Removing patients from their vehicles

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I was wondering about this one. Has anyone received any formal training on how to do this properly? I imagine medics, fire, and law enforcement do, but have never seen this addressed in the ED. I would think there is some legal thing here -- they are outside the ED, and inside their own private vehicle which is their personal property. Technically they aren't on hospital property because they are in their privately owned cars. We have had several people hurt this way, and I just had a crappy incident today as the triage RN involving this. You got your fat can into the car, now you get it out.

-Mark

I would think there is some legal thing here

awwww, man,

not the "L" word again:o

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I was wondering about this one. Has anyone received any formal training on how to do this properly? I imagine medics, fire, and law enforcement do, but have never seen this addressed in the ED. I would think there is some legal thing here -- they are outside the ED, and inside their own private vehicle which is their personal property. Technically they aren't on hospital property because they are in their privately owned cars. We have had several people hurt this way, and I just had a crappy incident today as the triage RN involving this. You got your fat can into the car, now you get it out.

-Mark

This situation opens ER nurses up to several legal issues. First, check what your ER's policy and procedures cover in this situation. If there is no policy, your hospital can(and will) say you are acting outside of hospital policy if there is a bad outcome. Secondly, if you have no trainning, you open yourself up to legal action againts you for preforming outside of your scope of knowledge ( I'm sure the BON would have something to say about that).

If this situation presents itself and you are not trained or covered by hospital policy, stabilize the pt the best you can in the vehicle and call 911 so trained professionals in this situation can give the pt the proper help they need and you you don't overstep the bondaries of your profession.

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Specializes in Emed, LTC, LNC, Administration.

I've called EMS more times than I care to remember to remove someone from a vehicle with neck/back/trauma complaints. I've placed a c-collar and done vitals and waited with the pt. until EMS could arrive and extricate them. I used to be a medic before I became a nurse, so I understand the need for scene safety first and then to protect the patient's spinal cord, and have tried to instill this in my fellow nurses. The best and easiest way to think about trauma and spinal cords is this:

ANY trauma above the shoulders, the person has a broken neck until x-rays prove otherwise. ANY trauma above the hips and the person has a borken back until x-rays prove otherwise. ESPECIALLY when you're talking about extricating the person from any type of vehicle.

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:confused: what about those folks presenting without suspected c-spine injuries; like the 34 week pregnant 16 year-old whose family doesn't want her to walk from the triage door to desk (~ 25 feet), but rage in the front carryin'-on, having a fit, and demanding assistance? happens more times than suspected c-spine injuries at my er!
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Specializes in Emed, LTC, LNC, Administration.
:confused: what about those folks presenting without suspected c-spine injuries; like the 34 week pregnant 16 year-old whose family doesn't want her to walk from the triage door to desk (~ 25 feet), but rage in the front carryin'-on, having a fit, and demanding assistance? happens more times than suspected c-spine injuries at my er!

What about them? Help them get out of the vehicle and into a w/c or onto a stretcher (depeneding on the need) and into the ED. The pt in your example could be taken by w/c to triage and then to where appropriate by the same. :)

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DEAD- Grab them by the belt and toss them on a stretcher

if they are talkin, walk -em. lol

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