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  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. Last week
  4. 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.
  5. Earlier
  6. Old folks Still here?

    ahhh yeah, money, the root of all things.
  7. 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.
  8. 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.
  9. Prayers to those in Vegas

    Let's keep the providers and patients in Vegas in our prayers and thoughts today. Awful awful things that one human can do to others. No words. (well I have some but they would get me censored)
  10. And then there's this

    Spock, Does your agency have the patient sign the electronic medical record directing payment to your EMS agency? If they do and the insurance company sends the payment to the patient then it would seem to me that the insurance company would be responsible. I would speak with your billing folks and your agencies legal counsel about sending a letter to the insurance companies to recover the unpaid bills plus associated costs.
  11. Heroin overdose

    Glad you're OK and doing well.
  12. Becoming A EMT. HELP!!

    Or come to Kansas City, KC Fire has a tremendous need for paramedics. If they paid what I am making currently, I would be back on the truck in a heartbeat. They just need to come up about 25K starting salary and then I'd make the jump. but alas, all the money that I make in a year is spent so it's not meant to be.
  13. Introducing Clubs

    Hello everyone, You can now create private groups here at EMT City. To do so, click on Clubs at the top and then configure your club. There are a few different options to choose from. Start one up and invite your friends to join you. Want a private place to talk about work without being on facebook? This would be the place. Want to just invite certain people into your club? You can do that as well. Want to invite everyone into your club? That can happen as well. I look forward to your feedback.
  14. Totally understandable and I'm glad to help out. I will definitely pass the word around. Have a great day! Jackson
  15. Hey! New EMT, need quick response to question please :)

    see my response to the original post.
  16. Double 'P' waves?!?

    Its difficult to comment on this patient with the limited amount of information available. I would be interested in seeing a copy of her EKG tracing as well as her medication list. Based on what you have told us it sounds to me like your patient was experiencing a second degree heart block. Did your patient have any history of tachycardia or any ablation therapy?
  17. Books Every Paramedic Student Should Read

    It's resolved. I'm in and have been looking around.
  18. Cardiac complications - Drowning

    Need more than just a empty post. Are you asking us to tell you what the cardiac complications - Drowning are or what? Need more info.
  19. There is a huge difference of opinions on this subject, even if you do a search on this type of subject here you will find many differing opinions. My thoughts are this, the better prepared with the basics the better you will be in the advanced stuff. I advocate for people to at least take A&P and then move to the other courses such as biology. Some people even advocate you take a bio-chem course. The other thing I advocate is for you and anyone else reading this, take at least 1 if not two semesters of English Comp. Writing a understandable and grammatically correct report is so important and it will definately make you a better provider. No one wants to read a report that reads like a 2nd grader wrote it. And if you went to court you would be destroyed by the other side's lawyer. I also advise you every semester to utilize the schools gym and get in shape if you can. The stronger you are and the stronger your back is, the longer your career in EMS will last. As for your question on the EMR - I don't have an opinion on them. Unless they are like the driver of a ambucab/vanbulance where you are taking pt's back and forth to the doctors office and appointments, that's not where experience is gained. Driving experience yes, but only non-emergency driving experience so you cannot really use that to say you have driven emergency. Transfer vans have their place in EMS but if you want experience, stick with waiting until you get your EMT and then look into EMT jobs. Now the flip side of it would be if the EMR jobs would move you directly to an EMT level job in a service that has those but most of the van services in my area are not run by the big EMS companies. they are run by nursing homes and such where you just drive the nursing home patients around. That is not EMS experience.
  20. Barely failed PAT. Short girl:(

    I agree. I am not sure about how the ones where I get stationed will be. I'm not the most patient person, so waiting to find out where I will be, etc is killing me. Once I start I will update any info I can
  21. I think that the Trevor Lowey guy should probably run for mayor or something like that I don't have much critiquing skills so from my stand point and experience I think you hit the nail pretty square on the head~~I wish more agencies would bring these 'life like' scenario's to the students on a regular basis. I know it takes a ton of people, planning and preparation but dammit our kids are worth it and if it saves one car full of teenagers lives and one grizzled old EMS'rs sanity, the pay off is immeasurable...... I have been involved in similar scenario's over the years that we brought to high schools, the only thing we've done different (besides not recording for a PSA which I'm sure involved a lot more time and planning) was to throw a few more students into the mix as first on scene observers/friends as well as one or two parents who listened to the scanner and heard where the accident was. We threw in a cell phone call message from deceased victims Mom on one of ours over the intercom that they had to listen to while watching the victim be assessed and covered up. ("Hey Jesse, it's mom. I heard there was an accident and I'm just calling to check on you. I'm on my way to the accident scene so give me a call back as soon as you get this message...."...etc. Some of the feedback that we got from the students was that call stood out in their minds as well and made them realize they were going to affect their entire family~~ P.S. In one area we were also fortunate enough to have the owner of a particular rowdy bar (read as-known to have several college aged patrons over the course of the summer who left there drunk, or 'slightly impaired' but drove anyway and were responsible for many of the tragic accidents in that area) sponsor the same type of scenario in their parking lot. That one got pretty interesting and did cut down on the accidents for a few year! I really enjoyed watching those PSA's tho, they were just the right length and done very, very well!!
  22. Dont' drive like this guy

