Advocacy & Safety - EMT Time

Generally speaking how long does it take the EMTs to check out a person who has been hit by a car and claims not to be hurt? Example, a cyclist or ped is hit by a car but says they are ok, but just to be sure an ambulance is sent to the scene to check them out.

If the EMTs show up against the wishes of the victim, who pays the bill?

Where I live there is no charge if they are not transported. Taxes paid for the initial response.

That's right! Me, a non-helmet-wearing bicyclist taxpayer with insurance. My taxes pay for all those helmeted bicyclists who crash because of riding too fast for conditions, certainly those who are rushed into the hospital with their cracked helmets without insurance.

Generally speaking how long does it take the EMTs to check out a person who has been hit by a car and claims not to be hurt? Example, a cyclist or ped is hit by a car but says they are ok, but just to be sure an ambulance is sent to the scene to check them out.

Elapsed time depends on the condition of the cyclist/pedestrian and the rules of a particular service. In many cases, the person must be transported unless he or she refuses. If the person refuses but seems to at substantial risk without emergency treatment, medics sometimes seek the help of a peace officer.

In some cases, medics will stall, stall, stall to give the injured person time to change his or her mind and to watch for symptoms. High costs and lack of insurance make this a tough call for some people. They have already been hit once.


If the EMTs show up against the wishes of the victim, who pays the bill?

In general, no transport, no bill.

EMTs that I have known will sometimes wait for a victim who refuses treatment to pass out. Then the victim cannot refuse treatment, and the EMTs will haul them off.

EMTs that I have known will sometimes wait for a victim who refuses treatment to pass out. Then the victim cannot refuse treatment, and the EMTs will haul them off.

How long will they wait?

If a jurisdiction has a private ambulance company that responds, there is usually a requirement for them to respond within a certain length of time. Usually 3-5 minutes. This is from the time they are dispatched, not the time the call is made. In many places the EMTs responding will be fire fighters. They usually also have a time requirement. Of course, these times are usually specified as the 'average' time it takes them to respond. So they can take longer for some if they are early on others. I have never seen it take more than 10 minutes in a metro area (after dispatch). The farther out you are the longer it will probably take.

As others have said, generally, it you are not transported there is no charge. If you are over 18 you can leave any time yo decide to. They can't keep you there against your will under most circumstances. A head injury could be an exception. If you have an altered level of consciousness they may be able to transport you against your will. Other than that, you can tell them you think this has taken long enough and leave.

What's the story? Clarks, why do you ask?

How long will they wait?

There's no telling. I once waited over two hours before a person agreed to transport because it was clear he needed it and we had the time available.

The person, if able, could have left the scene at any time.

There's no telling. I once waited over two hours before a person agreed to transport because it was clear he needed it and we had the time available.

The person, if able, could have left the scene at any time.

Do they have to sign a waiver before leaving?

This can get sticky if the person doesn't want to be transported. Read in I believe the Minneapolis paper about a guy who got in an accident and tried to refuse transport saying he was fine. Law enforcement got involved and he ended up being transported to the hospital against his will. He then spent several hours there before the doctor told him he was fine and could go home. He was upset because #1- he was transported against his will, and #2- He's being billed for the ambulance and ER visit, both of which he attempted to refuse.

Do they have to sign a waiver before leaving?

Patient? Yes... Thats if they are determined to be a competent adult. Basically the waiver is supposed to release the crew and agency from liability, in today's times though we all know what that means.

That's right! Me, a non-helmet-wearing bicyclist taxpayer with insurance. My taxes pay for all those helmeted bicyclists who crash because of riding too fast for conditions, certainly those who are rushed into the hospital with their cracked helmets without insurance.
And our tax money goes to police and EMTs having to deal with your stupid San Jose Bike Party BS.:notamused:

http://www.bikeforums.net/showthread.php?t=576733

http://www.bikeforums.net/showthread.php?t=563777

Do they have to sign a waiver before leaving?

