Your typical Lifeline call

[nikipoo]

We have this one guy in town that uses his lifeline to call for help getting out of bed. We wont have call there for bout a month or two, then we will get one for 3 consecutive days, usually around 3 or so in the morning. Always comes across as lifeline call for 80y.o male who has fallen out of bed. Get there and he is soaked in urine and cant get out of bed. Awsome!!!

[HERBIE1]

I agree... I can't stand crochity providers who grumble about the service call to assist a patient. For me, it is their emergency and if I am ever in that situation where I can't get to bed by myself, I would hope caring individuals would come and assist me and not make fun of me or laugh about me behind my back. I get very angry when people assume an elderly individual can't hear them when in fact many have great hearing and hear the derogatory comments made about them. I am 100% with you on this one vent...

Who said anything about making derogatory comments about a patient?

The crew responded to the call.

The crew and FD assisted the patient.

The crew and the FD asked the patient if he wanted medical attention.

The patient/Lifeline requested assistance for a patient who needed to find his glasses.

Was it an emergency that required the lights and siren response of an ALS fire apparatus and an ALS ambulance? Not in my book.

Did the patient need help- yep, and he received it.

Did anyone refuse to respond?

Did anyone refuse to help this person?

Were there any claims of verbal abuse by any responders on the scene?

Maybe he had no other choice- no neighbor or family member to help him.

If the area's service provides this type of help, fine.

If you think it's an appropriate use of an EMERGENCY service, that's your opinion.

I strongly disagree.

Edited October 31, 2009 by HERBIE1

[VentMedic]

Maybe he had no other choice- no neighbor or family member to help him.

If the area's service provides this type of help, fine.

If you think it's an appropriate use of an EMERGENCY service, that's your opinion.

I strongly disagree.

The system is not perfect and the OP did not state what other resources the quadriplegic person had. I would hope that he had a voice activated phone but for some that might not be the case. Also, some systems do call the person before sending a fire truck and an ambulance. If it is not emergent, the primary care giver might be called. The systems are not always perfect but by no means is it always the patient's fault. Find out how the system can be improved and don't just lay the total blame of inappropriate use of EMS on the quadriplegic person.

[scubanurse]

Who said anything about making derogatory comments about a patient?

I did not say in this case but in general... misunderstanding.

Patient education is also an option here. Instead of going out and joking about it, spend a minute or two with the patient and explain to them that their lifeline is an emergency.

And I know of some patients who are blind without their glasses and not being able to find them could result in a serious emergency if they were to walk (not in this particular case) and fall down a flight of stairs.

[tskstorm]

I agree with the OP and Herbie here.

Vent you tend to go over the top with threads like this...

Lifeline is a great device ... unfortunately just like any device it can be misused ...

It unfortunately does get misused and we the EMS providers are usually the ones most effected by this devices misuse.

I go to countless Lifeline jobs where there is no emergency, not even a problem, not a can't find my glasses, not I fell down, not I have an emergency, how about I just need someone to take out my garbage? or how about I need someone to go to the store for me. My favorite is when there is a HHA in the house, and there's a minor ailment that can easily be taken care of by a primary care provider and the HHA will hit the Lifeline button because they don't speak enough English to call 9-1-1 and explain what the problem is instead lifeline calls it in as an unconscious, or unresponsive pt, and we have an Engine company, PD, BLS and ALS responding ... I don't begrudge anyone appropriate treatment however its very important to have an appropriate response to not put "John Q public", and "Johnny Rescue" at risk.

[HERBIE1]

I agree with the OP and Herbie here.

Vent you tend to go over the top with threads like this...

Lifeline is a great device ... unfortunately just like any device it can be misused ...

It unfortunately does get misused and we the EMS providers are usually the ones most effected by this devices misuse.

I go to countless Lifeline jobs where there is no emergency, not even a problem, not a can't find my glasses, not I fell down, not I have an emergency, how about I just need someone to take out my garbage? or how about I need someone to go to the store for me. My favorite is when there is a HHA in the house, and there's a minor ailment that can easily be taken care of by a primary care provider and the HHA will hit the Lifeline button because they don't speak enough English to call 9-1-1 and explain what the problem is instead lifeline calls it in as an unconscious, or unresponsive pt, and we have an Engine company, PD, BLS and ALS responding ... I don't begrudge anyone appropriate treatment however its very important to have an appropriate response to not put "John Q public", and "Johnny Rescue" at risk.

