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Duty to act?


tmedic67

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Ontario is a seemless coverage system where regardless of the municipal boundaries the closest Ambulance must be assigned to the call. Dispatch centres share calls where they are close to geographic boundaries to find the closest vehicle.

If we're doing a transfer out of our region we must book on with the local Central Ambulance Communication Centre (CACC) as we move through their area and are responsible to service a call we come across or are assigned to the same as if we were in our own area.

Of course none of this applies to the Private IFT services; they're legally not Ambulances, don't fall under our legislation, aren't staffed by medics and cannot service calls on an emergency basis. In the event of a medical emergency during a transfer they must pull over and call 911. We'll sometimes see these trucks as first on scene as good Samaritans.

I practice by the standards I was taught. Everything I was taught in my training was needed to pass the written and practical exams. It wasn't really my place as the student to say that's wrong, oh you can't do this, or that's outdated, especially at times I wanted to say stop with your field experience stories. Most of the class was irrelevant stories to the current topic that the instructors would always talk about. Anything I said to the instructors would mean squat because of their experience and place in that class.

Granted I've had the odd run in with an instructor during CME who didn't agree with me, but good education should not only strive to have the latest information but should be responsive to debate. You don't build good clinical thinkers when you shut down students due to your position and ego. There is a place for an instructor to have authority based on their qualifications and experience but that's a starting point not the be all and end all. Relying too much on that authority is a red flag for poor teaching.

instructors said their biggest pet peeves is when they take a patient into the ED after falling down a flight of stairs,or involved with a MVA and the attending tells them to rip all the stabilization off the patient and it putting the patient in danger.

My pet peeve is when ED leaves my patients on boards unnecessarily after we arrive. The boards place is to extricate, once they're at the Hospital we need to lose it but I'm not in a position to remove what is now their patient.

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  • 2 weeks later...

Here I was told that we don't stop.

Everything out of our AOR is handled by Saudi Red Crescent. If we did pick up a patient, we can't "technically" take them back to our hospital because they don't "belong" to our hospital. If we tried to take them to a MOH (Ministry of Health) hospital, there is the chance they wouldn't accept them from us, and that would leave us with a patient in the back and no place to go. This has happened before I got here.

It's pretty F'd up, if you ask me. This is a country of universal health care where everyone has some form of coverage. :thumbsdown:

I've already seen docs triage people away from our place because they "members." :mad:

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