Just Plain Ruff

Of course, no one is going to do that, because you know the answer is going to be similar to mine below: Again, there you go with the blanket statements. I will go ask the director today. I will also pose the question to the nurse managers at the client I'm at. I'll let you know what the numbers are if they give me them. Flaming, are you willing to put your livelihood and career in jeopardy by telling the patient you made a mistake? Answer that question honestly.

Haven't seen it in a while at the small hospital I worked for but I do know that you also have to have aluminum foil covering the tubing and the bag or it breaks down.

I am not privy to that information so I can't say but again you make a blanket statement but you have absolutely no basis in fact to make that assumption. Maybe no patients are notified. Sorry but I don't believe that. AS a matter of fact, one of my favorite patients who I used to transport all the time told me that he was told of a error that a medic made. He actually said "Don't give me that drug as I wasn't supposed to have it last time but one of your guys gave it to me anyway" so I am assuming that he was notified of that error. I don't know who actually makes the final decision on when to tell the patient. AS far as I'm concerned I've done my due diligence by reporting the errors. I mean really, nurses who make medication errors don't run off and tell the patient right away do they? I've worked with some really fine nurses who made mistakes but I've never seen them go directly to the patient and say "Oops, I made a medical error. I'm sorry" What I've seen is that the nurse goes to the doctor and the doctor decides if it's an error or if there was damage done. The nurse reports the error to her supervisor as well. That's the process at almost every facility I've worked at and it's also the policy at the hospital that I am currently contracted with as I asked the nursing director of the ER what their process was. They scoffed when I said that there was someone who I was conversing with who said that if they made a medical error that they would report that error to the patient. The person I was talking with said this "I hope that person has good malpractice insurance if they are going to tell the patient first before going to their supervisor" So flaming, I really do appreciate your advocacy of your patient and maybe you are right that we don't report medical errors to the patient but by your going against your services procedures and telling the patient of the error, no matter how altruistic you are trying to be, does not negate the fact that you are putting yourself out on a huge slippery slope in liability and you open yourself up to tremendous personal liability. I don't think you are really understanding that part.

This is how my service or my last service dealt with this sticky issue 1. Medic makes an error and recognizes the error. 2. Medic reports error to nurse receiving patient and physician 3. medic reports error to supervisor or boss 4. Supervisor contacts receiving facility either the nurse or the doctor and gathers information on whether error caused harm or not. 5. Meeting with medic involved is established, medic involved gives process leading up to error and is given chance to suggest what could have been done differently. This meeting involves the medical director and supervisor who received the report as well as any QI or QA person as well as risk management. 6. If error determined to be a mistake on the medics part only then discipline or re-training occurs 7. IF error is determined to be a system wide occurrence or could happen again then policies are re-done and re-training entire system 8. If error killed patient or caused significant damage then service lawyers are brought in to advise and recommend action 9. It can go on from there. But that's the start of the process. I cannot give a good number of patients who were told about the errors. I'm not in management or Risk management so I don't know. NOr am I the services attorney which probably has the final say as to whether to notify the patient. Simple, not really.

Yet here you are criticising us for not telling the patient yet following proper channels yet you post that you dropped an entire bag of lidocaine into a patient, lied about it, said you contaminated the bag. Before you go and criticise us for not saying anything I believe that it is incumbent upon you to go find that patient you massively overdosed on lidocaine and tell them of your error. Until you do that, your arguments are moot and not worth us talking about. At least none of us who have posted here have lied about overdosing a patient. Talk about being hypocritical. It's not CYA City, it's making sure that proper channels are followed and that your service and the higher level providers are notified of the error made. If that's CYA then so be it but it protects me. You sound suspiciously like crotchity on this topic, you haven't addressed Dwayne's questions and you continue to refuse to allow us to express our opinions of what we would do by consistently telling us we are wrong. That in my book is pure hypocrisy. Go ahead and tell the patient that you gave them a massive overdose of lidocaine and then come back here and tell us how your service dealt with not only your overdosing the patient, but your not reporting the error and also lying about it.

