Just Plain Ruff

11.8 million in unpaid uncollectable bills.  Here are several reasons that were cited as why they cannot collect

Insurance denials

patients without coverage

and the fire departments inablity to gather accurate information

So play the director or the chief,  what of those three above do you think you should go after first before you ask for a increase from the taxpayers to help you out?  I know which one I'm going to go after.    

anyone anyone  bueller, bueller?????   how bout holding the fire department staff accountable to gather more accurate information.  But in all honesty, some of that inability may be not the crews fault, it could be patients giving them inaccurate info, not being able to get the patient to give them the correct info but I'm sure as heck going to find out why we have 11.8 million in unpaid bills.  that would go a long way to pay for some probably long awaited improvements.  

But sadly, this isn't just this department that has this problem.  If I had a crystal ball and could solve this problem I would be living like Joel Osteen.  

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

I have nearly 27 years of experience, 18 of it continuous, the rest of it sporadic and I have about 5 times as many total intubations as years experience.  I have approx 5 trauma intubations, I have 3 pediatric and 2 neonatal intubations.  I do not count my intubations in the Operating room with a Anesthetist because those were separate clincal and controlled intubations that were ZERO Pressure and I had all the time in the world to get the intubation right(with plenty of prep time prior to each tube).  

but I have countless cat and dog intubations thank you very much PALS courses. 

I would consider myself a seasoned medic who could intubate quite competently except for peds and neonates. 

but honestly, I believe that having a SGA as your backup airway is VERY VERY important and like Spock says, revolutionary.  

Would I trust a medic with only 2 intubations in the past year to intubate my family member? I'm not sure? But if he's the only one who responded then you have to trust him.  But you hope that he has the training throughout the year to make up for the real life experience and doesn't just rest on his laurels and not get that training because a failed intubation means that the person being intubated suffers.  A failed intubation that is not recognized and rectified, DIES.  Simple as that.  We've all seen the video of the lady and the failed airway.  It's awful. 

If medics aren't getting the tubes they need to keep current and competent, then it's up to their services to provide the education that they need on a yearly if not quarterly basis to get that education to keep current and competent.  Be that an OR rotation, a rotation with a busier service or just assorted airway mannikins and Airway education offerings.  

For all you EMS service directors/education directors, if you see that your employees haven't had a tube yet this year, what the HELL are you waiting for, get your people into a class and get their skills current.  The life they save might be yours.  Or you may die from a unrecognized Esophageal intubation.  It's your risk that you are willing to take I guess.  

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.  

Cant help you out but I wish you all but the best of luck.  

OH HELL< that sounded awful,  what I meant to say was I wish you nothing but the best of luck.  

I cannot believe that this project got Greenlit on Steam.  

UPDATE::

The suspect was captured last night around 8pm without incident.  My brother in law got off one shot and appropriate enough, he shot him in the ASS.  

Today they are bringing my BIL back from the KC MO medical Examiners office to his hometown 65 miles away for the funeral this coming saturday.  

Lady Justice, meet Dirtbag Ian,  do your worst.  

As of 11:45 the suspect is still on the loose.  

He crashed his car just after the shooting, so one can think that he was hit by gunfire but not sure.  

The gun was not found so it is safe to assume that he is still armed.  

He's killed one cop so one can also assume he's probably willing to shoot at those coming after him.  

My family that went to see my brother in law in the hospital

I cannot sugar coat this turd,  You cannot shine this turd and not call it a turd.  An honest review from Just Plain Ruff.  The review may be colored by the week I've had but I'm not sure.  

Run don't walk, run run run away from this piece of shit program.   This program looks AWFUL.  

Who did their QI and testing?  Who did their review and who actually told them that this was a worthwhile educational offering?  Whoever did should have their medic card taken from them and shredded.  A common spell check program would have caught many of the issues that I see but...... maybe the program they were using didn't come with a spell check.  Or maybe they turned it off?  Or maybe they used spell check and decided that they liked misssspellleed wrds btr???  Not sure.  

My 7 year old could tell them that this software is crap. hell even my 5 year old could tell them it's crap.  

