spenac

Way to many to continue this one. Just go search and join one of the existing.

Thats much better than in my part of the world. But I think under new guidelines EMS is going to see more insurance/medicaid/medicare denial of payments when it is determined that the patient could have safely gone by other means.

A quick search will find you several of this exact discussion.

You do not collect from the majority of 911 callers so in theory you make more money saying no to those that do not really need an ambulance. As to reputation head it off in advance by occasionally advertising when to call 911, and also alert the public that to be sure ambulances are available for their emergency that the Paramedics will at times say no to ambulance transport if it is determined after examination that it is not needed. This in time should stop the number of bogus calls, and save the service money. It also would free up ambulances for real emergencys. I know most get mad that I say we should deny transport, but when we act as taxis we encourage the abuse most systems see.

My way of thinking would be maintain BP above 90 systolic. By increasing BP to much could actually cause what ever was bleeding to start bleeding more. So I think they did right by limiting amount of fluid. There have been trauma studys that suggest our old wide open boluses may have done more harm than good by not allowing bleeding to clot or even cause internal bleeding to increase.

OK on your points: 1. ER only has to stabilize, which often when nothing life threatening is tell them this is not an emergency follow up with your doctor, I have seen that many times. The same can be done on scene, we can make examination and if no life threatening illnesses or injuries send them POV to the ER or to follow up with their doctor. 2. Never said deny transport to those with a life threatening illness or injury. But patient calls about wanting a ride to the hospital for a cheap lunch, sorry we should say no. The same could be said with the I sneezed last week and now at 0300 I can't sleep so I want you to drive me to get checked, sorry no way. 3. DNR does not mean no treatment so bad on them. Now some patients have no transport in their living will, so service can still not transport unless a person with power of attorney over rides patient when patient is unable to communicate.

So are there any laws that state that you must transport all callers?

Can you provide the state law that states that? Thanks.

I actually posted that as a topic and no one ever provided anything beyond service protocols that said anything like you call we haul. So I guess there is no law. In Texas we actually asked the state and were told it is up to the service and medical director if you can say no. My part time we say no all the time. My full time I get fired if I hint they don't need the ambulance.

It really is. I almost forgot that this site was about improving medical care and not about bashing everyone and wasting time in chat. Good job.

Our protocol calls for 2-6mg initial dose then titrate to relief. One service I can keep giving as long as patient needs it the other service up to a total of 20mg. If pain is severe and vitals are good I usuall start with 6mg and keep adding as needed.

We have several that still get used in disasters or if the hospital fails to return enough of them new fangled plastic ones.

Actions of fentanyl, morphine, ntg, in acute MI patients. When each should/should not be given, etc.

Medic was that sarcasm or have you missed much of the lastest studys?

Why limit the number of patients 10-13? Wouldn't it be more practical to debate whether 1 medic could properly care for 2 or more patients in the ambulance?

I can not believe someone says it takes to long to get a 12 lead. How idiotic!!!! By the time my partner has completed getting a manual BP I have all the leads in place, ask the patient to remain still, hit the button, darn, I'm done. By the time my partner walks to the drivers seat I know what needs done, and if I had a hospital with a cath lab I could direct the driver to divert to that location. I do not delay any treatment or transport time doing a complete exam. Maybe in some systems basics just go sit in the drivers seat and do not assist in getting vitals? Thats the only way doing a complete exam would cause a delay that I can see, but that would be just stupid so surely it does not happen.

I hope someone recognizes your name and turns it over to the girls that filed on you. Your unprofessional attitude is really not something to be proud of or to flaunt.

Actually you can still take NR with the short course. All it is is a test. Nothing more.

One and the same if you ask me. :twisted:

I know how did this get in here while we were argueing about important things like pron and toys? Thanks guys. As a paramedic student I have enjoyed reading this topic and it's links.

I do not you lousy Ny yankee. :wink:

Thats a workers comp claim if they can make it stick, so still out of my station. But again there is no way to reasonably accomadate someone that is a danger to their patients. Your primary job desciption is patient care. Now as to people on meds for mental illness such as depression I have worked with some that did their jobs properly and safely. But if they can not function when on their meds out they go, and you will not lose if he claims ADA.

Hmm lets see our Professional policy manual says no as we are not ff's.

Losers