As EMS/PHC Providers; Are We That Lazy?

[NYCEMS9115]

DC EMS Crew Disciplined For Not Taking Woman To Hospital.

http://link.brightcove.com/services/player/bcpid30317508001?bckey=AQ~~,AAAABvaL9Hk~,mLC66bU8hPPEixOfY5Pc8DGh7QP3dFX0&bclid=0&bctid=71261980001

EMS Didn't Transport a 2y/o and 2y/o dies.

http://statter911.com/2010/03/11/dc-police-conducting-review-of-paramedic-who-provided-care-to-dying-two-year-old-girl-homicide-detectives-will-try-determine-if-the-ems-worker-was-criminally-negligent/

Edited April 15, 2011 by NYCEMS9115

[Kiwiology]

Our Ambulance Officers have been pro actively leaving people at home for nearly four decades and sometimes they die.

It is unreasonable and impractical to simply "transport everybody" and not rely the professional judgement of the Ambulance crew to determine whether transport is warranted or not.

I am not sure I understand how that is somehow criminal!

[NYCEMS9115]

No PCR or Call Reports were done.....

[paramedicmike]

Our Ambulance Officers have been pro actively leaving people at home for nearly four decades and sometimes they die.

It is unreasonable and impractical to simply "transport everybody" and not rely the professional judgement of the Ambulance crew to determine whether transport is warranted or not.

I am not sure I understand how that is somehow criminal!

Kiwi,

DC EMS is notorious for a complete lack of professional judgement. What's criminal about it is that the capitol city of the US has one of the worst EM Services in the country.

These are but two examples of a broken system in what is widely considered to be the capitol of the free world.

This says nothing of the lack of education many within the system in question. That's an entire problem in itself.

[Bieber]

I agree with Kiwi on principle. With regards to this case specifically, without knowing the specifics, I can neither condemn nor condone. Were they in the wrong? Maybe. Was this just one of those things that happen? Also maybe. Not having a PCR, though, that's going to be what damns them.

[Richard B the EMT]

The way FDNY EMS Command does it, depending on certain variables, a patient can refuse aid and/or transport. Obviously, under other certain variables, the decision must and will be made with On Line Medical Control. No matter what the variables, if a "Patient Contact" is established, a PCR (Prehospital Care Report) must and will be generated, even if all it states is an unknown (male/female) refused all attempts at aid, and walked away from the crew at location, to points unknown.

[NYCEMS9115]

Its not about transporting everyone but if the patient wants to go to the ER; you take them to the ER. Your job isn't to make them refuse or tell them that they don't need an ambulance.

[HERBIE1]

Our Ambulance Officers have been pro actively leaving people at home for nearly four decades and sometimes they die.

[red]It is unreasonable and impractical to simply "transport everybody" and not rely the professional judgement of the Ambulance crew to determine whether transport is warranted or not.[/red]

I am not sure I understand how that is somehow criminal!

This may be true, (and I totally agree with you, BTW) but it's also the standard procedure in most places- at least around here. We don't get to decide who we should and should not take. If someone wants a taxi ride, then that's what they get. The legal language states that an "emergency" is defined by the caller, not the responding crew, meaning if the patient convinces the call taker their problem is legit (AKA- lie), then they get a response. Even if the crew finds out the complaint as dispatched was total BS, we have no mechanism to refuse to take the person. Thus, in most places we have overwhelmed systems and overcrowded ER's. In this country, lawyers run the medical field and dictate how we do our jobs.

[zippyRN]

Its not about transporting everyone but if the patient wants to go to the ER; you take them to the ER. Your job isn't to make them refuse or tell them that they don't need an ambulance.

hate to break it to you but the role of the Professional Emergency Care Provider is to direct people to the most appropriate means of meeting their care needs , whether it's telling them to go to Wally-World for 20 p box of paracetamol or calling in helimed to fly them to a tertiary centre - via every outcome in between, the key variable is knowing what outcome when and documenting the decision process and differential findings that led you to that outcome.

while Ambulance services are glorified taxi services , ambulance crew will be paid as taxi drivers.

This may be true, (and I totally agree with you, BTW) but it's also the standard procedure in most places- at least around here.

buit it isn't in vast trtacts of the civilised world

We don't get to decide who we should and should not take. If someone wants a taxi ride, then that's what they get. The legal language states that an "emergency" is defined by the caller, not the responding crew, meaning if the patient convinces the call taker their problem is legit (AKA- lie), then they get a response. Even if the crew finds out the complaint as dispatched was total BS, we have no mechanism to refuse to take the person. Thus, in most places we have overwhelmed systems and overcrowded ER's. In this country, lawyers run the medical field and dictate how we do our jobs.

nothing to do with lawyers and everything to do with poor clinical management and poor preparation for clinical practice, the legal aspects are as a result of that and of the'mother may i' system rather than Paramedics being Health Professionals in their own right ...

[BEorP]

Our Ambulance Officers have been pro actively leaving people at home for nearly four decades and sometimes they die.

It is unreasonable and impractical to simply "transport everybody" and not rely the professional judgement of the Ambulance crew to determine whether transport is warranted or not.

I am not sure I understand how that is somehow criminal!

Would you be able to share your protocol for this or direct me to a thread if it has already been shared? Thanks!