katbemeEMT-B

So, your patient doesn't sign ANYTHING? There is nothing for them to sign on the PCR? According to the HIPAA education we had to go through, they must be informed of their privacy rights and sign off that they were informed whether it is a separate form or on your PCR. You may want to check on that. It could be a lawsuit waiting to happen.

I work MotoX for ages 4 - 40+ and it's the same thing there. These bikers take falls that you would think could kill the average person but they stand up, pick up their bike, and keep going. It's what they are conditioned to do just like X-gamers are conditioned to take one hell of a hit or fall and get up and walk away. They may be hurting but they are going to refuse treatment. It's not cool to get carried out on a board.

I wasn't my patient but a medic was telling me about a patient he had who was in a bad wreck. He (the patient) was convinced he was dying. His wife met the ambualnce at the hospital. The man was in and out of consciousness and during a weak moment took his wife's hand and said, "Honey, I have to tell you something." Wife: "Yes dear" Husband: "You need to know that I cheated on you with your cousin" The wife looked at the medic and he told her it must be the medication. Well, months later this same medic ran into the guy (yep, that's right, he lived) only to find out that he had cheated on his wife and he was going to be a Daddy in a couple of months. The kicker to the story. It wasn't with just one cousin, it was two cousins on the same night. Now that's keeping it in the family.

What we have to remember as patient advocates (that's what we are), is that ANYTHING written on our PCR is private information and can only be shared with those people that are directly involved in the care of the patient, our boss, and state licensing board for monitoring purposes, and of course ourselves as the health care attendants that cared for the patient and wrote the report. Anyone else who wants to see this report must follow the steps outlined by HIPAA. It will then be determined if they have this right or not. This is a Federal Law and the ramifications are not worth divulging what should be kept to one's self. An example, the part-time job I work at uses the ToughBox for writing PCRs and file them online with I believe Image Trend software (don't take my word for it on the software program). Anyway, We have the ability to log on and pull up any PCR that has been written out of our station. Sounds great huh? It is as long as we have done the proper paper work and can provide a proper excuse for doing so. An employee recently did so to gain access on a patient for a friend. Well, said employee received a suspension and ALL employees were put on notice. This software tracks who accesses the reports and compares it to unauthorized entries. It's a great way to ensure that privacy is kept private.

Our HIPAA form that the patient or patient representative signs is a separate form from our PCR. It contains the patients name, address, and PCR number on the side of the form that is torn off for our records and the other side contains the legal information including how the patient can obtain his/her PCR information and their rights on the other side which is given to them. They never see the PCR. We have never had any problems with a patient or a patient representative refusing to sign. If they refuse to sign, note it on the HIPAA and also in your narrative.

Brent, thanks for posting this. It was excellent reading although it took awhile between calls. I love the different perspectives on the same call. I can also very much identify with Babs when she shows up to hug the kids. It brought tears to my eyes.

Okay, so I'm sure all here have heard about the I35 bridge that collapsed in Minneapolis, MN. It's about 60 miles from where I live. Well, I received some pictures in an email yesterday of the scene. As I viewed them I knew I had seen them before. It was deja vu. Pretty eerie. It sent chills down my spine. I also posted the pictures on the City (Minneapolis Responders Post). They are incredible.

My experience actually has to do with my son. When he was young and Cabbage Patch dolls were the thing, I searched forever to find one that had the same name as him. I finally did and he was over joyed. He used to spend time with my sister who cared for a mentally handicapped man. They would go fishing together, to the park, and just hang out. My son and Bob were very good friends. My son even renamed his doll Bob. A few years later my sister was transferred to a different day home and no longer had contact with Bob. Some time later, my son quit playing with his doll. I asked him about it and he told me Bob was dead. I dismissed it and went about my business. This went on for about two weeks until the day my son came up to me and asked why we can't bury little Bob like they did Big Bob. I told him Bob was fine. I called my sister who in turn made some phone calls only to find out that Big Bob had passed away two weeks earlier. When I asked my son how he knew about Big Bob he told me it was because Big Bob told him one night while he was sleeping. I just sat down and cried.

