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ericbryant09
03-07-2015, 03:55 AM
What is the interaction like on the scene of a car accident. Let's say a cop is already on scene and then the paramedics arrive. Does the Officer try to brief the paramedics on what happened or does he just get out of the way and let them take over?

Also, once the paramedics arrive at the hospital, who receives the patient and whats the brief like there. Is it just a quick exchange and the Doctors/Nurse take over? I have no experience in the medical field so all input is welcome and appreciated.

Thanks

WeaselFire
03-07-2015, 04:25 AM
What is the interaction like on the scene of a car accident. Let's say a cop is already on scene and then the paramedics arrive. Does the Officer try to brief the paramedics on what happened or does he just get out of the way and let them take over?

Depends on what the officer knows. He may tell the medical responders that a patient was moved for example. Or tell them the patient wasn't breathing and he started chest compressions. Or used a defibrillator. But he won't try to relay any real medical conditions, that's for the medical folks to assess.


Also, once the paramedics arrive at the hospital, who receives the patient and whats the brief like there. Is it just a quick exchange and the Doctors/Nurse take over? I have no experience in the medical field so all input is welcome and appreciated.

The responders will pass vital statistics along, usually pulse, blood pressure, major trauma and what, if any, medications were administered. They usually will do a quick knowledge transfer about the patient's condition and what got the patient in that condition.

Now, what do you need for your story?

Jeff

ericbryant09
03-07-2015, 09:42 AM
The officer is first on scene and patient is laying on the sidewalk.
Officer thinks he may have spinal injury and tells patient to stay still but he wont listen and becomes aggressive. The Paramedics have just arrived. On a side note the Officer is an unpleasant person.

Thanks

boron
03-07-2015, 12:52 PM
Who called the police? It's usually someone other than the injured person who calls it. Passengers or people on the street...So, it is very likely someone other, beside the officer, will be there who has seen what has happened.

I'm not sure how this is in the US, but in a heavy accident with one injured person, I would expect 2 paramedics and a doctor to step out from the ambulance car and they are then in charge to deal with him; it's not the officer who can tell what to do or not to do with him.

From what I have seen, paramedics often step to the injured person immediately and in a surprisingly non-excited and routinized manner. They ask the person for the name and such to evaluate his consciousness. They can touch his hands and legs and ask if he feels them. All conversation with others usually happens during the examination, so there's no initial "discussing time" with others.

If the person is aggressive, the officer can help to deal with him, hold him...but then it all depends how badly the person is actually injured. He may stand up and move around and still has broken vertebra...

nikkidj
03-07-2015, 06:34 PM
Nope, no doctors on ambulances in the US. When 911 is activated, police, firefighters, and EMTs/first responders will respond. If needed, the first responders will call dispatch and ask for a paramedic ambulance to be activated. If it's a simple fender bender, the EMTs are more than qualified to extricate, immobilize, and transport. However, if internal injuries are likely, then the paramedics will be asked to come, and they'll take over upon arrival.

As far as what happens in the hospital, the EMTs/paramedics will try to call ahead so the hospital knows that they're coming and can prepare a room. If it's a potential spinal injury, they'll likely activate the trauma team and go to a trauma room, where nurses, paramedics, respiratory therapists, and at least one doctor will be waiting. The medics will give report to the highest ranking person in the room, but obviously everyone there can hear the report. If it's not a potential life/limb threatening injury, the highest ranking person will likely be a nurse. The medics aren't allowed to leave without giving report to at least a nurse, so they get a little testy when there isn't anyone available to check the patient in.

In your scenario, where the patient is unruly, they might call security in, too, to help subdue the patient. While patient safety is important, it's important that the medical staff not be injured as well, and if it's required to ensure safety, the patient might be restrained, either chemically or physically. Worst case scenario, a patient could be sedated, paralyzed, and intubated so that he/she doesn't cause further injury to the spinal cord or other organs. Then, when the patient is completely immobilized, they can stabilize, clear, and treat the injuries.

HTH.

MDSchafer
03-07-2015, 07:24 PM
The medics aren't allowed to leave without giving report to at least a nurse, so they get a little testy when there isn't anyone available to check the patient in.

And occasionally they throw massive bitch fits when they're delayed five minutes because there's a code going on both of the RNs are otherwise occupied.

ericbryant09
03-08-2015, 05:08 AM
Thanks everyone, this helps a lot. :banana:

asroc
03-08-2015, 09:45 PM
I don't know if you're already satisfied with what you've been told so far, but I thought you might want to hear from an actual paramedic. nikkidj has covered it pretty well. Around here paramedics will be dispatched right away if the incident calls for it, leaving out the EMT-Bs. Most police officers have first responder training and know some rudimentary emergency medicine, so they might attempt to treat the patient or at least immobilize him. Once EMS arrives they'll rely any relevant info to the medics and help subdue an unruly patient if necessary. We have a very close relationship with our local police and even the jerks are usually professional.

