JPINFV

I'm sure that there's some clause in the employee handbook stating that the phone lines and radio is recorded. Now whether or not most employees read the fine print of their employee handbook is their own problem.

I'll let Orange County EMS's protocols stand as an example of California EMS. Bottom of page 3 has the ALS-No Contact requirments. Any patient not meeting that criteria means that the paramedic must make base hospital contact. Base hospital contact is essentially repeating everything on the PCR over the radio to a MICN. This includes, for example, details like what size IV was started. http://ochealthinfo.com/docs/medical/ems/treatment_guidelines/01%20Introduction/I-40%20BH%20Contact-Report-Tranport3-09.pdf Similarly, I think there's major issues when paramedics aren't trusted enough to start a saline lock or use a pulse oximeter without a cookbook describing the procedure. Saline lock: http://ochealthinfo.com/docs/medical/ems/treatment_guidelines/10%20Procedures/ALS%20Procedures/PR-75.pdf Pulse Ox: http://ochealthinfo.com/docs/medical/ems/treatment_guidelines/10%20Procedures/ALS%20Procedures/PR-65.pdf

Girlfriend's gonna get paaaiiiddd

Are there no urgent care clinics where everyone else lives? How about we try this. Determine no emergency exists to fulfill EMTALA and then require payment upfront before treatment? Healthcare is no more a right than food and I don't see grocery stores handing out free food to every Tom, Dick, and Harry who comes in.

...and to add insult to injury, you can't balance bill medicare like you can other insurance payments. At least with balance billing you stand a chance to recuperate at least part of what insurance doesn't reimburse for.

http://www.youtube.com/watch?v=aH6B1tXgYkQ

You'll probably want to talk to anyone local that deals directly with helicopters over those ideas. Also, if you are planning on running a medivac service, do you have the funding to provide the proper people, support services, and licensing (both state EMS office license and FAA licensing)? How about insurance (both insurance for the helicopter and malpractice insurance)?

Err... source? The number of applicants might be down, but I have a hard time thinking that the number of students is going to decrease anytime soon considering that there's twice the number of applicants as spots. Similarly, off the top of my head, the following medical schools have opened up in the past few years: Commonwealth Medical School (PA), University of Central Florida, Florida International University, Touro University: New York, and Rocky Vista University (Colorado). Additionally, several more medical schools (both MD and DO) are getting close to enrolling their first class of students. If anything, the number of US medical students is going up and will continue to go up. What hasn't changed is the number of residency spots to accommodate new graduates, which will force more students into the primary care fields simply due to a lack of options. It's been like that for a while. The last time I took out a non-government backs loan was my first year of undergrad for the 2003-2004 academic year, and that was a university backed loan, not a private 3rd party loan. Given the current benefits of student loans, I can't think of any reason not to take out Stafford subsidized, unsubsidized, and GradPLUS loans. As far as I'm concerned, with those loans it doesn't matter if I'm taking them out from Fannie Mae, Citibank, or through the direct loan program. In fact, in a lot of cases, I don't have a choice who services those specific loans as that is decided by the financial aid department. Where else can I find a fixed rate 6.8% (Staffords) loan where part of it I don't pay any interest at all until I graduate, have automatic deferment through school with a single capitalization (so no paying interest on interest until I graduate), that I can defer through residency, and can choose to repay in 10 years or 30 years with no prepayment penalty? Additionally, I can return any unused funds at any time during that term and get back the origination fee and the interest on that portion. Now, yes, interest rates are currently low, but what's going to happen 10 years from now when I'm in the middle of repayment? Um, even non-profits have to take in more money than they spend (i.e. profit) or else they won't survive. Now what's different is where the spend the money. One of the big non-profit hospitals in So. Cal. makes a tidy profit, so what do they do? Well, in the past 10 years they've built a new patient care tower, a new central plant, and are currently expanding their already large emergency room to handle more patients. In the end, there's nothing really non-profit about non-profits.