I would check with the school you will be attending. I'm assuming that because it is a 160 hour course it includes CPR. Most require CPR before admittance. Anatomy & physiology would be a good start for paramedicine (it would also be a great help for your basic). Also take some college English, Math, and Biology.

So, Friday we did a transfer from our local hospital to one of the metro hospitals. Our patient was an elderly male with an unstable IV site and several meds being infused. He was extremely anxious about the 60 mile ride in the ambulance even after a sedative was given. My partner and I took the time to visit with him and his family before we left only to find out that not only were we all if Czech heritage but he also knew my grandparents very well. He also knew my partners aunt and uncle. He seemed to be much more at ease knowing that we were almost like family. My partner, who was in the back with him, visited all the way up to the hospital which helped things go faster. Once we got him to his room and transferred care to the ICU we stood in the hall to get our things in order. His nurse came out and told me he wanted to see me. When I went into his room he put his arm around me and told me "you know, for a girl, you're a pretty damn good driver". I smiled, gave him a little squeeze and said, "thank you! I had to be careful, I had precious cargo." His smile was from ear to ear. It's the patients like this one that make me feel like I am making a difference. I like to help people and the ones that show they appreciate it make me want to continue what I do. They by far make up for the sh*t patients.

As has been stated, I think that I have brought something from every call that I have been on. Although I sometimes get irritated with the calls where the patient could have been transported by private vehicle, I also realize that these elderly people usually have no one else and more often than not are just looking for some one to say, "Hey, I care." I think the call that has really hit me the most was in my neighborhood. We were dispatched for a possible CVA. When we arrived on scene I realized that this was a long time friend of my ex-in-laws. I have also known this couple for many, many years. The patient was not presenting with stroke-like symptoms although she was having equilibrium problems. I got a call from her daughter the next day that she had been transferred to a specialty hospital and they diagnosed her with pancreatic cancer. She died three days later from mass amounts of blood clots throughout her body. It was definitely a tough loss.

We also use the clips. Not all the medics and emts like them so it makes it a convenient way to change things out before and after a shift. They just snap on and off. They easily slide up and down the leads for adjustment and then snap down to hold them in place. Ours were ordered with the monitors.

Where do I sign up? Oh yeah, do they serve coffee?

Yep, I guess I didn't explain it real well. Sorry. It does make it sound kind of funny. They fired him and have now implemented a no alcohol ten hours before shift policy. The crews used to respond from the bar. Gotta remember. At that time we were as small town as it gets. We have come a long way baby. We only have three members that were on at the same time as this idiot and two of them are retiring soon. We are all serious about our jobs and would not blink an eye at turning a fellow crew member in for violating the no alcohol policy. We remind each other that it's not just them at risk, but our patients and ourselves. Sorry for the confusion Dust. At least I made you laugh this morning.

It would be interesting to see some statistics as to whether BLS or ALS are involved in more accidents. Along with that would have to be included traffic flow (interstate, highway, city street, etc.), rural service, urban, or city, what type of service (private, hospital, or government owned), call volume, and education of those involved. This would be the only fair analysis. Maybe I will do something like like for one of my research papers when I go back to school this fall. I do know that I work for two separate services. The BLS service (205 calls/year) we only run hot MAYBE 5 times/year. It takes a pretty unstable patient for us to run to the hospital l/s. In the last year we ran l/s for an advanced CVA, kid that torched himself, cardiac arrest, seizing infant lasting longer than 5 minutes, massive overdose that we started transport as routine but she tanked on the way so we upgraded. Being a rural system with no ALS backup other than air care, we continually educate ourselves. I say we do it ourselves because we only get reimbursement for any education that is required to maintain our stated and national registry. The rest is at our expense. As far as accidents, we have only had one and that was quite a few years ago when a driver smashed up the truck (turned out he was well beyond drunk). They have now instituted regulations to avoid that and things have been great. I will say that in the my county and the neighboring county which we also service part of, there are two ALS services and five BLS services. The ALS services have a much higher crash rate than the BLS. I don't think it's a matter of ALS - vs - BLS, I believe it's demographics. They are in cities with a high traffic concentration and also service the interstate. Accidents are bound to happen. Hey Dust, thanks for the idea on a research paper. When I get it finished I will post my results.