System abuse is a dead horse. In many places, false alarms for fire and police- faulty burglar alarms, faulty fire alarms, etc DO generate fines after a certain number of responses. Is that a deterrent for someone to call 911 for a "real" emergency? No, but "automatic" systems are also prone to errors. In the Lifeline type systems I have seen, there is a telephone link from the patient to the company, which is supposed to verify the patient did not accidentally trip their alarm and does indeed need help. So, in the case of these nonemergencies, either the patient is lying to get someone to bring them a glass of water, the company is not properly screening the alerts, or it's a combination of the two.

If the Lifeline type companies want to promote their service to be able to summon help for a patient that simply needs nonmedical assistance, that would be great, but they need to be able to provide that help in some way- alerting a friend, family member, or some 3rd party to provide that help. Defaulting that help to a 911 service simply because they know that help will ALWAYS be there is wrong. That would also be a departure from their advertised use- to alert responders to someone who is having an EMERGENCY.

In these days of budget cuts, improper use of resources isn't just an annoyance, it costs a service money, and I know of no insurance company that reimburses for an FD, police, or EMS responder to fluff someone's pillow. Funding cuts, budget restrictions, and manpower reductions have finally hit public safety- the last sacred cow- so an honest look at things like this are not just to appease overworked first responders.

[VentMedic]

I agree with the OP and Herbie here.

Vent you tend to go over the top with threads like this...

Lifeline is a great device ... unfortunately just like any device it can be misused ...

It unfortunately does get misused and we the EMS providers are usually the ones most effected by this devices misuse.

I go to countless Lifeline jobs where there is no emergency, not even a problem, not a can't find my glasses, not I fell down, not I have an emergency, how about I just need someone to take out my garbage? or how about I need someone to go to the store for me. My favorite is when there is a HHA in the house, and there's a minor ailment that can easily be taken care of by a primary care provider and the HHA will hit the Lifeline button because they don't speak enough English to call 9-1-1 and explain what the problem is instead lifeline calls it in as an unconscious, or unresponsive pt, and we have an Engine company, PD, BLS and ALS responding ... I don't begrudge anyone appropriate treatment however its very important to have an appropriate response to not put "John Q public", and "Johnny Rescue" at risk.

It truly sucks to be a patient advocate in EMS. You can always expect to be bashed if you offer the views from the patient, hospital or HHA's side on some situations.

Tell us about your experience with disabled patients and home care situations. Have you done anything to improve the situation? Have you talked to quads, paras and the elderly about their frustrations? Have you talked with the reps from LifeLine or whatever company in your area? Have you offered training to the home health agencies? It may sound like I'm over the top because I provide additional information and not just find someone or something to blame. Seeing the situation in only one dimension does not give you a full view of the problems.

Blaming the patient is the easy way out. Of course, some in EMS would rather just piss and moan on an EMS forum about their dislikes about the system and patients rather than attempting to assist companies to find a better solution for their clients and patients. Thus, you become as much of the problem as those that "abuse" the system.

In these days of budget cuts, improper use of resources isn't just an annoyance, it costs a service money, and I know of no insurance company that reimburses for an FD, police, or EMS responder to fluff someone's pillow. Funding cuts, budget restrictions, and manpower reductions have finally hit public safety- the last sacred cow- so an honest look at things like this are not just to appease overworked first responders.

As least HERBIE is consistent. However, he doesn't consider the budget cuts that have put patients into home care situations with inadequate resources. I seriously doubt if he has participated in any petitions to get more funding for Medicare. EMS is a "me first" profession which is also why it doesn't get much support from other healthcare professions in some of their efforts for better funding. Other professions (NP, PA, RT, OT, SLP, RN, PT, MD) include the patients when they are lobbying for better reimbursement and funding. They don't criticize medical needs patients or the agencies that attempt to provide the with care. They try to work with these companies to see how the patient can be benefited and in turn, it usually benefits them as well. But for some opinions here, it would probably be easier just to build large nursing homes warehouse style instead of trying to work out some home care situations.

