Content Stream

Showing all content posted in for the last 365 days.

This stream auto-updates     

  1. Yesterday
  2. Double patient transfer - HIPAA breech?

    the question we should ask ourselves is this Aside from transporting 2 patients from a MVC or something similar, should we be transporting 2 patients like the original poster asked.
  3. Double patient transfer - HIPAA breech?

    I agree with both points. but if semi private rooms are not HIPAA violations that happen many times a day, then transporting two patients is not in my opinion. But again, I would want to see this in writing from either the Hipaa gods or my legal team. Michael
  4. Double patient transfer - HIPAA breech?

    The real questions should be 1. Can we safely transport two patients and provide high quality care to both? 2. Can we protect the patient’s health information and personal identifying information? I would argue that you cannot safely transport two patients in the same unit and that you cannot protect the patient’s personal health information.
  5. Last week
  6. Anyone ever done this?

    To follow on Mike's post, a lot of the issues with community based care is system based. ie a for profit system isint going to benefit from such novel ideas..again, a $$ thing. Working as part of a government funded service, it's a different story and all about value for money and keeping those out of hospital who can be treated in the comunity and trying to save ambulance resources for 'real emergencies'. We are doing this both in a call diversion program (only in its infant stages) where callers can be directed to local services and a paramedic run extended care program to deal with minor wound care / burns, epistaxis, catheter problems, some home rx for migrane, gastro, etc. The major success is that everyone benefits. And yes, major baseline education differences. And spending that extra few minutes preparing some food or having a cup of tea with a pt isn't just about doing a 'good deed' IMO, but is as much about being able to assess the daily living capacity of that person. Spending that extra 10 minutes chatting with someone and looking through the fridge can raise all sorts of red flags that might otherwise go unnoticed.
  7. Anyone ever done this?

    Paramedics don't have the educational foundations to do the things mentioned. Having worked in more than one arena within health care (paramedic and PA) I don't know that EMS providers are necessarily the best people for the interventions that are mentioned. This isn't to say that paramedics can't do those things and more. As Ruff mentioned education is ridiculously poor. This lack of education is a significant barrier. Many of the PAs I work with currently are former EMS providers. Several of them are current EMS providers outside of the ER setting where we work. PAs, and to some extent NPs with an EMS background, would be best suited to work in that community health role doing the things needed to help reduce ER overcrowding and all of the complications that arise from that. Unfortunately, there are barriers to this as well. Who is going to pay for that PA to be out on the street? I guarantee I'm more expensive as a PA than I am as a paramedic. Will call volume change when people realize the "ER will come to them"? How long until that becomes overburdened? There are logistical issues involved, too, never mind the legal issues that need to be considered. The EM group for whom I work has talked about doing a community medicine response with the local 911 providers (both BLS and ALS). There has been talk about putting PAs into a street provider role to start providing care outside of the ER. I'm fortunate to work for a group that employs the state ALS and BLS medical directors as well as the county medical directors who could help make this happen. I've volunteered my services as have several of my colleagues with EMS backgrounds. If anything comes of it I'll keep everyone posted.
  8. Anyone ever done this?

    I cannot answer your last question about the AMA but I can say I agree with what you posted. I've inserted GI Tubes, foley caths, nasal packed a nose bleed in the ER, Gave enemas, performed bladder scan, debrided a burn and other wound, sutured a simple laceration under the supervision of a doc, gave every medication known to our formulary and even administered 12 units of blood to a AAA patient that was leaking and damn near at deaths door. We as paramedics CAN do these types of things and we as an industry need to strive to be able to do them. BUT caveat Education is the key. when cosmetologists have more hours of training and "internship hours" than we do and they cut our hair, then something is rotten in denmark.
  9. Anyone ever done this?

    That is certainly the allure of a rural setting where you can almost be a part of the holistic healthcare that patients should get. In the ideal world we would have medics provide most of the care that these patients receive in ERs, instead of hospitalizing these patients and charging their insurance thousands of dollars, subjecting them to undue stress of transport and potential risk associated with it. Most paramedics should be able to insert GT tubes, perform debridement and other minor critical care procedures. We should be pushing for more education and expanding the scope, as nurses are overwhelmed with the load and healthcare costs are prohibitively high. EMS can certainly disrupt that market and provide high-quality just-in-time healthcare service that we all expect. We need to start caring about people and society and stop putting profits as the highest priority. And another thing.. why is AMA such a collection of scumbags? Seriously. Why?
  10. Earlier
  11. Old folks Still here?

    ahhh yeah, money, the root of all things.
  12. Old folks Still here?