We are actually dealing with a similar issue right now. Our service crosses into the neighboring county about 4 miles from a town that has just recently aquired an ALS truck to station there 8 - 10 hours a day. The dispatcher from the neighboring county will dispatch the ALS truck even though it is our PSA. The ALS truck has requested not to be dispatched as the service can have their license suspended by the State for entering our PSA without permission. Dispatch refuses to call us. It is now going to the State to be dealt with. What surprises me is that the ALS service is bringing the action against dispatch not us. I guess they are trying to protect their service.

We actually use a triage sheet on the BLS service that I work for. We record all info. that we will need not only to give to the ED but also to do our run report. When we are finished with our run report we shred it. It comes in really handy as we contact the hospital via phone en-route. If by chance we forgot to ask about something we will ask the patient while we have the ED on the phone. If he patient is unconscious, they have to wait until family gets there to answer. Never been a problem.

:coffee: :coffee2: Hi Lonestar! :coffee2: :coffee:

Terri called 911

in lime jello

My hope is that we don't ever have to worry about any needle sticks anymore. Let me say this much, if it happens to me, I WILL b*tch slap the medic that had the needle in his/her hand at the time. :twisted:

wax all over

So would it be ANY different if it were a courrier company and they had the accident? The only difference is they would be liable and they drive like sh*t. It falls under the same actions as if it were an organ being transported except they drive like raped apes to get there with that organ/s. I have seen that happen on more than one ocassion by the biggest service in our state. We take pride in our service and the fact that we are accident free and we intend to keep it that way. Yes, accidents happen but that is why we are taught to be proactive drivers not reactive drivers. We are always looking ahead for any dangers and approach everything with caution whether we have the right of way or not. As I stated, the driver MUST follow all traffic laws, stopping when required. Once the crew reaches the city limits the lights and sirens are turned off and they run routine. The main reason for the lights and sirens is to gain passage on the two lane road that is heavily traveled. It was something that was okayed through the State so apparently they agree that it is a neccessity. BTW: Not that I don't want to continue this...but we are getting off topic from Anthony's original post and I don't want to be a post stealer. You can pm me if you would like to. I have no problem with that.

I did not say we drive like idiots. utmost caution is used when driving. Speed limits are not broken. The lights and sirens are used to move traffic out of the way as the only access is a two lane road with lines of traffic that can be endless.. That doesn't mean the crew fly down the road faster than the speed of light. It also doesn't mean they fly through intersections like they are owners of the road. Even if we are on a run we approach every intersection with extreme caution and more often than not come to a complete stop before entering it. The reason for the life threat is that there is a high incident of heroin use and have been many reported cases of HIV. It is a small liberal community with a great outreach program. I will say that I only know of one needle stick that has taken place and that was before we got the retractables. BTW: The lab tech rides with to care for the sample. The crew has no contact with it and no, the supervisor has no vehicle other than his personal vehicle. We are a city owned, hospital operated service. We are not connected to the fire department other than rescue helps with extrication. We have four trucks and run two per shift. The other two sit in the garage not being used. We are not taking a unit out of service or crew as many of the crew live close by.

In our area, as I stated, there is one hospital that can do the rapid test. The blood draw is taken by ambulance to the hospital (not crew involved plus lab tech) and they wait for the results and bring them back to the ED. The reason for the ambulance personnel taking them is to ensure proper handling and to expedite transport as time is of the essence. Yes, they do go L & S. This is standard protocol for our area as a needle stick is considered a life threat. No results are EVER given over the phone from the lab to the ED. They do the initial test. Another a month later, six months after that, another six months later, and then yearly. They also test for HEP although it is required that we are inoculated for it. Anthony, I do hope all goes well for you. I will keep you in my thoughts and say some prayers for you. Oh yeah, at a minimum, slap the medic.