Was I wrong?

[JPINFV]

He was saying that since we can't diagnose, that confusion was reason enough...

He was last seen at baseline the previous night due to the fact that they were both asleep until the time of call. THe stroke could have had an onset (if it was a stroke) while he was asleep, which would indicate use of thrombolytics.

FYI, i completely disagreed with the EMT in question, I was just making sure.

We asked the patient if he'd ever had a stroke, and after a few minutes he said yes 5 years ago, however we asked the wife and she said no.

1. Your "senior EMT" is an idiot for thinking that confusion!=stroke. It's not like there are a dozen or so other things that can cause a person to be confused besides a stroke. As much as I despise accronyms for simple stuff (cought SAMPLE, HAM, PENMAN, DCAPBTLS), some accronyms are decent to good. Remind him what AEIOUTIPS is.

2. Your "senior EMT" is stupid. Does he call for ALS on every call? If not, then he is making a decision on the patient's condition as to what the patient has and what the patient does have. Sometimes a patient presents with signs and symptoms of different diseases. The list of possible diseases is called a differential diagnosis. Work your way through the list as far as possible ruling things out. Start with the most life threatening.

3. Your "senior EMT" is stupid. Does he really have no faith in what his examination is showing, or does he just get off watching a paramedic puting a patient on a 3 lead and starting an IV?

4. Your company sucks. Age and experience does not equal ability. Do you really get promoted to senior EMT just by being 18 or older?

5. Your company and state sucks for letting people under the age of 18 ride on an ambulance and be the primary care giver for patients. I remember being 17 and thinking that I was hot shit for being 17 and knowing everything. I remember how it sucked not being able to do some things because some other punk 17 y/o couldn't get their life straight, so now I had to suffer for it [side note: Young male drivers who can't seem to drive correctly suck too. It's your fault my insurance costs so much], but that's life. Under 18 is a minor and thus should not be giving medical aid on an ambulance.

[Oilersfan1]

I don't feel you are wrong, but I wonder what the reason was for your other EMT to say this.

Cheers :occasion5:

[Dustdevil]

I completely agree with JPINFV and his points. You were not wrong in your decision, and this "senior EMT" is a knob.

I would, however say that you were wrong to have spent that much time evaluating for something that you could do nothing about. Unless, of course, all of this pointless evaluating went on in the ambulance while enroute to the hospital.

And yes, your system was wrong for sending an EMT staffed unit to an emergency run.

[Imagine89]

Thanks for the responses.

[Imagine89]

I would, however say that you were wrong to have spent that much time evaluating for something that you could do nothing about. Unless, of course, all of this pointless evaluating went on in the ambulance while enroute to the hospital.

And yes, your system was wrong for sending an EMT staffed unit to an emergency run.

[ERDoc]

Just figured I'd add my 0.02(USD). It doesn't sound to me like you did anything wrong. This guy doesn't necessarily need a stroke center and he IS NOT a candidate for thrombolytics. As long as he ends up at a hospital with a CT there is not much else to do.

[Dustdevil]

Please don't get into the age debate, i'm sick of it, and regardless of what you say, I will remain confident in the care I give my patients.

Just for the record, in case you were talking to me, I did not, have not, and will not get into that debate. I don't have a problem with young partners. I do, however, have a problem with undereducated partners, regardless of age.

[JPINFV]

I would, however say that you were wrong to have spent that much time evaluating for something that you could do nothing about. Unless, of course, all of this pointless evaluating went on in the ambulance while enroute to the hospital.

And yes, your system was wrong for sending an EMT staffed unit to an emergency run.

For the sake of argument since the original poster already replied. Does it really take that long to evaulate a person for a stroke. Slurred speach and facial droup comes from talking to the patient, unless we're not supposed to do that anymore. Smile test, 5 seconds. Grip test, 5 seconds. Having your physical exam point away from CVA, priceless.

[Dustdevil]

I've seen new EMTs do that exam. I did that exam when I was a new EMT. I still do it. It takes a lot longer than what you are insinuating, especially when you are brand new and have not done it a million times before. Those tests and steps don't just pop right into your mind, rapid fire. You don't run through the sequence from memory. You sit there and think, and think, and think some more. You're like... "uhhh... okay, I did the grip test. Now what?" Then you fiddle with the blood pressure cuff for a few minutes while you think of some other test to give. Then as you're finally about to load them on a cot, you think of something else to check for. And, of course, all of that is only if you actually remember any of that stuff at all.

Yeah, in a perfect world, with a well seasoned and well educated medic, things run fast and smooth. Then there is the real world.

[Imagine89]

Just for the record, in case you were talking to me, I did not, have not, and will not get into that debate. I don't have a problem with young partners. I do, however, have a problem with undereducated partners, regardless of age.

Okay that was a misinterpretation on my part. Apologies.