frequent flyers and public relations

[spenac]

I really think we are talking about just doing public relations by going and visiting and maybe even doing a chore for people in the community. It does not sound like you are doing anything that is medical. If while there they ask for BP check you might need a patient contact form but otherwise I think we are not there under Ruffs description as a Medical Professional, but are there as a public relations officer.

[Arizonaffcep]

Again, the things you are writing are only what a Paramedic has been taught which is not wrong but not entirely complete for a "home visit" assessment. You are thinking from an EMS provider point of view and not in a preventitive plan of care.

Well ya! I AM a paramedic.

We are well schooled in the art of what to do when...not what to do to prevent. At least here in AZ, that's our role in life=reactionary medicine.

[CBEMT]

Ok, we have a new set of guidelines starting in about 2 weeks. If we are the primary crew on duty and we are not on a call we are being asked to go to some of our frequent flyers to check up on them.

"Blow me."

[Just Plain Ruff]

Jeminy Christmas guys, if you don't have anything constructive to add to this thread then just stay out of the thread.

edited to take out my last comment

[CBEMT]

My constructive contribution is what I'd tell the management that suggested this policy. Not directed at you. My bad.

[Just Plain Ruff]

fair enough, I knew it wasn't directed at me.

[spenac]

I actually think if it were limited to a quick visit and no medical care that there should be no worrys. IMHO even if you did a BP it should still not matter. Some patients that call just for attention might be stopped. They might even break out coffee and cookies. Sorry all the fears of a lawsuit for doing a good deed are way blown out. I do think it should be only one or 2 houses a day though, especially if you work 24's so that you can get some rest ans be fresh.

I still have not found the other thread where they discussed the number of calls that they quit getting after frequent fliers got attn. It maybe monday before I'm back on here to so maybe somebody else will find it.

[Arizonaffcep]

I actually think if it were limited to a quick visit and no medical care that there should be no worrys. IMHO even if you did a BP it should still not matter. Some patients that call just for attention might be stopped. They might even break out coffee and cookies. Sorry all the fears of a lawsuit for doing a good deed are way blown out. I do think it should be only one or 2 houses a day though, especially if you work 24's so that you can get some rest ans be fresh.

I agree! After all how many of us do "blood pressure checks" for the public? Even if it's out of "whack" we advise the patient that they should get it looked at, but it's their responsibility to carry that out. If they want transport then-not an issue. Otherwise, make a note in the daily station log about what has happened and that's good enough for us.

[VentMedic]

make a note in the daily station log about what has happened and that's good enough for us.

What about good enough for the patient?

Until you know the expectations of what is being asked of Paramedics by whoever is suggesting this program and the needs of the frequent flyers which could be serious medical needs patients, it would be difficult to say what is actually good enough. I think you may have a stereotyped view of "frequent flyers" as be BS. The "frequent flyers are not always just lonely old person who wants to serve milk and cookies to the young firemen. Many of ours have lung problems or very brittle diabetics both of which are also compounded by recurring infections in various areas of their body. Helping them management their care at home would be more appropriate than a BP check and a not to say "Been there".

These programs are excellent but EMS must be aware of what services are available in the community to refer to if the patient's care is beyond a BP check. As well, the Paramedic may need to understand what they are able to do and acquire more training to recognize more than just emergent situations which you pointed out by your statement "I'm a Paramedic" earlier when I talked about preventitive medicine.

As a patient advocate I believe the people in the community should have access to the appropriate programs and levels of care and not just a band-aid that might be convenient for the moment. If the program is well thought out with adequate preparation and all available resources can be utililized to facilitate the success of the care for the people then great. Community health has always been one of the areas where a paramedic could expand their abilities. However, the "I'm a Paramedic and I only do emergencies" has stagnated the growth potential for more education and advancement into that area.

[crotchitymedic1986]

Let me give you an example of how this can work: At one of my 911 employers, we had an elderly lady that lived basically across the street and four houses down from the Fire Station. She was in her late 80's, had no family, and the nice neighborhood she had moved into 40 years ago, was now basically the Hood. She lived alone and panicked very easily, when she panicked, she would have "pseudo-seizures" (not really a seizure, as she could clearly talk and answer questions during the seizure -- and call 911). So somewhere between 1-2 times per week, she would call after midnight for a seizure when something went bump in the night -- or maybe when she was just lonely -- who knows.

We did not have this program in place, but we did exactly what was proposed in this program. By going over to her house on M, W, F, after dinner, and checking on her, we eliminated the seizure calls after midnight. We also realized during these check-ups, that she rarely had dinner cooked for herself. So we hooked her up with the local support agency, and started bringing her a plate of food from the station when we had leftovers (not every night). And it was us that discovered her body, during one of these welfare checks, after she had died.

Now before we get off on "she was an abuser, and should have been treated as such": If you could find a cop to charge an 88 year old with a crime, I doubt there is a judge in the world who would have done anything about it. Her doctor had diagnosed her with a "seizure disorder".

Whether you agree or disagree with what we did, I think I can say we did "the RIGHT THING (or the WWJD thing)". I think we enriched her final years, and I know she enriched ours, as she was really just a sweet lonely old lady.

And no, we didnt get a refusal when we went to her house, or even assign a case number. We did the neighborly thing. I guess some bad things could have happened that would have left us hung out to dry --- but in hindsight i am glad we did what was right.

In my humble opinion, we are here to serve the public, and that service is not limited to strictly emergency patient care. I later worked for smaller rural services that cooked thanksgiving meals and delivered them to the needy, and also collected and delivered christmas presents to needy children (note I said needy, not homeless).

Too many services focus all their energy on "saving lives", which is a good thing, but you have far more opportunites to "touch someone's life", and you dont have to sacrifice the first to do the second.