akflightmedic

Well, first of all it is called HIPAA not HIPPA. This case took place in February 2001, long before HIPAA was implemented. What does HIPAA have to do with the story anyways? Just curious. For those that are interested, HIPAA the first part was created in 1996. The second part of the act which governs how we handle private medical information was implemented in April of 2003 with one year extensions for smaller organizations. The security portion of the act which affects us the most, was issued on 4/21/03 with a compliance date of 4/21/05. It lays down the rules for administration safeguards(such as privacy officers, ongoing training,etc), it also covers physical safeguards and technical safeguards. Final enforcement/compliance took place THIS YEAR! As of 3/16/06, no one is allowed any more violations or leeway with noncomplaince. Now they will start issuing huge fines and not letting the violaters get away due to the excuse of we didn't have adequate time or whatever. If you do not bill for your services, you do not have to comply with HIPAA!! Does that mean it is ok to give out information because you do not fall under this act, of course not! Its not criminal but it is unethical. For example, over here in Osama land, we do not bill for our services so I am free to share info with anyone. Granted, we dont post flyers but if a supervisor is wishing to follow up on an employees illness, we are allowed to share. We do have some safeguards meaning illnesses one might attain while on RnR, rape, etc. those are treated with a little more due regard, but for th emost part even if we talked about it we would not be in violation of HIPAA. Non transport fire departments, and volunteer agencies that do not bill are in the same situation.

Was there sound with that?? All I got to do was read the words but its still funny, but I bet its better if I can actually hear them.

Page 4 and page 6 have what you are looking for EXCEPT for side opening. http://www.copsplus.com/clipboardsorganizers.php?start=61

Many moons ago when I was affiliated with a volunteer agency, we used to bill their insurance. Whatever the insurance paid thats what we accepted. If insurance denied, oh well. The residents loved us for that and it actually helped increase donations at our fundraisers because some that we transported decided they could afford a little something out of pocket. They also new we were serving the residents with no insurance without requiring payment. During transport or afterwards, whenever it is most appropriate, we would ensure the patient was fully aware we were volunteer, they would not recieve a bill, we would charge their insurance only, if they didnt have any not to worry and finally if they wanted to send us anything, even 5 dollars..here is the address to remit funds to. This worked out great and it sustained the squad for many years.

That was a lovely counter point. I thoroughly enjoyed that! Now I wasnt thinking of that route for a counter argument, however I did think of several different types of bananas which makes that argument flawed. Do they think we are so ignorant as to believe there is only one type of banana? There are almost as mnay variations of bananas on this world as there are apples. For example, in the Philippines, the bananas are very tiny, some only 3 inches in length. They also are hard to peel and most of them are not curved. The best time to eat them(meaning when they are ripe) is when they are dark/black on the outside. If they are yellow they are too firm and not as tasty. I know this from personal experience. What about plantains? Are they in the same family? Are they a "banana". I dont know...things that make you go Hmmmmm....

PRPG, the answer lies here.... http://en.wikipedia.org/wiki/Manhole_cover

Hey Teri, you said the same thing twice, just in a different way. Sorry, I couldnt resist.

Here is the solution to your pen issue Anthony. There were many times I found myself with only one pen in my pocket and "uh oh!" I had to get a signature from an icky patient. Many times I have either A: asked the pt to put on a glove and sign or B: Put a glove on the pen and asked them to sign. Not once have I ever had a complaint or negative comment. They usually say ok cause I tell them straight up I dont want your blood on my pen as I use this one over and over.

Those were great! Thanks for the link, as I will be using those.

How do you know? I mean the bleeding part ok, but what about Hep C? Or how do you know they dont have it, had a minor cut and left some miniscule amount of blood behind on a public surface that you happen to come in contact with? And you are implying that all your patients are? I made it clear that I wear gloves when doing any procedure or with any patient that has active bleeding or involves bodily fluids. But the majority of our patients are not bleeding. As for having Hep C, its like AIDS or any other disease. You have no way of knowing who has it and who doesn't. A patient complaining of knee pain, headache, abdominal pain, back pain, whatever does not warrant being all freaked out over contamination. The calls that we do encounter where this is a valid concern are few and far between. Please do not misinterpret my point. I am a strong advocate for BSI, I just think there has to be a balance of common sense along with it.