Now, for those who want to say "I'm over the top" again, please for to the national association websites for any of the professions I mentioned and see what legislative actions they are working on. I don't just pull this stuff out of thin air. It comes from many years of being active in both of my chosen professions. Unfortunately, EMS has been the toughest for legislative issues largely because of the "me first and only" attitudes that exist in this profession. This is true for some individuals and the many different agencies that do EMS. It is also evident by the 50+ different certs this profession has just to please some and not for the benefit of either the profession or the patient. The new big screen TVs, patio furniture and barbecue sets are a pretty nice also. I also find that those who run only 2 calls per 24 hour shift complaining the loudest about being overworked with LifeLine calls. Those in busy areas are usually relieved when it is a public assist patient where the lifting and paperwork are minimal.

Edited October 31, 2009 by VentMedic

[tskstorm]

I also find that those who run only 2 calls per 24 hour shift complaining the loudest about being overworked with LifeLine calls. Those in busy areas are usually relieved when it is a public assist patient where the lifting and paperwork are minimal.

I work in NYC average 1 call per hour the city averages 3500 calls a day, and I have never worked with an individual who liked these types of calls. We don't have stations to sit around watch TV or eat, we have an EMS room which consists of a small desk with and for paperwork, and supplies to restock, the end. Maybe the 400 providers I work with actually like using the skills and knowledge they have learned. Sure caring for the using this term loosely to cover every type patient aforementioned 'disabled' is part of those skills but probably not the skill the majority of providers enjoy ...

To further reply to your post, I'm doing 1 call per hour, and the average call takes 50 minutes to 1 hour, so I am constantly running, and because of our staffing, I'm averaging 60 hours a week ... When do you suppose I should meet with the patients or talk to reps ? I don't have the time for that. The ultimate point here will be everyone no matter whether they are quad, para, alien, dog, emt, paramedic, firefighter, cop, waitress, doorman, or janitor, EVERYONE has their own frustrations. Yes let me offer a multimillion dollar Home health care company tips ... I mean their business plan is chalked full of excess money to spend on my ideas. Maybe these idea's are plausible where you are ... In a city such as NYC, its not even close to being plausible.

If for some reason you took my original post to be something against "quads, paras and the elderly" you did not understand, there are big holes in the chain of health care between home care, social work, primary care providers and emergency medical providers (hospital and pre-hospital.) If a patient lost their glasses and went into the ER they get an eye exam (if they're lucky) and a referral. If we gave similar care pre-hospitally, we would be handing the patient a referral to speak to a social worker, home health aide, or a patient advocate. I understand picking up someones eye glasses is no big deal, but in a city with a high call volume, you could be tying up multiple resources and running up a high bill which will be unpaid for, while a cardiac arrest 1 block away has the same resources coming but those resources have double the response time. I guess we could "buff"/"pick up" the job ... but if we haven't finished an RMA we can't leave to another job. Further if a person is unable to care for themselves in as simple a matter as picking up their eye glasses, how do they feed themselves etc... now it becomes a question of are they in a safe environment, or is this cause for a social removal so we can get the person to the hospital so a social worker there can get them 24/7 HHA ...

Wow that was a lot of ellipse points guess I had a lot of trailing thoughts!

[stcommodore]

From one urban ems'er to another thanks 'tsk' for giving ventmedic what for. We have a

ed alarm abuser that has been know to press it 3-5 times a day. Medics have "damaged his alarm box" and used all means possible but the ems higher ups have yet to do there job and get him in a nursing home. This pt doesnt need our respect or lessons on being disabled he needs to stop abusing the system.

This is just one example of abuse. Thankfully you didnt need ems tonight where we ran for 2 hrs constantly out of squads.

[HERBIE1]

It truly sucks to be a patient advocate in EMS. You can always expect to be bashed if you offer the views from the patient, hospital or HHA's side on some situations.

Woe is me. Feeling a bit persecuted?

Tell us about your experience with disabled patients and home care situations. Have you done anything to improve the situation? Have you talked to quads, paras and the elderly about their frustrations? Have you talked with the reps from LifeLine or whatever company in your area? Have you offered training to the home health agencies? It may sound like I'm over the top because I provide additional information and not just find someone or something to blame. Seeing the situation in only one dimension does not give you a full view of the problems.

You're over the top because it's easy to talk the talk when you aren't working in the real world. What you ask are social services tasks, NOT EMS. People get advanced degrees and devote their careers to solving problems like these. If someone wishes to take it a step further and contact a company, discuss patient advocacy issues, that is far over and above the responsibilities of an EMS provider.

