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I have found that it is not so much what you put in your ears as much as what is between them that really counts! ... Yes, quality stethoscope does matter if one is trying to distinguish clicks, murmors, tones... etc.. which most EMS medics never perform or even understand. Purchase one that meets your expectations... R/r 911

So because it does not change how we treat we should just ignore it? How many patients lie about what is actually going on? So you ask a female are you bleeding a lot they might answer no only a couple of drops when in fact they may be flowing. But you choose not to look because mommy said it is wrong to look at a girls private parts. Now at the hospital you tell them what she told you. They place her in a low priority and later they find her dead. Why because she bled out because you did not do a complete patient assessment. So do what is right and at least look at the affected area. I mean with the logic provided we should not be removing clothes from the affected areas of a trauma patient. So a patient reports no my arm is not bleeding so we don't roll up or cut off the sleeve to find the bone sticking out of the skin because we relied on what the patient said? Makes no sense does it. Same goes with the no no's, the private parts, the what ever you call the parts you are afraid of looking at. Do the job, do the job right. You are a medical professional and a patient advocate, do a proper assessment so you can properly advocate for your patient.

Partly true. Actually the online process also requires one to be associated or have a specific assigned "training officer" that must authorize or acknowledge that the information is correct and true. As well, a licensed medical director is also required to confirm that your skills are correct by field examination or a Q I type evaluation. As noted all this information is found on their website.. www.nremt.org Good luck, R/r 911

Based on proper requests of further history and information obtained, this should lead to the aspect of visual/palpatory examination. However, full vaginal exam on female, no. Patients can be very vague in their complaints of discomfort in the pelvic region. A good paramedic should be able to acertain pertinent information with proper questioning to warrant a proper examination if needed as without the this, how the hell can they know what is really happening, and can they do anything for the problem. There are many things that you can inspect/palpate for so you have (no pun intended) a better handle on the situation (crowning, swelling, trauma, bleeding, drainage, etc.). There are proper times and improper times when examinations are needed. Either case, you should always have patient consent and hopefully a witness with you.

So here you are on the way back to the station for shift change when you are toned for a sick female. You cuss and scream while on the way but are the professional once on scene. Patient complains of pelvic pain. Do you just load and go and make sure she's stable or do you examine her properly? Do you ask questions then expose and see if there are any visual cues as to the problem? Do you have her open the vagina to expose any possible injury? Do you palpate to check for swelling, deformity, tenderness? Ok same if a guy. Do you expose if complains of testicular or penile pain? Do you palpate?

We are medical professionals and if we do not see the vagina or the testicle that the patient says hurts we can not help nor can we relay accurate report to the doctor. We must do a complete focused exam on the area of complaint and that means looking, listening, feeling. Do not be bashful, do it like you have done it a million times and the patient will have no problem with it and the doctor will respect your report more as you actually relayed patients complaint combined with what you found during exam. It is my pet peeve that so many do not act as professionals and do the job that needs done. As soon as it deals with a persons no-nos they refuse to touch or look, lets just load and go. Vital information could be missed that could delay the care they need.

Well, as I am sure you know, the dirty little secret in the medical/legal world is that even if you do everything by the numbers, it does NOT mean you are insulated from potential litigation. Nothing like a dead or disabled victim to get some judge or jury to award a huge judgment for a plaintiff, or force a settlement- regardless if the accused have followed all the rules. One little errant or ambiguous word in a report, or from a witness is all it takes to put someone through legal hell. A "good" attorney can make even the best intentions of a provider seem suspect, and they can make even the best written report seem like a "Dick and Jane" book. Most of the time, things are pretty cut and dried, but every so often, we get "one of those calls" where good judgment, (along with the usual CYA principles and protocols) is key to covering your arse. I don't know about you, but I do not make nearly enough money to accept responsibility for going out on a shaky legal limb. It's been said a million times here- It's much easier to simply transport, then spend the requisite time and energy explaining/justifying why you did not.

I agree with the 'Herbmeister'. Make sure that all your policies are clear and that you understand them fully. The biggest thing is that you do not offer medical advise, but as stated to inform the patient of the potential risks of refusing medical care. Don't you make the decision that an ambulance is not needed, And finally, document everything with signatures. One little piece of jargon I always use with refusals after the patient is informed is that 'patient acknowledges understanding......"