Short Transport times

[Asysin2leads]

My service deals with both short and long transport times. If we get called in the city our times are 3-5minutes. In the County it's 10-20minutes. I personally wish I had longer in back than 3-5minutes. It's frustrating not being able to get everything done because you're at the back door of the ER. I just hurry the best I can and get the most important things done first.

Dan

They way I look at it is that EMS is a continuing spectrum from field to hospital. If we get things done in the field, great. If we get the patient to the hospital really quickly and provide necessary care enroute, that's good too. I mean, if you are 3-5 minutes away from the hospital, and you have a critical asthma patient who needs intubation, and well, you just can't get the tube, I think it is the more responsible thing to control the airway using BLS techniques and get to the hospital where a respiratory therapist can give it a shot in a controlled, well lit environment. EMS works on a time/procedure factor. If it will be quicker to start a life saving procedure in the field, do it. If it will be quicker to get the patient to a hospital to have them do it there, it is in the patient's best interest to do that. This attitude of "if you didn't do the skill in the field, you are just lazy/incompetent/etc. etc." needs to stop. Too many providers are putting their egos above patient well being.

[mediccjh]

I tend to stay and play a little bit. Sit on scene, get my crap done, including IVs, and then go. Unless it is a very critical pt, and I can get all I have to get done on the way in the short amount of time.

I do not stay and play for traumas though.

[RichmondMedik]

This attitude of "if you didn't do the skill in the field, you are just lazy/incompetent/etc. etc." needs to stop. Too many providers are putting their egos above patient well being.

unfortunately being one of the people that is involved with QA/QI, I find to many providers that fit this statement -- they are lazy, incompetent and if it is not "THE BIG ONE" they want nothing to do with the call -- so the EGO also works in the other direction

We,as advanced care providers are the ones on scene and have to make the decision on what is right for the patient at that time -- but if you have to make excuses for why you didn't treat a patient -- my opinion is then you know you should have

Paul

[akroeze]

Back to short transport times. Last night called to a local rest home for a SOB with sats of 70. We get there and our monitor says around 79, throw on the NRB. Take some vitals hook up the monitor and all that, ausculate for some slight expiratory wheezes so we set up a ventolin and pack up to go. Get all loaded up and are maybe 4 minutes from the home to the hospital. 2 minutes into the journey she's starting to complain of some chest heaviness. That's not near to enough time to assess and do anything about it. If we had a longer transport time we would have been able to.

[Richard B the EMT]

For something like that, I'd document on the call report, that, due to the short transport time, I was unable to fully reevaluate the patient. I would also treat (and document) whatever I'd found during the time available.

[akroeze]

For something like that, I'd document on the call report, that, due to the short transport time, I was unable to fully reevaluate the patient. I would also treat (and document) whatever I'd found during the time available.

Oh yeah, we did. It consisted of getting OPQRST and that's it. Not even enough time to pop some ASA.

[Asysin2leads]

This attitude of "if you didn't do the skill in the field, you are just lazy/incompetent/etc. etc." needs to stop. Too many providers are putting their egos above patient well being.

unfortunately being one of the people that is involved with QA/QI, I find to many providers that fit this statement -- they are lazy, incompetent and if it is not "THE BIG ONE" they want nothing to do with the call -- so the EGO also works in the other direction

We,as advanced care providers are the ones on scene and have to make the decision on what is right for the patient at that time -- but if you have to make excuses for why you didn't treat a patient -- my opinion is then you know you should have

My point was, sometimes it is better for a patient to be at the hospital rather than the crew exhausting efforts on scene. If a patient was having an MI, and had difficult veins, and was say 3 minutes away from the hospital, I think it would be better for the patient to be transported to the hospital for intravenous access if it was failed on scene. I know many people, however, who take IV access as some sort of personality challenge.

[RichmondMedik]

I agree if you cannot get the treatment done then by all means PUAHA -- what I see is providers not even starting or trying because " we were to close to the hospital " that is in my opinion the attitude that needs to be changed

Paul

[EMTBDOWLING]

the ambulance station that i work for covers allot of area, with towns few and far between. it sometimes is a necessity to call in a med flight, because the patient may get worse before they get better.

[ambogrl]

mediccjh said:

I tend to stay and play a little bit. Sit on scene, get my crap done, including IVs, and then go. Unless it is a very critical pt, and I can get all I have to get done on the way in the short amount of time.

Me too, especially when a lot of our calls are like "1.2" miles from the ED. We have REAL short calls like that and LONG ones like over 30 mins. So take your pick. It usually is the downhill trauma that is 30 min out and the granny that has the flu that is 2 min out. The way the world turns man.

~Ambo