Save 1-2 million patients in 2009 ??

[crotchitymedic1986]

OK, the math was questioned, lets address that:

1. A 1-2% failure rate is universal to almost every business. No business is perfect.

2. We know for a fact that 400,000 US citizens die each year from hospital medical mistakes. I think the last number I heard was that there was about 5,000 hospitals in the US, and there are far MORE EMS providers than there are hospitals. So it is reasonable to assume that our numbers would be proportionally higher.

Next, can you guarantee that the supervisor is smarter -- NO, but most supervisors have some seniority and have shown that they were better than others in the company at one time.

You can dislike this all you want, but it is an ugly EMS secret that needs to be dealt with if you are a true patient advocate. What has happened in DC is not unique, nor limited to that geographic area.

[akflightmedic]

OK, the math was questioned, lets address that:

1. A 1-2% failure rate is universal to almost every business. No business is perfect.

2. We know for a fact that 400,000 US citizens die each year from hospital medical mistakes. I think the last number I heard was that there was about 5,000 hospitals in the US, and there are far MORE EMS providers than there are hospitals. So it is reasonable to assume that our numbers would be proportionally higher.

Next, can you guarantee that the supervisor is smarter -- NO, but most supervisors have some seniority and have shown that they were better than others in the company at one time.

You can dislike this all you want, but it is an ugly EMS secret that needs to be dealt with if you are a true patient advocate. What has happened in DC is not unique, nor limited to that geographic area.

You have some of the most unsubstantiated and flawed logic/reasoning. It is pointless to debate you or counter your side as you offer no facts...EVER. You pull conclusions out of thin air.

You also seem to have a lot of "dirty little EMS secrets" that not many of us seem to encounter as much as you did/do.

[crotchitymedic1986]

Are you saying that in all of 2008, your service has not had a single patient death from someone who "refused" EMS transport ? And all I can do is use logic and reasoning as EMS is not required to report these incidents like hospitals are, so there are no "real statistics to use", but if you google phrases like

EMTs blamed for death

Paramedics blamed for death

EMS sued over patient death

You will see this is not an isolated problem, but in your heart you already know that, as everyone in this room has heard a story about a similar call in their region (if not their service).

[BEorP]

That would mean 2,500,000 deaths, total, for the whole US. If we were to change one rule, we could save alot of these patients.

Please define"alot of patients." I find your hypothesis hard to believe.

[reaper]

Are you saying that in all of 2008, your service has not had a single patient death from someone who "refused" EMS transport ? And all I can do is use logic and reasoning as EMS is not required to report these incidents like hospitals are, so there are no "real statistics to use", but if you google phrases like

EMTs blamed for death

Paramedics blamed for death

EMS sued over patient death

You will see this is not an isolated problem, but in your heart you already know that, as everyone in this room has heard a story about a similar call in their region (if not their service).

Those are the key words there. Someone is always going to try and lay the blame on someone else. The pt may have refused AMA. Then they die! Of course the family is going to try and blame the last people to examine them. This does not mean that the provider did anything wrong or negligent. That is just human nature, to blame someone else for the problem.

[crotchitymedic1986]

Fair questions: Define Alot: It was my experience that when my medics called a supervisor to the scene to help them talk a patient into going (who needed to go, but was really refusing) the supervisor was able to talk the vast majority into transport. And that wasnt always because the supervisor knew something to say that the medics didnt, but i think that the pt realized "if these guys are so concerned about me that they called a supervisor, and the supervisor agrees with them, then I should probably go".

With that being said, some small percentage would still refuse, so I dont think you can save them all. But what if the number is only 10% of what I think it is ? If we only save 200,000 patients, would it not be worth it ?

And I appreciate the desire to defend the medic and say that we cant be blamed if the patient refuses, but we know that the vast majority of refusals are not "true refusals" but rather the result of some conversation where the medic said "you will be ok to go by car or go to your doctor tomorrow, as indicated in the DC cases.

[crotchitymedic1986]

And in the case of a patient that died after truly refusing, wouldnt it be great to be able to tell the jury: Hey, not only did we beg him to go, but we had a supervisor come to the scene or called the patient on a recorded line, and we still couldnt get him to go. Please admit this taped conversation as defendant's exhibit- A, and play the tape for the court (or note our refusal form that was also witnessed by the supervisor).

[firedoc5]

And I appreciate the desire to defend the medic and say that we cant be blamed if the patient refuses, but we know that the vast majority of refusals are not "true refusals" but rather the result of some conversation where the medic said "you will be ok to go by car or go to your doctor tomorrow, as indicated in the DC cases.

Any Medic that tells someone something like that, and they know the pt. needs to go, then that is a poor decision. If they feel needs to go at all, do everything you can to get them to go with you now. Not later or by car.

I think that DC has a problem with "burn-out". When Medics are burned-out they become apathetic and non-compliant with pt's. and their treatment and transport. If you get a "whatever" or "who cares" attitude, then it's time to get some help.

[HellsBells]

EMTs blamed for death

Paramedics blamed for death

EMS sued over patient death

Ok, I tried your little test, then I put in the statement doctors blamed for death, and doctors sued over death, there were a lot more hits for those.

There are major faults to your logic, which I think you have to address.

However, lets talk your statement at face value. Your Hypothesis (if you can call it that) is that of all the 911 calls 250, 000, 000, there are 2,500,000 that result in death. There are two major flaws with that logic

1. You assume that these pts would have lived with transport to the hospital, even with the best care from all medical providers, some pts will die.

2. You assume that any error or omission from a paramedics care will result in death.

Believe me there is NOT 2,500,000 deaths occurring a year due to failure to transport, it would not go unnoticed.

[crotchitymedic1986]

OK, I can conceed that you have made a very logical arguement. The fact is that we do not know, because:

a. The occurences are not reported to an entity. So we have no idea what the number is, it could be 10% of what i am proposing, maybe its 400% of what I am proposing.

b. Many that do occur, do not result in lawsuits, because we whip out our Ace in the hole, "the refusal form that was signed by the patient" (although the medic told them they didnt need to go).

c. Many times these patients are the least educated and on the lower end of the socio-economic ladder. They dont complain or sue, because they dont even know that they can --- and if they did, who is the white court gonna believe, those professional medics in uniform or me the african american crack addict or homeless person ?

But as i stated in my last post, lets assume our numbers are far superior to the hospitals (who by the way, kill 400k with all the lab, xrays, and procedures available to them), and are far less than what i suggested (take it down to as low as 10% of what I think it is). How many deaths are too many ? 100,000, 50,000, 25,000, 1,000 ? How about "1" being too many ?