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EMTs go to great lengths to transport patients

Staff writer

If a victim is bleeding profusely from multiple gunshot wounds when the ambulance arrives, the only thinkable solution to Peabody paramedic Larry Larsen is a hasty ride to the hospital.

However, Larsen has seen patients in this condition refuse transport.

“I can’t take someone against their will,” Larsen said. “All the laws are the same.”

In such a situation, Larsen will confer with a police officer to have the patient arrested, putting the victim into protective custody and eliminating his right to refuse transport.

In short, Larsen will go to great lengths to get patients the care they need. Larsen and other Marion County emergency personnel have had to convince more patients recently to be transported to the hospital.

“If I think they need to go to the hospital, I’ll do everything to make them go,” Larsen said.

According to Marion County Emergency Medical Services Director Steve Smith, an increasing number of patients are refusing services. Cost is one of the primary reasons patients are refusing transport, Smith added.

“Quite frankly if someone needs to go to hospital, I don’t care about insurance, I give them what they need,” Larsen said.

Larsen has four options if a cognizant patient refuses ambulance transport. His first option is to convince the patient, suffering in an emergency, to take the transport.

If this first option fails, Larsen quickly goes to plan B, which is asking the patient who they can call to drive them to the hospital. If this fails, Larsen asks the patient to call their doctor.

The worst-case scenario Larsen said is to wait, do nothing.

When a patient is not lucent, Larsen transports the patient without discussion.

In another severe situation, Larsen has been at the scene of car wrecks and has had patients, who were bleeding internally, deny transport to the hospital. Knowing the accident victim was in a haze from blood loss, Larsen later transported the patient when he or she lost consciousness.

“If someone isn’t aware and oriented,” Larsen said, “they can’t make an informed decision. They go without discussion.”

Smith said the second reason patients deny transport is that they do not realize they are in bad shape.

“We’ve gotten situations where we’ve gotten calls (of), ‘we just need help getting up, getting down,’” and the situation is actually worse, Smith said. “I’ve been on a call where the person has been on the floor for 24 hours. They’ve been without food, can’t go to the bathroom.”

Smith said there have been situations where EMTs have transported patients in their private vehicles. Larsen has steadfastly avoided that situation because of the liability.

“I don’t ever let insurance dictate whether a person goes or not,” Tampa crew Chief Jesse Brunner said. “You let the hospital deal with money.”

Brunner did not say there was a time he transported a patient in a private vehicle. He did say he and the other Tampa crewmembers have transported family members of victims in private vehicles to and from the hospital during a call.

There was recently an instance where Brunner took the sister of a patient to the hospital in the patient’s car. He drove them both back to their home and walked them both to the door. Because he was driving a private vehicle, Brunner was not paid for the trip back to the woman’s residence.

“If we can’t accommodate the patient’s needs, of the elderly, we need to get out of the business,” Brunner said. “We do a lot things for free.”

Marion EMT Kim Ross said she has taken patients’ family members to the hospital in her own vehicle. She and Brunner are willing to take this extra step because they know their patients in their community.

“Our patients are more comfortable because they recognize the people that are taking care of them,” Ross said.

Smith is urging Marion County residents to accept transport, to allow EMTs to do their job — a duty for EMTs that has never been about money.

“Every ambulance service, they know, for a fact, that people are alive today because of them,” Brunner said. “There’s nothing greater than having that person in the community thank you later on.”

Last modified Aug. 11, 2011

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