Medical/Telemetry Control - Yes or No?

[Richard B the EMT]

For those of us who remember "Johnny and Roy", they carried around a "12 Watt" 2 way radio, which they could hook up and use to transmit an EKG. That is Telemetry, as I understand it. That is why the Medical Control at FDNY EMS is called Telemetry Control, I presume.

[rdenman26]

We have moved away from protocols to guidelines in order for medics to have more say in the patient care, as it was felt that patients dont always conform to protocols. That said if you deviated from the guidelines you have to remember you may have to justify what you did, so it aint made that much difference.

The only things we have to get authority for is thromolysis in my service. But thats either the medical director/ chieg executive (both docs) or the clinical manager (senior paramedic) who carry a mobile phone with a screen to transmit the ECG to. We can also ring this phone or just ring the local hospital if we feel we need advice.

[Richard B the EMT]

Bumped up, again.

[bikermedic]

we dont have tele. be nice for backup though when you get a new er doc who dosen't like to give orders

[medic429]

We have standing orders - up to a point- where you are then to contact Medical Command. One Command system has a doctor specifically for this reason...that's all he/she does is answer the phone for command. Another system, you call and get the ER doc. Either way, I like having the "back-up".

[Richard B the EMT]

Well stated, "medic429."

[Richard B the EMT]

(Bump!)

[Skuter]

Hey gang.

I guess I kind of fall in the middle. Pretty extensive medical directives, use them as needed. Lots of training (close to 1000hrs of theory/clinical/field perceptorship) to get to this point. That's on top of the 2-year course to be a PCP and in most cases a couple of years on the road.

Have the telemetry (we actually call it a "patch") for those cases where its CYA or anything outside of the directives. We don't send ECG, we give our interpretations to an ER doc.

We have to patch for orders to do cardioversion and needle decompression. (However, just to be confusing, we have an open order to perform these procedures if pt condition "warrants immediate action".) Also have to get orders for Amiodarone, Adenosine, Dopamine and Narcan.

I'm not sure where that puts me on the poll. I'm happy to have the ER Doc available if needed but content with the directives I have.

Skuter

[AZCEP]

I like to have an MD/DO when I need to ask a medical/legal question.

Otherwise, patients will receive the treatment that they need without asking permission.

ANY problem with the A-B-C's gets treated with everything that I have, then the receiving facility is notified.

Beg forgiveness, don't beg for orders.

[Richard B the EMT]

We have new people here, now. Anyone else want to comment, or add their vote to the survey?