ERDoc

All I can do is echo what Ruff said, patience. Out of curiosity is seniorcare the old transcare/metrocare? Alright, one more question, if you don't mind me asking what EMT number is NYS up to, like, what are the first 3 digits?

But the legal definition of medical negligence is when the medical practitioner fails to provide the care which is expected in each case thus resulting in injury or death of the patient. (http://definitions.uslegal.com/m/medical-negligence/) So, in this case there is no medical neglicence as nothing happened to the pt. Is it bad care, absolutely. Is it negligence, nope.

It always bothered me when my volley got full dress uniforms. I always avoided things that required wearing them, such as parades. I think this comes back to EMS being the lost, wayward child not knowing where they fit in. Is EMS public safety or is EMS part of the House of God? Does EMS want to function/act more like the cops/FFs or more like the ER? I tried to locate an MD/field physician/medical control badge on google images to make a bad joke, but I can't even find one. It seems to me, the more experience and/or education one has, the less they need all of the glitter telling people who they are. EDIT: I was able to find a website where I can make one. Opinions?

LOL, been there done that.

What is your theory systemet?

Sorry for the confusion. My "mental ruminating" comment was directed at Ruff and his comment about the housekeeper. There are a different set of rules/laws that affect things that happen on hospital property. As for your situation, it sounds like you and the pt are on the same page and headed in the right direction.

I will appologize for sticking up for the real field providers here and end it at that.

It's cool that you guys were able to arrange that for her. I think it brings up a great time for some mental ruminating. Let's make it a hypothetical cleaning person in a hypothetic hospital somewhere else. Is there an EMTALA mandate here?

I don't recall personally using profanity, but if I did I appologize. As for the youth programs, I am well aware of them as that is where I came from. We had youth members as young as 13, but couldn't ride the ambulance until 16 and never were we considered part of the minimum crew. All of us, including the 13y/os, knew their place. None of us ever thought we were some form of EMTs. I also came in contact with other youths from across the country during competitions and no one I ever met thought they were an EMT. So, either the OP is being horribly misinformed by his department putting himself, the pts and the department at risk or he is clueless and has delusions of grandeur putting himself, the pts and the department at risk. Looking more at what has been said, my guess is this is someone looking to stir the pot, which he/she has done pretty well. If the OP is being truthful, I hope he has read everything we have said, even if we have been mean and it hits him hard, for his sake. If he/she is really as gung-ho about EMS as he/she presents then there may be a great future ahead but it would be sad to see it ruined before it started because of either his/her ego or an inept department.

Istater, I agree that we can be pretty hard on new people here. But look at what he has said in the posts and this thread and tell me it doesn't raise some red flags. The local department has trained him in first aid, but yet he claims to be responding to scenes as an EMT. He even stated he has to wait 4 years to take the exam. What state allows you to be an EMT without taking the exam? I hope he is not identifying himself to pts as an EMT. He states that the state issued the card. But then he says he is nationally registered (we'll assume that he doesn't mean NREMT). He has been asked which state several times and has failed to answer. Which state issues certification cards to people who have not taken the exam and allows them to be nationally registered? There are several states that won't even recognize NREMT, much less a state issued card without a reciprocity agreement. I can tell you that even if he had a card and taken a test in whatever state he is from, NY state would not recognize it. No one under 18 is allowed to be an EMT. I know NY isn't the mecca of EMS, but I use it as an example since it is the one I am most familiar with. They wouldn't even let him be a CFR. When has the government ever changed the rules for anyone other than a politician? When it walks like a duck, sounds like a duck and smells like crap, it's probably crap. EDIT: Posted at the same time as istater. I don't think anyone on here has a problem helping someone with questions. The first 2 posts after the OP were non judgemental and friendly. I was the first one to call BS once he/she started misrepresenting himself. You are right, there are people that don't know everything about their position, but it's pretty clear whether you are or are not an EMT even at 14y/o.

