Short Transport times

[mizzoumedic74]

Short transport times deffinately make you switch your sequence of events. I work for both an urban and a rural service and working in the city makes you switch into a "priority" mode, i.e., what NEEDS to be done prior to arriving at the ER. Other things that are different is my ideals to what I can do on scene prior to transporting in an urban setting. It's deffinatly a different world but the increased volume of calls is great.

[kemt217]

Our service in town has about a 1 to 2 minute tansport time. We do not stay on scene to do IV's or stuff like that when we are that close to the hospital. We transport from the nursing home to the hospital which is across the street from the hospital, no time to do much of anything. We document why things weren't done according to protocol. If we are out in the county, depends, transport could be anywhere from 15 to 30 minutes, just depends on if we come back to town or go to the closest larger hospital.

[fire911medic]

In city, very short always less than 8 min unless traffic from hell. We cover county as well though, so if out in county, it may get up to almost 45 min depending on where we are. So call us urban, call us rural, we can go either way.

[MAMed]

The shortest transport time I've heard of in our service was for an unconscious behind the wheel of a car in a local hospital parking lot. Nurses said it was out of their scope of practice.

[Just Plain Ruff]

NAMed those nurses were giving you a load of crap. They are probably the first to stop a a car wreck and say "I'm and ER nurse" and then try to help you when they are truly out of their scope of practice.

I believe cobra says that if the patient is on their hospital grounds then that patient is theirs. Our cobra investigator said to us one day that if we can see the patient even if he's 1 foot outside the hoispital property then he is our patient.

The hospital that had it's nurses watch as a 14 year old bled out due to a gsw lost a huge lawsuit becuase they saw the patient yet failed to act. They said since he wasn't on their property that he was not their patient.

[Ridryder 911]

Sounds like they "punted and the field goal was good!"... You are right, COBRA definitely addresses scenarios on testing if an occurrence on hospital grounds and even surrounding area within so many hundred feet, the hospital is responsible.

Might want to contact the risk manager and DON, to have them do a refresher.. I am sure they would love to hear about this!... I am sure you will some classes very soon!...

R/r 911

[Ace844]

Sounds like they "punted and the field goal was good!"... You are right, COBRA definitely addresses scenarios on testing if an occurrence on hospital grounds and even surrounding area within so many hundred feet, the hospital is responsible.

Might want to contact the risk manager and DON, to have them do a refresher.. I am sure they would love to hear about this!... I am sure you will some classes very soon!...

R/r 911

I did that once. Took a symptomatic CVA pt form an Urgent care who said the patient was to be seen at ER X. We treated and transported said patient there. The triage nurse after taking report and directing us to transfer the pateint to the ER stretcher in the hall at trige comes back and says. This patient was suppossed to go to ER Y, our affiliate, so put the patient on your stretcher and bring them there. Of course I said no, i would not do so immediately, but if the triage nurse would kindly send the ED attending out to evaluate the pateint and then sign our run form dictating med con orders to that effect that we'd be happy to. The triage nurse got pissed, and then said never mind, we'll call private co. C, they'll do it.

I said thank you, we'll the triage nurse being vindictive went to the Er nurse manager and she came out to talk with us, and said "why didn't you just take the pateint. I said 2 reasons, COBRA and EMTALA. I also reexplained the situation and again, reiterated that we'd be happy to transport said pt provided the aforementioned conditions were met. She said thats all right and left. The ER called and complained, the co tried to fire myself and my partner unsucessfully for contract jeopardy... :roll:

I wonder how many crews would have just transported the pt never knowing how much litigous danger they were in...Lucky for me and my partner i knew what these 2 things were and 'how' they were applied.

out here,

ACE844

[stcommodore]

I've worked calls in the parking lot of our local trauma center. Staff can't leave the building to respond to a call because they are not insured to pratice nor trained to work in the "pre-hospital" setting. Hospitals have there in house responce teams and such but somtimes we don't always know all the background to why things happen the way they do.

[PRPGfirerescuetech]

I've worked calls in the parking lot of our local trauma center. Staff can't leave the building to respond to a call because they are not insured to pratice nor trained to work in the "pre-hospital" setting. Hospitals have there in house responce teams and such but somtimes we don't always know all the background to why things happen the way they do.

Wasnt a law created by Clinton in 94' requiring hospitals to respond to any patient within 250 feet of their front door?

anyone?

I seem to remember this as a Rid reference...

PRPG

[Ridryder 911]

Yes, that is true. For as not being insured to work prehospital, I believe is a crap excuse. I really doubt that is true, I do believe they told that but was not being honest. I am sure, that insurance company much rather cover the staff on a person that injured themselves on the hospital grounds, than to have to wait for EMS to arrive to deliver care in the parking lot of even walk way to ER.

Yeah, let's worry about licensed health care workers providing emergency care, and not someone in full arrest or fell and bleeding, etc... hmmm don't think so.

Far as special people .. why? Surely, all the ER nurses are required to attend ENA trauma nurse core curriculum class (TNCC) and advanced ATNCC. This class certifies, to place patients on LSB, CID, KED, and traction splinting, as well as removal of patients in an auto. Most ER requires this to be hired or employed as an ER nurse or should.

Basically this is a 3 day mini-EMT course, that reviews and familiarizes nurses with most prehospital equipment to allow them to know how, why it used and works. As well of course the basics of trauma, patient assessment, treatment and spinal immobilization skills.

R/r 911