    Honestly, it just comes down to money. If I could go through two years of school, and not have to worry about finances I would do it in a heartbeat.
  13. Old folks Still here?

    Brent I don't know many people who are more fit to be a paramedic than you are. I say that in all sincerity, so why haven't you gone on and gotten your medic, the EMS world is missing out on your being a medic.
  14. Anyone ever done this?

    I tend to agree partially and disagree partially. In a busy urban setting, of course you cannot spend a lot of time on scene to do this extra service but I believe that it's a case by case basis. If the person has family on scene or that can get there within a reasonable amount of time then by all means clear the scene but if they don't have anyone near, then in a rural setting with low call volume, I see nothing wrong with helping them out with a meal or something. You have to have common sense and if you aren't responsible enough to know the boundaries to keep from doing bad things then that is a bigger issue than what we are talking about.
  15. Old folks Still here?

    Crazy, isn't it? The more you learn the more you realize how little you know. Why stop there, thought? Paramedic school?
  16. Anyone ever done this?

    Maybe its the urban setting, but I've never had that kind of downtime. Also spending more than 20 minutes in NYC requires you to give you an update, as there have been potential times when EMTs done some bad things on scene involving patients. You never want EMTs/medics to spend more than 30 minutes on scene of any emergency IMHO.
  17. Anyone ever done this?

    Cooked meals, made coffee, done laundry after a DOA in bed was taken away by the funeral home. Heck I've even fed cattle and unaddled horses.
  18. I need assistance finding a medical director

    Texas requires medical directors to be ER physicians or have some special CE about being a medical director that is hard to find. This isn't commonly known and at one service our family medicine medical director was brought under investigation by the Texas Medical Board for this. I would check with the stats to see if Georgia has this requirement.
  19. Anyone ever done this?

    Amen brother. I have indeed cooked several full meals for patients, usually I would get them something to tide them over and then later in the day or the next day I would bring them over a full meal so at least they had something in the fridge when they got hungry. There's a lot of need out there, we see it every day.
  20. I need assistance finding a medical director

    Ok I'll give you the win on could they be the MD but do you want a family doc as a medical director of a EMS service? I think not.
  21. Anyone ever done this?

    I would hope we have all had situations we have handled similarly. Maybe not cooking a full meal for them, but going above and beyond the call. Thats why we signed up for this gig, wasn't it?
  22. Old folks Still here?

    It's going alright so far. I love how much more critical I am considering everything. Things I have never thought about before.
  23. I need assistance finding a medical director

    Well, they COULD be the MD. But..... are they qualified for the role? I know a couple of services around here have a family doctor that is their MD. I do not know anything regarding those doctor's history and background though.
  24. I need assistance finding a medical director

    I also find it interesting that you are starting an ambulance service and don't have a medical director yet. that would have been my first order of business after deciding on whether or not I wanted the headache and digestive problems of starting an ambulance service. At least with my medical director chosen early I could probably get the prescriptions to help me with the anxiety, headaches and gut problems that will come with this venture. No plain old doctor will do for a medical director, you need one that understands EMS, a podiatrist or OB GYn won't cut it. You at least need a critical care doc or better yet an Emergency dept physician. Not busting your balls here but why haven't you procured the services of a medical director?
  25. I need assistance finding a medical director

    I find it interesting that you are starting an ambulance service but don't know where to find a medical director. Have you budgeted for one? If you don't know where to find one how do you know how much it will cost you? Do you have friends that work EMS in your area? I would start by asking around to see who the medical directors are in your area. Unless somebody in the forum is close to your area I doubt that we can help you specifically. Its possible that a simple google search of the other ambulance services in your area will give you their medical directors.
  26. Hello, I am currently starting an ambulance company in Georgia and i am required to have a medical director. Can anyone direct me to where i can find a medical director? Thanks in advance.
  27. A few funny pics

    A couple of these are pretty funny. I can relate to feeling like the kid in the ambulance early on lol.
  28. Double patient transfer - HIPAA breech?

    I believe that that nurse is incorrect. Writing would be good though. and what about patients who are sharing a semi-private room? Is that a ongoing 24 hour a day HIPAA violation?
  1. Load more activity