No. EMTs do not have any power of coercion. A patient is able to be an ornery cuss and walk away without signing a waiver (often called a "refusal"). It's not like the EMT can arrest you. But, IMHO, the right thing to do is to sign if you don't want transport. All patients do when they sign a refusal is to formally document the decision that they, themselves have made. If they don't want transport, then they should "man up" and admit that they don't. Right? Seems fair enough to me.

The refusal largely exists to protect the EMT. It proves that the EMT did not "abandon" a patient. To abandon a patient is just about one of the worst things that an EMT can do.

This can get sticky if the person doesn't want to be transported. Read in I believe the Minneapolis paper about a guy who got in an accident and tried to refuse transport saying he was fine. Law enforcement got involved and he ended up being transported to the hospital against his will. He then spent several hours there before the doctor told him he was fine and could go home. He was upset because #1- he was transported against his will, and #2- He's being billed for the ambulance and ER visit, both of which he attempted to refuse.

In a case like that I can't say as I blame him, and the cop(s) and emergency crew should have to pay his bill(s).

As even though I don't necessarily agree with them there are religions out there don't believe in/allow "modern medical practices." And it could be seen as a violation of their religious freedom to force medical treatment on them against their will.

Patient? Yes... Thats if they are determined to be a competent adult. Basically the waiver is supposed to release the crew and agency from liability, in today's times though we all know what that means.

Yep, look long and hard enough for a slimy enough lawyer and you can sue over anything.

Do they have to sign a waiver before leaving?

What JonathanGennick said with one variation. In at least three states and perhaps all the medics can convince a peace officer to take the patient under custody if it is clear he or she needs transport.

My practical advice to a cyclist who does not want transport is to be alert to medic responses to a first refusal. If they do not take it well, let that be a warning. Turn then into your advisers. Ask about risks. Explain any financial concerns. Use their responses to help you make a fully informed decision.

No. EMTs do not have any power of coercion. A patient is able to be an ornery cuss and walk away without signing a waiver (often called a "refusal"). It's not like the EMT can arrest you. But, IMHO, the right thing to do is to sign if you don't want transport. All patients do when they sign a refusal is to formally document the decision that they, themselves have made. If they don't want transport, then they should "man up" and admit that they don't. Right? Seems fair enough to me.

The refusal largely exists to protect the EMT. It proves that the EMT did not "abandon" a patient. To abandon a patient is just about one of the worst things that an EMT can do.

Your description reminds me of a story one my Cadre SGT's told us when I was going through AIT at Ft. Sam Houston. He was working in the ER and they had a drunk come in who wasn't being very cooperative about being treated. And seems that by the time they got him on the table to treat him that he had a few more bruises then when they first brought him in.

Yes, I know that there are things that can and do happen in the military that couldn't happen in "real life." And there are things that can happen in "real life" that couldn't happen in the military.

I agree that a person who refuses medical treatment should be adult enough to admit to it. Of course as I just said in another post their refusal may not have necessarily a personal choice and may be religious in nature. And to treat them against their will would be a violation of their religious freedom.

In a case like that I can't say as I blame him, and the cop(s) and emergency crew should have to pay his bill(s).

As even though I don't necessarily agree with them there are religions out there don't believe in/allow "modern medical practices." And it could be seen as a violation of their religious freedom to force medical treatment on them against their will.

Never mind the religious case. It violates my personal liberty. If I don't want a ride on an ambulance, I should never be forced to.

What JonathanGennick said with one variation. In at least three states and perhaps all the medics can convince a peace officer to take the patient under custody if it is clear he or she needs transport.

My practical advice to a cyclist who does not want transport is to be alert to medic responses to a first refusal. If they do not take it well, let that be a warning. Turn then into your advisers. Ask about risks. Explain any financial concerns. Use their responses to help you make a fully informed decision.

The problem with that is that you run the risk of violating a person's religious and personal freedom. Granted as I said I don't necessarily agree those who refuse medical treatment for religious reasons, but it's their right. Just as it's their right to refuse for whatever personal reason they may have. And one would think that common sense would/should dictate that if one is involved in an accident that it is better safe then sorry and to get checked out by a doctor or at least nurse practitioner. Just to make sure that there are no serious injury. Even if they do go to the hospital immediately after the accident and are "cleared" that there's still a remote chance of injury showing up at a later date.

