St John Ambulance

[4353]

As soon as a patient states they dont want treatment or says "**** off *** off" or anything along those lines the relevant paper work is done for refusing/declining treatment 62 82 out the door.

[Nafenn]

I believe in this instance that facts being Female aged 17 with Illegal drugs and no parents with her a responsible Parent or Blood Relitive should have been contacted and not discharged. Police should have been contacted as information was assertained, underage with Illegal substance ( Duty Of CARE). Then Parents would have Called and Authorities directed by Parents. Regardless If a person has taken drugs and required medical aid They should of Been transported to Hospital with in P2 catagory (within 45). This should have put as a first to do as pt requries being monitored and what place better than Hospital where can have vital obs obtained in aprofessional environment.
Police were present at the Event and should of been notified straight away. If she has refused treatment she can be taken in by Police under Protective Custody (also Duty of Care). Really The responseability should be on SJA to call Police as She was in their care.
Responsibilities and Accounts of actions should always be carred out

Mate, how were the First Aiders to know she was under the influence of drugs... they most likley thought it was dehydration or something

by the way, were you there with a god like view of everything? because the Media does not always know 100% (tm not going to be liked, but it's true).

now, im not defending her... my view is that she shouldent have had them in the first place: but first aiders (and police officers for that matter) are not mind readers... she told them that she had taken dexamphetamine, so how were they to know that she had taken otherwise?

[canon]

As soon as a patient states they dont want treatment or says "**** off *** off" or anything along those lines the relevant paper work is done for refusing/declining treatment 62 82 out the door.

So we have been called out to a little old granny that has split her melon open and upon arrival wishes to refuse Rx and is agressive and abusive, or a psych patient who is obviously manic and a danger to both himself and others. Additional resources should be and is the way to go in this circumstance. In fact over east if it isnt happening yet Paramedics may be given the authority to section psych patients under strict cpgs until definitive assessment and or Rx is provided. There are some interesting articles out there now regarding this,have a look through google scholar or perhaps the monash library for some literature on this topic.

[canon]

I believe in this instance that facts being Female aged 17 with Illegal drugs and no parents with her a responsible Parent or Blood Relitive should have been contacted and not discharged. Police should have been contacted as information was assertained, underage with Illegal substance ( Duty Of CARE). Then Parents would have Called and Authorities directed by Parents. Regardless If a person has taken drugs and required medical aid They should of Been transported to Hospital with in P2 catagory (within 45). This should have put as a first to do as pt requries being monitored and what place better than Hospital where can have vital obs obtained in aprofessional environment.
Police were present at the Event and should of been notified straight away. If she has refused treatment she can be taken in by Police under Protective Custody (also Duty of Care). Really The responseability should be on SJA to call Police as She was in their care.
Responsibilities and Accounts of actions should always be carred out

Mate, how were the First Aiders to know she was under the influence of drugs... they most likley thought it was dehydration or something

by the way, were you there with a god like view of everything? because the Media does not always know 100% (tm not going to be liked, but it's true).

now, im not defending her... my view is that she shouldent have had them in the first place: but first aiders (and police officers for that matter) are not mind readers... she told them that she had taken dexamphetamine, so how were they to know that she had taken otherwise?

Sorry Nafenn but i have to agree with search again on this one bearing in mind that i wasnt there and only going on the info provided by yourself and searchy. A patient approaches first aid for assistance and states taking a drug and states 17 years of age and female. The simple fact that they went to first aid for help is a warning sign and confesses to taking a particular drug regardless of what it is indicates this patient has little experience with the drug. Having said that you are also right in saying that we were not god overseeing the incident and for all we know she may have taken more drugs after leaving first aid. would the outcome have been
different with a para there? who knows probably not but it would be nice to see paras working in conjunction with vollies across the metro area ie all stations having para vollie crews. This could only be a good thing as 1- always have a para on scene, 2- increase in vollie knowledge
and skills. Deepest sympathy again to all involved

[Zebedee]

I can't believe some of the nonsense that's being put out in this thread about what people "should" be able to do, or all these hypothetical situations about grannies with their heads split open.

It really is quite simple. As a Senior First Aider, I have been given a certain amount of training, and have been given a certain set of instructions on how to approach a situation where someone may be in need of some assistance.

Those two things are critical - number one: do not do *anything* to a person unless you have their permission, and number two: do not do anything that is outside the scope of what you have been trained to do.

So, under those two cardinal rules, as soon as someone refuses assistance (or further assistance), the situation is very clear. They refuse consent, you stop. That is what I have been trained in, and that is how I personally would approach such a situation. To do otherwise breaks rule two - not to act outside your training.

