spenac

I am so glad I do not work for a mother may I system. That must suck to always call to do what needs doing.

I've heard that to, go figure.

There has also been speculation that some of the so called cured individuals actually never had aids. Until there are larger numbers of cures it is still conceivable that some were not diagnosed correctly to begin with.

JVD as well as trach deviation are late signs. If you let your patient get to that point you have missed something during a proper exam.

Yellow, Blue, Green, Tiger stripe

Maybe we all move to Canada when we get sick?

Heres one thats never been used before: Comfortably Numb - Pink Floyd

That or the person they claimed to cure was actually not infected. Don't hold your breath.

Wow I'll take that it is sure to quantify my life. Leave worn out stinky bates side zip medic boots.

One of them should have placed a foot on the birds body, then reached down and twisted the birds head off. Very easy and the bird no longer suffers.

Would you transport the guy in the scenario that started the following topic? Keep in mind I even included an ask God card to be 100% sure that it was not a mental or physical problem. http://www.emtcity.com/phpBB2/viewtopic.ph...18&start=60

Since so many are upset that I suggest we decide in the field to deny transport I bring this back to life.

Crotch the ER has similar numbers of sending patients home that later die or return and end up in IC. Again no matter how many tests you run you really can not be 100% sure any patient will make another 24 hours. It makes me sad that so many seem to be content being taxi drivers. I am not saying deny every patient, but why in the hell would I drive someone to the hospital for lunch, to get their stubbed toe checked, that sneezed once last week, I could go on and on with a list that after you exam would be clear there is no need for an ambulance and honestly no need for an ER. As long as we keep the you call we hall mentality we are encouraging people to abuse us and the ER's. Honestly this is less risky than field selective spinal immobilazation that many services are implementing.

I love when you ask them to rate the pain 10 worst ever, 1 none and they say 10. Then by the time you unlock the happy meds they have fallen sound asleep. Then you call the hospital patient rates pain 10 of 10 and is currently resting comfortably. Hospital asks how much and what type pain meds have been given. I reply none. They respond what was pain rated at again? 10 of 10. What is patient doing now? Sleeping. UMMM OK take them to triage on arrival. Maybe I am such a boring person I just put them to sleep with my presence.

Hey Dust keep in mind the Canadians are smarter than us. Just saying. :twisted: And have I told all of you I hate you yet? I am so jealous. Wish I had not gotten hurt as then I could afford to take off, butas it is gotta try and work every shift I can to get caught up. Have fun.

I see more where you are coming from now. I have a medical director that expects us to be up to date. We do have criteria that would eliminate us not taking a patient that has problems as you describe. There is no 100% way of knowing a person will not die within 24 even with all the resources at the best hospital in the world. So the fact that a person dies 24 hours after being seen would not in it self lead to you losing a lawsuit. Now I agree education is lacking in many schools and in many services it seems. We really need to start a new topic because we are hijacking my thread. I really want to see any federal or state laws that say you have no choice but to transport all that ask.

I hate all of you. It's not fair. I want to go. Guys have fun, wish I could be there, sounds like I might learn 1 or 2 things and maybe even teach Doczilla a few things from a real medical professional. :shock: :twisted: Doczilla thanks for including those of us here for a great educational experience. Maybe next time.

I disagree with you about negligence. A service medical director establishes reasonable criteria for denying transport. As long as you work within that criteria you have nothing to fear. Again if you live in fear of being sued get out because you will do more harm by omission than by being aggressive. You can not be aggressive if you live in fear of being sued. Now why is it shady to provide appropriate medical care for an injury or illness and send them on their way rather than costing patient money that could be better used elsewhere and also taking an ambulance out of service when it should be available for a real emergency? Again we are not taxis, we are mobile emergency rooms. Be a medical professional or get out. I am so grateful I have such a forward thinking medical director at my now part time job. Wish I could get my current full time job medical director to allow us to get more aggressive in treating.

UMSTUDENT as long as you do your job right and document your findings it would be hard to lose a lawsuit as you describe. they have to prove you were negligent, that you caused harm. I work in one system where we treat and then deny transport. We administer meds such as nubain, promethazine, etc, then let them go on their own. If you live in fear of being sued you really need out of this profession. If you do your job right including denying patients when you can document that there was no need for an ambulance transport you will be just fine. We are not taxis and if we do not all start pushing for protocol changes though thats all we will be.

Each patient is different, treat that patient. Based on the initial info you gave I still say they did right maintaining BP above 90 systolic. Now were other s/s present that would change that, hard to say not actually having been there. You will be a fine medic, just get your confidence level up. People can sense if you are insecure and that makes your job harder. No matter how scared act like you know what you are doing and that you are in control.

That would be impossible. Every patient would have to examined. They would have to meet a set of criteria. Guy calls 911 wants a ride to lunch. You would have to check him out physically and mentally before saying no. The person with a broken arm, what type of break, good circulation, is pain severe, etc. OB active labor transport them all because they change to darn fast. Guy coughing, skin color, O2 sats, lung sounds, edema. This is not about shirking the job this is about doing the job right and the job is not taxi driver. You can not say any one illness/injury will not be transported, it would be patient by patient basis. Meet the criteria for saying no say no. If you have any doubts despite the checklist saying you can say no you transport any way.

If improved patient care happens then fine if some cuts to number of ambulances out there. I do not think it is right that tax payers are supporting taxis. I agree that 90%+ of EMS transports could be done by other means safely. But as we are going to err on the side of caution, we would have to presume that we still will transport 75% of callers as we do not have x-rays, etc ( now when we get ultrasounds, etc that may drop more ) to rule out everything. Just as ER docs even when they know it is nothing will still err on the side of caution on some patients that really should be kicked out and sent to local doc. In my area we are severely understaffed and no work force to replenish with so actually no cut backs. But in areas that have ambulances and fire trucks on every corner there should be cut backs. It is wrong to justify fire numbers with ambulance runs, and it is wrong to justify ambulances with BS transports. Educate your Paramedics, develope a check list, etc, and only transport serious illness or injuries.

But when we cave in and transport the sick but non emergent patients we become no more than a taxi. Educate the public that Paramedics will examine then if not deemed emergent will not transport. We are medical professionals, not taxi drivers. Doug your law quote does show we must show up, treat or transport if needed, so there is still an out. I do not see the law saying you must transport all callers. It is time that as PreHospital Medical Professionals we start acting as such. When, IF, we ever get our act together we need laws and protocols clearly stating that we can say no. It is wrong that we continue to help the abuse of the emergency system.

Thats a policy not a state law.

Just 2 of way too many. http://www.emtcity.com/phpBB2/viewtopic.ph...light=ems+music http://www.emtcity.com/phpBB2/viewtopic.ph...light=ems+music