Rural hospital Freakouts!

[Ridryder 911]

You know (not to belittle or pick upon specific poster) this is why we have the reputation we do...... I have seen many EMT's even Paramedics snicker and laugh at Doc's, nurses or even other medics of situations ... (i.e medical treatment, educational issues, staffing... Then only to find out, they were so foolish and made arses out themselves, then they are usually too stupid to realize it.

What is it with this profession that makes one think that because they took a simple couple hundred course, that they actually know medicine? I must profess, next to the housekeepers, I believe EMS in one of the most ignorant in generalized medicine... hmm ...then again most housekeeping know the difference between colonized MRSA and non-colonized.

I find this ironic due to most have NEVER really worked in medicine at a clinic, hospital, even a nursing home. Shocking but yes, it's true most health care professionals do not consider EMS really even a medical field, rather it being a public service (which, I totally disagree). The most exposure to medicine for some is the 30 minute wait in ER either dropping them off or the couple hundred hour clinical. wow... that makes one an expert huh? That would be like a oncology nurse being an expert in EMS, after completing a ACLS class.

I have been in the medical field for nearly 30 years, I still continue to learn and be amazed, and yes frequently ask questions... in my own department, & other areas... Yes, even housekeeping. I really have attempted to change my attitude in the past years, hopefully maturing (not getting old!) and realizing it's a big world out there... and everybody's' job is just as important as the next... think of it the next time, you see that empty trash can.. someone did their job well.

R/r 911

[Just Plain Ruff]

This is just too good to pass up. just by reading the topic I knew that this would be a rural ER bashing post.

Just what part of this scene was not an emergency?????

I have worked in those types of ER's. I have worked in two ER's where there are one or two nurses on in the ER. They are usually very good. But the case you have tried to keep from slamming on the nurses you work with, which you failed to do so sounds like a true emergency. You actually said two things, I'm not here to rag on nurses and then you say immediately after that "well maybe a little"

9 months pregnant, seizes at home, then again in the ER parking lot or wherever she siezed the 2nd time is a extremely critical patient. Sure sounds like you came in and saved the day. ONe other consideration other than eclampsia could be an amniotic fluid emboli to the brain which is an almost 100% fatal occurrence. The fact that you considered this a non-emergency patient makes me question your understanding of pregnant patients that seize especially pregnant patients who are due within a day or two of the seizures. This my friend is a extremely critical patient and the fact that you didn't realize after the fact even when you drove this patient 160Km to another hospital where she was immediately wheeled into the OR and intubated - apparantly you failed to realize even then that this was a critical patient.

Were there any other patients in the er? That could have added to the stress and "freak out factor" if they had other patients that they had to take care of also and it was just the two of them.

Consider also the fact that not only do you have a mother's life in the balance, you also have a full term baby in tremendous danger too.

I'd do some research on eclampsia, seizures in late pregnancy and also amniotic fluid emboli.

If it is a small hospital in a small rural town then I can bet you that one of the nurses may have known the patient which puts another big pucker factor as you never want to treat your friends or family members.

Finally the other question is this which has been asked once already - why no air transport. This patient was a prime example to be flown.

At least the nurses knew enough and were able to call for Barry's help.

[buckeyedoc]

Eclampsia is most definitely an emergency. My biggest question would be, why didn't they fly her out if the hospital was 100 miles away. My ex-wife nearly died of eclampsia. She seized one time and her HR and the baby's HR dropped so drastically that she was in the OR in a matter of seconds and was having a c-section. Is it just me or is this systemlord a wanker?

[Dustdevil]

The really sad thing is that Systemlord probably reached this conclusion through listening to Barry the paramedic supervisor. :?

[Ace844]

The really sad thing is that Systemlord probably reached this conclusion through listening to Barry the paramedic supervisor. :?

I agree with all the above posters. You know I can't decide which factor or factors in this case that is the worst in the following factors.

A.) Be it that this individual came here and tried use us all to help themselves feel better for bashing on Nurses and having no real understanding of the events that were unfolding.

