So I was in Triage the other night and there was a pretty bad MVC. I think there were 6 accident victims total and we got the 3 least injured. Since triage was slow, there were two of us and we had 4 empty beds in our triage waiting area so we took the patient's from EMS.
All of them had stable vitals, were ambulatory, no LOC, wore seat belts. None of them had been driving and all had been drinking (they were all 22 or 23 so legal age). The police were on scene. They had some slight abrasions we put bacitracin on and that was basically it.
Now here is my concern. I could tell these guys wanted to leave because one of them had a brother (the driver I think) who went to another hospital. Charge nurse was a bit adamant that they couldn't leave (to me and the other nurse, not the patients). So not a huge shock they abscond when we were basically expected to watch them and she gets upset, but turns out they stepped out for a smoke and security basically brings them back in and watches them.
She gets the attending back there to assess the patients after a couple of minutes, two of whom he discharges immediately. One he decides to draw an alcohol level on and move her to the main after it comes back positive. I'm not sure what the plan was after that since my shift was over at that point and my mind clocked out about the same time.
The only thing I can think of them doing was running more tests, treating her as an ETOH and keeping her until she sobered up or got a ride, or a combination. Or maybe getting her etoh as an excuse to keep her to run more tests?? Because before he ordered the alc on her he had to have seen she was ambulatory and cognizant. And why just her and not the other two?? The whole situation just seemed weird to me.
Where I am once the girl's blood alcohol came back he couldn't just discharge her. (Blood alcohol was like 250).
Now once security brought them back after they went outside, they stayed with no problems, at least not by the time I left. But earlier they had clearly wanted to leave to check on their friend. Even if the doctor had seen them and wanted to run tests they would have signed out AMA.
I guess I'm wondering if we had any type of legal basis to hold them to begin with? If they had been more adamant about leaving after security brought them back, I don't know how comfortable I'd have felt keeping them there. And I'm usually pretty aware of which patients just can't up and leave and which ones can.
Just looking for some feedback. Maybe there's something obvious I'm missing.