    Just because you are in an ambulance doesn't give you the right to drive like a DICK!!! https://www.ems1.com/fatal-incidents/articles/314329048-EMS-provider-charged-in-fatal-4-vehicle-crash/?NewsletterID=&utm_source=iContact&utm_medium=email&utm_content=TopNewsLeft1Title&utm_campaign=EMS1Member&cub_id=usr_rYgxvJiMpoxX5g7Z
  23. Posting EKG's Potential Hipaa violation

    ok, in a facebook thread today, someone brought up that posting a 12 lead or just a ECG tracing is a hipaa violation even though you black out the patient name and identifiers. NO, you say it isn't, say it aint so!!. Well actually it is according to the article I will post below. The event ID of the tracing of the 12 lead specifically identifies the patient, not by name but by piece of equipment and a specific patient and can be used to trace it back to that specific patient, and in effect IS a hipaa violation, Here is a great article that was posted to this facebook thread: http://www.the-hospitalist.org/hospitalist/article/126200/how-avoid-data-breaches-hipaa-violations-when-posting-patients-protected Your cardiac monitor identifier numbers related to number 18, and even if you get rid of the first 17, a resourceful person, albeit not very bloody likely, could connect the monitor identifier, patient identifier back to the patient and thus hit you with a Hipaa violation. Advice on this situation - BLACK OUT all identifiers in the top and the bottom of the EKG tracing when you post it to facebook for a case study or you post it here. The facebook thread I was on even said that many of the EKG review sites and case study sites have as a rule for posting that ALL identifying numbers and codes, names and any other numeric identifiers be removed prior to posting or the post will be deleted. It's a one in a million chance that someone will connect the dots, but do you want to be that 1 instead of the 999,999? I sure don't. Be safe out there.
  24. NREMT Written test Paramedic level

    Welcome. You're right. No sense worrying about it now. What's done is done. Wait and see what your score turns out to be. Let us know.
  25. Upgraded Software

    Ok, my first club BIFP's Big Important Fluffy Paramedics Now get me some membership criteria. List em out here.
  26. Medical conditions causing crush syndrome

    Off Label has a great post. I really do believe that obese patients that fall and can't get up for an extended period of time will exhibit signs and symptoms of crush injury. How long does that take is unknown but I suspect it depends upon BMI and the amount of tissue compressed. I've had patients with crush injuries from traditional causes (building collapse) and medical causes and they are very challenging. Prehospital concerns are acidosis, hyperkalemia, low BP, and pain. A crushed extremity that does not hurt is a very bad sign and will result in amputation and possibly death. Saw far to much of that in Haiti. May the tube be with you. Spock
  27. National Registry EMT Lapse

    Yeah, I understood that point, I was involved in a facebook discussion, no lets say a heated discussion this morning over what I mistakenly should have left on facebook regarding what I wrote. I just don't get that how some people are so hell bent on getting so angry about being called an ambulance driver or how their job is more important when in the end, we all serve one group, the public. I couldn't get it through the thin skinned facebook group of people who I thought I was a so called valued member of that I finally just said screw it and removed myself from their drama but I made a cardinal mistake of bringing that baggage and crap from that group here. But I do stand by what I said here though. And you know what, to your point of who gets their first, as long as the patient or member of the public gets the help they need, does it matter who get's their first? does it matter if it's a shiny fire truck with a paramedic or an emt(well sometimes it does) or does it matter if it's an ambulance. Sometimes all that's needed is a splint and a bandage. sometimes it's a defibrillator. Sometimes you need 4 trucks and a ambulance. Sometimes you need 4 ambulances and 2 trucks. As long as we serve the public. For many fire departments that runs 10% structure fires and 75% EMS calls and the rest are PR and lift assists and assorted other calls, do you really need more fire trucks than ambulances? Seems out of balance but the public sees the big shiny trucks and says "wow look at that fire engine, the city really cares about us citizens ya know" Do a news search on Fire Union versus City of Grandview Missouri and read the crap the union is putting out about how many citizens are going to die if the city doesn't put a sales tax on the ballot this year. More of the same gloom and doom from the fire union "the city will burn, people will die and firefighters will perish if the citizens don't approve this sales tax"
  28. CHF & Low BP

    Low dose dopamine is notorious for causing tachycardia and it has been seen in higher doses also. CPAP can drop the BP because of the increased inter-thoracic pressure causing a drop in preload. Let's face it, this patient scenario is a nightmare for ANY health care provider and if you get your patient to the hospital or to the end of your shift with a pulse, then you did a great job. A puzzlement to be sure. May the tube be with you. Spock
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