Calling the Paramedics

[guest@endurance.net]

K S SWIGART   katswig@earthlink.net

Unless things have changed since my ambulance driving
days (possible, it has been a lot of years), the legal
answer to the question is that as long as a person is
"oriented times four" they are considered competent
to decide for themselves whether they are in need
of medical treatment or not...even if they are bleeding
to death in front of you.

To be considered oriented times four a person must be
able to answer the following four questions:

1. Who are you?
2. Where are you?
3. What day/time is it?
4. What are your circumstances(i.e. do you know where
you are and what you are doing here)?

If a person can't answer all four of those questions
correctly, then they are not considered mentally
competent, and they WILL be transported.  And you
can bet, that virtually any paramedic or emergency
medical response personnel will be asking those questions
almost immediately after arriving.  And if the person is
not conscious, obviously they cannot answer any of those
questions.

However, if they CAN answer those questions, no matter
how bad off anybody thinks their condition, they can refuse
medical treatment.

If, however, the paramedics have been called and the person
has accepted treatment (and transport), then you can also
bet that anybody who had had a horse flip over on them and
was complaining of pain in the torso IS going to be put
in a C-collar and strapped down to a board (including duct
tape over the eyebrows) for transport.

So that tells us legally who is allowed to refuse medical
treatment from paramedics, etc.  It does not, however,
tell ride managers what they should do if they think that
somebody at the ride ought to have medical care but
insists they don't need it.

What _I_ would do if I were a ride manager, is ask the
same four questions.  And if they can answer the
questions but still refuse to let me call the paramedics,
I would ask them if there were any thing else I could do
to help, anybody else that I could call, etc.  And then do
what they asked of me.

There is, of course, the problem of who pays the paramedics
if they do come out.  If the injured person asked you not to
call the paramedics, but you did anyway and then the
paramedics came and the person was deemed competent to
refuse treatment, that person could not then be stuck with
the bill for having the paramedics come.

And while it may vary from state to state, it is also unlikely
that the ride manager (or whoever, in good faith) called the
paramedics would get stuck with the bill either.  Most likely
it would be the paramedic company (or FD, etc.) that would
end up having to eat the cost because there would be nobody
they could bill (especially since they frequently end up having
to eat the cost of unpaid bills of people who DO actually
accept the services).

kat
Orange County, Calif.

p.s.  All of this assumes that the injured person we are talking
about here is an adult.  For children the rules are different...
it becomes the decision of the person appointed as the "responsible
adult."  And one hopes that there are no minor children at
endurance rides for whom SOME adult is not responsible.  But,
if such an adult is not present or cannot be reached, then the
emergency personnnel can act to resolve the emergency hoping
that a responsible adult can be located in good time, and if not,
then the minor can be made a "ward of the court" (happened to
my little sister when she was in a car accident and broke her
femur and my parents were unreachable).