Administration and Leadership, Columns

Pro Bono: Responsibility for Patient Belongings in a Disaster

Issue 9 and Volume 39.

When disaster strikes, the EMS provider’s first duty and priority is to aid those in need of treatment and transport. But with the responsibility for patient care may come some degree of responsibility for the patient’s belongings. Patients place huge personal value on their personal items and belongings, and we owe it to them to make sure they’re taken care of wherever possible. That’s part of treating the patient with respect and dignity—the true mark of a professional EMS provider.First and foremost, EMS providers must protect themselves. Scene safety—including safety of the crew—is paramount. Providers can be of no use to anyone if they’re injured or incapacitated by a violent patient. Put another way, nothing in the applicable standards of care requires providers to sacrifice their lives, health or well-being for the benefit of a patient.

When a hospital or other facility is being evacuated, the EMS crew should inventory the patient’s belongings to be transported with the patient, if feasible. The belongings should be secured in a bag and labeled with the patient’s name and any other pertinent information. The patient or a representative of the facility should sign the inventory of belongings when leaving the facility. Upon arrival at the destination, the belongings should again be inventoried and a signature obtained from the patient or a facility representative acknowledging receipt of the belongings. The inventory and acknowledgement should be kept on file with the record of the transport.

When responding to a mass casualty incident or other public disaster, the same triage and tracking mechanism used for patients should be used for patient belongings. If possible, secure the belongings in a bag labeled with the patient’s name or triage ID and keep the belongings with the patient.

In the event that a patient has a weapon or other potentially dangerous item, EMS crews shouldn’t handle it unless absolutely necessary to prevent harm to others. Law enforcement officials should be alerted immediately and the item should be secured so the patient can be treated and transported without endangering the safety of the EMS crew.

When assisting with an evacuation or transport from a patient’s home during a disaster, a patient may wish to bring many belongings with them. While patients may be upset about leaving belongings behind, the first priority of the EMS crew must be the patient’s health and safety. Encourage patients to bring only belongings that are absolutely necessary and can be easily kept with the patient during the transport. As with a facility evacuation, the patient’s belongings should be inventoried, bagged and labeled, and the patient should sign an acknowledgement both prior to departure and upon arrival.

Under most circumstances, an animal can’t be transported in an ambulance and wouldn’t be accepted at a hospital or shelter. Of course, it may be appropriate to transport the patient with a service animal if it’s possible under the circumstances and patient care or the safety of the crew isn’t compromised. The EMS crew may also attempt to coordinate with animal control and other enforcement agencies to ensure the safety of the patient’s pet. The crew may also attempt to secure the animal in a safe place in the home with food and water before transporting the patient.

During transport, the patient’s personal belongings should be secured in a location where the contents aren’t exposed to contamination risks and don’t compromise crew member’s performance or safety. The bottom line is that—at all times—the care of the patient and the patient’s safety should be the top priority. EMS providers should exercise “reasonable care” in protecting and preserving important patient belongings when doing so doesn’t interfere with patient care. Doing so will help to protect the provider and agency from liability, but it’s also good customer service!