Ethics part 2: making good and right decisions in paramedic practice

02 August 2022
Volume 14 · Issue 8

An 85-year-old named Anne, who has known vestibular issues, tripped on a door threshold resulting in a floor time of 3 hours. Remarkably, there are only minor injuries with normal examination aside from an elevated heart rate of 96 beats per minute (bpm). Concerned about rhabdomyolysis due to floor time, the paramedic crew decides to convey her to the hospital to monitor her creatine kinase level.

Despite the creatine kinase and other blood tests being normal, Anne subsequently contracts pneumonia resulting in a month's stay in hospital. Upon her return home, Anne no longer feels she can leave home due to a combination of anxiety and loss of muscle mass from her experience.

The purpose of this scenario is two-fold. Firstly, paramedic practice is about managing uncertainty; the first paragraph likely makes logical sense, even when arguing an alternative decision such as staying at home with monitoring, it is difficult to ascertain what the consequence will be. However, with knowledge of the overall consequence, this decision may shift from being a good one to a bad one, with resultant reconsideration that the initial action may have in fact been the wrong one. Furthermore, what is the impact on the following elderly faller the paramedic encounters? Would that decision be the same or completely different?

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