eb1040

I did not say the recording of the birth was delayed. I said verification of birth, recording and the actual birth cert are all different processes. If a baby is born at home "emergently" and is transported to the hospital by ambulance, there will be a hospital bill. I do know the process from when I was born as told by my parents and also when my kids were born as told to me by the hospital and county. As I have stated, things are different today. Different states and different counties have different processes. Compare it the EMT and Paramedic certs. Please read post #19 just above yours. The actual birth certificate does not have to be immediately released for many reasons. Verification of birth can be released and filed. So if you know all of the state and county processes for the entire country for the years prior to 1980 then you can argue I am wrong. I don't know how old you are but your attitude towards those who are older and have actually dealt with these situations is not the best. Even when certifying and hiring people many years ago, some ran into difficult because of the way their birth was documented or not documented. Not everything was computerized nor did we have all of the "mandatory" reporting and time limit laws.

I just edited for a more indepth explanation. It is not uncommon for a county to withhold issuing the actual certificate for several reasons even today. Verification of birth, recording and the actual certificate are all different processes. It there is or was unfinished business concerning your birth, then the actual cert was not issued. That does not mean there was no record of your birth recorded. But, that was also an issue back then when some births did not get recorded. Remember, this was in the past as I mentioned. You obviously are too young to remember home birthing and when people actually paid cash for hospital bills. Talk to your grandparents about the good ol' days.

The birth can still be recorded but just like the title to your car, you may not take physical possession of it until YOU own it and not the bank. The hospital would record the birth with the county and you might get a verification of birth. Once the hospital notified the country that all was settled, the actual certificate would be released. The process of adoption and state custody also runs through a similar process. It also was not that uncommon for the births to not be recorded immediately since they were home births. We also didn't have all the computer records we have now not that long ago. Kids weren't born with an iPOD and iPAD attached. Anybody born before 1980 might remember hearing about this.

With all the babies being born daily there probably would not be enough ambulances to run all the calls. For every 1000 babies born in an area, 999 of those probably were done so without an ambulance. At most it would be an IFT to take the mother and/or baby to a more appropriate facility. But, the cost of an ambulance, (let's say $1000), is nothing compared to the cost of the hospital which can run up to $20k. A few years ago hospital held the release of the birth certificate until the bill was paid. Also a few years ago, women living in very poor areas would call for an ambulance, usually volunteer (free or min charge), to deliver or witness a delivery of the baby. Then it was just a quck check up and signature of a physician or midwife to get the birth certificate signed without the expense of the hospital. I will add that for the cost of an ambulance, even if it is BLS and going by a private company, some FDs are now also charging an additional response (nontransport) fee which can be as high as $500.

The full article is here: http://cjonline.com/news/2012-12-13/mother-good-hands-during-emergency-highway-delivery Being in the cold for a long period of time can also stress a mother in labor and a baby out. I would say they got lucky on this one that all did go well. Meaning: 2 Police Officers, Jackson County EMS and Mayetta Fire Department. But, I suspect it was the mother who put forth the greatest effort. I am a firm believer in giving someone their right to a certain amount of privacy in this special moment. The woman, the husband and one "catcher" should be present in the immediate area. There is no reason the husband can not be involved to some extent. This should not turn into a spectator sport for those who have no role in the actual delivery.

I think you are being overly sensitive about believing the media is just out to get EMTs. The article never mentioned an ambulance and give a description of the vehicle he drove. If you google "hit and run" you will find anyone including nurses, teachers lawyers, mayors and police officers who have been headlines. It all depends upon you own interest as to whether someone will read the article. Many will care less about a hit and run since it is barely news worthy unless it is in a very small town or maybe a sports superstar is involved. But, don't you find it just a little "catchy" that someone who holds the title of EMT would hit someone and then leave them along side of the road to die? This is not much different than a school teacher who makes headlines for having sex with his or her students or a Police Officer accused of rape or murder. The headlines come from situations of irony where you hold a position of trust or to protect and become the person others should be protected from. The media could have made a bigger issue out of the 7 arrests for this guy who was still working on an ambulance but didn't. I think EMS discredits itself here.

