spenac

Doesn't peeing on your feet stop jungle rot?

Wow elect yor Lt's? Bad idea. Those with rank should be hired not elected.

Vent I think you are missing the point. Any untrained person can do what is being talked about here and go give these people a little attention. If anything is noticed that needs more then get that ball rolling. If noone stops by that ball never gets rolling. So hey stop by say hi. Ask about the kids, grandkids etc and make a blue hairs day.

LOL. More likely we load up stub toe and get in a wreck and stub toe dies from wreck than that. Then instead of 1 lawsuit there are many. Also crotch if patient decides they do not want to go their signing a refusal is not unethical. They decided. Now if we deny transport then need different statement signed.

I actually think if it were limited to a quick visit and no medical care that there should be no worrys. IMHO even if you did a BP it should still not matter. Some patients that call just for attention might be stopped. They might even break out coffee and cookies. Sorry all the fears of a lawsuit for doing a good deed are way blown out. I do think it should be only one or 2 houses a day though, especially if you work 24's so that you can get some rest ans be fresh. I still have not found the other thread where they discussed the number of calls that they quit getting after frequent fliers got attn. It maybe monday before I'm back on here to so maybe somebody else will find it.

But Ruff if I appplied you would find out I am a 14 year old kid that just dreams of being in EMS rather than the Paragod wantabe that I project myself as. :shock: If the economy should hit my service I might have to give you a holler, but looks like the budget and 10% pay raise are locked in for 2009, in fact we will be hiring more people to staff one more ambulance soon. Of course I don't have a passport so might not be able to go that far north. :wink:

I laughed but maybe I should cry as that is probably really happening.

Well it is a definite fact that in the NFL they used a door to carry a player off the field many years ago. Now the NFL is one of the forefront in emergency trauma medicine.

I really think we are talking about just doing public relations by going and visiting and maybe even doing a chore for people in the community. It does not sound like you are doing anything that is medical. If while there they ask for BP check you might need a patient contact form but otherwise I think we are not there under Ruffs description as a Medical Professional, but are there as a public relations officer.

Speedy some common sense comes into play. Most callers will still be transported if they want to go. Now in saying that the guy that stubs his toe, even if broken toe does not need an ambulance 99% of the time, and the 1% of they time they would need the ambulance their other vitals would tell you they need to go. The caller that you get that just wants a ride for lunch or the store near the hospital and even tells you that is what they want. They do not need to go. The caller that can't sleep so decides they want to be checked to see if they have a cold since they sneezed once last week does not need to go. I refuse to be a complete taxi. Yes often the illnesses and injuries we transport could safely have gone other means but again any doubt you go ahead and offer transport. Guy has indigestion after eating spicy food, maybe even though 12 lead is good might be in early stage of heart attack so you transport. There are no 100% in medicine, no matter what level you practice at. It is time that EMS wake up and start treating people but also sending them to other places besides ER and by other means than ambulances when it is not an emergency. And if they say they have no other means to get there sorry to sound calloused but not my problem, they need to get a friend or pay a real taxi to take them to the store by the hospital. As to what they call emergency and what we should call emergency means we educate the patients and at times that education should include saying no. If we talk till blue in the face about what really needs an ambulance and then still transport the only thing they learned is to call us for a free ride.

But the question he asked was if you deny transport is it ethical to just have them sign refusal. And again with proper education there is no reason that we should not deny transport to those that do not need it. Thankfully one of my medical directors allows that. As to the refusal when we deny them would be fraud. If we deny we must have them sign that they understand that we are denying them transport as ambulance is not needed and that they can go to doctor by other means. We only get a refusal signed if patient refuses our offers of transport or treatment.

Right. :wink:

If you deny transport to a patient that does not need ambulance transport, which all services should do, you should have a line for them to sign that explains that EMS deemed that they did not need transport by ambulance. It is bull that we continue to act as a taxi. Examine your patient, give treatment as needed, and transport if needed. If they are not in need of the ambulance say no and explain alternative ways they could get to the doctor. Quit clogging the emergency system with non emergencys.

Seems like something like this was posted a few months back. And the news articles that were quoted if I recall correctly mentioned how it actually did cut back on the 911 calls. But I do not recall all the details. If I run across it I will post the link. As to causing people to call more often I think it could actually maybe give them the attention when it is more convenient and stop the calls. A medic I work with said where he used to work they would do little things for the frequent fliers that would help the patient but also make their job easier if they still got called. He mentioned one example where the patient was a frequent faller and the house had steep steps so the service built a nice big porch with a gentle slope ramp. It served the purpose of helping eliminate many falls for the patient and made their job easier when they did have to go pick up the patient. The money saved by eliminating one call to that house probably covered the cost of the materials they used to build it, plus it eliminated an obstacle that could have led to injury of a medic. So I guess it might not be a bad idea to consider.

Good point. And your right alot of ambulance chasers look for that little details to make those involved pay.

Not a bad idea.

Any new research about this subject?

So all those rolling codes people do are illegal. Cool now no more excuses for a rolling code.

Wow a very profound statement especially for a FF/EMT. :wink: Really though Lone is right professional is professional. Be a professional or get out. This is not a social club.

You are right these actions are unprofessional as they can actually even cause harm to patients. I agree with Vent this whole discussion is unprofessional.

A deciding factor that should come in to play in a companys deciding how many hours to allow crews to work is there a reasonable expectation of getting plenty of rest to stay sharp. In a busy service 8 hours may be to much. In other areas 14 straight 24's could be no problem. So I am against blanket rules, laws, etc setting a maximum. Legally whose fault is it if a mistake occurs? The one that makes the mistake. A person stays out all night having fun with friends and then comes in to do an 8 hour shift and screws up in my personal opinion is much more responsible for the mistake though than someone who makes a mistake at the end of a non stop 24 hour shift. Why? Because work caused the fatigue in the latter. The persons stupidity in the 8 hour worker caused the mistake and they should in my opinion as a juror should get harsher punishment.

My advice is don't kill anybody!!!!!!!!!!!!!!!!!!!! :wink: Relax and always act calm no matter how scared you are.

Over 20 years ago I was able to break my lease after I explained to the manager honestly what was going on. They even refunded my full deposit. Also my depend if they have hard time filling slots.

Great answer. The more in depth we understand, the more respect our calls in the field will get from the ER's. If we call in and say the line goes up and down and may be a little wide but not sure and the humps are maybe not same shape and I don't know if this matters but in one spot the lines are real tall and in another they are real low, Not going to get much respect. I'm not a 12 lead expert yet but I'm getting there.

IMHO patient might require RSI to deal with possible airway compromise. Compromise actually could be swelling and by secretions. RSI will take patient out of pain and also protect airway.