Blaming the patient is the easy way out. Of course, some in EMS would rather just piss and moan on an EMS forum about their dislikes about the system and patients rather than attempting to assist companies to find a better solution for their clients and patients. Thus, you become as much of the problem as those that "abuse" the system.

More arrogance.

As least HERBIE is consistent. However, he doesn't consider the budget cuts that have put patients into home care situations with inadequate resources. I seriously doubt if he has participated in any petitions to get more funding for Medicare. EMS is a "me first" profession which is also why it doesn't get much support from other healthcare professions in some of their efforts for better funding. Other professions (NP, PA, RT, OT, SLP, RN, PT, MD) include the patients when they are lobbying for better reimbursement and funding. They don't criticize medical needs patients or the agencies that attempt to provide the with care. They try to work with these companies to see how the patient can be benefited and in turn, it usually benefits them as well. But for some opinions here, it would probably be easier just to build large nursing homes warehouse style instead of trying to work out some home care situations.

I'm consistent because I'm not trying to BS anyone.

What happened to you in your career that you seem to have such a dim view of EMS providers? If you started spouting your personal opinions and generalizations about EMS around 99% of the people I work with, you would be quickly shown the door- if you were lucky.

Other professions have professional, paid lobbyists and arms of their groups to push their agendas. IT is also their FULL TIME JOB.

Now, for those who want to say "I'm over the top" again, please for to the national association websites for any of the professions I mentioned and see what legislative actions they are working on. I don't just pull this stuff out of thin air. It comes from many years of being active in both of my chosen professions. Unfortunately, EMS has been the toughest for legislative issues largely because of the "me first and only" attitudes that exist in this profession.

Again, another generalization I completely disagree with. Based on my experiences- and from people even on this board, I see nothing to back up your claim. People here are looking to exchange ideas, obtain information, and verify things. They want to be able to do a better job and help their patients. You need to separate street level providers from administration. Very few providers have the time, resources, or connections to lobby on the behalf of their profession, especially when many work OT and second jobs just to make ends meet. The administration/leaders of the industry are the ones tasked with these functions, and many are in those positions by default- they've risen through the ranks and attained a certain level of accomplishment, but not necessarily the knowledge needed to lobby or push legislation. Often they base their opinions and efforts on experiences when they worked the streets 25 years ago or more. Every one of these folks that I have met or read opinions from is out of touch. Save you faux outrage for the people you claim to rub elbows with- the leaders and administrators. THEY make the policies, not a street level provider. It's easy to blame someone else, but in order to effect change, you need to have the proper "vehicle" to get it done.

This is true for some individuals and the many different agencies that do EMS. It is also evident by the 50+ different certs this profession has just to please some and not for the benefit of either the profession or the patient. The new big screen TVs, patio furniture and barbecue sets are a pretty nice also. I also find that those who run only 2 calls per 24 hour shift complaining the loudest about being overworked with LifeLine calls. Those in busy areas are usually relieved when it is a public assist patient where the lifting and paperwork are minimal.

The different levels of certification are not a convenience, they are based on the needs of an individual area. You can trumpet how you think every EMS provider should have 12 years post grad under their belts before they can ever touch a patient, but yours is an unreasonable opinion, with no basis in reality. You think providers should be more educated- so do I, but I also see the value of a volunteer EMTB in an area that cannot afford anything else. Your smug claim as a "patient advocate" does not wash if you cannot see the value of having any provider vs having nothing at all, because a community cannot afford to hire an EMTP(and all the other costs associated with ALS care) with a college degree and 12 initials behind their name.

That college education would be far more valuable if it concentrated on management, leadership, and business, as this is the real need if we want to move forward from here. Like it or not, EMS is in the health care BUSINESS, and needs to be treated as such.

Again- talk to someone in a busy area. They could operate out of the nicest firehouse, station, garage, ER in the world, but if you run back to back calls, how much time do you have to enjoy the perks and amenities you speak of? As for busy providers being glad to have a nonemergent call like a Lifeline alert- I call more BS. Most providers in busy areas LIKE to be busy and do the jobs they were trained to do. Although nonemergent calls are part of the game, belittling an EMS PROVIDER because they haven't solved all their nonemergent patient's social service needs is nothing more than arrogance and shows a lack of understanding of the basic issues involved in this problem.

Edited November 1, 2009 by HERBIE1