No question...they got him out with the Jaws of Life and he was in emergency surgery within an hour. EMTs saved his life, and I'm very thankful. Yeah, those are the calls that make it all worth while.

2) I was 17 and my 19 yo boyfriend was driving. We were rear-ended by a tow truck. I was fine, he had some neck pain. He consented to transport, I tried to refuse. But I was under 18 and my parents weren't there, so the EMTs told me I had no choice. I was right, I was fine, but I understand why they were cautious. My guess is that they knew you were fine, but being under 18, you can't sign a release of liability. It's a pain in the ass, but despite the fact everybody knows there's nothing wrong, you go.

3) I was 15 and on a learner's permit. My passenger was 19, so I was driving legally in FL at the time. It was around midnight, and I ran off the road into the woods. Spun around several times, bounced off a bunch of trees, completely trashed the car. Passenger was thrown out. I got myself out of the car and went to a nearby house. Homeowners had already called 911. I called my parents, who were less than five minutes away. Parents got there after police, before EMTs.

I had scrapes and bruises, but I had remained conscious, didn't hit my head, nothing felt broken or injured. EMTs were distracted finding my passenger in the woods and getting him transported (he was okay, miraculously nothing worse than a concussion). When they finally got around to me, I was finishing up with the police report and just wanted to go home. I got a couple of questions about how I felt, the EMT shined a flashlight in my eyes, and they told me I could go home. I *think* my parents signed something, but I'm not sure. Nobody took vitals or anything. Here you have two different things going on, one a failure on the part of the EMTs, the other legitimate.

People focus on the worse problem, in this case an ejected passenger. People ejected from vehicles are viewed as serious patients until proven otherwise. Ejected people have a tendency to die. So the focus was on your passenger. But ignoring you while focusing on another patient is not a good technique. If you don't have the personal to do it right, you call for more.

I had one case in which two snowmobilers went swimming. Found the first one in a person's house, where he had gotten himself to. I did a quick check and other than mild hypothermia, he was fine. And his buddy was missing on a lake that is two miles long. The fire chief had set up command on the other side of the lake.

I called my Chief by radio, asking him to send a mutual aid rescue to the house to do a more extensive check of the first patient, and then started backtracking his snowmobile so that we could locate the other snowmobiler.

So yes, sometimes you get too much to do with too little resources, but that's what mutual aid is for. So I'd ding the EMTs for that failure.

However, your parents were there. Parents are pretty good at checking out their kids. You were up and walking around, apparently coherent, and mom and dad were fine with your condition. I'd offer transport, but I won't push it. And I imagine one of your parents signed a release.

So it really just depends. I would have thought that with the severity of that last accident, they would have strongly encouraged transport. And with the minor nature of the second one, they wouldn't have insisted. But I'm not an expert, so I don't know how it all works.

I would expect they'd at least say hello to her, but beyond that I think you're safe writing it however you want. Writers should always know what's supposed to happen. And then figure out how to make something happen to meet their needs. And poor EMTs (or any other profession) are a great way to do it.

Best of luck,

Jim Clark-Dawe

Best of luck,

Jim Clark-Dawe

blackrose602
01-25-2011, 12:31 AM
Thanks, Jim! That actually cleared up some things I'd been wondering about over the years. I definitely agree that writers need to know how things *should* work, but I do think it's important for them to know about the wide range of *real world* experiences too :)

DeskBoundTeaDrinker
01-25-2011, 01:52 AM
Yep, I was in a car totaling but non injury (to me) accident last year and the EMTs asked if I wanted to be checked out, but weren't pushy (I was up and around, not bleeding, it was relatively low speed, and didn't need to be extracted etc.) but did make me sign a waiver that I refused care and their transport - ambulance rides are quite expensive so I did get my neck looked at that day, but by coworker driving me there for free. When I got a copy of the police report later for my insurance company it noted that I'd refused treatment and ambulance transport.

There was another car involved where a door was caved in and the driver had to be cut free - he was not badly injured but the EMTs took him away (and given the need to be extracted were likely more assertive in looking at him and taking charge of him).

I've been in other situations (rear ended, other driver hit and ran) where I called to make a police report and told them to not bother sending anyone, and they agreed. The 911 operator asks if there are injuries and do you need an ambulance - if you do not, they don't send one. If you do, in the US, you get a fire truck and an ambulance both (or multiple sets, depending on the number of drivers).

Kitti
01-26-2011, 12:46 AM
I'd like to add that whenever I've seen someone sign the waiver to refuse transport, the EMTs have repeatedly reassured the signer that refusing transport does not in any way affect his/her right to come in to the hospital on his/her own with accident-related injuries (esp. whiplash developing later).

PattiTheWicked
01-26-2011, 12:54 AM
I worked as an EMT in the early 90s in South Carolina, in a fairly laid-back area just outside a large city. Our EMTs worked out of the fire station, in addition to there being a countywide EMS system. Typically, if a call went out for any kind of accident or call, the EMT truck was dispatched automatically.