None of the news reports nor the medical director report has indicated that the scene was unsafe. Less than idea accessibility due to snow? Maybe, but that's a far cry from unsafe. If the scene was unsafe and I was in the paramedics shoes, I'd be shouting from far and wide that it was unsafe and why it was unsafe. Not just mumbling something about it being hard to get there while the dispatch recording is being played about me bitching about having to get out of the ambulance because the patient can't walk.

Why doesn't the medical control report state anything about dangers in its analysis of the call?

Worth repeating over here... I'll let the quote stand on it's own. http://www.post-gazette.com/pg/10082/1045012-100.stm#ixzz0j3pUfl47

http://www.post-gazette.com/pg/10082/1045012-100.stm#ixzz0j3pUfl47

Sure, if there is no significant downtime. However, things like laptops becomes completely permissible when there may be hours between calls while sitting on a street corner.

First off, for the record, I first heard of Chatroulette on another forum and have no need to actually use the site Kinda of yea, kinda of no. Chatroulette is a video chat service where it randomly pairs you up with another member to chat. This is a guy on there that does piano improve so this video should give you a good idea how the site works and the type of people on it while being funny.

Here's the problem. Off the cuff remark? Sure. The problem is that not all off the cuff remarks are the same. Just because a situation might be difficult doesn't mean that I get to say, "F this, let the patient figure it out." That's how I see the 'If the patient wants to go, he's gonna have to walk' comment.

How many other "rights" require the work of someone else? If a physician refuses to see a patient or discharges a patient from his practice, does that mean that the physician violated the patient's civil rights? Both of those are paid for by taxes and fees. Additionally, a business owner getting a fire inspection done doesn't get it for free. A bicycle license isn't free. Plenty of other police and fire services Additionally, the police force in the US are agents of the state, not agents of the people. The courts have said countless times that there is no duty to protect any one citizen.

Anyone who seriously considers that this bill will make preventative care "free" has never taken high school economics.

This will make for an interesting SCOTUS case.

Did you really just equate judging EMS based fire suppression as a whole as racist in the same post where you judge all private EMS in the same post?

Did I ever claim that the crew was the only party at fault? However I have found nothing that can exonerate the concept that 'if the patient wants a ride, he'll have to walk to the ambulance.' In fact, even the medical director in his report found that notion completely unacceptable.

Link to the legislation Link Additional notes: Caps certification fee at $15 and recert fees at $10 for fire fighters and police officers who don't work in EMS outside of their government job. Exempts fire fighters from being investigated by the EMS board.

From another news article. http://www.wpxi.com/news/22580232/detail.html Here's a Google Map of the area. Map According to the call review report (link), one ambulance got stuck near the bridge on Elizabeth St and according to the news report, another ambulance was able to make it to Chaplain. Additional quotes from the call review Second ambulance crew: Sorry, but with something like that then I absolutely can't buy a 'scene safety' argument. It's not about scene safety if you expect the patient to trudge through the weather instead of sheltering in place. I've had calls where I've had to think on my feet and get additional resources and make solutions. I can't imagine calling dispatch and simply saying "we can't make it" without offering either possible options to be implemented or advising dispatch that I'm going to have to use alternative methods to get to the patient. I agree that it's a systematic failure, but we shouldn't be dependent on either management or dispatch to devise all of the solutions to complications.

I'll ask the same question over here. If the snow storm is safe enough to ask for a patient to walk to the ambulance then how could it be too dangerous for the crew to walk to the house. If the storm is so dangerous as to put the rescuers at risk, then why are they asking a patient to leave the safety of there home to walk to the ambulance?

Sorry, I think that they lose a little bit of protection when asking the patient to walk the trek. Sorry, but if it's safe enough for the patient to brave the weather, then it's safe enough for the crew. What's next? Fire fighters refusing to enter any burning houses because the people inside should just walk out on their own regardless of their condition? Regardless, the crew would have to walk from the ambulance to the house even if the ambulance was parked out front. In the mean time, some suggestions: PLUS equals Or use a to move patient from house to ambulance. or at the very least, set up shop and administer care on scene.