Save 1-2 million patients in 2009 ??

[akflightmedic]

The problem is you seem to think everyone needs convincing and your argument is the only right one and that no one else had thought it before.

Your delivery lacks tact and there is not much we can do for you in that regard. One day, when you come off the high horse to where all we lowly commoners are and present your thoughts in a well thought out, non attacking, non condescending mode, you may have more intelligent discussion at your disposal.

[crotchitymedic1986]

I have no high horse, I have asked for suggestions, but most replies have been a denial for the need for action. I am open to any suggestion that fixes the problem, I only offered the one that seems the most logical too me, doesnt make it right or wrong.

But for those who believe that EMS mistakes only occur in Washington DC, that is fine. Tell me how you would fix their problem. It should be easy since no one at your service has ever made such a mistake, so just tell us what you do to prevent it.

[Dustdevil]

But for those who believe that EMS mistakes only occur in Washington DC, that is fine. Tell me how you would fix their problem.

That's the simplest question ever asked here. Are you honestly incapable of answering that question yourself, without getting into some long, complicated theory? I can solve DCs problems with two words. Or actually, just one word repeated twice.

[crotchitymedic1986]

please share dust, as I am not at all familiar with their system, only its reputation.

[Dustdevil]

Fire.

Nuff said.

[akflightmedic]

Here are examples of your high horse and lack of tact which causes many of your discussions to sour. I have made notes of how your context seems to come across.

If I promised you that by changing one thing….would you be for it ?

You already know the answer, and it seems to be your way or no way.

Ok, I will go ahead and spill the beans, and then you can attempt to argue my hypothesis:

See, "spill the beans", again you knew the answer. You demonstrated superiority by knowing something and teasing us, instead of presenting in an intelligent format. Then the statement of "ATTEMPT TO ARGUE"..come on, to imply you are right and we can not succeed...get real man.

So, why not make this easy, but necessary, change to ensure that the lazy or inexperienced providers do not get refusals on patients who need transport ?

Oh but wait, your idea is sooo easy. It is the right way of course AND it is easy, however there are many other logistical issues that would need major planning to ensure this smooth transition.

And then you insinuate that only the lazy or incompetent are getting refusals. No call is ever the same and to box in every refusal into this context is an insult. Patients do not present with all the proper symptoms (due to them not reading the text), they do not report all the symptoms, any number of things could affect who and why a refusal is obtained.

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.

Here you go again as with previous threads..the "ugly EMS secret". No it is not an ugly secret. This is another one of your ways of delivering a potentially controversial subject in the context that "we all do it or know of it", which is entirely untrue. There are no universal truths in medicine.

Then you say I (the reader) am not a true pt advocate if we do not deal with this issue. The correlation you present is horrible, unfair and just plain idiotic.

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).

Now you presume to know what is in my heart. Quite the mighty horse you got there mate. You presume to know what I have or have not heard as well, quite omnipotent you are.

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

We do? Are they? They are?? Man you are everywhere and know everything...amazing!

we are talking about the ones where lazy medics talk someone out of transport, and then have them sign a refusal, leaving the patient at home to die.

Again, it seems to only be directed at the lazy medics and they seem to be prevalent in your world. Interesting.

[crotchitymedic1986]

interesting interpretation, thank you.

[Arizonaffcep]

http://www.trueposition.com/web/guest/emer...y-call-location

Indicates 200M 911 calls, not every county has 911, and not all emergency ambulance calls are handled by 911, so 200M is a low number.

But that is fine, lets assume all my numbers are bogus. How many is too many ? If the real number is only 100,000 deaths, does that make it better ?

First, the source you quoted is not valid. It's an advertisement for a private company. A good source is a peer-reviewed journal, well respected health agencies (CDC, WHO, etc.) scientific journals (these are peer-reviewed).

Here's what gives it away..."Only TruePosition has the intellectual property, technical expertise and unparalleled operational experience to provide mission-critical, location-based safety and security solutions like Emergency Call Location. Today, TruePosition’s U-TDOA location technology keeps over 100 million wireless subscribers in the United States safe and secure." http://www.trueposition.com/web/guest/emer...y-call-location Now...the 200m is referenced from FCC-a good source. Lets look at this: "According to petitioners, in 2006, PSAPs in Tennessee reported more than 10,000

fraudulent 911 calls from NSI phones in just a three-month span of time. In Florida, several

PSAPs reported approximately 8,400 fraudulent 911 calls from NSI phones in just one month

(December 2006), constituting more than 96 percent of the 911 calls received by those PSAPs

from NSI phones." from http://fjallfoss.fcc.gov/edocs_public/atta...OC-281494A1.pdf

The reason I bring in the "fraudulent" 911 calls, is because, although it is not a significant portion of the calls made, they are a percentage, which needs to be figured in.

As far as the 200million calls to 911 a year...I've spent roughly an hour scouring the FCC website for numbers. The closest I can come up with are: "Currently, about 260,000 calls nationwide are placed to 911 every day." This is from document ntcc4002 from the FCC website. The only problem is, the number of calls listed was from 1994. But it calculated out to approximately 95 million calls a year. If you can find it, cite it in a post. I'd be curious to see the actual number from a more recent year.

Acuracy is needed for a good debate. Otherwise, it means nothing. When you bring "facts" into play, support them by citing where you got them.

[crotchitymedic1986]

I agree, facts are an important thing, but unfotunately, as stated many times, EMS is not required to report these errors, so the only ones we know about for sure are the ones that resulted in a lawsuit that was publicized in the media.

But again, I do not think that anyone of any experience in EMS can claim that mistakes are not made. We can argue about what percentage it is all day, but even if it is only a fraction of 1%, that is still alot of patients, nationwide.

Lets just use the busiest service I ever worked for as a Paramedic. They responded to 65,000 calls per year, and had a transport percentage of around 55-60%. If they only had an error in 1/10th of 1% (meaning 99.9% had no errors at all) of all patients seen, that is 65 patients per year (I said errors not deaths). Yes I know that not all calls had a patient, but some calls had more than one patient, so I think it equals out. That is just one county in one state. Out of 65 potential errors, I think it is reasonable to assume a handfull of deaths, when you do not transport 40-45% of patients. And from my experience there, saying 3-4 of these types of episodes sounds about right.

But again, if you only saved one life this year, in your area, by changing the way refusals or medication errors are handled, would it not be worth it (by whatever strategy that you use) ?

[Dustdevil]

But again, if you only saved one life this year, in your area, by changing the way refusals or medication errors are handled, would it not be worth it (by whatever strategy that you use) ?

Again, it is as simple as one word. Fire.