Just Plain Ruff

She does live alone She is normally able to ambulate with a cane. She does have a semi-clear path of egress She does have a phone. I called her doctor but no answer. My medical command won't give me the order to transport against someones will when they are A&O X 3 so thats a dead end. PD could come but I didn't think to call them. Cincinatti stroke scale - abnormal on all counts There is no-one who has power of attorney over her The droop I cannot remember her having but her friends tell me that it's been there for a long time. The patient also says that the droop and weak arm is old. She does have a dry fruity smell from her breath Stroke scale - abnormal 12 lead - not done BGL - still looking for the batteries No obvious reason for the fall Dizzy - now she is after getting her up off the floor LOC - NOPE She remembers everything Friends didn't see anything, she was in a locked apartment for over 24 hours AH HA the batteries are here YOu take a glucose and you expect it to be low with her not eating for over 24 hours. But it's not. Its a whopping 545 You are now arguing with this lady about needing to go to the hospital. She still says no. You've already read in my previous posts that she is A&O X 3 and remembers everything. How do you get her to go? What would you tell her? I have an outcome for you in a few posts from here. It's a doozy. Yes Dust, she reminds me of you except for the weight and the gender. We ended up getting her to go. What are your guesses of her CT scan and Labs?

I'm sorry but this just makes me sad. sad sad sad and pissed off and Sick of this whole political correctness.

No offense to the LPN's out there but Lead placement????? Was it right? Assuming it was Pericarditis until ruled out. But what about the peaked t-waves - possible overload of Potassium? Maybe too many red bulls or he got into grandma's pills? I'd do another 12 lead just to verify.

Now that would be too easy wouldn't it but I'll give it to you. You look at her face and you see obvious left facial drooping and you notice her left arm is floppy. Theres more info but you have to ask for it. Now that would be too easy wouldn't it but I'll give it to you. You look at her face and you see obvious left facial drooping and you notice her left arm is floppy. Theres more info but you have to ask for it.

Ok, well your glucose monitor in the bag that you went out to get shows blank - the batteries are dead. She said she stood up and slid down the chair. she is pushing around 375+ yes she was totally naked She had a large wet spot around her but she said that she just got done peeing for the 2nd time in the last hour. the only injury you find is a abrasion to her wrist from the carpet with her trying to get to the door. Lung sounds slightly congested but not a wheeze heard. your partner is still trying to find batteries for the glucometer in the ambulance She says she walks in her house naked all the time You now have gotten her up off the floor. It was a real job but she was up. There is something very obvious that you see when you get her to the chair.

Ok, she's A&O X 3 She knows who the president is and she hates him. she also hates all "Them bastards in washington" She is 79 years old Type II Diabetes - diet controlled Last oral intake - > 24 hours ago she fell at 6pm the night before bp 210/104 Pulse = 84 RR = 16 skin color is pink cool and dry. Her oral temp - don't know She continues to tell you, "Just pick me up and put me in the chair and you can leave. I don't need to go to the hospital" She's pretty adamant that she isn't going to go with you.

As a new medic this one probably takes the cake. Was working at a small rural EMS system. Called on a possible overdose. We arrived, searched the house and found nothing. I decided to search the back yard. I didn't tell anyone (first mistake)where I was going. Walked around and saw a detached garage. I went to the windows and saw the patient lying on the floor, appearing to be unconscious I yelled for the gang to come help and I began to climb into the garage. The door wouldn't open and the top part of the door was missing. This was approved by the cops. I got in, the others were trying to lift this 900 pound garage door up, not very good luck. My partner was climbing in now. I touched the patient and the fight was on. Out pops a glock from the patients shirt and all I see is my life flashing in front of me. I grabbed the gun, my partner then arrives and we fight this kid until the FD basically pulls the door off it's hinges and the cops who had put out a Officer needs assistance call, jump in. All I hear was sirens coming and then once the patient is subdued and arrested, I realized how close I had come to dying. I transported the kid to the ER and throughout transport he kept telling me that he didn't want to kill me but he had to, the voices told him to do so. Moral of the story and the Duh moment was this, If you and 5 other guys can't get the door open do not go into an enclosed space with a patient until you have backup. The patient can lie there for the little extra time it takes to get the door open. Don't risk it.

