You are dispatched for an overdose. You find a 48-year-old homeless man sitting on a park bench, eyes closed, nodding forward. You give him a little shake and he opens his eyes and looks up at you. You ask him if he is okay and he says he is all right. He says he took a pill a friend gave him earlier and it made him drowsy. Next to him you see a cat, eating from a small tin of cat food. He gradually becomes more alert as you talk with him. You think he should go to the hospital. You suspect he took an opioid and that some passerby gave him naloxone as there is a used naloxone vial under the bench that doesn’t look like it has been there forever. The man has a pushcart with what could be all his belongings. The sun is heading toward the horizon and there is chill in the air. He says he was hoping to get a bus to maybe go stay with his sister who lives a half hour to the north, but he thinks he missed the last bus that runs that route. You ask him about staying in one of the nearby shelters, but he says the shelter won’t let him stay there with the cat. The ER won’t take him either with the cat, your partner tells you. A crew brought a patient in with an animal last week and the hospital called a supervisor on them, he says. You nod, but don’t respond.
“Is your cat a service cat?” you ask the man.
He looks at you blankly.
“Is he a support cat?”
“Yes,” the man says. “I have papers somewhere here.” He starts digging in his cart, which looks like a hoarder’s house packed into a cart.
“That’s okay,” I said. “I can see you have a bond.”
You tell your partner, we are obligated to take service animals. If the cat is not a service animal, but just an emotional support animal, you aren’t required to transport, but it is cold out and he doesn’t have anywhere to stay, and he does seem to be post overdose. They won’t like it, your partner says. If he was having a MI right now, you say, we would take the cat, right? Hospital be damned.”
“Of course,” your partner says.
You talk with the man some more. He says he is feeling better. He doesn’t want to go to the hospital. What’s his plan? He has a friend who lives down the street. He may see if he can stay there. The cat is in his lap now. He is scratching it under its neck and the car is rubbing up against him. He puts the cat in a little gym bag that is set on top of his shopping cart. He gets up slowly and latches on to his cart with two hands and starts pushing, heading off down the street.
Hospital confrontation avoided.
I have transported animals before. From service animals with their special uniforms announcing themselves to yes, cats. At the hospital, if it’s a service animal, the animal can stay in the room with the patient. If it’s a cat, the hospital sometimes puts them in an infection control room. I’ve gotten looks of displeasure, but no one has ever truly yelled at me. Hospitals are used to adapting on the fly. Obviously, if you can get someone on the scene to take the animal and it is okay with the owner, that is always best, but sometimes the circumstances are what they are. If he had really needed to go and wouldn’t go without his cat, I would hope no one would have denied him rapid transport just on account of his cat.
Our state, unlike some others, doesn’t have a specific protocol on how to handle animals. Here’s Chicago’s protocol.
EMS TRANSPORT OF SERVICE AND SUPPORT ANIMALS
It includes this passage about support animals.
There is no federal legal obligation to allow emotional support dogs to accompany a patient in the ambulance. The decision to allow the patient and dog to remain together is based on the patient’s need and ability to control the animal, as well as the crew’s ability to transport the dog safely.
If the patient needs the animal and can control it, and you can transport the animal safely, do what you need to do. In the end, fall back on common sense and do what is right for your patient.