B.) The fact they came from an 'educated' area-sysstem design and still suffered #1.

C.) That this person had no concept that by their own description this patient was at best highly unstable, and more than probably unsafe for transfer.

D.) As mentioned previously; that this individual posted more anecdotal 'shtuff' to try to support their case and yet saw nothing wrong with their or their partners actions here.

E.) That this they never considered air or other more appropriate asset use or to call their OLMC doc to expalin why they thought this patient may be should not take an hour ride with the standard non-CCT ALS ground ambulance and that this individual had no idea this IS A TRUE EMERGENCY. This is further compounded by the fact that there was no consideration given to thwe fact that 'immediate non-stabilized transfer' in this method may actually increase this patients mortality... :roll:

F.) All of the above factors in combination with so many more I don't have the time or deire to expend the effort to point them all out...

Why do we allow people like this to practice and continue with this type of performance in EMS?!?!? If we allow this to continue amongst our peers why are we surprised when the Janitors and secretaries make more than we do and achieve a better professional standing?!?!?!!?

Out Here,

ACE844

[systemlord]

Well it seems there has been some replies! To some of the people that wrote constructive posts thank you. It is my belief that one never stops learning...and that the patient is always number one. When I post about a recuring problem at this hospital ( without your knowledge offcourse ) and I rag on the nurses.. who cares?? Whats with the somber and serious demeaner... I work there all the time and with the docs as well. To call me a wanker..???because you dont share my point of view on my own opinion is rather sordid!!! You must be the belle of the ball! So I did my research on eclampsia....I talked with the medic..chatted with the docs after to see what and how it exactly happens! So I am not clueless...as much as you like to think! I think we can all differentiate btw an emergency where u need to go NOW.. then something where we first have to fix the problem and then go. So to think that I know it all is bollocks..because I dont..I still have a lot to learn and know that. To the air flight question. We dont really use fixed wing and our helicopters are unfortunately reserved for " true emergencies " this one not being one! As I roam around the forums I do hope to learn some new stuff...unfortunately I dont deal well with " wanker " and glib comments! Humor is a great stress reliever...isn't it?

Much love from the kuwait of the north!

[Scaramedic]

...our helicopters are unfortunately reserved for " true emergencies " this one not being one!

Who made that decision?

I always treated both Pre-Eclampsia and Eclampsia as an emergency, i.e. lights and sirens to the hospital for the definitive care the pt. needed. In this case the definitive care was 100 miles away, yet you have stated it was not a "true emergency." I disagree and it seems all the posters so far also disagree.

So I have this question is for our flight medics, would you consider this a flyable case?

Peace,

Marty

:joker:

[chbare]

Systemlord, (9 months pregnant + seizures = eclampsia unless proven otherwise) (eclampsia = emergency). How could you not consider this an emergency? I am not looking to pick a fight, however, I am very curious to hear the rationale behind why this patient was not considered emergent. Eclampsia is an emergency in a hospital with definitive medical and surgical care, let alone a hospital that must send their patients 100+ kilometers away for definitive care. The sequela of eclampsia can include; intracranial bleeding, liver failure, abruptio placenta, retinal hemorrhage, renal failure, pulmonary edema, fetal hypoxia, hypofibrinogemia, and both maternal and fetal death. The fetal mortality is 25% and the maternal mortality is 10%. In addition, you have two patients.

Take care,

chbare.

[medic429]

and off we went to hospital 160 km away and straight into the OR were she was intubated and ready to be operated on!

Keeping it very basic.....I cannot remember the last time I took a patient to a hospital, straight to the OR, where they were intubated and operated on and NOT called that and emergency! Even if you thought hospital #1 was "freaking" didn't the actions of hospital #2 make you think that the first nurses weren't necessairly "freaking out" for no reason?

[Ace844]

This is one of those times where I wish the "DITCH DOCTOR, and some of the other more famous personalities" would come on back and RE-EDUCATE this individual in the manner for which they so obviously need to be. This is either arrogance of the worst kind (that which is held up on a house of ignorance) or a desperate cry for education, and further training.

Out Here,

ACE844