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Question for Paramedics and EMTs


ItsCordell

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For those who are emts or paramedics or firemen/women, etc. how frequently do you encounter people in diapers? What do they tend to be like (old/young/poor/rich/genders/races)?

 

Have you ever cut clothing off say, a trauma victim, to find a diaper or other pad underneath? What do you assume? How do you react? Is it common for emergency personnel to laugh about these things? In what situations is it appropriate to cut off clothes? What would you say to hospital staff about things like this?

 

What’s the weirdest thing you’ve ever seen on a call? Weirder than diapers?

 

Are you required to be confidential - like follow HIPA just like any other medical

Person?

 

Thanks for sharing your experiences - I’m just curious after a recent car wreck where I was wearing a pad - but did not go to the hospital or anything.

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I was a firefighter/paramedic for years.    I have twice, if I recall, encountered a diaper on older people  In both cases we were called to patients who were in bed on our arrival.   One guy had a poopy diaper that fortunately fell off him when we were putting him on the stretcher.    We left it behind.    The other was a woman who had asked if we could step out while her daughter changed her prior to us transporting her.   We complied.

Unless there is something we really need to get at (like a bleeding artery or something), we don't tend to cut off clothes in the field.    They will do that in the hospitals (especially trauma centers).    The docs and nurses in the ER have pretty much seen everything.   When I was doing my training in the ER, there were a number of patients that came in with diapers.   No big thing.   We didn't say anything about it.

HIPAA didn't exist back then, but if the department attempts to collect money (ostensibly from the patient's insurance), they are covered entities under HIPAA.   Even without HIPAA most paramedics by law or just ethical practice would not disclose anything about their patients.

The most amusing time was we had a pair of teenage girls come in with real bad sunburn.   Now here I am only a few years older than they are and the doctor tells me to rub antibiotic ointment on all the affected areas.   I'm sure he thought it was a double win where I got to rub these girls and here the girls had this hansome young fireman to attend to their needs.

I had a patient come in with a stab wound in his shoulder and a 0.42%BAC.    He was a hoot.

I've come across obviously transgendered patients.

I did come across a guy who got chucked off his motorcycle and went bouncing down the highway at 60 MPH.   Worst road rash I ever saw.   Declined treatment.  Said he "does this all the time."

The one time I came close to inappropriate behavior with a patient was that I got called out to a kidney dialysis center for a woman with extremely low blood pressure.   Now we've got these things called MAST (Medical Anti-Shock Trousers) which essentially you put on the patient and pump up and it pushes the blood up into the torso and brain (think fighter pilot G-suit).    Of course, we roll on to the scene and I've got the airway kit and my IV box and the driver grabs the radio (we were still carrying the old biophones like you see on Emergency!) and I tell him to bring the MAST trousers with him.   We get in there and the patient is an elderly diabetic lady who has had both legs amputated.    My driver turns to me and says "where are you going to put these."    I had to work hard to avoid breaking out laughing.   I almost decked him after the call was over.

 

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Yeah, we never cut people's pants off prior to the hospital usually.   All the times I observed things, the patient was already undressed (usually because they were in bed but occasionally, they were sitting around either in some sort of night time attire or undressed when whatever it was happened to them).

I was working with an ER doc during training when she decided she needed to (urinary) cath a patient.   She asked if I wanted to do it and I declined.   While she's doing it she says "I guess you don't do this in the field."   I pointed out they could hold it until the got to the hospital.

 

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Yeah, we never cut people's pants off prior to the hospital usually.   All the times I observed things, the patient was already undressed (usually because they were in bed but occasionally, they were sitting around either in some sort of night time attire or undressed when whatever it was happened to them).

I was working with an ER doc during training when she decided she needed to (urinary) cath a patient.   She asked if I wanted to do it and I declined.   While she's doing it she says "I guess you don't do this in the field."   I pointed out they could hold it until the got to the hospital.
 


Oh that’s interesting, so if clothes are going to come off, it’s more likely to happen once at the hospital?
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Yep.   Like I said, If you were cut or had a broken bone, I may cut the affected area open to see it, but I can't recall ever completely removing someone's pants.    Most of my exam is done by palpitation.

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I know there are people in all types of professions who are AB or DL.  Still, if it was me needing a paramedic I would hope that all of them are professional and dedicated to their job and concentrate on getting me stable and to the hospital as quickly as they can.  I would hope they are not distracted by the fact I might be wearing a diaper or "laugh" about it.  Personally, I believe that paramedics are all great people who do their jobs quickly and as efficiently as possible.  I can't see a paramedic commenting much to the hospital staff that the person was wearing diapers.  Maybe that information is valid to staff, but I would expect them to convey vitals, what it was like when they got to the person, what they did to stabilize them and all that.  Maybe I'm wrong.  I just hope if I'm ever in need of a paramedic if wearing a diaper and get one who is AB or DL, that will not be any distraction at all to their work and hope they don't "Assume" or "React" any differently than they would with someone who wasn't wearing a diaper. 

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Whether a patient is wearing diapers or not is largely irrelevant.   If it's a trauma situation, the clothing is going anyhow.   In other situations, if they still have a diaper on, the staff will assume incontinence.   If there is no diaper on and the patient wets the bed or whatever, they'll deal with it (there's almost always chux under the patient anyhow.    Even normally continent patients lose it in an emergency situation).

 

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I haven’t had an issue with diapers yet, but I was in an auto accident while wearing panties. The ER staff is or was very professional and nothing was said.  They see it all. 

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I was wearing a nappy when i had some sort of siezure/blackout, and when i came to i was in the back of an ambulance, after the guy filled me in on what happened he said i would be taken to hospital. Before we got there i explained i was wearing a nappy but not for need ( back then i still had control ) and cool as a cuccumber he said he has seen alsorts and just gave me a disposal bag to put the nappy in before we got there, he was a very nice guy no negative comments or sniggers.

Maly.

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