Just Plain Ruff

Flaming, the reason why it's sleazy or creepy is that of all the people in the world out there the medic in question chose to try to date a patient that he took care of. It's one thing to go and buy the medic a drink like you have had done, it's another to try to ask out a former patient. I'll challenge you with a this. Go to your boss, ask him/her what the agencies stance is on a medic dating a former patient. Then go ask them this follow up question. What would happen if that medic had gotten the patients phone number from the hospital face sheet and contacted the patient via that information and she/he made a complaint. I can bet your agency would not like the fine that the office of Civil rights would levy against the service for a blatant disregard and breaking of Hipaa. Last time I checked an individual violation can result in a 25K fine against the service. I have a friend who is a multi-millionaire because he lodged a hipaa complaint against his former employer. I'm not saying that it doesnt' happen every day but what I'm saying is that if someone is that hard up that they have to go after a former patient to try to date them then that's just messed up. I await your answer to the challenge question above.

Ok, so let's go one step further on the meter what happens if they are dating casually, and the medic responds to her medical emergency. Can he no longer date her? I also call this sleazy but I've been tempted to get to know a former patient or two but that was way before I was married. I always felt it was not the right thing to do so I never acted on it.

Hells bells, I agree that she was best served by our ambulance in getting her home but this did indeed tie up one of only two ambulances in our county. No other calls came out that night. I also treated her with utmost respect and was the one who said to put her in the ambulance and drive her home. I felt it was BS because she did have a husband who could have come got her but he was so pissed at her he said "tell her to get her own fucking ride home and maybe she won't do this again". It took us less than 30 minutes from call start to finish and made a lifelong (at least 3 more weeks) fan of EMS here where I worked.

it is a great book but I thought the same thing that ER Doc did. The last chapter is a pretty good one and it ties most of everything together.

Just why are you reaching down to your ass trying to grab a hair, do we need to know something?

So what if the patient came to him while he was on shift. The patient made the contact not the other way around? Is it still wrong? Taking info from the face sheet is NOT COOL and it is creepy and it is a violation of HIPAA since you are using that information for personal gain not medical treatment. During patient care you had a need to know. After patient care was over you had no need to know so it's wrong.

so the person who drives their wheelchair 2 miles and the battery runs out and all they need is a ride back to their house is not a BS call? Your definition of a bs call and mine are vastly different. Plus I take slight exception to the fact that vollies can call these types of calls BS and not paid EMS providers. Who do you think pays for the gas for the ambulance? Who pays for the providers to come to the scene? It's the other patients and the other staff members who have to take up the slack for a "BS" call. Being a taxpayer, I have a significant issue with people who call 911 for non-emergencies and take the last ambulance out of the city leaving my family and others ambulanceless. You can say that that person felt they had an emergency but someone who calls for a sore throat or some other non-emergent problem that could have easily been taken care of at an Urgent care center or a doctor's office is where I get a little frustrated. I will never deny a patient the right to an ambulance or a right to enter the health care system but there are more appropriate venuus out there than taking an ambulance out of service. WE in the united states have become spoiled to the point of "I want it now" so I'll call the ambulance and they will come right out. We in EMS and FD have become our own worst enemies. The fire service in order to stay afloat relies on EMS calls to keep their budgets up. The fire service has done such a good job in fire prevention that they made it a necessity to get into EMS becuase let's just say, there's not a lot of fires happening anymore, at least not like in the 1970 and 80's. EMS has done sucha good job in getting people to call 911 that they many times have more calls for service than they do ambulances. I can't begin to tell you the number of days that the ambulance service in Independence MO or KC MO have gone down to level 1(meaning 1 ambluance for the entire city) because of ems calls, many of which are not emergencies. Are we our own worst enemies? But remember, flaming is the only voice of reason on this forum. Everyone else is wrong, all the time.

Just hit delete. I have always said that if you are too tired to work you don't work. If I'm being forced to work so much overtime that I fall asleep at the patients house, then I'm going to find a new job. Plain and simple, you don't fall asleep at a patients house, regardless of how many hours of overtime you have worked. There are two issues here. 1. The companyneeds to begin to address the number of mandatory overtime hours. That's a given. 2. What if she fell asleep in the back of the ambulance and the patient crashed. I know of one medic who fell asleep in the back with the patient, the patient arrested and the patient was unassessed for over 10 minutes. The patient was a stable patient but the patient just happened to pick the back of the ambulance to die. Was being transported for a routine doctors office visit. The medic voluntarily resigned and was subsequently disciplined by the bureau of EMS or so I heard. He actually is no longer a medic. But seriously folks, if you are going to rat out your organization and hope to keep your job after doing so then you better do it anonymously. Putting your face on the news is a good way to get fired. Why not instead of being the public face of the dirty laundry airing, why not work behind the scenes with the company to find out solutions to the problem. I can almost guarantee that any company will be happier to work with you behind the scenes than after you put your face out there trashing the company. plus what the company is doing isn't illegal so it's not a whistelblower case. The fired employee has no recourse over the firing based on "whistleblower" status.

