You are having a late dinner at the base when a call comes in for response to a multi-vehicle crash. You and your partner arrive at the scene to see a 3-car head on collision caused by one of the cars driving the wrong way up the off-ramp of the Interstate highway. You head to the offending vehicle and attend to the driver who is just being extricated by the Fire Department team. He is slightly obtunded and has multiple facial lacerations and a bloody face. He keeps asking what happened in his slurred speech, and you see several beer cans on the floor of his car where the side of the car has been cut away. You hurriedly snap a few pictures of the cars and scene with your new cell phone that has the latest camera technology on it while your partner is starting an IV. The patient is then loaded into the ambulance and transported to the local trauma center.
Your patient is immediately attended to by the trauma team as other patients from the same incident are arriving with police escorts. You excitedly give your report to the attending ED doctor and show him the pictures of the scene and the damage to the cars. He thanks you for the information, and you and your partner prepare to leave.
A very normal event in the life of most busy paramedics, right?
Then the police officer approaches you and asks to see the photos, and you excitedly and proudly show him the extent of the crash. “Wow”, he says, “great pictures”. He then puts a small label on the phone, puts it into an evidence bag and tells you this is going to be held as useful evidence in the vehicular homicide case against the patient you attended. You vehemently protest him taking the phone, but to no avail. Now you begin to think about all the other photos that are on the phone/camera!! Uh-oh!! Your new girlfriend is going to be really mad when she finds out about this!!!
You must buy a new (and cheaper) phone, and business goes on as usual. Then 15 months later you get a letter from a lawyer. He requests all your records and your appearance at a deposition to answer multiple questions. You call the attorney who poses several questions he will want answered: Was your patient intoxicated? Did he have a concussion? What was his mental status? What did your pictures show? (The loss of the camera thing and the girlfriend again!) How did you go about starting the IV? Did you give any meds? And on and on.
After the call, you think—Who was this guy? Why did he want that information? Why does he need my medical records? OH CRAP!! Did I just violate HIPPA?
What should have I done?
Much of what you read in the above example is very routine, but some of it is not routine at all. We at The American Institute of Crime Scene Integrity (AICSI) realize that most first responders receive very little training in the details of how to go about providing the appropriate patient care at an incident like the one above, while at the same time disrupting the scene as little as possible. Many of the routine incidents that require medical attention also have the potential to be crime scenes. The importance of maintaining the integrity of the evidence at a crime scene is paramount!
Our goal at AICSI is to present useful, helpful information in a concise and interesting format to help prepare all first responders for any of the potential crime scenes where they might have to respond and work, and at the same time providing them with continuing education credits.