Looking at it more.  I opened some of the screenshots and found in one of them

Look for the Measurement section   there is a RR Sys and a RR Diast     is that a new form of respiratory pressure?

Same screenshot   sinusrhytm  (yes that's how it's spelled)

Same Screenshot  Consciousness is Dimmed  (really, maybe the makers are dimmed but consciousness?)

They revert to German in the text box at the bottom and the patient is now head up!   Wheeeeeeeeeeee!

next screenshot  - the one with the crucified c-collared guy

Check airways - can you have more than one?

What the hell is heat auscultation

What is a cardiopulmonal???

For diagnosis - you get to ask the patient - For the win!!!!!!!!!!!!!!

Final screenshot - 

Under Drug administration 

So the maker found a new class of drug - Analgetic

And the maker of every thing holy they even spelled Insulin wrong  - Insuline - did they wake up stupid, holy hell batman

in the EKG the HF is 144

And you can run the Ringers solution either fast slow or OFF   What the HELL

And for volume infused what is 0,11ml?

Again, run, don't walk away from this shitty program.  I don't care who I piss off about this program.  People pay good money for programs like this and expect to learn and possibly recertify with programs like this. And to put crap out like this is just WRONG and to me it's stealing their money.  The maker should be ashamed of themselves for promoting and selling this crap that should have never been coded into computer language at all.  

If these are the BEST screenshots that the developer has to offer, then I'd hate to see what the rest of the software is like.  Jeesh.

Whoever pays 14.99 or even 35 cents for this garbage deserves what they get.  

My friend,  when their website is chock full of grammatical mistakes and spelling errors you would be very very safe to stay far far away from this product.  If they cannot even get their website right, think of what their scenarios will be like.  

Here's a list of screw up's on the site

1.  Emergencys 

2.  Heart Infarction

3.  Patients should be Patient's

4.  And my favorite  "Get a diagnose on realistic ways"    

This is just too much to bear.  

Now, I'm not the greatest grammatical expert but this is awful.

The best advices that I can gives you is to stear cleer of thise prduct and look otherwhere.  

But don't atke it from me, I just stayed at a holiday inn express last night. 

This is my brother in law. I had to wake my wife up this morning to give her the news.  I then had to wake my mother in law up to give her the news on her birthday that her son had been killed the night before by a oxygen stealing piece of dog shit suspect.  

Our house and entire family are in turmoil right now and it truly SUCKS BIG FAT DONKEY BALLS.  

Pray if you do that kind of stuff, send good vibes if that's what you do.  

http://www.kansascity.com/news/local/crime/article165802862.html

the suspect is still at large, still has the gun that killed my brother and is still dangerous and may actually be shot as well so that makes him doubly dangerous.  

This past month has sucked totally and I'm not sure what more my family can take.  If you get a moment, please think of us with good thoughts.  

thanks

53 minutes ago, Country girl said:

Thank you for your response.  Yes he mentioned my dad my name and his medical condition.  My father had 24/7 Care by nurses in my home so there was no need for concern.  The doctor came 1-2x a month.  He simply was frustrated that he had to transport him 5x in 7 years and said i was using ambulance service as a "taxi".  Every time he was transported he was admitted.   I will take your advice and speak to the management of the company.  I just feel like he overstepped his boundaries and defamed my character as caretaker.  

this is a definate hipaa violation and needs to be addressed.  the fact that he feels that way about your father, imagine how he feels towards the patients who call 1-2 times a month.  

So your job now is to get your ducks in a row, make sure you have dates and times of when he talked to your source.  You may also need to push this because some services are like the honey badger and don't give a shit.  Not saying this service will be like that but they might.  

You might also start to look at a different transfer service to transfer your father but that's a very drastic step to take.  You can request that this particular EMT not be assigned to his care but that woudl also be very hard to enforce.  just police the care he gets.  

I wish you the best of luck.  I would be quite miffed and upset at this type of shenanigan going on.  I hope you get satisfaction.  If not leather gloves at 50 paces.  

