Legal question here involving refusal of service. What do we do in the case of a pt refusing service, however is calling 911 for under the table services for a lift assist from a vehicle to the pt’s residence because they are not able to. Most times in a ROS situation we are asking the pt to get up and move around to show that they can do daily activities to be able to stay at home. Our equipment is “extrication equipment”. We’re now being called as a lifting service to utilize our lifting abilities and extrication equipment (stair chair, backboard, stretcher) to move pts who otherwise can’t into a residence and it being called a refusal of service. Where does the liability fall and what are paramedics suppose to do? As any other ROS, we wouldn’t treat the pt with medications, we would advocate to go to the hospital etc. This is a unique situation that a lot of us are finding ourselves in. Being called for a ROS as the reason on pt contact, but demanding services.

The directive now states that we are to initiate transcutaneous pacing immediately if the pt is severely symptomatic/pre-arrest and not delay for IV access or atropine, etc. If they are in a spot that requires a lifting chair to extricate, should we wait until they are on the stretcher to initiate it or initiate then discontinue for extrication, reinitiate, etc. Then how would you like us to move the pt to the stretcher?

I was just curious about a possible contradiction in the Trauma TOR VSA Conditions/Contraindications. In the updated Trauma TOR Conditions it lists that a condtion as “Signs of life when fully extricated with the closest ED >30 min transport time away”. However in the following contraindications it lists “Signs of life at any time since fully extricated medical contact” as contraindicated for the TOR. My question is, in a scenario of a Trauma TOR eligble patient that has signs of life after full extrication, then becomes VSA, would the Trauma TOR apply or not? Would distance to the hospital come into play?