Patients in triage

[ksmedic202]

It doesent happen very much here, so I was just wondering what others were doing in that same situation. We give report to the nurse and usually get a room assignment in the ER. Very rarely do I get told to send the patient to triage. I prefer to release the patient to an ER nurse and have her make the decision on placement. I realize that my nurses trust my report, but I feel they need to have "eyes on" the patient.

As for PCR's, we are hospital based so our office is in our main recieving hospital. Write the report and place the original in the pt's file, a copy for us and a copy for our admin. If I am transferring a patient to an out of area hospital, then I complete the form and fax a copy of it back to the recieving hospital, speciffically to the floor where I dropped the pt off at.

[Capman]

Your administrator should be fired. The better systems require run reports be completed at the destination, and a copy left for the patient's hospital chart. That is very definitely the ideal way to go, whenever time constraints allow. If you have to run for an emergency before you're finished, that's one thing. But if you're just in a hurry to get back to your recliner to watch Turd Watch, that's BS. These things should be documented while the patient is fresh in your mind, or mistakes will occur. And the hospital should have access to a record of your care. Otherwise, when they say you failed to give them a proper report, you'll have no defence.

No job is done until the paperwork is complete.

That makes sense to some extent but...

Completing a run report at the hospital is one thing if you are a service that still uses that stuff they used to call paper. Maine EMS is all electronic. It is new and has many issues yet to be resolved.

http://www.memsrr.org/

So....

If the hospital is cranky because they don't have a copy of our run forms, then they had better put computers on line for the paramedics to use to enter run forms prior to leaving the hospital. Which; by the way, is something that they have not done.

So, be careful about slamming services about practices that may not necessarily be within their control. Also, remember this is Maine. You could at least give us an "atta' boy" for having cable to watch "Turd Watch". :)/

[spenac]

If the hospital is cranky because they don't have a copy of our run forms, then they had better put computers on line for the paramedics to use to enter run forms prior to leaving the hospital. Which; by the way, is something that they have not done.

It is not the hospital that has to comply. My backwoods country hickville service uses electronic PCR's. We keep a laptop with internet card on a couple of the trucks. The other trucks don't have them. We installed comps at the hospital for us to use. So your service needs to spend some bucks or they make you all look bad that you do not leave a pcr with the hospital before you leave like you should.

[JPINFV]

If the hospital is cranky because they don't have a copy of our run forms, then they had better put computers on line for the paramedics to use to enter run forms prior to leaving the hospital. Which; by the way, is something that they have not done.

So, be careful about slamming services about practices that may not necessarily be within their control.

plus

equals run sheets printed out before clearing the scene regardless of location.

[Capman]

Hey, I'm not going to sit here and defend my service when deep down I know that you are right on target with what you are saying. But keep in mind that it is not my job to sit here and bash my service either. It is far from perfect, and money is one of the large problems that we face here. The fact of the matter is that we are hospital owned and getting them to spend some cash to make right is easier said than done.

They purchased multiple Tough Books for the purpose of doing this, but now do not want to shell out the "claimed" $1000 per license per computer to put the Service Bridge software on these Tough Books so we can do run reports off line. So, we can only use the on line version through Maine EMS, which as you can tell in our situation; poses a problem.

This very topic has plagued our service since going electronic last January. You can show me all the fancy portable printers and other ways to get the hospital their run form in the fashion you say, but all it's going to do is make me jealous because our service will probably never get it.

So, I hear what you are saying and I agree whole heartedly, but I don't make the rules, I just follow them. Maybe if they get their a$$ in a sling about this, they may consider improving in areas such as this.

Thanks for the info'

[CBEMT]

If the hospital is cranky because they don't have a copy of our run forms, then they had better put computers on line for the paramedics to use to enter run forms prior to leaving the hospital. Which; by the way, is something that they have not done.

Every service here who E-PCRs has onboard printers. They make two copies- one that Triage signs and goes with the crew, the other for the hospital/chart per protocol.

[Dustdevil]

Hey, I'm not going to sit here and defend my service when deep down I know that you are right on target with what you are saying. But keep in mind that it is not my job to sit here and bash my service either.

Plus 5 for that. But I understand what you are saying too. Sounds like the state is complicating things horribly through statewide micro-management. Obviously, you can only play the hand you are dealt, and the state is dealing from the bottom of the deck.

Not to hijack this thread, but I have mixed feelings over these kinds of situations. Obviously, somebody needs to be doing a lot better job of managing EMS, so I respect the state's intent in getting involved. On the other hand, it seems that most states that go crazy with EMS management only manage to create an inefficient bureaucracy, without achieving any real benefits. This would seem to be one of those cases.

[strippel]

We take a decent percentage of our customers to triage. There are many regulars, and people with small boo boos who call.

At our main hospital, the ER charge nurse has to look at the patient as you come in the door. (Either walking, or on the litter). They will either ask you the deal and decide, or just point to triage. We then put the patient in a chair, and put them on the list. If we have time, we find one of the triage nurses, and give them the story. Usually, they are busy, and we are going on another call.

There are many times we have to wait for a bed, or use the "gasp" dreaded hallway bed, until a room frees up.

The second hospital, you walk the patient past the ER staff, and then triage nurse, to get to the waiting room.

The other two hospitals, we always get a bed.

We use ePCRs, so we do not leave a written copy. Our computers are only located in the stations, so even if we had the time, we couldn't write in the trucks. Besides call volume is high, transport times are short. If there is a problem, ER staff knows how to find us.

If things go according to plan (HA!), we should have SCMODS* in the trucks within a year, including ePCR software.

*Blues Brothers Movie reference

[gvandellen]

We take a decent percentage of our customers to triage. There are many regulars, and people with small boo boos who call.

At our main hospital, the ER charge nurse has to look at the patient as you come in the door. (Either walking, or on the litter). They will either ask you the deal and decide, or just point to triage. We then put the patient in a chair, and put them on the list. If we have time, we find one of the triage nurses, and give them the story. Usually, they are busy, and we are going on another call.

There are many times we have to wait for a bed, or use the "gasp" dreaded hallway bed, until a room frees up.

The second hospital, you walk the patient past the ER staff, and then triage nurse, to get to the waiting room.

The other two hospitals, we always get a bed.

We use ePCRs, so we do not leave a written copy. Our computers are only located in the stations, so even if we had the time, we couldn't write in the trucks. Besides call volume is high, transport times are short. If there is a problem, ER staff knows how to find us.

If things go according to plan (HA!), we should have SCMODS* in the trucks within a year, including ePCR software.

*Blues Brothers Movie reference

You just described our system exactly!!!

After 5 years in the ER as well I've never seen a Doc look at a run slip. History changes anyway. People just tell the docs more.

A good rule of thumb...If the patient needs a line based on our assessment they get a bed if not they get a chair in the waiting room with a nice 3-6 hour wait which isn't all that bad around here.

[Just Plain Ruff]

Strippel wrote "We take a decent percentage of our customers to triage. There are many regulars, and people with small boo boos who call"

So let me ask you a question - who's idea was it to call your patients customers instead of patients.

Is it your own or your companies idea?

The reason I ask is if it was your companies idea to call them customers instead of patients then your company must be employing someone who came from the customer service arena.

I'm just curious where you got the idea to call your patient a customer.

no slam on you, just a question