It is 6:40pm and you are off work in 20 mins. Call comes in for a woman who needs help up off the floor. She’s not injured. You think that this is going to be a simple pick up and leave call. You arrive at the apartment after a 1 minute drive. It’s directly across from your hospital. You did not bring anything into the apartment with you. No med bag, no oxygen and no monitor. No cot either. Most of these pick up and leave calls at this apartment complex are just that. No care needed. Besides, this is the 4th time you can recall running this apartment number in the past year. Each time previously has been a pick up and put back in her chair. She just cannot get herself back up off the floor due to her weight and her arthritis. You enter the apartment and are confronted with a disheveled apartment, cluttered with treasures (patients point of view), popcorn on the floor and a rather heavy elderly female lying buck naked on the floor. Friends are covering her with a sheet to preserve her modesty She adamantly says “I need help up and I’m NOT going to the hospital” Once you have recovered from the flashing of a lifetime you get down to business. You have every ALS gadget you can want. You have a general acute care hospital 1 minute away by ground. Your nearest specialty centers such as STEMI, Stroke and Trauma are 60 minutes by ground and 30 minutes by air. Run with this one.

so that's where those naked pictures of Dustdevil came from.

Drove by a bad motorcycle accident in Lakeland Florida. That wasn't you was it?

I agree Spenac If the OP has inside information maybe they will share it, it seems that they do at least about these providers. but since we do NOT know what happened, how can we be sure that what was reported really happened? What I'm getting at is this. Newspapers make money selling papers and news organizations make money with higher ratings and this is a great story to sensationalize and possibly NOT GET RIGHT!!!!!!!!!!! Plus the ambulance service If the original poster infers, is a shoddy service, or at least it's medic mill medics are, why wouldn't they try to blame the crews in order to deflect bad publicity away from themselves. I haven't heard of any ambulance service throwing their employee's under the bus to keep out of hot water (SARCASM) So until we get more info, maybe we can be a little less judgemental and more thoughtful and reflective and use this to serve our educational interests and learn from it. Not knee jerkedly hang the providers out to dry. Maybe these guys did all they were supposed to but there were extenuating circumstances - which to kind of quote the manager of the service - it was a very unique call. (not sure what that means.) Looking more at the quotes from the paper - this sounds like (I'm assuming) a cold body. News quote starts here The ambulance service determined that paramedics Pat Bajorek and Brandy Johnson followed all the appropriate procedures last month when they attended the patient, 52-year-old Pamela Harper, but they made mistakes nonetheless, said Jon Swanson, director of Metropolitan Emergency Medical Services. "They did everything that they were expected to do in terms of protocol, but it's a question of interpretation," Swanson said Monday. "Obviously there was an error made because we left her on the scene, and we accept that, and we have to stand up to that." Harper, dressed only in undergarments, was found in the backyard of a home near Napa Valley Drive at 6:30 a.m. March 26. Ends here This says to me that they failed to (I'm assuming again) determine that her body temperature was very cold and thus you cannot determine someone dead until they are warm and dead. I did some research and found via Weatherunderground.com the low temp in Little Rock on March 23 was 37 degrees. The high temp later that day was 60 degrees. At 6am I don't know what the temp was but I can postulate it was around 40 degrees or so. It had also rained that night or morning. Put those two together and this could have been a cold weather arrest. So if they did not interpret that the woman was cold and they didn't run a long enough strip on the monitor then I can see how they missed it. 3 hours later the temperature would have warmed up a bit to mid 50's or so maybe. So she could have "thawed out" by then. I'm not sure If I am on the right track here but this is just some additional information that I looked at. Ruff

Hold the phone a minute The patient had all the signs of being dead. If the patient had those signs and you call the doctor and the doctor concurs then why are we slamming these providers???? I know this is a huge mistake but.... if the signs of life are not there ergo no pulse, no respirations, no auscultatable heart beat, Asystole on the monitor then I'd call this lady dead. I'd look for other signs, like Lividity or rigor but dammit to hell If the signs are there, why are we chastising these medics. now the article says more about their being other circumstances but what the hell do you guys want them to do? Talk to God and say "Hey God, can you send me a sign that this person is really dead??" What if no sign comes down? Are you going to make them wait on scene for 3 hours just to make sure that no signs of life are there during that 3 hours. Let me know when you guys stop making mistakes in your daily life, then you can cast stones. Until then..... I know this will not make many on here happy with me but dangit, this forum continues to amaze me at how much judgement there is here and it makes me very sad. Now when the rest of this story comes out then we can cast stones and chastise these medics but until then we need to learn from this rather than crucify.