Paramedics in particular are usually very busy since there aren't that many of us, and by the time we're at the ER we often have other calls already pending so yeah, we don't like standing around and waiting. I've never had MD's scenario happen where the entire ER staff is somehow occupied with one code and unavailable to treat any other patients, but then we only work with good hospitals.

MDSchafer
03-09-2015, 03:14 AM
Paramedics in particular are usually very busy since there aren't that many of us, and by the time we're at the ER we often have other calls already pending so yeah, we don't like standing around and waiting. I've never had MD's scenario happen where the entire ER staff is somehow occupied with one code and unavailable to treat any other patients, but then we only work with good hospitals.

At most ERs the triage nurse is the one who takes reports on incoming patients, but weekday overnights, from 3 a.m. to 7 a.m. a lot of level II and III EDs will only staff one RN, so if there's a code, or blood that has to be transfused, transport has to wait.

Weirdmage
03-09-2015, 04:18 AM
My brother used to be an ambulance driver in Norway (, he's a dispatcher now), he's just visited me this weekend in South Yorkshire. He told me about when he was visiting the USA (Florida) through work when he was an ambulance driver (, think it would be EMT by US standards). They got called to a women who had a bleeding leg...She had cut herself while shaving her leg in the shower. Five firemen, two paramedics, and two Norwegian EMTs visiting "invaded" her house. He said one fire-truck was five people, and that in many parts of teh US the Fire Department run the Ambulances, so you will always get a Fire Truck and an Ambulance if you call 911 on a medical emergency.

ericbryant09
03-09-2015, 06:10 AM
Thanks again everyone.

The main thing I was wondering about was the interaction between cop on the scene and the paramedics when they arrive.

If the patient is exceedingly unruly would the paramedics sedate him to prevent him from harming himself? He may have a spinal injury.

asroc
03-09-2015, 11:10 PM
At most ERs the triage nurse is the one who takes reports on incoming patients, but weekday overnights, from 3 a.m. to 7 a.m. a lot of level II and III EDs will only staff one RN, so if there's a code, or blood that has to be transfused, transport has to wait.

Like I said.




If the patient is exceedingly unruly would the paramedics sedate him to prevent him from harming himself? He may have a spinal injury.

That's possible, yes. If the patient is suspected to have a spinal injury (which is usually the case after a car crash) he'll be mechanically restrained anyway, as in immobilized on a backboard. It's still possible to move on the backboard, but more difficult. Many police officers have training in backboarding and would help the medics with the procedure.

Chemical restraint ( = sedation) is usually considered a last resort and depending on where you are there may be a set of conditions that have to be met first. In my jurisdiction it's at our discretion and our usual drug of choice is haloperidol.


So EMS arrives on scene and is greeted by Officer Jerkface.

"You guys stop for coffee or what? Anyway, one victim, white male, early thirties, ran into a light pole. Cuts and bruises, gash on the forehead, looks like he bumped his head but he seems conscious. He's pretty agitated, though, I've been trying to get him to lie down and stabilize his spine, but he keeps squirming. Have fun."

Medics roll eyes, tell Officer Jerkface to keep the patient's spine immobilized and get to work.

MDSchafer
03-10-2015, 04:43 AM
Like I said.

Where do you work that every ED has multiple RNs on site 24 hours a day? I know of a lot of rural hospitals that staff one RN overnight weekday and at least two major metro level II centers as well.

asroc
03-11-2015, 12:16 AM
A largish city. Our primary receiving hospitals are five general Level I-trauma centers and one Level I pediatric, all among the best hospitals in the country. All of them are staffed 24/7 with several RNs and specialized physicians, like they have to to earn their verification from the ACS. A hospital ED where there is regularly only one RN on staff doesn't meet the ACS criteria at all.

Besides the staffing issue there's also the problem of communication. When EMS calls ahead to give their ETA, it is the hospital's job to make sure there is enough personnel to handle the patient by the time EMS arrives; if they can't handle the patient to tell EMS; and if they can't handle any new patients, to go on diversion. Good communication is vital in emergency medicine. If this happens once, whatever, but if "massive bitch fits" (interesting choice of words there) are common, all signs point to a badly-run emergency department.


OP, is your story set in a rural or an urban area? As you can see, it makes a difference.

ericbryant09
03-11-2015, 05:47 AM
Its in an urban area, Seattle to be exact. It is just getting dark, around 7pm.