The Only Thing That Matters Is the patient in front of you

[iamyourgod]

Thank you for the correction -- typing fast is not a good thing ---- it is not a matter of ems sucking, it is a matter of not always having the proper tools to make a definitive diagnosis (lab and xray). Actually AMR did a national study that showed that out of every 100 refusals you have, 7 will get admitted to the hospital, 2 of which to ICU, and one will die --- the numbers are universal to any service. During my time with a hospital based provider, I also studied this as a CQI project (only one hospital in the county, so 90% came there, and i had access to their records) and the numbers were accurate. I reported my findings to our regional council, and when the other 911 services performed the same project, they had roughly the same numbers (doesnt equal out that way every month, you have highs and lows, but averaged over a year, it works out --try it)

[Dustdevil]

Err, how does one become postictal without having a seizure?

Oh, I'm sure it was just a febrile seizure. :roll:

Why do I get the feeling this guy is from FDNY?

[hammerpcp]

The OP is obviously trying to be inflammatory - illustrated by his/her screen name, comments and rebuttals, and the sheer volume of posts- however, he/she/you do(es) make some valid points.

I have seen and worked with paramedics who sign off individuals who probably should have been transported. The vast majority of the time there are no negative repercussions (for the medic), and one never hears about it again, they 'get away with it' so to speak. I say this to illustrate that this is a valid topic to discuss. Not all medics do it (sign off someone who shouldn't be, or influenced them to sign off), most people don't do it all the time, but most people have done it at some point.

I take this as a reminder that although my job is hard and stressful at times I still have a duty to every single pt, on every single call despite what I may be experiencing personally at the time.

What can I say, I have a thing for the underdog :wink:

[iamyourgod]

Amazing, there is an honest medic in the room.

[akflightmedic]

Amazing, there is an honest medic in the room.

And it was not you...?

[Happiness]

Okay I have to say someting. First of all one thing I was taught is that you may get the frequent flyers but there will always be that one time that they really need the help. I live in a small community that has a high etoh call rate and yes you do get sick of it all. But if you have a pre crappy attitude about those pts your are going to be off guard when dealing with and then what the hell do you do. I don't judge my pts and treat every call with them with the attitude "I want to treat my pts with the same respect as I would want myself if I was the pt." I am not going to say to my dispatch oh they are a frequent flyer and I'm not going. You cant pick your pts nor should you be able to, you get what comes that day.

The day that as a paramedic is responsible for that will be a sad day

I once had a nurse say to me "Oh you brought me a real pt" and my response was "Well what the hell do you think Im going to bring you fake ones"

just saying

happy

[Doczilla]

[spenac]

I see so many questions with the common underlying problem, " I am on scene with this drunk, this crazy person, this system abuser, this non-emergency, this DNR" -- how can i get out of transporting them, or why should i have to tie up my ALS unit with this. The answer is that the only thing that matters is the patient in front of you. As a paramedic it is not your responsibility to plan, budget, or deploy enough ambulances to cover peak call volume. When you start leaving these patients behind so that you can get 10-8 for the real emergency, you will get yourself burned. You do not have the lab or radiological equipment necessary to rule out all possibilities of illness/injury. Do your job and take care of your patient.

If you are not educated enough to be able to examine, treat as needed, transport if needed, and deny transport of those that can safely go by other means to the doctor you have no business in EMS. The you call we haul mentality is bull. It is time EMS grows up and quits being a taxi service. Doctors often do not have labs or xrays to rule out every possible problem either before kicking people out of the ER.

[HellsBells]

I'm starting to get the feeling that iamyourgod has an ulterior motive for posting on this site. All of this individuals post topics seem to have some sort of connection to litigation. Boning up for some type of class action lawsuit with a personal injury lawyer are you?

[Asysin2leads]

I'm starting to get the feeling that iamyourgod has an ulterior motive for posting on this site. All of this individuals post topics seem to have some sort of connection to litigation. Boning up for some type of class action lawsuit with a personal injury lawyer are you?

Thank you HellsBells, for once I don't have to provide the seemingly paranoid response to the thread. Iamyourgod, I am not sure what your motive is here. Either you are a very uneducated person who just realized the gravity of the decisions a paramedic makes and fails to realize that everyone figured that out many years ago, or you're just trying to piss people off.

You've defintiely succeeded with me because you remind me of every single Kool-Aid drinking asshole I had to deal with during my experience with the largest and most inept bureaucracy EMS has to offer. You are the person, who, after a decent, hard working paramedic complains about nearly getting into five traffic accidents rushing to the chest cold call, comes up with something out of the playbook like "It is what it is." or "BS calls keep you in business" or "You don't know you're not a doctor". It is all crap. Before I get into your stupid little debate, and before you attempt to tell me how to do my job, why don't you tell me, when you have to go talk to the family of the paramedic who was killed going to your BS call so you can get your insurance billing, what are you going to say to them? That they sacrificed themselves saving lives? Do you plan on telling that old lie to keep the money coming in?