No worries. You are being a germaphobe. Its funny how soon as you get in the "medical response" mindset, everything is contaminated. Do you worry like this when you are off the job. You touch doors, windows, shake hands, pick things up in stores and set them back down, pick fruit everyone else has touched, read magazines everyone else has touched, go to the bank and use the same pen everyone else has touched...but all of a sudden because we arrive in an ambulance, everything is "contaminated". You look at the person you are transporting and determine whether they are good enough to touch your pen or whether they have to use your throw down pen. You look around the box and wonder what has touched what. How is this any different from any other public place. Sick people, nasty people, urban outdoorsman, booger picking, non hand washing after ass wiping people go to the same places you do every single day. Some of them even serve your food at restraunts. So tell me what is the problem? Why so worried? If you think about it, how many of the people you transport are really, truly sick? How many of them are bleeding all over the place uncontrollably? Not too many is my guess. So if you wash your hands or use the little bottle of antibacterial wash frequently, there isnt too much to worry about. I will catch some shit from some people over this one, because it is something I preach but do not follow 100 percent myself, yes I am a hypocrite folks but I have to follow teaching standards. I typically do not put on gloves until I have made visual contact with the patient. It pisses me off watching drivers of the rig steering with their elbows trying to put gloves on. Did you really save that much time and was it worth the risk to save a few seconds? I think not. If it is toned out as a trauma and I am not driving, I may go ahead and put on gloves and if it sounds like a really bad trauma, I put on two pair of gloves. This is not for added protection, it is for the simple fact that when they get soiled or if I have to make contact with a 2nd patient, I strip off the first pair and have one already on. Ever try to put gloves on after stripping one pair and your hands are all sweaty? Not an easy task. Anyways, once I deem gloves necessary, due to patient condition or performing an IV or something of the sort, I put them on. But as soon as I have everything hooked up, IV flowing, pt stable, I get rid of them. There is no need for them at that point. I am now free to touch everything in the truck without "contaminating" it. Upon arrival at the ER, I will put on another pair if the pt is going to need assistance with moving as I don not wish to put my hands in urine on a ALF resident nor do I wish to support someones weight under their arms with no gloves. Once you are done with the pt, a simple little wipe down should be sufficient. As for that bottom sheet thing your partner does, is it fair to all the other patients to keep reusing it? What if a pt has crabs and you pass them to the next person? That is a bad practice that should cease. Just take the few extra seconds, spray with Hibacleanse and wipe down your stretcher for crying out loud. Why so freaking lazy? As for the throw down pen, all my pens are throw down pens. I never bring a good pen to work, no point in doing so. But I haven't done written reports for years. I have been electronic since 2001 so the pens I have are just for my note taking. I keep them in my pocket for easy retrieval and disposal. They arent going to bite you. You should also be in the practice of deconing your truck at least once a week. Wipe down everything. Empty cabinets and wipe them down, Wipe the radio, wipe the overhead grab bars, O2 tree, steering wheel everything. But whatever you do, do not ever, and I do mean ever, climb in the cab after assisting me with the patient, drive me to the ER and unload with the same gloves on, having never removed them, because you think it was unnecessary to change them. Big pet peeve of mine in case you didnt notice.

Please do a search on this topic as we first discussed this almost 2 years ago when there was a huge movement everywhere for people to start this. We debated both the pro and con and for the most part it has no relevance for the prehospital personel rendering treatment.

OK, if you really want to know. I am a fork and all of my dreams, goals, and achievements are kernels of corn. If you try to scoop all the kernels at once, several will fall off. If you stab at them, you will get some of them but again not all of them. However, if you persist with your scooping and stabbing, and sometimes even getting a little help from your piece of bread to push them in your path better, you will get them all. It is just a matter of time, patience, persistence, and determination.

You have to tell me why you are a spoon. I am a fork. I will tell why shortly. I want some other people to have fun first.

I am serious. That was an interview question I had this past summer for my job in FL.

Fork, knife, or spoon. Which one are you and why?

Now thats funny...

While informative, your responses are off topic. If you wish to start a thread on the hows and why of a drug test please go do it. If you wish to gives us insight to your thought processes, by all means respond to the scenario. Thank you.

Phil covered it nicely.