Most people were more than willing to let an EMT check them out, even if it was just a small fender bender. At that time, we didn't have any waivers or anything to sign if people refused treatment. If they didn't want it, and we couldn't see any reason to push the issue (you know, like that giant piece of glass sticking out of your forehead), then we told them they were welcome to go on their way, but we would advise them of things to watch for as potential warning signs.

And I'll echo was Jim said -- if there was a man and a woman together, and the man insisted the woman was fine, typically we'd find a way to separate them and make sure she was REALLY fine. I can think of two occasions where it was a Very Good Thing that we did this.

Rabe
01-26-2011, 08:46 AM
And I'll echo was Jim said -- if there was a man and a woman together, and the man insisted the woman was fine, typically we'd find a way to separate them and make sure she was REALLY fine. I can think of two occasions where it was a Very Good Thing that we did this.

And it's not just for the possibility of a domestic issue - especially if, as the OP posted, the guy is a future love interest but doesn't know the person at the time - how can they possibly speak with any authority on the person's condition?

Years ago, when my father passed out for a moment and fell off a chair at a restaurant, the EMTs came and checked him out. I spoke with them and asked if they believed, in their professional opinion, he needed to go to the hospital. One of them told me that he was refusing and I told him that is not what I asked.

He then stated that my father was refusing and I told him that if he thought he needed to go, then he would be going. The EMT told me that my father had the right to refuse, at which point I told him that by the time I got done talking to him, he would no longer be refusing IF they felt he had to go to the hospital. Finally I got ahold of the smarter (apparently) EMT who explained that the situation didn't require my father to go to the hospital at that time.

It should be actively noted, however, that EMTs don't offer a refusal as a matter of course. The paramedics in my area will now advise if, for some reason, they don't believe an ambulance ride is necessary. I went to a callw here a young boy was 'choking' and by the time we got there it went from him 'choking' and 'not breathing' to 'coughing really bad'. That call the paramedics checked the kid out and said they didn't feel a transport was necessary. Same day, a gal had low blood sugar and fainted, several times. The possibility of refusing transport was never brought up.

In my own car accident it wasn't brought up. Of course, I wasn't able to talk very well - nor sign anything - so it wouldn't have mattered.

Rabe...

Becky Black
01-26-2011, 04:01 PM
Can I just say, I always find it annoying and contrived in a book when a character refuses to go in the ambulance without a damn good reason (like they're on the lam, or whatever.) I can kind of buy it if it's in America and they're going to end up with a big bill if they go to the hospital, but I recently stopped reading a book where that's what the heroine does in her very first scene (doesn't want the authorities called at all) and the story is set in the UK, so the money issue doesn't arise and there were no other good reasons. It came across as a plot contrivance to get her into the company of the hero, rather than a natural thing for her to do. It made me think, she's taking the first step on the road into "Too Stupid to Live" territory.

blackrose602
01-26-2011, 05:59 PM
That's really interesting, Becky. I never thought of it that way. Perhaps it's because I grew up in the US, so concern over the bill is just part of the culture, but I always just thought it was normal to refuse if you don't feel injured. If I was reading a book where a perfectly healthy-seeming (walking around, talking, no real pain) accident victim decided to get in the ambulance "just in case," I'd be thinking "what a wuss." Very interesting how our cultural upbringings color our perception of "normal."

Becky Black
01-26-2011, 07:48 PM
That's really interesting, Becky. I never thought of it that way. Perhaps it's because I grew up in the US, so concern over the bill is just part of the culture, but I always just thought it was normal to refuse if you don't feel injured. If I was reading a book where a perfectly healthy-seeming (walking around, talking, no real pain) accident victim decided to get in the ambulance "just in case," I'd be thinking "what a wuss." Very interesting how our cultural upbringings color our perception of "normal."

Yes, it could definitely be a cultural difference. If I'm in a car accident I'm up for all the free x-rays and scans they wanna give me - just in case! :D If that makes me a wuss, then call me a wuss.

glutton
01-26-2011, 10:28 PM
so the money issue doesn't arise and there were no other good reasons. It came across as a plot contrivance to get her into the company of the hero, rather than a natural thing for her to do.

But did it fit the rest of her characterization (although there might not have been enough yet in the first chapter to tell) or not? I think there must be many people who, if they get in an accident but aren't really injured, would rather get home to bed than waste the extra time going to the hospital. I'm definitely one of them - don't want to miss out on any sleep and get up the next morning to feel like a zombie all day! Even if it was early I'd probably rather go home and spend a few hours on the internet, watch a movie and/or drink a few beers before bed than be waiting in the hospital. :P

Becky Black
01-27-2011, 12:23 AM
But did it fit the rest of her characterization (although there might not have been enough yet in the first chapter to tell) or not? I think there must be many people who, if they get in an accident but aren't really injured, would rather get home to bed than waste the extra time going to the hospital. I'm definitely one of them - don't want to miss out on any sleep and get up the next morning to feel like a zombie all day! Even if it was early I'd probably rather go home and spend a few hours on the internet, watch a movie and/or drink a few beers before bed than be waiting in the hospital. :P

I didn't get far enough to tell, but if it did fit the rest of her characterisation I wouldn't have liked her. ;) It just seems like madness to me. How can you be SURE you're not really injured? Sudden deceleration can cause neck injuries. You can have hit your head and not even realised it. Natasha Richardson thought she wasn't really injured and a couple of days later she was dead.

