Karim, even een zijweg, welke bevoegdheden etc hebben paramedics in dit soort gevallen, bij. laten afkruisen van rijbanen, sluiten van sneleweg ivm eigen veiligheid, gfedwongen opname/vervoer naar SEH bij medische problematiek (WGBO/BOPZ-gerelateerd bijv.bij TS-en, psychiatrisch patient met verdenking bacteriele meningitis etc.)
Ik moet zeggen dat dat vrij goed geregeld is, bij elk snelweg incident zijn er altijd voldoende traffic units aanwezig en wordt vaak sowieso al de rijbanen afgesloten en hoeven we daar niet eens meer om te vragen.
En ook bij gewone kleine aanrijdingen wordt de weg gewoon afgezet door traffic units, op beide uiteinden wordt 'n wagen neergezet die de rijbaan blokkeerd en iedere automobilist weet dat die dan gewoon om moet draaien.
En als een patient wiens leven echt in gevaar is en die dus echt mee naar 't ziekenhuis moet weigerd om te gaan krijgen we direct of een politiearts of een huisarts terplaatse die de patient "sectioned" waardoor hij/zij tegen zijn/haar wil meegenomen mag worden.
Wij mogen ze niet fysiek verwijderen als ze nog steeds weigeren maar daar is de politie dan weer voor, die sleuren de patient gewoon 't huis uit als 't moet, en als ze agressief zijn gaan ze gewoon in de boeien.
En dit kan allemaal heel snel gaan, vorige week nog naar 'n overdosis gegaan, jonge vrouw had 'n grote hoeveelheid tabletten genomen en weigerde mee te gaan, 'n half uur later was ze sectioned en had de politie haar in onze ambulance gezet.
Sectioning gebeurd onder The Mental Health Act 1983 :
The Mental Health Act, which was introduced in 1983, is intended to help doctors deal with patients who may have a psychiatric disorder.
Under the Act, patients can be sectioned or detained against their will and given treatment. Who can be 'sectioned' under the Mental Health Act 1983? People with different types of defined "mental disorder" can be admitted to hospital against their will under the Act.
These include those with "severe mental impairment", "psychopathic disorder" or "mental illness".
What happens during the sectioning process? A patient can be sectioned if they are perceived to be a threat to themselves or other people.
Generally, a patient can only be sectioned if two doctors and a social worker or a close relative of the patient believe it is necessary.
One of these doctors is usually a psychiatrist. The other is often a doctor who knows the patient well.
However, in an emergency one doctor's recommendation may be sufficient.
An approved social worker also has to be involved in the assessment, and has to agree that being sectioned is the best course of action for that patient.
The social worker then makes the application for a place in secure accommodation for the patient.
Sectioning a patient enables doctors to assess the extent of the patient's mental disorder and, if necessary, to administer treatment.
How long can patients be detained? If a patient is sectioned as an emergency case, then they are said to be detained under section 4 of the Mental Health Act.
This enables doctors to detain them for up to 72 hours.
If doctors believe that further assessment or treatment is necessary then the patient can be detained under section 2 of the Act.
This means that they can be admitted to hospital and detained for up to 28 days to undergo a full psychiatric assessment.
At the end of the 28-day period, if the medical recommendation is for the patient's stay in hospital to be extended, a further six months can be given under section 3 of the Act.
A patient can be discharged from hospital at any time if doctors believe they are no longer a threat to themselves or anyone else.
What rights does the patient have during this time? Some treatments can be given to people detained under various sections of the Act, even without their consent.
This is possible if the treatment is believed absolutely necessary to prevent the patient's condition deteriorating while they are in hospital.
Some more powerful treatments and operations, however, require an additional court order under the Act.
These include any operations which destroy brain tissue or aim to stop parts of the brain functioning - such as a lobotomy - and the surgical implantation of sex hormones in order to reduce the male sex drive.