If a young 17 year old female came to me and told me that she had taken a drug, and wasn't feeling well, I would assist her in the ways that I have been trained in. If she at any times changes her mind and refuses assistance, then again, I would act in accordance with how I've been trained.

It's perfectly simple, and I'm honestly not sure what all the fuss is about.

[canon]

I can't believe some of the nonsense that's being put out in this thread about what people "should" be able to do, or all these hypothetical situations about grannies with their heads split open.

It really is quite simple. As a Senior First Aider, I have been given a certain amount of training, and have been given a certain set of instructions on how to approach a situation where someone may be in need of some assistance.

Those two things are critical - number one: do not do *anything* to a person unless you have their permission, and number two: do not do anything that is outside the scope of what you have been trained to do.

So, under those two cardinal rules, as soon as someone refuses assistance (or further assistance), the situation is very clear. They refuse consent, you stop. That is what I have been trained in, and that is how I personally would approach such a situation. To do otherwise breaks rule two - not to act outside your training.

If a young 17 year old female came to me and told me that she had taken a drug, and wasn't feeling well, I would assist her in the ways that I have been trained in. If she at any times changes her mind and refuses assistance, then again, I would act in accordance with how I've been trained.

It's perfectly simple, and I'm honestly not sure what all the fuss is about.

Just an interesting topic zeb, old granny thing is not a hypothetical it has happened and additional resources were called in for concern over her welfare. Correct me if im wrong but i dont think anyone here has actually indicated to continue Rx without their consent more a case of if there is a concern for that persons welfare then call for help which you will find is part of your training as a first aider.

[gkoutlis]

I can't believe some of the nonsense that's being put out in this thread about what people "should" be able to do, or all these hypothetical situations about grannies with their heads split open.

It really is quite simple. As a Senior First Aider, I have been given a certain amount of training, and have been given a certain set of instructions on how to approach a situation where someone may be in need of some assistance.

Those two things are critical - number one: do not do *anything* to a person unless you have their permission, and number two: do not do anything that is outside the scope of what you have been trained to do.

So, under those two cardinal rules, as soon as someone refuses assistance (or further assistance), the situation is very clear. They refuse consent, you stop. That is what I have been trained in, and that is how I personally would approach such a situation. To do otherwise breaks rule two - not to act outside your training.

If a young 17 year old female came to me and told me that she had taken a drug, and wasn't feeling well, I would assist her in the ways that I have been trained in. If she at any times changes her mind and refuses assistance, then again, I would act in accordance with how I've been trained.

It's perfectly simple, and I'm honestly not sure what all the fuss is about.

Just an interesting topic zeb, old granny thing is not a hypothetical it has happened and additional resources were called in for concern over her welfare. Correct me if im wrong but i dont think anyone here has actually indicated to continue Rx without their consent more a case of if there is a concern for that persons welfare then call for help which you will find is part of your training as a first aider.

Canon - If you have a problem with the protocols of St.John Ambulance, rather than bitch about it here - write in to SJAA and see what response you get.

As far as I am concerned, the crew at BDO - did their absolute best CONSIDERING the circumstances!!

G

[Zebedee]

Correct me if im wrong but i dont think anyone here has actually indicated to continue Rx without their consent

People have been suggesting all sorts of things from the safety of their keyboards, such as "the patient may become any in many cases will become combative and will try to refuse treatment so does that mean we just let them be."

To me, the answer to that question from my perspective is "absolutely yes". If a person refuses assistance, then assistance is not given.

Or what about "If someone requests medical aid and then refuses it then comes down to the discretion of the first aid provider ... as stated before certain conditions require prompt action and i would much rather treat a conscious patient than wait."

I'm not sure how to interpret that statement. If you look at it in one frame, it could suggest that a person receive some kind of assistance, whether they want it or not. This is outside my training, therefore it is not a situation I would ever put myself in.

if there is a concern for that persons welfare then call for help which you will find is part of your training as a first aider.

Calling for help is pretty much the *first* thing that any first aider does, and then hands over care of a person to someone more appropriately qualified and experienced as soon as practically possible. However, for that intervening period where I'm "it", the decision is mine on what course of action to pursue. And In every case, my course of action will be in accordancde with my training. And to sound like a broken record here, if the person, no matter who they are, tells me they do not want my assistance, then I would follow the instructions received as part of my training and not provide them with any assistance.

It all seems distressingly logical to me. "If a person refuses assistance, then assistance is not given." I don't know what part of that is hard to understand.

