Piss Poor Pre-hospital care in the juvenile justice system!

[ladyfirefighter36]

Regardless of her past, and what she had done or not done, those people had a duty to take her complaints seriously. She should have been given medical treatment. I can't believe that a nurse would not start CPR or give oxygen. Come on, that much should have at least been basic. Are these people being investigated. What poor care. I wouldn't want any of them touching me or my family.

[Richard B the EMT]

I feel likewise. If by the "fact" that a patient is incarcerated, they deserve what they get, there would never be any FDNY EMS responses to Rikers Island, where the NYC Department of Corrections maintains several large jails, excuse me, "Correctional Facilities".

Supporting that, but from a different take, as reported in today's Newsday newspaper, a mentally deficient man, at Rikers for drug possession, talked back to the Corrections Officers, and for that, was given a "tune up" by the other inmates, who pushed away the COs. The beat down resulted in the man's death. The case is currently being heard in court, with 7 inmates being charged in the death, an unknown number of unindited other inmates, and the Corrections Department reviewing the behavior of the COs involved for possible improprieties or improper following of protocols. Per the family of the deceased, the COs should have also been charged in the death. For the record, the Medical Examiner's office has ruled the death a homicide.

As for calling a person a client, why not, as when they are in your care on the ambulance, technically they are your client.

[Ridryder 911]

Chris... they are client's. In nursing school we are taught to address patients as clients, and document as such. This means you have a contractual obligation to that person.. paid or not. Many EMS education & EMS services that are progressive have "removed" the patient attitude & replaced it with client.. reflecting that they pay our salary, & we offer a service to them.

Now that being said, I too agree it is a shame that occurred. But, P.E is one of the hardest diagnosis to obtain.. approx 80% are missed, & that is on patients with history that co-relates to precursors.

For all those that posts, "Oh how could they " attitude, I work in a town with 3 correctional facilities. We see an average of at least 5-10 prisoners a day. I would say 50% are repeaters, & the other 49% are "want to get out of jail trip". So until you have been there, & seen the 20 year-old chest pains.. or really bad jock itch case, or the falls from the bottom bunk at 3:00 in the a.m., don't give me the bleeding heart story. They get treated & examined like every one else, except creditability on history is not respected.

Yes, she should have been examined more thoroughly.. would it had changed her treatment plan...probably no. Being incarcerated or not. I do not know a physician that is going to accept a non-paying teen age patient & perform a V-Q scan. At best, maybe a d-Dimer lab test.. then still no change in treatment, unless high indication of such.. recent trauma, stasis of legs etc.. Are you going to admit a teen ager with shortness of breath, with sats in the upper 90's.. CXR usually will not reveal Pulmonary Emboli.. even ABG's can mis-leading unless she is compensating.

We could all write a bleeding heart story on each & every case .. "as he attempted to defecate..beads of prespiration ran down his face.. his face flushed with engorged blood.. lips blue from bearing down.. he could feel his heart beat slowing..his anguish.."

Sounds like a journalist was contacted by the family, to increase the chance of litigation. Now the citizens will be on the "war" to change things.. & what are they going to change ? Send them a bill for 6-10 million dollars for needless medical care then the journalist can write another story of tax payers waste ?

My 2 cents worth...

Ridryder 911

[THE_DITCH_DOCTOR]

Exactly Rid. Well said.

[Summit]

Correct me if I am wrong, but the difficulty of a PE Dx seems irrelevant. The newspaper made it sounds like the vitals clearly showed the patient to be in unstable and deteriorating condition, that no appropriate action was taken, and that ACLS was not followed either.

[THE_DITCH_DOCTOR]

Like we've (Rid and I) said it sounds like they did anything that could be reasonably expected given the circumstances. As has been said before, what happened in the end was unfortunate, but I would be able to sleep quite soundly if I had proceeded as the medical staff did with this case.