Come on Michael, while very entertaining, it was way off topic. And you didn't even answer the questions. On a side note, I think we could author some hellacious books together.

I will clarify for some people. In most systems, if you go to the EAP ( Employee Assistance Program) before you are ever caught or about to be caught, they will work with you, get you help and in most cases save your job. If you "confess" or admit to a probelm after being caught or as you stand there with cup in hand, most will dismiss you because you are only trying to save your job at that point, as you had no interest in helping yourself prior to us testing you. So a simple heads up would not be in order eh? Not even to steer him towards the EAP?

Whit my brother...you got issues. I dont know what kind of system or coworkers you are subjected to but I feel very sad for you. 1. I always have a bag and montior in my hand. No EMT carries the airway bag or lifepack for me as I am quite capable and those bags/equipment are not for you. 2. With the exception of an extremely critical patient, I always help make the stretcher ready WITH my partner. 3. I clean my mess as I go, the same way I cook. A lot of times you would never believe I had just ran a code or cooked dinner as both places (ambulance/kitchen) are clean when I am done. 4. I hear more "life saving" stories out of EMTs than I have ever heard out of a medic. BY the time you become a medic you are more of a realist and know most of that BS just won't fly. 5. As far as complaints about other health professionals not knowing what they are doing, that is a personal issue that you have been exposed to, but again I have heard more EMTs talk crap about medics not knowing what they were doing more than medics talking about ER staff. Again, once you have become a medic you have a greater respect and understanding of your peers knowledge and training and are more apt or inclined to learn from that instead of contemplating when you can get in the next medic program, how fast you can complete it and why won't your partner let you do ALS things in thefield, because they really are that big of a deal. 6.As far as scenic routes, that is so very childish and does it really benefit your patient...you know the person we are employed for. Does it matter if he is homeless with diarrhea? Do you routinely discriminate against your patients based on their socio economic status? By the way, this patient would have YOU riding in back anyways with me doing the driving as this situation in most cases does not warrant ALS intervention unless severe dehydration is present. You sound as if you have a very hostile situation. I treat my partners with DIGNITY and RESPECT, always. After all, we are partners and it is a two way street. I am so very sorry for your miserable experiences in EMS as this is and can be a very rewarding career that can produce some very close friendships with your partners.

Ok gang, here we go again... You and your buddy, best of friends for years. You met in EMT school 10 years ago, double dated, went to medic school together, both of you have since gotten married and had children. Your families hang out often, picnics or just getting together and having a good ol American cookout. Your wives are friends and your kids are friends. You both work hard, heck you are only medics and we know the amount of OT you put in just to get the finer things in life for your family. Things are not always easy but hey, thats the way life is supposed to be. Through a lot of hard work and dedication, you finally get promoted to a training officer position. You are estatic! You love teaching and the hours are M-F with a nice raise. Things are going good. While getting settled into your new job, the Chief decides to task your position with one additional responsibility. He wants you to be Safety Officer as well, whose duty primarily includes random urinalysis screens. No probelm you think. How difficult is it randomly testing people's urine? The way it works, is Human Resources generates a random list and you test them and mark the results. A few weeks later, you get the random people for the day. Your buddy is on the list. You have no concerns as you have known him for years. But, you always have lingering doubts no matter what, so you think about giving him a heads up just for the heck of it. Question #1. Do you give him a heads up? Why or why not? After much internal turmoil, you decide to give him a heads up. He appreciates it and guess what? He says remember the camping trip I went on last week? A joint was passed around and even though I shouldnt have, I took a few hits. What sould I do? Help me out my friend. Question #2. How do you proceed? Many options run through your mind. A. Allow him to come pee and just not watch as intently as you should? B. Advise him to confess to EAP that he has a problem before testing and therefore save his job? C. Be a hard ass. Drugs are drugs and he should have known better! You wrestle with all these thoughts and you think of his wife, kids, career...he is a great guy that made a very bad decision. WHat would you do?

Asysin, I dont think that particular technique was being questioned. What was being questioned was the original poster has said there was a center console that involved having to elevate the patient over in order to get them on the board. If there is nothing in the center it is a smooth transition as you are aware. Plus, in this instance, the EMT had the pt llift themselves to get on the board due to choosing this method of exit.

GRRRRR...... Back off......