[canon]

Correct me if im wrong but i dont think anyone here has actually indicated to continue Rx without their consent

People have been suggesting all sorts of things from the safety of their keyboards, such as "the patient may become any in many cases will become combative and will try to refuse treatment so does that mean we just let them be."

To me, the answer to that question from my perspective is "absolutely yes". If a person refuses assistance, then assistance is not given.

Or what about "If someone requests medical aid and then refuses it then comes down to the discretion of the first aid provider ... as stated before certain conditions require prompt action and i would much rather treat a conscious patient than wait."

I'm not sure how to interpret that statement. If you look at it in one frame, it could suggest that a person receive some kind of assistance, whether they want it or not. This is outside my training, therefore it is not a situation I would ever put myself in.

if there is a concern for that persons welfare then call for help which you will find is part of your training as a first aider.

Calling for help is pretty much the *first* thing that any first aider does, and then hands over care of a person to someone more appropriately qualified and experienced as soon as practically possible. However, for that intervening period where I'm "it", the decision is mine on what course of action to pursue. And In every case, my course of action will be in accordancde with my training. And to sound like a broken record here, if the person, no matter who they are, tells me they do not want my assistance, then I would follow the instructions received as part of my training and not provide them with any assistance.

It all seems distressingly logical to me. "If a person refuses assistance, then assistance is not given." I don't know what part of that is hard to understand.

I dont understand why the hostile intonations within your last statement. Im not trying to bag
anyone and definately not trying to bag sjas paid and non paid employees. I continued this discussion as a broad topic and not intended as a BDO beef but more as a holistic view of first aid in general in WA and possibly some thoughts from a different perspective. Its great that you stick to the way you were taught and so should everyone else . I understand what your trying to say and your right, but there is definately no law stating that any first aider cannot call for additional resources if concerned, doesnt mean we treat them.The statement pertaining to the treating a conscious patient means that if isomeone had genuine concerns about a patient who refuses Rx additional resources could be called in and if deemed appropriate to do so by them then an action plan can be implemented in which it would be much wiser to do than wait for them to be unconscious.

There will always be controversial topics within pre-hospital care and so there should, without
it the industry wouldnt move forward . BDO is small fry in the grand scheme of things and has
been sensationalised by the media. Those guys did their best and at the end of the day that is all that matters

[Tyranus]

Well it now seems you're both arguing the same point!

1. Both of you agree that treatment can't be given to those that don't want it.
2. Both of you agree that assistance for things that can't be handled should be requested as soon as possible.
3. Canon has said that if someone refuses treatment and you as the first aider are concerned for their well being then call for assistance...which is the same as the second point
4. Both of you agree that you should stick to what you have been trained to do
5. Both of you agree that the SJA volunteers did their best on the day

So there's 4 or 5 points which you both fairly well agree upon if you count point 3 as seperate. So it appears the BDO argument is sealed.
Maybe continue the discussion holisticly but set some guidelines for your discussion or something, but I don't think there is a need to continue debating/arguing the same points.

[canon]

boom boom tish, goes to you. Just reading back and am seeing the same thing lol. =D> However
i still agree with search again , no offence zeb.

[gkoutlis]

boom boom tish, goes to you. Just reading back and am seeing the same thing lol. =D> However
i still agree with search again , no offence zeb.

What is it about you that just edges the tension here? Stop trying to stir people.

G

[canon]

boom boom tish, goes to you. Just reading back and am seeing the same thing lol. =D> However
i still agree with search again , no offence zeb.

What is it about you that just edges the tension here? Stop trying to stir people.

G

How is agreeing with Tyranus stiring and im entitled to disagree and or agree with whomever i choose. I have in the past voiced concerns to zeb via pms and recieved explanations
and accepted them whole heartedly. Not trying to stir mate and thankyou Zeb for the stimulating convo.

[search.again]

I Guess all we can do is wait until the Cooroners report comes to hand and his recommendaitions come into view This will no doubt take some time and the same old questions will be raised but sadly never answered.

[Infernal]

Just a quick note guys this is not the place to argue about political stances over who should have done what, where when how and why, radio scanner forum, if you want to talk about that stuff give the ABC a call.

Second to that, when a Ambulance is called, consent has been given to help a patient, if a patitent refuses transport, the paramedic must try and do what he can to get the person to go, with out the use of force obvioussly, if the patient still declines, then the patient must sign a ANR (ambulance not required form) and must be witnessed that the patient has refused transport, and therefore removing liability from the ambulance service.