I am a new paramedic... In some hot water, need some help? In trouble?

[paramedic_t]

I had a patient, this week who had fallen of a balcony while drunk. He had a visible head injury and complained of tingling in his hands and feet and back pain. He was in and out of consciousness. I immobilized him and cut off all of his clothing down to his underwear. Once police got all of his friends away from the scene I removed his underwear as well so that i could examine his entire body. I left him naked for only 2 minutes max. then put covers on him. Once we left him in the E.R, my partner who is a 10th year paramedic yelled at me for taking off his underwear, she said it was "classless and immature" because he was conscious. She even threatened to report me. But that was what i was taught to do, and she said nothing on scene, plus as soon as he hit the e.r he was naked again anyway. Is she picking on me? or was i actually at fault? what would you have done?

[Annointed_RNStudent]

She sounds immature to me!

[uscstu4lfe]

tell her to get her panties out of a knot and grow up!

[nuangel1, BSN, RN]

aslong as you covered him up after your quick exam i don't see the problem.i think she has the problem.

[JBudd, MSN]

Most of our trauma patients arrive in the ER with their underwear still on, clothes cut up to the hips. What would you have done differently seeing or not seeing the genitals? Unless you saw signs of bleeding, there wasn't really a need to finish exposing in the field, in my opinion. I don't think what you did was wrong so much as not really needed at that point in the field, too much chance of bystanders seeing what they didn't need to. I know you waited until his friends were moved away. Naked in the ER is different, there is a lot more control over the environment.

Again, not exactly wrong, but not really needed just yet. Need to balance the patient's privacy against his safety in assessment/transport. Your partner likely didn't say anything in the field, because we don't tend to cut each other down (reprimand) in front of others. Immature? no. Inexperienced, well yeah.

[Atheos]

I'm no paramedic but if you ever save MY life feel free to cut off my underwear. At that point I am pretty sure privacy will be the LAST thing on my mind!

[paramedic_t]

Thats what i said. She said that he didn't need to have his privates exposed to all those people. But the only people who saw were the police officers, and a few of his friends that the police were questioning.

Should I consider keeping the underwear on in that case from now on?

Or is this proper procedure I should continue to do?

[flightnurse2b, LPN]

it really depends on the situation. you need to make sure that it is completely necessary for you to expose the patient like that, especially outdoors and infront of friends.

i will be quick to cut pants up to the pelvis, but if i dont see emergent need to assess the genital area, then it can wait until he gets to the ED. i understand your concern about spinal cord and traumatic brain injury, and that would have been mine as well, but think your assessment should have left the patients undies on unless you reeeeeally thought you needed to take them off.

i know what its like to be a new paramedic, its exciting and scary all at the same time. your partner needs to chill out. you did what you thought was right at the time and you are still green. instead of repermending you, she could review how to do a rapid system assessment while maintaining prioritization and privacy.

good luck to you! :)

[FFMedic2RN]

If you feel that you need to remove all of the clothes and you are the medic running the call then remove them all. If removing the pt's tightie-whities is the only problem that I would have had with a new medic I would be grateful.

You kill them your way, I'll kill them mine.

Stay Safe...

[MadisonsMomRN, BSN, RN]

I don't think it was bad. I am not a paramedic but it just seems to me that you were doing what you felt needed to be done. What if something was going on and you did not remove them and missed it... you would have been the "bad guy" then too?

I agree with Stanley RN2B... if you have to remove my underwear to save my life... do it!

[paramedic_t]

Thanks for the input, really appreciated. Just a final question, if it were amore traumatic injury involving bleeding or cardiac arrest I would have to make the patient "trauma naked" no matter who was watching or where we were correct?

[birdgardner]

If your pt. is in cardiac arrest, why would you strip off his shorts unless he is obviously exsanguinating through the groin/perineum with every chest thrust? You'll be too busy doing other things.

IMO, 2 min. is too long to leave his privates exposed if there is no injury you are treating there. Look and cover - drop the shorts or something on top of the area.