AGAIN, remember, what you think is a medical mistake may not be a mistake! What you consider unethical may not truly be unethical But to go tell the patient about what you in YOUR opinion consider to be unethical or a mistake is just asking for trouble with a capital T. You follow proper channels to report these errors, those channels protect you and your employer from bogus lawsuits or they allow for legitimate lawsuits to occur. There are proper channels to this issue. I"m all for thinking outside the box but when you go and tell a patient about the error (if it truly was an error) then you put yourself and your service/employer at a distinct disadvantage in keeping your ass out of the poor house. I can tell you this, if I was running an EMS System and you told the patients about every medical error without following proper channels then your butt would be out on the street quicker than you can see the door shutting behind you. You telling the patient about the error without allowing me or my service directors to properly investigate the issue puts every person at that services job in jeopardy just to assuage your guilty conscience. I like your advocacy stance but sometimes there are times you just keep your mouth shut until all the facts are in. Had I have told the patient about my error in giving morphine rather than valium, that patient would have no sooner than my leaving the room been on her phone with the lawyers and filing suit. Did it harm the baby, not in the least, did it harm the patient not in the least yet yes it was an error. But did it harm the patient - no so my career would have been ended or at least I'd have been fired for giving the medication error and telling the patient first without telling my boss. That's why we have procedures for these types of things.

You have until next august for medic school Good deal. Here is what you should do. Enroll in either a university or a community college. Take the following courses College level A&P College algebra English composition underwater basket weaving (that's a freebie) and a physical fitness class. Get those classes under your belt and you will be way way way ahead of the game. Good luck

Well when a woman gets to be president that argument will be moot won't it? Until the country elects a woman as president you can drop that card but until then......

Have passport, have immediate availability if money is right. Not nationally registered though. I know that's probably a sticker point. ACLS and CPR and PALS expired but can get them in 4 days if needed.

So if we stop, render care and delay transport for the patient in the back. That said patien in the back crashes and codes while you are doing whatever to the patient in the car. The patient dies. Is that not negligence. 1. you had a duty to act - your duty was to your patient not anyone else. 2. You breached that duty - you left your patient or delayed transport to take care of the other victim 3. your patient suffered harm 4. The patient suffered harm based on your actions Doesn't that make you negligent? I think that all 4 of the criteria for negligence have been met. Or am I wrong?

Really, ALL women and independents. I'm an independent and I support a abortion ban with limits. I don't think it needs to be a constitutional amendment though.

From the quote in Red above The Emergency Medical Technician refuses to participate in unethical procedures, and assumes the responsibility to expose incompetence or unethical conduct of others to the appropriate authority in a proper and professional manner When you witness a unethical procedure then your duty is to expose it but not directly to the patient. Are you completely sure that what you consider unethical as to truly be unethical. I'm sure there are cut and dried examples of unethical behaviour but there are many more examples and with a new baby in our house I'm running on about 3 hours sleep over the past 4 days so I cannot think of any concrete examples on either side but give me about 10 more hours of sleep and I'll provide some. So telling a patient that something was done unethically without going through the correct channels puts you on the slippery slope of being on the wrong side of the argument. As far as I'm concerned the patient is not the correct authority nor do they have really have the knowledge of knowing what is ethical or unethical? ah I just thought of one Drunk patient, was nasty and beligerent on scene. Had pretty good lacerations to head as well as a large hematoma. Patient spit in medics face. Medic said to the patient that he was goign to paralyze the patient if the patient didn't settle down. Patient didn't settle down so the medic RSI'd the patient. Medic wrote in patient report that due to head trauma and transport time that he felt the patient was too unstable to tolerate the transport so RSI was considered and implemented. Unethical? OR slightly unethical or good medicine? The EMT came to me and told me what happened. We went to the medical director. EMT said he felt the RSI was unnecessary due to patient being awake and drunk. Reviewed chart as well as discussed with trauma team at the trauma center. The patient ended up having a large subdural so the intubation and paralysis was needed. So what initially looked to the EMT as an unethical or unnecessary procedure was in all reality a vitally needed intervention. So what one person considered unethical or a mistake may not actually be that.