This might be interesting to follow. The hospital released a preliminary finding that the explosion was caused during a code with a defibrillation procedure. http://www.therepublic.com/view/story/23aa5d01aebc417e9f06f3ea898ac079/US--Hospital-Explosion I wonder if it was an EMS response to the code or if the hospital's Code Team was contracted by this unit.

Due regard? Night time. Fast speeds over driving the visibility of your headlights. "But 6 of the 8 other FFs responding responded the same way" does not always make it right. It just means I would not have wanted to be anywhere near that fire station with 8 FFs driving 100 mph and passing on rises in 8 individual POVs. It is bad enough with 2 big fire and EMS trucks responding in daylight with L&S to put themselves and others at risk. As far as the LEO, once they just "assume" a scene is safe without following through with caution, they usually end up dead. The car itself does not always indicate who is driving it. EMS has had enough stolen ambulances with some outstanding citizens stealing them and driving at high speeds.

But, in medicine, duplication or bringing up the old is not necessary a bad thing. This topic also not what I would call old. Many things are initiated in another country and watched in the US for many years until the company gets approval to market it here in the US. If you see something interesting like a medication or piece of technology and wonder if it will ever be introduced in prehospital, you should follow it and not forget it. My approach in my last post may not have been presented well. I am not dismissing this device since I think it is definitely needed to get a more ideal care setting in long term care of these patients and to change the minds of the insurances about rehabilative possibilities. But, prehospital has so many other areas it could spend $80k for each device on such as better safety features for ambulances, intubation training equipment, CPAP, ECG monitors and communication systems to better connect facilities and professionals. A secure data system to retrieve patient info quickly like Kaiser would also be great for EDs. If I had my preference right now and reimbursement by the insurances had to be chosen, I would prefer it spent on identifying locked in syndrome and placing these patients in a more appropriate care setting for rehab potential or for providing appropriate care for what might be the rest of their lives. The other area would be funding the neuro centers to provide the highest possible care to treat TBIs and CVAs. It took over 70 years for some medical devices like CPAP, ECGs and portable verntilators to enter prehospital for EMS even though specialized transport teams started using them 30 years before. This is new so keep watching and bringing up the topic again in a few months to see if it has been seen by anyone would not be a bad idea.

This is not new since it was also discussed here on this forum a year ago. http://www.emtcity.com/topic/20185-an-eeg-device-to-replace-the-gcs-thoughts/ The key to many brain injuries is preventing more damage from occuring and getting them definitive care for the swelling, bleeding and hypoxic effects from impair circulation. This may also mean controlling the seizure activity and pain from this injury such as a hemmorhagic cva or from other traumatic injuries. Getting the cooling started could also be one of the interventions although usually initiated in the ICU due to the volatility of these patients to keep them hemodynamically stable. Even small amounts of shivering and obvious seizures would render an EEG tracing useless. Time could be a major factor. Delaying transport to document and transmit a clear reading might not be practical. The initial level of consciousness may change rapidly as the brain reacts to the injury and if intervention is delayed. Taking a higher level of consciousness could also be deceiving leading one to believe everything is better than it actually is. Sometimes this might also be more academic since the intervention for the damage should still be initiated. EEG monitoring can also be done once the patient is in the OR with other sophiscated technology. However, this could be a useful tool for smaller EDs which utilize telemedicine to communicate with a neurologist or neurosurgeon while the patient is awaiting transfer. It could help determine stabilization for a long transport but the other diagnostics will need to be done which can be digitally transmitted to determine appropriate preps once the patient arrives at a Neuro center. Again prioritizing procedures may need to be considered. I definitely see this as a useful tool in determining locked in syndrome. But, in American health care that might mean very little in the placement or long term care. Very few Acute Rehabs take locked in syndrome patients due to the lack of insurance days. SubAcutes and SNFs will provide limited amounts of PT and Speech but until the patient can participate in some of the therapy, no insurance will provide much if any coverage for these services.