What JonathanGennick said with one variation. In at least three states and perhaps all the medics can convince a peace officer to take the patient under custody if it is clear he or she needs transport.

I purposely avoided getting into that can of worms. We have now entered the dreaded "lawyer-zone" :D.

In Michigan, a law-enforcement officer can indeed take someone into protective custody and then require transport and treatment. But that is not done lightly. Mental status comes into play. The officer (and the EMTs too) must be able to document that a patient is not in his/her normal frame of mind. It is not enough that the officer and EMT believes that the patient needs transport/treatment. I can believe that a patient needs treatment all I want--s/he can be bleeding, have broken bones, whatever--but it does not matter one whit so long as the patient is mentally competent.

I wish the OP would come back and post "the rest of the story". My guess is that he was in a wreck, and that whatever EMT crew evaluated him took their time in order to see whether any signs and symptoms came to light. It is very often the case in a trauma such as a car wreck that injuries are not immediately apparent, not even to the patient. I was in a wreck last winter and did not even realize I was bleeding from the head until the blood ran down into my eyes. And I had bruises develop the next day on parts of my body that I had no idea had been hit. A good EMT crew will take the time to thoroughly assess the patient.

i can give some answers based on my experience as an EMT in NJ, but it's been about 10+ years ago.

how long does it take for an ambulance to show up? how long is a piece of string...? One time there was a three car pile-up (complete with 2 DOAs; an eight year old boy and his mom) directly across the street from the rescue squad, ten minutes after a monthly meeting started. within a minute or two of hearing the crash outside, we had three ambulances and surplus EMTs on scene. other times we've had several squads from the town occupied at or beyond capacity and another call comes in; that could be 10+ minutes before there are EMTs on scene.

as a rule of thumb: small town; cops will get there first. big city; cops won't show up at all.

the billing that was being fazed in about the time i left: if you don't have insurance, you don't get a bill. if you have insurance, they get a bill. i think it's called "soft billing". i'm pretty sure it doesn't apply everywhere.

if you want to refuse treatment, just be polite and firm. you'll be asked to sign an RMA (refuse medical attention) which is just a CYA for the EMTs. if someone refuses to sign, we would note "refused to sign" on the form and have it witnessed by a cop (the cop's not there to force or coerce anyone to go for an ambulance ride; they're just an impartial witness). it's not unheard of that, if there's no other emergency, EMTs will just hang out for a while because peoples' conditions' often "crash" after the adrenalin starts to wear off, and then decide that a trip to the hospital is a good idea. in most (all?) jurisdictions, if someone passes out or is otherwise non-responisive, then implied consent (http://en.wikipedia.org/wiki/Implied_consent#First_aid) is assumed and they'll wake up in, or on their way to, the hospital. very rarely does a situation call for having police take someone into custody so they can be transported to the hospital.

i can give some answers based on my experience as an EMT in NJ, but it's been about 10+ years ago.

how long does it take for an ambulance to show up? how long is a piece of string...? One time there was a three car pile-up (complete with 2 DOAs; an eight year old boy and his mom) directly across the street from the rescue squad, ten minutes after a monthly meeting started. within a minute or two of hearing the crash outside, we had three ambulances and surplus EMTs on scene. other times we've had several squads from the town occupied at or beyond capacity and another call comes in; that could be 10+ minutes before there are EMTs on scene.

as a rule of thumb: small town; cops will get there first. big city; cops won't show up at all.

the billing that was being fazed in about the time i left: if you don't have insurance, you don't get a bill. if you have insurance, they get a bill. i think it's called "soft billing". i'm pretty sure it doesn't apply everywhere.