Have the partner stop the ambulance. Have him get out, walk to the vehicle and look. IF you see a patient then the partner gets to go to work. If he can get him out, then he can do something to help him. If he's trapped then he's gonna be in the car for a while. Depending on severity of the patient depends on what happens to that patient. Can't put the emt in back to watch the als patient can ya? So your partners on his own at least till a car drives up. Then put the driver of the car (if possible) to work with the partner. Sometimes you just cannot help everyone, no matter the fact that you want to, there's just times when you have to help the one who stands a better chance of being helped and for me that's the cardiac patient I'm transporting.

So they are the ones who are sending me those million dollar emails!!!!!

OOOOOOH I know who you are referring to1!!!!!!! ha ha

I grabbed the wrong syringe and gave morphine to a seizing pregnant patient. I guess by Flaming's logic I should have told the patient but I did what I was supposed to do in my service. I told the doctor immediatly upon discovering my error. I then called my supervisor and told him of the error. The doctor said "So that's why she has pinpoint pupils" and he said "no harm done" I followed my chain of reporting which actually makes me want to report errors, it's done in a non-judgemental way and we run through ways to avoid the errors in the future. Had I have been required to report it to the patient I would have been much more reluctant to do so due to the threat of lawsuits and all that. When I report it to the right channels, I am assured that I will be protected by my service's legal services if and or when I'm sued for the error. I actually asked one of the supervisors about telling a patient directly about an error and he had to go to the service managers and ask them. They told him, if the medic reports an error to the patient prior to reporting it to the physician taking care of the patient and then to management/supervisory staff at the service, then I'm on my own in my defense if I tell the patient. So if the patient sues, then I have to get my own lawyer and I CANNOT afford that lawyer. So we have reporting requirements and procedures for a reason. I will NOT relay to the patient that an error was made on my part, not because I'm scared that I'll get sued, but I follow proper procedure. It's good on you that you personally will tell a patient of the error you made with them but I wonder how many of those errors you can personally help pay for, if your service let's you go for not reporting the errors properly.

I don't like any of the candidates that are for the republican party. Cain has my vote so far but we all remember howard dean, he was the flavor of the month for the democrats and look where that got him. Perry's out, bachman and huntsman are done. Paul stands little chance. So it's either cain or Romney. The old adage is sometimes true, if at first you don't succeed, try try try try again. Goes for two of the candidates in the race.

November!!!!! Do tell? EMTcity meet up? Deets please.

Might want to get ahold of Mateo on this forum. He's currently working in NC he might have some insight.

I know the option is available but I don't like that option. Scares the hell out of me not to mention my patients when I did hang them as a 3rd patient.

I've been involved in a ambulance crash with two patients. one of the bench and one on the cot. Both patients were strapped down the best we could and the bench patient had a net on the end of the bench. Both patients suffered no injuries. Me on the other hand, yep I did. To blanket state that the bench is not safe is just that, a flimsy blanket. No-one that I've seen on this thread seem to want to transport the patient on the bench seat but the mother of all necessity usually dictates that you do just that. And why in the hell if you feel that the bench seat is unsafe, why are you using an unsafe piece of equipment to transport a patient. Would you use an unsafe defibrillator on a code? Would you use expired drugs on a patient? Aren't you saying that the bench seat is unsafe so why are you transporting patients on the bench seat if it's so unsafe????????

Dwayne, you just take both kids. No question. Put one on the bench seat and the other on the cot. Simple. I don't like having to take care of two critical kids but you know the old saying 'you do what ya have to" I had a transport about 15 years ago. Car into telephone pole, blizzard like conditions, we were actually on the way back froma long distance transfer and came up on this one. ONly one really hurt person but 7 total people in the car. Called our dispatch and had them call the county that we were in to have an ambulance respond. They told our dispatch that the closest ambulance was 45 minutes away. We had a transport time of about 40 minutes to the nearest hospital. We just packed all 7 of the patients in the ambulance and away we went. Got reamed from the staff of the hospital on why we brought them all in in one ambulance. I told them why. They understood. I had 4 sitting on the bench seat, one in the captains chair, one in the front seat of the ambulance (this one was not injured) and one on the cot. I was on my knees for the 40 minute drive. Leaving the people there would have been negligent. And waiting for the other ambulance would have been silly. Does anyone remember transporting a patient hanging from the cieling? IF you ahve been around for a while you might remember it.