If they are billing for two transfers but it was the same trip then I would suspect it as fraud. You have a duty to report this. In the end. If you do report it and the government gets money from fines I believe you are entitled to some of those fines based on the fraud reporting guidelines. I know of a guy who reported a bunch of unauthorized accessing of he and his familie's medical record and it amounted to over 2300 times that his wifes boss and co-workers accessed their records. He filed suit and reported it and the fine was huge. He got something like 1.2 mil from the settlement. Whatever government group fined the hospital said that it was a pattern of behaviour that was rampant and flagrant and they fined the hospital huge. I think he got like 10% of the fine paid to him under whistleblower statute. His wife worked for the hospital at the time this happened.

Schulte is also seeking $1 million in a separate count on behalf of Lippy himself, for his "great fear and apprehension, and therefore conscious pain and suffering," before the craft hit the ground. so when a loved one of mine gets in a car wreck and dies, I can sue the other driver for the "great fear and apprehension, and therefor conscious pain and suffering, just before and after the crash that kills them"?????? If that suit wins, then this will open a HUGE can of worms in litigation. I can see it now. Personal injury lawyers unite. The first television commercial from some ambulance chaser. "Hey not only can we get the driver of the vehicle who injured you for negligence we can now go after him for your conscious pain and suffering just before and after the accident. Go with us, we'll get you more money"

The title was misleading: sorry I don't want to take away the thunder of the East coast gathering. Well since I cannot get to the one up in the Northeast I propose having one in Missouri. I think Missouri might be easier to get to. I know I've tried this before for Missouri and it got good response but never got off the ground. I'm looking at maybe a weekend in June or July. Weekend - Friday night and Saturday. I have just the place to hold it. Please respond to this with your interest. I'll give this topic 1 week and then tally up the responses. Reply with the answers to these questions 1. Interested or not? yes or No 2. June weekend yes No 3. July weekend Yes No 4. Max you would pay for food/drink and venue cost. _________ (I was thinking 20-40 for food and drink for both nights and 20-40 for the venue 5. Alcohol or not? 6. Will you share a room with someone to defer some of the costs. Yes No Let's see how much interest we can get on this.

Thank God they used Dust's Avatar. has anyone seen what Dust Looks like?

And no matter how you polish a turd, it's still a turd.

Actually, I just remembered another one. This one was different though. I had a ER doc in a small rural ER where I worked. We got a call on a code and since there were no patients in the ER he decided to come along. He was giving all the orders and I was doing all the work. I did put him on the airway where the patient had aspirated copious amounts of coffee ground emesis. He was covered in black liquid vomit. He vowed NEVER EVER Again. Nah, I just read He did the Cric and thought Crikey so I added the vegemite

I'm not sure what the requirements are in Missouri but every service I've worked for has had protocols for physicians taking care of patients. If they are insistent that they be responsible for the patient then I tell them they have to ride along, they cannot assume care for the patient until they have contacted my medical control and my medical control physician gives them the go-ahead. If they are going to assume care then they HAVE to ride to the hospital with me and the patietn. They then have to sign the patient care record with their DEA number only if they gave narcotic orders. Once the physician is told they have to ride I've only had one take me up on it and in that particular case he was the on-call trauma surgeon at the hospital we were heading to. He allowed me to do the EMS side while he was at the airway. This particular patient was in a head on and the sun visor nearly took the crown of her head off. There were brains all over. We ended up cric'in the patient and doing a lot of stuff to her. Unfortunately she passed away soon after reaching the ER but this doc had no problems signing the report. That's the only time I've ever had a doc assume care and ride with me. AFter the call he said that he really was out of his league but I thanked him for the Cric and bought him a vegemite sandwich.

Except that his head is white but his hands are black. I guess he could have some sort of skin condition or he put on a pair of black ems gloves. hmmmmm

Just put two new blog entries up. Hope you enjoy http://www.emtcity.com/index.php?app=blog&module=display&section=blog&blogid=9&

OK the DA is talking out his rear end. "the legislature dropped it in their laps" is a cop out. I plan on having the chat with the son soon, very soon. It is my responsibility to tell the kids not the schools.

Well, I'm sure his wife is softer than the goat. I've met his wife. She's a very pretty woman. I've seen pics of his goat, his goat looks like well, a "Goat"

Didn't realize you were home. What does next week look like for you? I'm here for the next 6 weeks.

Is there anyone in Lakeland florida that might be interested in showing me the town. I'm working at a local hospital down here. If anyone is interested in getting together for a drink or a quick bite to eat, drop me a line. ruffems@gmail.com