if you want to refuse treatment, just be polite and firm. you'll be asked to sign an RMA (refuse medical attention) which is just a CYA for the EMTs. if someone refuses to sign, we would note "refused to sign" on the form and have it witnessed by a cop (the cop's not there to force or coerce anyone to go for an ambulance ride; they're just an impartial witness). it's not unheard of that, if there's no other emergency, EMTs will just hang out for a while because peoples' conditions' often "crash" after the adrenalin starts to wear off, and then decide that a trip to the hospital is a good idea. in most (all?) jurisdictions, if someone passes out or is otherwise non-responisive, then implied consent (http://en.wikipedia.org/wiki/Implied_consent#First_aid) is assumed and they'll wake up in, or on their way to, the hospital. very rarely does a situation call for having police take someone into custody so they can be transported to the hospital.

Thank you for the information. Here are a couple of good questions, let's say that someone has a RoadID, or "dog tag" from their local pet store saying even if unconscious not to transport, just to revive. Would that be honored? Also if an individual has instructions on their person saying to transport them to a particular medical facility will that be honored?

Thank you for the information. Here are a couple of good questions, let's say that someone has a RoadID, or "dog tag" from their local pet store saying even if unconscious not to transport, just to revive. Would that be honored? Also if an individual has instructions on their person saying to transport them to a particular medical facility will that be honored?
yeah, whenever someone asks what hospital you want to go to, tell them Honolulu General Hospital ;)

about a "revive only - no transport" dog tag, i have no idea. that type of thing changes based on court decisions and legal interpretations. i've been out of the game for about 10 years.

my own opinion: it would be taken into consideration along with other factors, but if you're unconscious and have a bone sticking out of your leg, you'll wake up in a hospital, not the side of the road. a DNR (do not resuscitate) is different, and has more standing, legally. but DNRs are pretty much unheard of among people leading active lifestyles.

choice of hospital will also be taken into consideration, but if you're in pieces you'll likely go to the trauma center; if you're overdosed you'll likely go to the detox; etc.

samuel leo is the best book for microwave..
for emt jordan is good..


Thanks

Berand
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When I got hit, I called 911 and told them I could move around and probably didn't need to go to the ER, but I wanted to be checked out any way.
They took 48 minutes to show up.
I asked the EMT, no transport no charge to anyone, its a city service (may differ in your city)

Thank you for the information. Here are a couple of good questions, let's say that someone has a RoadID, or "dog tag" from their local pet store saying even if unconscious not to transport, just to revive. Would that be honored?

Almost certainly not.


Also if an individual has instructions on their person saying to transport them to a particular medical facility will that be honored?

If the instructions were found and were reasonable for the situation they would often be honored, but that would depend on the rules of the service.

yeah, whenever someone asks what hospital you want to go to, tell them Honolulu General Hospital ;)

about a "revive only - no transport" dog tag, I have no idea. that type of thing changes based on court decisions and legal interpretations. I've been out of the game for about 10 years.

my own opinion: it would be taken into consideration along with other factors, but if you're unconscious and have a bone sticking out of your leg, you'll wake up in a hospital, not the side of the road. a DNR (do not resuscitate) is different, and has more standing, legally. but DNRs are pretty much unheard of among people leading active lifestyles.

choice of hospital will also be taken into consideration, but if you're in pieces you'll likely go to the trauma center; if you're overdosed you'll likely go to the detox; etc.

That would be one hell of a transport bill. . .;-)

But it would be given some consideration? Which is probably a good thing to some.

Ultimately that would probably be the course of action. Even active young people should have at the very least a living will in case they find themselves in a situation where they are unable to speak for themselves. As well as discussing with their doctor whether or not a DNR is appropriate.

That's good to hear as I am sure there people with legitimate reasons for wishing to be transported to one facility over another. Such as a Vet wishing to be transported to the nearest VA facility.

I'm asking because there was an 8 year old kid that got hit. People said it took the EMTs only 15 minutes to examine him and let him go, seems like that couldnt have been a full exam. anytime a kid is hit i would think they would take them to a hospital. but as i understand it this was a black kid in a poor area so maybe it just depends on who you are and where you are.