Christopher.Collins

Thatd work great with my old dept's Mass Casualty and rehab rig 'cuz it had a big fold out cannopy on the passengers side. Also play a radio station thats on site somewhere (during a big sale or spring break) so its a real party.

Wow, I had no clue Id open a can of worms... or something. *Pulls out the camping chair and cracks open a cold Sam Adams* Thanks for the feedback guys.

Not sure if I understand you or not but if so you have a point... maybe the drunk you took to the hospital 3 times the past two shifts is a diabetic. Whether or not you did know that pertinant history, you may not know whats really going on untill your there.

Not sure about toxic shock, my friend may have mentioned it but its been a while, but Id be surprised if she wasnt. They got all sorts of odd sexual emergencies in that ER, one girl used a frozen hotdog, I didnt know that vaginal secretions could... well freeze. For the record, the can. One guy went in with a vibe stuck fully up, well you know. He was sitting at registration giving information, the secratary could hear it still buzzing away.

Ill try not to jack the thread Doc (appologies in advanced if too many people become interested) but I have a good vaginal bleed story. I dont know the full details, but a young girl had come into the 24hr clinic my old service transports to. The girl had just recently started getting her period and came in complaining of the usual signs/symptoms of a period, but also presented with signs of shock and just all in all looked like crap. Anyways that did a vaginal exam and pulled out I believe upwards of 6-10 tampons, turns out she didnt know they had to be removed. A good freind of mine who was an ED tech for that pt had said the good doc threw up after the 5th or 6th tampon he removed.

Not to mention if its a wooden broom handle (God I hope they were at least smart enough not to use that) splinters could have broken off inside of her. Possibly causing future problems if undetected.

Now if only we could do something like that with birth control..? You know, among Darwin Award candidates? But then again we'll have population problems to follow upon that success.

Thanks Spen... maybe a sample isnt 100% usefull after being diluted, but obviously it dosnt hurt to look. Im not pi$$ed at the fire dept, I am a firefighter too, cant be hatin on my brothers. Just being a smart @$$.

How was she feeling leading up to this? When did she last eat/drink and what? How tall is the pt? (110 kg = 242 lbs) Any known weight gain over past few months? Deffinatley, as already established, dont rule out pregnacy. Any past hx of preg - children - abortions? Have PD or fire obtain sample from toilet. :twisted:

Not sure if its an exception... but QI/QA would have to know about this (in the first place) and it would have to be approved by them or whomever in management is in charge of photography or privacy control.

Well Don, it can really go either way. I think theres some info missing but Im ganna kinda wing it... Last months issue of JEMS was mostly about on scene and patient photography. If you havnt seen it I reccomend getting the back issue on jems.com. Anyways part of it comes down to your agencies polocy on photography... if there isnt one at all he could technically fight it and even possibly win. What he should have done (Im going to assume he didnt) was cosult your director of service in regards to said member. While his intent in the photography was not negligent there are other ways to approach the situation. They could have questioned others who have worked with him (the bad emt), ED physicians... etc. And then decided how to address it from there, be it appoint him to work with an FTO or just be under watchfull eye of senior personell, QA and managment. I am willing to say that termination may have been a little extreme, but I dont know the full details. If this member was a clean cut, good record type with no history of such problems, then maybe a warning or suspention for negligence. However (based on what you have said), fact of the matter remains he did go over someones head and violated patient privacy.

I remember many a time where a hospital has told me to go ahead and load the pt on my stretcher while they get the paper work ready... and I flat out tell them nothing is going to happen untill I get the paperwork. And if I dont get my W-10... dont bother. Facilities around here have been known to refuse pts who are not sent with all the propper paperwork. Not to mention I had an instance where I had the pt on my stretcher... and the staff "just found out" they were still waiting for lab results (that could not simply be faxed, they had to be sent with the transport). Well we "handed off" care back to the hospital... and couldnt transport the pt for at least an hour when the paperwork was finally complete. The dispatch gods made us wait too... so with what paperwork I had, I had my whole PCR finished before I even transported. Of course, I added relavant information on the transport itself afterwards.

The feedback thing is really excellent as well. I remember pulling up to an MVA (motorcycle rearended an SUV) and seeing the pt in a pool of blood with one firefighters fingers halfway into his neck pinching of a severed carotid. He was quite litterally torn open on the right side from his neck all the way down too just below his rib cage... organs and lungs partly visible. CAOx3 to everyones surprise and hows this for MOI, the impact and speed of the motorcycle on to the rear of the (stopped) SUV spun it (the SUV) 180 degrees... we're talking Chevy Suburban! My partner, a senior medic called for additional ALS backup even though we were 3 min out from the trauma center... who in turn had him air lifted to a higher up trauma center out of state. Anyways, my point is... that call was made all the better for when we were able to find out the pt had a posative prognosiss and was listed in stable condition.

