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Wednesday, January 16, 2008

Protocols likely ignored in child abduction case.

In a previous post Bob Ellis comments on a rather bizarre case in Colorado in which an 11 year old boy was seized by a sheriff’s SWAT team after a minor injury the day before in which the boy apparently bumped his head while clowning around with an older sister. A neighbor called for an ambulance but the boy’s father didn’t think the injuries warranted an expensive trip to the emergency room. World Net Daily reports that the paramedics, upon arrival, forced their way into the families home and insisted that the boy be transported to the hospital. The father refused, stating that he was capable of monitoring the child’s condition and making decisions about his son’s need for additional care.

The paramedic on the scene is reported to have been angered and upset about the father’s refusal to allow transport to the hospital and thus the sad case develops as the paramedic contacted the local police, then the Sheriff’s office and then Social Services, apparently alleging neglect of a minor. This set into motion a sequence of events that culminated in the invasion of the family’s home by a SWAT team with weapons drawn and threatening lethal force, simply for the purpose of forcing a medical evaluation of the boy.

Emergency Medical Services, which encompasses ambulance service and paramedics, is regulated by state agencies and the care rendered by EMS personnel is specified in approved protocols that are written by a medical director, usually a physician who specializes in emergency medicine. When circumstances arise that extend outside the written protocols, which often happens, the paramedics are instructed to contact their medical director for instructions on how best to proceed.

A search for EMS protocols in Colorado did not turn up any documents for protocols specific to Garfield County, but I reviewed others from other services and found that they were quite similar to that which we use in Indiana. In the situation at hand protocols dictate that the paramedic contact “medical control” regarding transport of a minor against the will of a parent. There is no mention in the story about a medical director being involved in the decision process of the paramedic and this suggests to me that the paramedic acted on his or her own, outside the approved protocols. If that is the case, this person has violated a very serious responsibility of EMS workers.

Paramedics and EMTs are called upon to deal with patients often under the worst of circumstances: extreme trauma, agonizing grief, hysterical patients, obstinate and angry patients and families, drunkenness, other forms of intoxication and often just plain stupidity. It is sometimes a challenge to hold their own emotions in check and to behave professionally and appropriately, i.e., according to protocols. But professionalism is the strict standard to which we hold these workers. It appears that the paramedic who set this event into motion let his or her emotions take control and the consequences will be severe for all those involved.


3 comments:

Bob Ellis said...

It's easy to get our ego bruised when someone doesn't want our help.

But short of verifiable abuse or neglect, professionals should respect the privacy of families and the right of parents to make decisions for their children.

The end result of a doctor prescribing Tylenol, fluids and ice demonstrates that this incident was overblown.

Anonymous said...

I agree, Bob. I think the doctor acted sensibly. He could have played along with the sheriff and social workers and made more of the injury than there was. No one would have questioned a decision to get CT scans, overnight admission for observation, even a lumbar puncture (spinal tap) to rule out a subarachnoid bleed, but the doctor acted professionally and appropriately, did a history and physical exam and discharged the boy to the care of his parents. Sometimes doctors are nice, reasonable folks who want to do what is best for their patients

Anonymous said...

Every person involved in this incident should be fearing for their future. I'm dumbfounded that no one during the course of this event stopped to allow common sense to prevail. The paramedics, sheriff's department, social services, and the judge are all going to called on the carpet over this one. I sure hope the father is enjoying shopping for the new fancy sports car and vacation home that the punitive damages from this will buy.

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