Okay, the other night I was working and one of the residents who is ambulatory by wheelchair went off on her own as is her habit. Apparently, she was trying to get into a locked nutrition room and cut or pinched her fingers badly enough that she bled a large puddle of blood in the hallway. So, when she was found a complete assessment was done. Cold compresses and pressure dressings were applied until she could be transported to the nearest ER for stitches. The ambulance company was called and transport arranged. When the crew to transport got there, the paramedic took the pressure dressing off!!!! right in front of me!!! and the woman's fingers commenced to bleeding again. The medic asked the EMT if she still had the (now contaminated) dressing or if she had trashed it. Of course she didn't trash it. The paramedic tried to stick the old dressing back on with no tape. He had the lady, who was confused, hold it on her fingers and she kept dropping it and kept bleeding. I went to get a new dressing but by that time, they had her on the stretcher and were leaving and the Medic said she would be fine with out it that she wasn't going to loose enough blood to hurt her!!!
I am a newly minted RN, and so do not fully understand all of the policies and procedures in my facility just yet. So, I talked it over with another RN. She said that when the transport comes, the resident becomes their patient and they can do what ever they want to them.
I told the secretary when I called the transport that the resident had a pressure dressing applied and that we already knew she would be haivng stitches. (steri strips were not an option) I understand about dropping the ball with regard to communication, but he didn't have to cause the woman so dad gum much pain when he ripped the tape off! He didn't need to do more than listen to me give report to him about what had occured.
So what is the role of the Paramedic? What is their scope of practice?
Any suggestions on what to do should this occur in the future?