I dunno guys. I mean the age if anything is the only big deal in my eyes. Responding to a call is responding to a call, period. How different can it be showing up on scene in your beat up Gremlin (remember thoes things?) backfiring and chugging smoke out the exhaust? I personally think that anyone under the age of 18 should never be allowed to respond to a scene alone, or be on a scene alone. And by alone I mean without a senior member (not a parent or adult), or at the very least without the approval of a senior member. Furthermore, anyone under the age of 18 should not be allowed on major highway accidents. By highway I mean with exits and dividers, high speeds and everything (not one of thoes piddly "highways" that are just a major road). Other than that, nothing wrong with a bicycle at all. Hell, I grew up in a small town (but big on tourism) and the beaches were always packed in the summer time. So with my chiefs approval I started a 1 man bike patrol. Every day (especially holidays) Id sign out a portable radio... and yes I had medical equipment in a bag too (no O2 or lights/siren though)... and patrol the beach areas and mall. It did great for PR no less. Alot of people thought that it was great for not being paid. I enjoyed it to, alot of exercise.

Well its true that HIPAA is actually more for specific purposes than some of us take it... but in my eyes that dosnt mean that the patient isnt entitled to further privacy.

Wooooww, damn. I think mine cost like $500... I didnt have to pay a penny of it but I still feel ripped off.

Hawaii... but I dont know what his word is worth, most bounty hunters to the best of my knowledge think hes a joke. Thanks for the attempt at info Richard, Im assuming theres some inside joke as to NY Police side stepping any questions? Anthony you have a good point as well, Im sure it comes down to the custody issue more than anything.

Thanks for the info Ruff. I had a feeling that it may be acceptable, but I really wasnt too sure. I guess having all thoes privacy rights and HIPAA lectures drilled in over time works. But yea, Id be plenty angry too if my kids info wasnt shared and that resulted in their illness. Thats pretty much what the HR rep emphasized as well, but I didnt want to just take a chance on her word alone. Again thanks!

Some of you may already know Im seeking to leave my desk job. I found a place that has caught my eye, though it does not put me back in the ambulance as I preffer. Its a place called Natures Classroom and its a camp for kids that runs through the school year. It sounds like itd be a great job because itll keep me on my feet, outdoors and I love kids too. But I read something on their website under the job description that has me a bit, perplexed? http://www.naturesclassroom.org/medical%20person.htm "The medical person should share food allergy and birthday information with the kitchen staff." Ok so I dont know how privacy acts apply in this kind of environament, and I also understand the need to know about food allergies, but this just dosnt seem right. I asked the HR representative about this and she flat out said nobody has ever sued for sharing information for the childs safety. I just wanna make sure Im either right about my feelings on this being wrong... or that Im taking the privacey rights a bit too far? Id rather not go in for an interview and start jabbing at them based on my pre-hospital experience over (as she put it) "pre-ambulance care." Any help would be greatly appreciated. Im really interested in this position, but if I have to do what Ive always been taught was wrong... I want to know if it is. That way I can say no thanks in a polite way to the job offer.

So I was wondering, as I continue to see more and more bail enforcement companies and agents in my area. Just how does HIPAA apply with them? If I get called by PD for a combative suspect I can choose to have them come on board the ambulance or follow me in their vehicle. But Bail Enforcement Agents are not sworn officers of the law and do not "arrest" a suspect, therfore if I am ever called to treat a suspect they are taking into custody... do I contact PD if needed or can they legally be in the ambulance?

Yea, good ole' government. I missed the qual for medic on my ASVAB by like 2 or 3 points for the Army. You have to make or beat the score without a wavier for the "healthcare specialist" MOS... I may not be a medic but Ive been in EMS for 5 years, that cant possibly have been worth 2 whole points on a freakin written test that had maybe 2 first aid related questions?

As long as the deciding factor of the win is an actual fight, rather than age or years in power... otherwise I think Castro woulda had a 1 up on the world.

Im always in need for more money... but Ill go after you if he offers more :twisted: I dont take sides

If you dont mind my asking, how is the relationship between both agencies as of now? Decent, could be better, some tension, etc? What if anything could be causing a need for improvement? For hospital to EMS relations, do you guys celebrate EMS week? One thing alot of hospitals in my area do; is take at least this one week a year to show their appreciation for us. They have cold cut sandwiches and other food and cold drinks in bulk all day every day during the week in the EMS lounges. Some make up t-shirts, mugs and gift bags... (these would be handed out by staff to make sure any indavidual isnt abusing it though), thank you banners hanging over the ambulance ED entrance. Things like that. It really does make us feel like a team, and like we are appreciated. As far as EMS to hospital relations... alot of times, especially on the night shift, my partner and I would pick up coffee and food for the ER nurses and staff. This of course is if time permits as one never knows what the Dispatch Gods have waiting for you. But regardless its always helped. At the end of my night shift rotation (we rotated 3 nights on, 3 off, 3 days on)... my crew would go for breakfast. And we'd invite whoever was working in the ER that shift. Training together as you say is deffinatley a good idea as well. Our flight service (LifeStar) is sponsored by Hartford Hospital and based there as well as Bakus Hospital (Norwich, CT). They offer an observer program for medically certified personel. Only requirments are to be currently affiliated with an agency that can offer a letter of reccomendation, weigh under 200lbs, and be certified as a first responder minumum. Your there for a whole shift, and fly with them... but beware you may be booted on a scene for various reasons, but someone will always be willing to help get you back. You may assist the crew (1 RN and 1 RRT) if asked which is usually if CPR is needed.

ANY time I am ordering my 1' on wheat Southwest Steak and Cheese w/lettuce, tomatoes and jalepenos at subway.... or any time the order is complete and I have it in my hands still warm.