Vermont Medic loses license over fatal crash

[Just Plain Ruff]

Captain, I see your point and it's your decision. It's fairly easy over here, everything invasive means breaking the law so I've done it quite often.

Then again, (as Kat pointed) you breached your scope too... would you do that again? What if your procedure had gone wrong? What if that paramedic had succeeded with his?

How many doctors fuck up massively and don't have their license to practise revoked?

NO I would not do it again, this was when i was a fairly new medic and did not have the experience, I believe, to make that leap that relocating the knee would possibly cause me to lose my license.

I've over the years, 15 years have passed, developed a education and a view of EMS that is much different than what I had back then.

I was a new medic(relatively) and I was 10 feet tall and bullet proof. I took chances and those were stupid decisions. Not to say I took a lot of chances but let's just say, my perspective in 15 years has changed quite a bit and what I would have done back then, is completely different from what I would do now.

So no, I would not do it again.

As for what if the procedure would have gone wrong, I do not even want to go there.

What if the medic in quesiton's procedure had been successful, well he'd be lauded as a HERO and lifesaver and probably get a medal and a beer summit at the white house, but seriously, even if it did go right, the outcome from the state should be the same. If they are going to Yank his license for this abortion of a call, they should also be ready and willing to yank his license if the call turned out with roses and accolades. Going outside the rules like he did, no matter if he saved the life or not, should not make any difference to the State on his punishment.

But we all know that it would. They have to make an example of this guy in terms of what he did, he went outside his scope of practice, his actions may have led to the death of this patient and they need (my thoughts only) they need to show that they mean business when you break the rules. Had he have saved the guy, I can bet that the outcome of this medic's license, we would be discussing a different tune.

Edited October 3, 2012 by Captain ToHellWithItAll

[Richard B the EMT]

I do hope all in this discussion remember that local, county or parish, state or province, and country protocols may be totally different, as I note both US and Canadian string contributors. There will probably also be similarities, too.

[BushyFromOz]

I wish EMS would take a page from the airline industry point of view, and instead of investigating with the view to decide if punitive action is required against thoise being investigated, they should look at the system.

Medic got tunnel visioned

Why did medic get tunnel visioned

Medic performed procedure not supported

Why did not medic perform said procedure

Medic allowed EMT family member to stay on scene

Why did EMT remain on scene

If the system is not at fault then the medic is then up the creek in a barbed wire canoe. I know why my lot dont to a systems analysis, and its because they know its busted and they dont know how to fix it.

You dont see any of these articles saying "medic X was cautioned, suspended without pay for 1 month then placed on a rigourous re-education program and probation for 2 years". Sacking doesn't really get to the rot of the problem

Kat

Ive been reading through some of the judgement from you professional body and it concerning to me how rigid their application of "scope of practice" is

I didn't read anything in any of the judgements i read, none mentioned anything about clinical decision making that is appropriate at the time

Its concerning, they employ a bunch of motivated, intelligent, educated people place them in a position where problem solving skills are the order of the day then tell them to follow a cook book and any "problem solving" gets you a professional misconduct charge

At least thats the way it reads

[Arctickat]

I do hope all in this discussion remember that local, county or parish, state or province, and country protocols may be totally different, as I note both US and Canadian string contributors. There will probably also be similarities, too.

I, for one, understand this, but we're not really discussing differences in protocol, but the repercussions of exceeding Scope or not following protocols.

[DwayneEMTP]

I was blessed to have made this decision early. When faced with what I considered to be a moral and ethical conflict when first going to Afg I called Babs, and she said, "If you damage your paramedic spirit to stay employed...or allow someone to suffer so that you can keep bringing home a paycheck, I won't thank you for that. Don't come home and expect me to call you a hero." This is a woman running a single income household and raising a handicapped child...And, as Babs almost always knows what's best for me, I've followed that for my career.

There have absolutely been times, while I was performing an intervention, thought, "I'm going to get so fucked for this..." But I didn't get hosed on those, actually. I got hosed the times that I performed what I knew for a fact to be within protocol, but no one at the service had the balls to perform. I'm guessing a few of us remember my hypoglycemia/ I/0 patient? (That was a pleasant thread, wasn't it?)

It's going to be decided by what you can live with, in my opinion. If you are ok living with the fact that you allowed someone to die, or suffer when you had the knowledge and skills to mitigate that, as you're covered by your protocols, then ok. I won't judge you for that. I won't find it abhorrant that you chose to protect your family first.

For me, and this is a personal decision not an argument for my point of view....I have chosen not to allow suffering if I can mitigate it. I just simply don't believe that you can allow a person to be further injured, or remain in pain, or, in cases that I'm personally aware of, allow people to die, because your protocols say that you must, and then ever come back from that and pretend that you're a real paramedic. The heart and soul of which, I believe, to be patient advocacy.

It's an interesting delimma, that's for sure...

[island emt]

dwayne: what you might have done or not done while working in a foreign country is different . You still had rules to follow , but were operating under a different type of ROE.

when I worked at a private gig the rules were different than what is the normal outside the gate.

The DR's we worked for allowed different things for different providers.

Yes we have all made a conscious decision to push the limits of the law. It's how willing were we to take the consequences?

[DwayneEMTP]

Hey Island, the times that I was mentioning were inside the U.S. working on the street. I've never been jammed up outside of the country....

[Richard B the EMT]

I do hope all in this discussion remember that local, county or parish, state or province, and country protocols may be totally different, as I note both US and Canadian string contributors. There will probably also be similarities, too.

I, for one, understand this, but we're not really discussing differences in protocol, but the repercussions of exceeding Scope or not following protocols.

What I'm referencing, is some of our members are almost autonomous, not needing either OLMC or a Dr, until and unless they feel a patient needs to "Get to da choppah". Those would be Paramedics serving in wilderness encampments, as one example, mid ocean oil rigs as a possible other.

(Forgive the "Governator" reference, I just couldn't resist.)

[chbare]

I worked in such a situation; however, I never felt the need to perform high risk procedures with significant consequences and little benefits when I was close to a hospital. Let us not forget multiple issues including pharmaceutical misuse, ignoring the request of a physician and delay in transport were also quoted.

If a counter argument is going to be valid, somebody here is going to have to defend the paramedic's actions and show how they could be considered standard of care or even best practice.

[Arctickat]

I don't know that anyone here is actually trying to defend his actions. More that we're debating if the punishment fits the crime.