Today’s correspondent is a Victorian paramedic who has:

… a question about seat belts for your blog. 

There are already several articles about seat belts, and what the legislation says about them in emergency vehicles. But my question is around standards of care and our registration now that we’re registered healthcare professionals. 

Would placing seatbelts on a patient be considered a minimum standard of care? And is it malpractice or medical neglect if we don’t put seat belts on patients without appropriate extenuating circumstances? Could this affect our AHPRA registration? 

There are indeed many posts about seat belts – see https://australianemergencylaw.com/?s=seat+belts

The issue for paramedics is whether any conduct constitutes unsatisfactory professional performance or unprofessional conduct (both defined in the Health Practitioner Regulation National Law cl 5 (as applied in Victoria by the Health Practitioner Regulation National Law (Victoria) Act 2009 (Vic)).  Unsatisfactory professional performance is behaviour that demonstrates that:

… the knowledge, skill or judgment possessed, or care exercised by, the practitioner in the practice of the health profession in which the practitioner is registered is below the standard reasonably expected of a health practitioner of an equivalent level of training or experience.

Unprofessional conduct is:

…  professional conduct that is of a lesser standard than that which might reasonably be expected of the health practitioner by the public or the practitioner’s professional peers, and includes— … (c)the conviction of the practitioner for an offence under another Act, the nature of which may affect the practitioner’s suitability to continue to practise the profession.

It is an offence for a driver to not wear a seat belt (Road Safety Road Rules 2017 (Vic) r 264) or to fail to ensure a passenger wears a seatbelt (r 264A).  As noted in earlier posts (see for example Seat belts and passengers in emergency vehicles (May 23, 2022)) there are exemptions for people traveling in an ambulance (see r 267C).  

The question then is whether securing a seat belt, or not, represents ‘practice of the health profession’ or ‘professional conduct’.  Fitting seat belts is not a core paramedic skill but paramedics do owe a duty of care to their patients and their patient may be quite vulnerable eg a child or the unconscious. 

It’s a question where the answer would be the classis ‘it depends’.  If the paramedic consistently refused to put seat belts on all patients because they just ‘couldn’t be bothered’ and were cautioned about that by supervisors or peers, then continued failure may represent inappropriate skill or judgment in the delivery of patient care.  If, on the other hand, a paramedic did not apply a seat belt because they were too busy providing life saving care then it will be a non-issue.

I cannot imagine it is anything the Paramedicine board would see as ‘professional conduct’ at least not in most circumstances.  The best way to answer to question is to look at the definitions of unsatisfactory professional performance and unprofessional conduct and ask yourself whether you think this conduct could, and in what circumstances would, fall within either definition.

This blog is made possible with generous financial support from the Australasian College of Paramedicine, the Australian Paramedics Association (NSW), Natural Hazards Research Australia, NSW Rural Fire Service Association and the NSW SES Volunteers Association. I am responsible for the content in this post including any errors or omissions. Any opinions expressed are mine, and do not necessarily reflect the opinion or understanding of the donors.