MD on scene???

[MarionMedic]

Had an interesting call a while back with VFD.
Vehicle 2 rear ended vehicle 1.
We get called.
Everyone is OK but we have to follow protocol until Ambulance arrives.

Well, Vehicle 1 ("my" car) has a man and a VERY pregnant woman in it.
The man is out and the woman is still in passenger seat.
I start my assessment and the man walks over and states "I'm a physician and I'm taking responsibility for my wife's treatment.
Now, we've got this woman in a c-collar and manual immobilization at the time so I'm not real happy to remove it til the no-haul is signed.

I explained, yes I explained, briefly how our protocols work and that we really should wait until the Ambulance arrived before removing c-collar.

He actually agreed and even told his wife to sit still.

About that time another man and woman walked across from another vehicle. Yep, another MD.
The second MD said he'd take responsibility. I was explaining the reason why we should wait and protocol and about then the husband/MD told the second "DOC" to basically take a hike.
I thought they were going to get into it.
Woman was transported for eval and everything was OK.

Just thought it was funny.

I got to work with the husband/MD a few weeks later on a clinical. He thanked me for explaining the "why's" of what we were doing.


BTW - he was an "anesthesia MD". Another good reason to assume ANY/ALL on-scene MD's are podiatrists.

[lexfd5]

You need to have an attorney draw up a document for just those cases when the "on-scene" doctor wants to take over. We have them and the gist is: You "on-scene" doctor take complete and shall be solely responsible for the patient and the medical personnel, as they will be acting under direction of your, "on-scene" doctor medical license and malpractice insurance. On scene personnel will follow your direction only, they will not follow standard department protocols once you have taken charge of the patient.

Usually when we pull this out most usually let us take care of the patient. They don't like that total liability thing.

[wnwd00]

where i work we have a letter like that, but the letter along with our protocol says more or less; regardless of the direction you (the on scene MD) give the providers both ALS and BLS are going to follow their establish protocol, and practice. if you chose to sign the form you assume all liability for their action from the current online medical director and must remain with the patient until transfered to another MD at the recieving medical facility.

i have never had a problem with a doctor on scene, once they have seen this letter.

[Weruj1]

here is how it works here :
1) must SHOW credentials of Dr.
2) must contact on-line med control and let them know the situation, and they may or may not allow the MD o/s to take charge
3) MUST sign the run report..............if we transport MUCT go with us to the ER. Usually when we get to this part ........they back out and let us do our thing.

[montet202]

Personaly I love it when I have the benefit of an MD on scene. They make for such a great IV pole...as long as they keep quiet.

[RyanEMVFD]

We had one sit there and hold c-spine for us on a motorcycle accident. Then he left, good doc in my opinion.

[mitllesmertz1]

The fact that the husband was an MD or not is not the issue.
If the pregnant lady wanted to leave with her husband, were you going to tackle her? Why look for extra patients?
This is a simple AMA/ROR, whatever you call it in your area.
Explain risks involved of not seeking further treatment, have pt sign form, contact your base per protocols, wave bye-bye, maybe give her a stuffed animal for the baby.
Why make a fuss over his being an MD or not?
Oh,by the way, Anethesiologosts have a pretty good understanding of spinal anatomy, ever heard of an epi-dural?

[jhardyjr]

We usually don't have a problem with Doc's, or nurses. We had a good wreck the other day on the Interstate. 1 suv rollover, with 1 ejection. 15 y/o m pt, with poss head injuries. We get there and there are people everywhere, looks like mass casulity. The boy is in the median covered up with blankets and someone holding C-spine. I walk up and introduce myself and ask whats going on. It turns out that the man holding c-spine is a neuro-surgeon. I did my assesment and then after we boared him, I asked the Doc to get a BP. He kinda looked puzzled, must have been a while since he has done that. But he did a great job assessing before we got there.

[MarionMedic]

Maybe I was crooked in explaining that.
The MD/husband was willing to continue on scene care as we were providing AFTER I explained why and asked him to reconsider.

By the way.... it's spelled "mittelschmerz"

[mitllesmertz1]

By the way.... it's spelled "mittelschmerz"
LOL!!! this is my third time using the name, I keep forgetting my password and start a new account, so I have to spelll it differently every time...

[N2DFire]

We don't have a form but we do have a written Protocol.

G-18 - Verification of On Scene Medical Personnel
1. EMS personnel will accept an order only from a physician with a license to practice medicine in the Commonwealth of Virginia. Other health care professionals, i.e., nurses, medical technicians, physician assistants, have no role in providing medical control.

2. EMS personnel may accept written orders from a physician transferring a patient from one medical facility to another if the orders are appropriate and within the scope of these protocols.

3. When not in a medical facility, and not known by the providers, the individual must provide identification verifying that he/she is a physician and willing to provide medical control to the providers.

4. The EMS provider will ask the physician to sign the PPCR. At the EMS provider’s discretion, he/she will ask the physician to accompany the patient, in the ambulance, to the hospital. If the physician agrees and the orders are within the scope of these protocols, the EMS provider should follow them.

5. If the on-scene physician refuses the procedures outlined in step #4 or orders supplied are inappropriate, the following shall be taken:

a. Immediately contact Medical Control.

b. Advise the on-scene physician that you are operating under the direction of a Medical Control physician and ask him/her to speak with the on-line physician. If radio communications are not available, contact must be made by phone.

c. The Medical Control physician may ask the on-scene physician to provide an I.D. proving he/she is licensed to practice medicine in the Commonwealth of Virginia.

d. The on-scene physician will be granted or denied permission to treat the patient by the Medical Control physician.

e. The EMS personnel shall continue treating the patient with the assistance of the on scene physician if permission is granted.

f. If permission is denied, inform the physician that the on-line Medical Control
physician is assuming the responsibility for patient care.

For Item #4 - we no longer use paper based PPCR (care reports) so in order for the DR to be able to sign it - I have to type it up @ the ER and print it first - so s/he is going to have to ride w/ me regardless.

Also - since we've had the discussion about Nurses and "other providers" before - note Item 1. :D