Had a call to the scene of a person who had left home at 1am and was found 3 hours later, cold and exhausted. She was a paraplegic and had one of those motorized wheelchairs. She made it about 2 miles before her battery on the wheelchair died. We got called because she was "cold" just like the OP's patient. So we were already up, we just loaded her in the ambulance, put her wheelchair in the back as well and drove her the 2 miles to her house. She thanked us and we went on our merry way. 3 weeks later she was hit by a car while crossing a busy highway. She had a crosswalk 500 feet to the north of where she was hit but she apparantly was too stubborn to use it. I worked that call as well. Sucks to be the only ambulance in the county at 9pm at night.

I have found that those who tell you that you have dues to pay by being an EMT for at least a year were told that same mantra/crap when they became an EMT. Back then it was probably a good thing to do but now it's like an old wives tale, just that, a tale.

Very true Kiwi. But in the USA is where my question is focused.

Dwayne and Systemet - I read the quote in dwayne's signature. Rock on. It's completely true.

But isn't that putting patient number 2 in the bls truck at significant risk. Giving ALS medications and then dumping him on the bls crew? It's damned if you do or damned if you don't. I was always taught and drilled in the head that if you give medications or ALS interventions to a patient then you DO NOT leave that patient or put him in a lower level ambulance since you have provided ALS Meds. What if both patients crash at the same time. YOu can't just drop the first patient to go take care of 2nd patient. It just seems that you decide which critical patient you take care of and give the other to BLS to hoof it to the hospital. Once you begin ALS procedures on patient 1 and then drop him into the laps of the bls boys, isn't that a recipe for disaster? I seem to believe it is. There is no real right or wrong answer to this scenario but I think the truly wrong answer is the one where you give ALS level medications to a patient and then put him in the hands of a bls crew to "do the best they can and please try not to let him die!"

Instant classic

Let me ask this. Does anyone see anything wrong with some of the responses of load the patient up with medications and then send them BLS? Here is one of the quotes Under the suspicion of cerebral edema, if the medic could give him a dextrose solution, osmotic diuretic and corticosteroid like Dex it would in my opinon prolong the stability of the patients vital signs. What are the thoughts of the group of loading medications on a patient and then dropping him down to BLS status? I know that we have a out of the box scenario but is it appropriate to give medications of an osmotic diuretc and corticosteroids to a patient and then put them in a BLS ambulance with no medic. Or am I reading that out of context and way off base?

because you have to have a utilization of all equipment and since those guys are just sitting around waiting for the need of a ladder why not send em on a medical call. Seems like the absolute best way to utilize your resources.

And are we sure that an ambulance wasn't dispatched at the same time as the fire truck. less than 9 minute response time is pretty good and they must have been relatively close to the scene. Maybe the ambulance came from the fire station the pumper came from. Again, until the investigation is complete these are all speculation.

Unfortunately it's probably true Richard. I was driving home from louisiana a number of years ago, had an interview with Acadian ambulance. I had my Louisiana medic license as well as Missouri license. Came upon a MVA with a seriously injured patient. First ambulance arrived and was an ALS ambulance but only had two emt's in it. They said that's all that they could get to respond. We worked on getting the patient packaged and ready for transport. Patient needed an IV as well as pain management but when I made contact with the receiving hospital and explained who I was the hospital said just transport. I asked why he wouldn't give me orders for ALS and he said that even since I'm licensed in Louisiana I need to be employed by a ems company to perform skills. Not sure if that was right but that was his stance. So I put the patient in the ambulance and they left. I was willing to go to the hospital with the patient but was precluded from doing so. Did I like it , nope, did I understand the doctor's stance Yep!!!! If a medic called my hospital and asked for orders and they were off duty and not employed by the ambulance service that covers our area, then they would not get orders either. The law is a fickle thing. It is what it is. Is your medical director or medical control willing to give medical orders to a off duty medic who is not employed in your jurisdiction?