It would be great to know about Locked-In Syndrome but testing for it is rarely possible until after the brain has been treated for the injury. This may include many hours in IR after CT Scans or MRI or whatever surgical interventions along with burr holes and drains. There may also be several days of a hypothermia protocol along with heavy sedation and maybe even paralytics if necessary. It may take months for the brain to start to heal itself to even where this is a reasonable test. Some tests might be done at 3 months and then again at 6 months as a follow up from ICU. A great book and okay movie about a real person's experience with locked in syndrome. Imagine it being like having a paralytic with no sedation but living it 24/7 with no way to show you are alert. Due to the nature of some brain injuries your HR and BP responses would not be functioning well enough to be an accurate indication. http://www.imdb.com/title/tt0401383/

But, the crew did check. We use a supply form also for what was used on our shift. Apparently all was asked of him was to do the paperwork for inventory. This has been from other sources now other than LeDuff. We also don't know how many times this Paramedic go off easy from others picking up after him or how many times his supervisor reminded him before this write up. It was also mentioned that he has an administrative hearing which includes a union rep scheduled that is unrelated to this incident. No one said the patient did not get a blanket nor was delayed in getting a blanket. The whole issue is after the fact with replacing what your used on the ambulance. If it was a busy day you just say "sorry, forgot" and do what need to be done rather than running to a hysterical reporter for dramatics. It is fairly known that blankets are used for other purposes such as drop cloths and those using them might even have filled out the supply sheet for that purpose even if they did not go to a patient. Still it is all part of controlling the inventory just like it was a bandage. Detroit might suck but when you use that as an excuse to distract from your own performance, it shows poor character. It is no secret this shockjock of a reporter will take something and put his own spin on it whether right or wrong and edit for his benefit. Then, it is "he told us" which essentially brings it all back to the Paramedic who came to him for this story. http://www.myfoxdetr...tly-false-story There also have not been an alot of co-worker or union support on this as of this time as there have been for the other incidents in Detroit. Friday should be interesting if this reporter rallies a demonstration at city hall over this.

They did check the unit and that is when they found what wasn't done. We don't know how many times this has happened to them prior to this and what else might also have been missing. It was the blanket which the reporter chose to use. If this Paramedic has given a statement to a more credible reporter with his union rep present in uniform or something other than pajamas and not in his bed, I might be more willing to believe this was all just about a blanket.

Do you mean by the sarcasm that a crew shouldn't expect a truck to be left in good order from the previous shift? It would not have looked good either if they didn't have a blanket to give someone who needed it either because someone else failed to restock and they failed to check. This may also not be the first time this has happened and they may have gotten tired of his shit. The department may have been well within their right to discipline the guy but with the other issues, things got turned on them. There is probably still much more to this story. Anyone who knows this reporter expects to be entertained and shouldn't bother wading through the dramatics to see what the point is. I thought the video was embarrassing for EMS to have a Paramedic in orange pajamas with the footies in bed with a reporter lying in his bed literally curled up next to him. The headline said "suspended" but in bed it was stated the Paramedic called in sick on the day of the interview. Also, the video actually makes a case for "inventory control" of donated property intended for the patients since it shows the blankets being used as drip cloths while painting a fire truck. http://www.firehouse...m-of-house-fire If you want to make a public statement, be professional. Get out of bed and put on clothes that make you look like a professional. Have a union rep with you or at least your statements should be reviewed by the union rep. Reporters like LeDuff don't really care what they make you look like as long as they can get a story to support their own agenda with liberties taken with whatever facts there are. edit: The guy got his blanket. It is the paperwork and follow through on seeing the restocking gets done. Even though the blankets are donated, that doesn't mean they should not be treated like any other property. For those living in cold weather, a warm blanket is valued especially if homeless. The example of the drip cloths is a good one for inventory control where the homeless won't see those blankets until they fish them out of the trash. I'm sure some here may have one or two in the trunk of their cars to protect the surface from tools or have grabbed a handful when moving furniture.

Considering it was the crew followig the Paramedic in question who initiated this, it means he didn't restock and do the supply paperwork to replenish what was missing. What it really means is Charlie LeDuff has more publicity for his new book which is to be out soon.