Taking Vitals

[Timmy]

So… Let me get this right… You have staff who are qualified in advanced first aid doing critical care transports?

I pose this moral question, how is this possible?

[tskstorm]

A while back I was working BLS at the end of my medic class, Working with a brand new EMT, 3rd or 4th shift, we were working a 911 service, picked up a 13 yr old female with her menstrual period. Long story short, pt vomited, we took her down stairs, mom signed RMA for stair chair, get in vehicle take vitals, palp abd, it was warm out A/c was on pt was cold, put a blanket around her, txp around the corner (Literally 35 seconds from pt's door to ED doors.)

Case closed right?

Its never that simple, my partner and I were told to write incident reports and to come down to be interviewed, because a complaint was made, among the complaints was we didn't take vital signs.

Now by the time the complaint trickled down to me, I had seen another 250+ patients between work and school over the next 2-3 weeks. I couldn't remember which way was up with the patient, and I was driving. During my incident report and interview I specified I remember vital signs being taken but I did not remember who took them. I can attest to this because I know if I don't take them my partner did or as suggested I would have taken them myself, no reason not to they take just a few moments. I would need to review the ACR to be specific (which has a check box for who took the vitals.) I was also asked if my partner took vitals from the time we left the scene to the hospital, honestly not knowing I told them I didn't know, I was focusing on being a good driver if even for a short drive. This was my story and I stuck with it, however my partner being new, when interviewed admitted to not remembering who took the vitals and couldn't remember if we actually took them. He was fired on the spot.

Point here, is if someone asked you did your partner take vitals? What would you say, since you know the answer?

Are you willing to lose your job or your certification/license for this partner?

Not a decision to be made lightly, but a decision that will have an impact on your career, and on your opinion of yourself.

[HERBIE1]

Very good advice, and an excellent post. Way to stand your ground and do the right thing for the ICU pt, inspite of being pushed by the resident MD and the nurse!

Thanks.

I'll never forget that call, even though it was nearly 25 years ago. I remember I was working with a fairly new medic who was scared to death because we "disobeyed" a doctor. After we left the ICU, I sat him down and explained that we don't work for that doctor, we work for the patient. I explained that we didn't just make a decision on our own, we confirmed it with medical control, which is exactly what we are supposed to do. We do what's right for the patient, and if you know you are right, you stand your ground- regardless of whom you are dealing with.

Let's just say this was not among the top tier of hospitals (and still is, I believe) a very small, nontraditional ER, which meant if we brought in a cardiac arrest to the ER in the middle of the night, we would need to work that patient in the ER until a resident from the floor could come down and take over. Generally, the only thing the doc would do is confirm tube placement, confirm asystole, or simply pronounce them on the spot.

A while back I was working BLS at the end of my medic class, Working with a brand new EMT, 3rd or 4th shift, we were working a 911 service, picked up a 13 yr old female with her menstrual period. Long story short, pt vomited, we took her down stairs, mom signed RMA for stair chair, get in vehicle take vitals, palp abd, it was warm out A/c was on pt was cold, put a blanket around her, txp around the corner (Literally 35 seconds from pt's door to ED doors.)

Case closed right?

Its never that simple, my partner and I were told to write incident reports and to come down to be interviewed, because a complaint was made, among the complaints was we didn't take vital signs.

Now by the time the complaint trickled down to me, I had seen another 250+ patients between work and school over the next 2-3 weeks. I couldn't remember which way was up with the patient, and I was driving. During my incident report and interview I specified I remember vital signs being taken but I did not remember who took them. I can attest to this because I know if I don't take them my partner did or as suggested I would have taken them myself, no reason not to they take just a few moments. I would need to review the ACR to be specific (which has a check box for who took the vitals.) I was also asked if my partner took vitals from the time we left the scene to the hospital, honestly not knowing I told them I didn't know, I was focusing on being a good driver if even for a short drive. This was my story and I stuck with it, however my partner being new, when interviewed admitted to not remembering who took the vitals and couldn't remember if we actually took them. He was fired on the spot.

Point here, is if someone asked you did your partner take vitals? What would you say, since you know the answer?

Are you willing to lose your job or your certification/license for this partner?

Not a decision to be made lightly, but a decision that will have an impact on your career, and on your opinion of yourself.

Who made the complaint- the family or the ER? Did the patient code or something?

[snoopy911]

So… Let me get this right… You have staff who are qualified in advanced first aid doing critical care transports?

I pose this moral question, how is this possible?

No timmy. I guess I didn't make myself clear. The critical care team consists of 2 RN's, 2 EMT's, and possibly a doctor or a respiratory therapist.

[Kiwiology]

So… Let me get this right… You have staff who are qualified in advanced first aid doing critical care transports?

I pose this moral question, how is this possible?

From wht I have seen American EMTs render no care whatsoever and are just a set of hands for the physician or RN.

[Don1977]

From wht I have seen American EMTs render no care whatsoever and are just a set of hands for the physician or RN.

I beg to differ.......

[BoCat9]

I was on a routine transport once and was taking a set of vitals and found out the cuff I was using had a broken gauge. I asked my partner to remind me to get another one before our next call, and she said "why, I'm not going to take any anyways". I lost any trust I had in her that day.

[SA_Medic]

Scary stuff. In South Africa you are required to have a drivers license in order to enter the profession. From time to time we (supervisors) simply arrive on a scene or call and do "quality" checks on the crew at hand. As supervisors or ALS providers we have rapid response vehicles making such checks easier. I had a 4year ILS member recently who had no idea how to check HGT when I asked her to please check it on a suspected hypoglycemic case. Her incompetence resulted in a disciplinary hearing with a final written warning.

I also instituted remedial action for this and forced her to check HGT on all patients, no matter what the complaint. Later that week I noticed her running through the office taking HGT from everyone there. Suppose her job suddenly meant a whole lot to her.

This dude needs to be sorted out real quick. If he lies so blatantly about vitals, he will easily lie to save his own ass while dropping you in the crapper like a hot potato. Sadly in life you are the most important person when it comes to watching your back, no matter how long you know someone, they won't do it as good as you can.

[snoopy911]

Ben you don't know how our CCTs work so... don't make me smack you! Just kidding! I get to do more then you think.

[Timmy]

No timmy. I guess I didn't make myself clear. The critical care team consists of 2 RN's, 2 EMT's, and possibly a doctor or a respiratory therapist.

No Prob, thanks for clearning that up