Conflict on Dual Medic Units

[Paradude]

Uh Oh..... PISSING MAAAAAATCH!!!!

-Paradude-

[firemedic05]

Exactly, I don't know how this topic of dual medic turned into a pissing match, it seems if you have an opinion in the forums, you will be chased from the city with pitchforks. Honestly, WTF. I so see the point in not doing an IV every time, and as I said I don't alllll the time, just presenting my argument for why I do it. I guess I should put tail under legs and run for the hills or wait a minute I am not a quitter. Sorry, for trying to put two sides to an issue my bad.

[CBEMT]

Dude, if you research my posts AT ALL I think you'll find that I'm the LAST person that chastises anybody for not following the typical EMT City group-think.

However, there are times when I see something so over the top that I have to say SOMEthing.

[medic001918]

...and as I said I don't alllll the time, just presenting my argument for why I do it.

That statement contradicts itself. But you did say that you do it on every patient. Here's your post:

I am also one who likes to D-stick, IV, and ECG on every patient.

and

Why not? What does it hurt?

If you're going to argue your point, stick to it. Don't back pedal and say that you don't do it on every patient. You've already clearly stated that you do so, and that it doesn't "hurt." You seem to be intelligent enough to rationalize your thoughts. Stick to them. While we might not agree with them, everyone's entitled to their own thoughts and ideas. You can keep yours. They just don't agree with me. It's the same way as my ideas clearly don't agree with you. Doesn't make either of us wrong or involved in a "pissing match."

Shane

NREMT-P

[Paradude]

Is Firemedic05 in court here? He makes some points and tells his preferences and somehow it gets spun into being a cook book medic. Trust me, there are few things I dislike more in our profession, and I have read this string. I don't see where cook book medic blares out. I could make it into that, but I would have to be digging. Guess what? I like to start IV's on most patients, and I like to put people on a cardiac monitor. I call that being diligent. Every time I start an IV, I do a glucose check from the blood in the flash chamber. All that, and I preach to students all the time on not being a cook book medic.

Guess I gotta practice more what I preach. :roll:

Lighten up people!

-Paradude-

[Ridryder 911]

Part of our responsibility to our profession and to our patients is accountability. We should have to be able to justify any and all of our treatments. Just because it is a procedure we want to perform or like to do is not reason enough. Not only is it unethical, but billing for a procedure and knowingly that procedure when it is not warranted could be considered fraudulent.

Can you imagine a physician performing an IV or FSBS on routine dental carrie? Just because they can? Again there is a difference between even treating as per standard and then treating appropriately. I know of many medics making the patient fit the protocol instead of treating the patient as an individual.

If one is performing an accurate history and detailed assessment, many of those procedures can be eliminated and may not be needed. Remembering, the main reason for an IV in the prehospital setting is for only two reasons. They are : fluid replacement and route for medication administration. FSBS is validating glucose levels, not being used to solely identifying the reasons for symptoms or treatment.

I know of a ED Physician that would order a FSBS on each patient, and within a month had accumulated over $10,000 billing on patients. All because at one time he had been "burned" ; fortunately he was challenged and make changes.. to say the least, it immediately changed.

Again, we need to be aware of accountability..it is our responsibility to our patients and employers and our profession.

R/r 911

[Connie31079]

I don't start an IV on all my patients that I transport either, but what do you say to those nurses who whine "What? No IV??" when you're wheeling your patient into the ER who doesn't have an IV in place?

Unfortunately, this happens to me quite often, and I just have to bite my tongue, because most of the time, they're not listening to my reasoning as to why I didn't start an IV to begin with.

Embarassingly, in the past, I've started an IV on some patients who I felt DIDN'T need one, just so that I didn't have to put up with the wrath of some of the nurses in the ER when I get there.

Sometimes it's just easier that way....anybody catch my drift???

Fair to the patient? Certainly not....but they don't get billed for each individual procedure we do here. Wether they get O2, 2 IV's, cardioverted, paced, and 3 meds during transport, or if we just sit there and chat with them pleasantly along the way, they get billed for the same amount regardless.

I try and treat my patients as I would like to be treated, and I know most people don't like needles, so if I feel they don't need an IV, 95% of the time, I won't start one, or do a blood glucose, or anything that's remotely invasive, that might cause pain.

If it needs to be done, I do it, if I can justify why it didn't need to be done, then I do that on behalf of my patient as well.

Except to shut up the nurses.....

Oh yeah, as to the original question, I'd love to work on a double-medic truck, but that NEVER happens here. If I come to work, and paired up with another ACP for the day, guaranteed we're being split up, and turned into 2-ACP units, usually with a PCP for a partner. Which I don't have a problem working with either. I'm just glad to have a full-time job.

[akroeze]

I don't start an IV on all my patients that I transport either, but what do you say to those nurses who whine "What? No IV??" when you're wheeling your patient into the ER who doesn't have an IV in place?

Unfortunately, this happens to me quite often, and I just have to bite my tongue, because most of the time, they're not listening to my reasoning as to why I didn't start an IV to begin with.

Embarassingly, in the past, I've started an IV on some patients who I felt DIDN'T need one, just so that I didn't have to put up with the wrath of some of the nurses in the ER when I get there.

Sometimes it's just easier that way....anybody catch my drift???

Fair to the patient? Certainly not....but they don't get billed for each individual procedure we do here. Wether they get O2, 2 IV's, cardioverted, paced, and 3 meds during transport, or if we just sit there and chat with them pleasantly along the way, they get billed for the same amount regardless.

I try and treat my patients as I would like to be treated, and I know most people don't like needles, so if I feel they don't need an IV, 95% of the time, I won't start one, or do a blood glucose, or anything that's remotely invasive, that might cause pain.

If it needs to be done, I do it, if I can justify why it didn't need to be done, then I do that on behalf of my patient as well.

Except to shut up the nurses.....

Oh yeah, as to the original question, I'd love to work on a double-medic truck, but that NEVER happens here. If I come to work, and paired up with another ACP for the day, guaranteed we're being split up, and turned into 2-ACP units, usually with a PCP for a partner. Which I don't have a problem working with either. I'm just glad to have a full-time job.

Are you from Ontario?

As a side note, I don't know of anywhere in the entire province that routinely puts 2 ACPs together.

[Connie31079]

Nope, not from Ontario.

Nova Scotia, Cape Breton to be exact.

[bufordkid57]

Yeah, I've been working as a Paramedic for about a year now, and I've gotten into plenty of pt. care conflicts with other Paramedics. It just happens. Of course, there is always the select few that a person just cant get along with, but there is one of those everywhere you go. I wouldn't sweat it