And who is the medical director that allows you to do this? Every EMT/paramedic in the US functions under the license of a physician. What physician is allowing a 14y/o to jeopardize their license? On that note, what insurance company is allowing you to put their profits at risk by covering your malpractice? You are also changing your story. You originally said you were nationally registered, now you are saying that you are eligible to be called up by the feds. Which is it? As for your fellow emergency responders not understanding the context of your situation, we understand it fully. You are FOS. We have plenty of rural/woodland/wildland people here and every one of them can tell you your story is crap. You still have not directly answered the questions posed to you by me and triemal.

1. What state do you live in? 2. How can your govt issue you a card saying you are certified if you have not completed the testing? 3. Do you seriously expect us to believe you are NREMT certified? They require you to be 18y/o, nice try though.

No, you have responded to a couple of calls as a citizen who has some knowledge of first aid and have a few friends who are EMTs. You ARE NOT an EMT until you have a card from the state saying you are and approval from your medical director. Thinking anything else is dangerous and will get you and your pts in trouble. You seem eager, which is good, but don't let it end your career before it has even started.

It's hard to agree or disagree with such a vague statement. It sounds to me like you are following your trauma protocols.

OK, so again I ask. Do you fly every trip and fall who hits their head? According to your logic, your local hospital cannot handle them and they need to go to a trauma center because they might have something bad going on.

OK, so you obviously missed the part where we all agreed that there needs to be a family meeting and a care plan developed with all of the appropriate parties. Try to stay with us.

In every case you listed you know the diagnosis. You are completely missing the point and I don't think you will ever see it especially when you start using cliches. What do you think the Level 1 whatever center is going to do for someone who fell and hit their head? They are going to do a CT scan and if negative (assuming no other confounding issues) send them home. What is your local hospital going to do? Same thing. Again, you are using unnecessary resources for something that doesn't exist. Do you fly all of your fall/head injuries to the level 1 trauma center? You should be since they might have something that your local hospital can't handle. Do you fly all of your possible kidney stones to the tertiary care center because your local hospital doesn't have urology? Your thinking is seriously flawed. Do you take that 20 weeker to your local hospital that does have OB? If so, why? 20 weeks needs to go where you have MFM and NICU.

You could be right, especially since there are no schools anywhere that have care plans for their students that don't involve calling 911.

Most ERs do not have access to MRIs, but almost every one has a CT scanner. If you have tPA and a CT scanner, then yes you are set up to handle a stroke, at least in the initial stages. I do it in my neck of the woods all of the time. The few that get tPA get transferred to the tertiary care center, the ones that don't get admitted locally. I also have STEMIs in my neck of the woods without a cath lab because EMS goes to the closest facility with all STEMIs. The cath lab is about 45 min away by ground. I agree with you that we are no the best place for them to go but that is protocol. They don't even take the pt off their stretcher. When you know what is wrong and there is a hospital that can take care of it, you should go there. The problem with head injuries and strokes is that you don't know what is wrong until you obtain imaging (let me guess we should treat the pt and not the machine). A very small portion of head injury pts (especially the kind in this scenario) need a trauma team/neurosurgeon, most go home with a negative scan assuming one is done at all. Why use unnecessary resources?

You won't get any arguments from me, as I agree with everything you said. Let's also throw some of that money at community/high school CPR training so that good CPR can be performed until the cavalry gets there.

I wouldn't consider 58y/o as elderly (but I may be biased since my 40th birthday is less than a year away). Although the meds are not listed, it is possible that he is on Plavix, et al, given the stroke history. The staff states he is a little "disoriented", so can we truly clear his c-spine clinically? I guess it depends on our personal exam. I don't see a need for a stroke or trauma center. This is something that can easily be worked up in most ERs, although I question the one the pt was originally at. To answer the OPs original questions, I do not think nitro is indicated and I would hold aspirin until the head CT is clear.

I disagree. There are plenty of places that have care plans for their students, especially when they are specialized schools that deal with people with chronic diseases. I completely agree that the emergency contact should be notified each time, but good luck getting a recorded line at a school.

It's all about ROI. There is no return on health care, it's all about spending/losing money. A sports stadium will pay itself off in no time. If you were a politician looking to get reelected, where would you put your money?

I would say just the opposite Mikey. All of the studies have shown one thing, although not explicitly. Time is one of the most important factors. We could develop the miracle drug that will convert everyone into a sinus rhythm, but if we can't to them in time, it is still useless.