The heroine in the story didn't want the police there either, which the hero - whose truck she'd ploughed into the back of - went along with, which also seemed stupid. If someone ploughs into my vehicle hard enough to leave their car undriveable, and then doesn't want the police involved, I want them breathalysed! :rant:

Also she owned a cottage with a stupid name.

glutton
01-27-2011, 01:40 AM
Not everyone feels the need to be so "careful." I could easily see myself acting the way both the hero and heroine did... just because someone doesn't think the way you do hardly makes it unbelievable.

RJK
01-27-2011, 02:27 AM
I was in an accident where a car T-boned my car, right in the driver's door. I didn't feel any injuries, not even a bruise. 5 weeks later, I notices a pain in my neck that radiated down my right arm. I eventually went to a chiropractor for treatment. He asked if I'd been injured lately.
I said, "No."
He asked if I'd been in a car accident lately.
It was only then that it dawned on me that the injury was from the accident. I eventually needed surgery on my neck. I now have pins in three cervical vertebrae and plates stabilizing the fused joint.

I should have been checked out immediately after the accident. Although I don't know if the outcome would have been any different.

Nivarion
01-27-2011, 08:42 AM
I recently had an experience with the local EMT's. We've got several crews, and some of them are not as good as others. :(

Anyways, I was riding my bike going to work when a guy in a big old bungalow RV. I was stupid that day and not wearing a helmet, and got myself bounced onto the ground hard.

No one noticed it at the time, but I had skid on the ground hard enough (I was maybe doing 15mph, the other guy 25.) that all of my clothing had holes in it. One of them was large enough for me to get my hand through, but I didn't have a scratch under them.

I had a large bleeding wound on the side of my head. I felt fine at the moment, and declined to be taken to the hospital. They threw a band aids over most of my open cuts without washing, though I didn't notice at the time since I was talking with a police officer, didn't check pupils, gave me a card with their number in case I started to show symptoms and left.

I vaguely remember a them pushing a couple of papers at me, I remember reading them and I think I comprehended at the time what they meant. I was worried about how much an ambulance ride would cost since the guy didn't realize he had hit me, I had no insurance and no one to pay for me.

Two hours later, I had a general feeling of being unwell, nausea, and a pounding head ache so I went into the hospital. I had a severe concussion and needed several staples in my still bleeding head wound. My mom was very upset with that group of EMT's.

Just as a question. I've been having almost daily headaches since then. Is that the PCS that the doctor told me about or should I go back in?

chevbrock
01-29-2011, 04:03 AM
I'm Australian and here the ambulance ride is also free, but I also know of many people who have refused a ride. I can think of a few possible reasons for the OP's MC:

1) They don't want to look like a "wuss", carted off in an ambulance when there is nothing obviously wrong with them.

2) Concerns over "taking up" an ambulance which could be attending a real accident somewhere else.

3) Complete embarrassment that the MC has had a car accident on their first outing with the LI, and just wanting it all to go away with the minimum of time and fuss.

Tsu Dho Nimh
01-29-2011, 05:42 AM
I have a scene where the MC was sort of in a car accident (didn't really collide with anyone, she spun off the road in icy conditions, but ended up with a horrible Migraine headache from using her telekinetic powers). The LI tells them (at her request) that she's fine and doesn't need any help. What would be the normal procedure in this.

EMT has to hear it from the MC and get the waiver signed. They'll want to take pulse, BP, flash lights in her eyes and talk to her to get a clue how alert she is. then get the refusal form signed.

The LI has absolutely no authority to accept or deny treatment on behalf of the MC without some sort of medical power of attorney.

Rabe
01-29-2011, 10:13 AM
No one noticed it at the time, but I had skid on the ground hard enough (I was maybe doing 15mph, the other guy 25.) that all of my clothing had holes in it. One of them was large enough for me to get my hand through, but I didn't have a scratch under them.

This may or not make you feel better...but bike helmets are only rated for low speed crashes - mostly falls from a standstill...usually.

In most bike speed crashes, they're not all that great. But, would probably have saved you from having a large gash in your head. And extra material between your head and the road isn't always a bad thing.

Rabe...

Becky Black
01-29-2011, 11:49 PM
Of course, I'm also nosy and would want to got to hospital and gather material for possible future writing uses - as well as to make sure the inside of my head wasn't filling with blood. :D