[Great_Llama]

I can't speak to the medical condition and a part of me would certainly respond negatively towards the staff at the hospital based on this article alone, but having lived in LR for a few years and not being a fan of the Democrat Gazette, or truthfully and mainstream news media, I have to question the whole tone of the article. It's clear to me that the writer is basing "facts" on one side of the story, since he made it clear the agency involved wouldn't respond, they are taking what they think they know and making it into a "fantastic" story. Of course that is their job. No one would read it otherwise, it would just be a bunch of useless facts that no one would understand of pay attention to so they embellish. The tone of the article bothers me because it seems like a journalist doing their best to paint a grim and dismal picture of abuse and lack of care. I've also worked in prisons, where I myself was responsible for the "care" of 200 inmates at any given time, these were set at 100 to a side. This was as a guard. Inmate lie, cheat, steal, etc. You can't believe anything they say because it's all a game, the whole system is a game. You have officers that are trying to play this game and win while being generally understaffed and overworked. So you can't watch everyone. I've been on suicide watches before and I didn't lose anyone, nor did anyone ever actually commit suicide at our facility while I worked there (don't know about before or after), but I know it's simply impossible to watch everyone. I also worked our infirmary and I could go on and on about the actions of inmates and how hard it is to deal with them on a day to day basis.

Yes they still deserve care, but they make it harder on themselves, because they see everyone as a potential target for their little games and as such the staff often has to deal with not only the the real medical concerns of people once they can actually figure out what is really going on, but also try to weed past the mind games and crap that the inmates are always trying to pull, often to get a shot of something or another. They have nothing better to do. They should investigate and if they were found to have not treated this person properly they should be disciplined and held accountable, but I think it's hard to form an informed opinion based on one news article. Its one of those times where you say, if it really was that bad, something should be done, and in truth the lawmakers in the area will certainly do something, because too many people will take the article at face value. There are too many people that believe anything CNN, ABC or the like throws at them, no matter how ridiculous the claims. I don't want to turn this into an argument over the news media, but in my opinion taking any article or news story for face value, when all the facts are clearly not known is silly. It would be easy to say "hang them evil horrible health care providers" and in fact this journalist has all but said that and convinced others of their "facts", but I highly doubt we've heard the whole story simply by reading this article, so I'd personally caution against a rush to judgment.

Just my opinion. Sorry if I took the topic off track, but there was a perspective missing from this whole article and that made it bad journalism in my opinion.

[Guest]

She screwed up and she paid with her life. If she hadn't have been a crack addict she wouldn't have wound up in the situation she was in. Her prior abuse is no excuse. She's is the one solely and totally responsible for her situation, in fact she probably received more medical attention inside the detention center than she would have as a roving crack addict.

And you swear you are a Democrat?????? :wink:

[Guest]

I' m sorry, but when someone is that sick that death is knocking on there door anyone with any medical knowledge should recognize this. I feel this is failure to act. just my 2 cents.

[THE_DITCH_DOCTOR]

And you swear you are a Democrat?????? :wink:

Yes, but at the same time I do believe in personal responsibility. There's a difference between being a Democrat (which I am) and being a bleeding heart liberal (which I certainly am not) that most people have seemed to forget about.

MCAD, the patient wasn't in extremis initially- she just appeared to just be whining and malingering, playing up her asthma. Granted the way the patient was handled once she crashed was less than stellar, but that can be probably chalked up to thorough unfamiliarity and lack of practice with emergency procedures. EMT's and paramedics, since we handle this kind of thing on a very regular basis, tend to assume that everyone is up to speed and well versed in how to manage any emergency that comes their way. However, let pose another question- How many of you have worked a code or emergency in the office of a physician whom you respect, but the emergency went badly because they don't practice emergency response. Just because things went badly doesn't mean they are stupid, incompetent, or anything else other than what they actually are: nurses who don't handle emergencies often; now if they were ER or ICU nurses I said hang their butts out to dry, but since that is not the case no one deserves to be punished for what happened.