AMT shares protocol following the death of David Smith

Active Life

PEORIA, Ill. — There are still unanswered questions after a Peoria man died in police custody.

David Smith, 33 of Peoria, died after Peoria Police took him into custody on Oct. 28. Officers found Smith, an armed robbery suspect, unconscious in a yard in the 300 block of S. Saratoga St.

Advanced Medical Transport evaluated him on the scene then released him to police, who said they later found him unconscious again. Smith was transported and pronounced dead at a hospital the next day.

Advanced Medical Transport, or AMT, has to follow procedure when responding to a medical emergency. The company would not discuss the ongoing investigation into Smith’s death, but shared details about its protocol.

Lauren Emanuelson, AMT critical care medic, said the response depends on the situation at the scene. The goal is to identify the patient and the complaint.

If the patient refuses or implies that they do not want to be hospitalized, paramedics conduct a “capacity assessment.” This includes gathering background information on the patient, monitoring his or her ability to communicate and checking for alcohol consumption.

There are signs medical officials look for when determining if a patient is in the right state of mind.

“Subjectively you’re going to be looking at how a patient appears, are they able to hold their body upright?” said Emanuelson. “Are they able to engage in eye-contact? Are they able to verbalize with you?”

Upon receiving that information, medics assess the possible risk of the patient not being hospitalized.

Emanuelson said if the patient does not have to capacity to make a decision about whether to choose treatment, paramedics fall under the provision of “implied consent.” This means paramedics automatically transport the patient to the hospital with the assumption any reasonable patient would want treatment.

“When you call for an ambulance, if it was concerning enough to call it’s probably concerning enough to get evaluated for a definitive diagnosis,” she said.

However, patients maintain the right to sign a refusal form. This document informs the patient of the risks of refusing care and hopefully allows him or her to make an informed decision. The paperwork requires three signatures: the patient, the Peoria Area EMS provider on scene and an adult witness.

If the patient does not sign the refusal form, a medical power of attorney can sign for them. In the case of children, a parent may sign.

According to Emanuelson, the witness can be any adult capable of signing who watched the process of the patient declining treatment. In Peoria Area EMS protocol, it is preferential to attain a signature from a police officer on the scene. If police are unavailable, paramedics will seek another family member or adult bystander.

She adds that paramedics try to decipher whether a patient isn’t giving an answer because they physically cannot or choose not to.

Regardless, Emanuelson said the safest bet is taking the patient to the hospital if they are willing to go.

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