One more thing,  this doesn't rise to the level of getting an attorney involve jsut so you know.  It also doesn't rise to the occasion of going to facebook or to the news.  Not saying you will do anything of this sort but...... some glory hounds would.  

if he named your father by name then more than likely yes.  You need to go to this emt's employer and discuss this with them.  Simple and let them take care of it. 

Unfortunately I'm sure that said EMT was concerned about your father and was probably looking for advice on a tough situation but he should not have said anything. 

Now if he just mentioned that he transferred a elderly patient to a hospital and he felt that person had too many medical needs and should be in a nursing home then no, there was probably NO violation unless your father was easily identified by his description. 

Sooooooooooooooooooooooo, long story short, go to his department and discuss with a supervisor or manager.  Be advised, an accusation founded or not, is likely to damage this guys career, so please make sure that you have all your facts straight before you go to his employer.  Please do not think that I am trying to keep you from going to his employer but make sure that you have your ducks in a row on this one.  

sure, just call me Plain, it's easier to type.  

I've only had a crush injury patient in the truest sense, where the patient or the extremity has been crushed by a heavy weight such as a car or a large weight.  

Obese patients after thinking about the true etiology of a crush injury I do not believe would be able to cause enough force on the extremity to sustain a crush injury.  

The fact that you are still asking these awesome questions are going to get you props from all of us here brother.  Shows that you want to learn and just don't want to get it spoon fed to you.  

I would definately put the obese patient down as a candidate, especially an extremity that gets caught under their weight after they fall and are unable to get up on their own.  

Depressed patients, I'm not so sure.  

What about the stroke patient who falls, lands on the affected extremity and is not found for 2-3 days or even 6-8 hours?  

2 hours ago, maphakge mn said:

hi guys,i just want to know in which way can i start my private ambulance in south africa fast and how to register it and where will i register it as well?

I'm not sure anyone can help you here.  If you want to do this fast you might not be willing to do it right.  

After reading this document http://www.gov.za/sites/www.gov.za/files/38775_rg10427_gon413.pdf  which seems to come directly from the government of South Africa on setting up Emergency Medical Services, there is no way this will be a "fast" process.  

This is another website you might want to look at   http://sapaesa.co.za/

I get the feeling from your well thought out post that you really don't have any intention of doing this right.  Prove me wrong.  Tell us what your credentials are, what your intentions for a Private ambulance service is and why you are qualified to start a private ambulance service in South Africa.  The most important question is this, why do you think doing it fast is better than doing it right?

On 6/26/2011 at 11:44 PM, MoneyisinEms said:

An Ambulance Service is not very hard to start. With the right direction. A good place to start is Regulatory Licensing and Compliance. They do everything for begining to end. They Process Your State License Application, Medical Protocols, Get u a Doctor, Help u Find an Ambulance & Supplies they even process your City Application & help you get a Medicare & Medicaid LicenseThey have in- house Medical Directors and personell that can assit you with every aspect from Bls Service to MICU. If you need serious help look them up!!

Bazinga, so simple a geico cave man can do it.   so can this new ambulance service pass the state review that goes with it all that says that there is a need in the area you want to cover for another ambulance service?  Will that area which is already covered by an established ambulance service willingly let you come in and take business away from them?  Sure they will, they will just roll over, let you rub their belly and say Good dog, take it like a good puppy while we take some of your business.  No where I have ever worked has the established ambulance service just sat back and allowed this to happen, even with transfers only. 

Not many doctors out there want the added headache of medical director of a fledgeling brand-new ambucab service.  They better brushup on their malpractice insurance coverage because they have just taken on an unknown entity that they have no idea how good their providers are, how good that service actually is and whether or not that service really is well run or not.  

Just who is Regulatory, licensing and Compliance?  are they an actual company?  Provide a link.  

I think you are walking around with Jade colored or rose colored or just no glasses at all and are really in for a rude awakening when you try to do this.  I had a friend who dumped 250K of his own and 1.2 mil of a venture capitalists money into a start up ambulance service and they lost all but 75k of that money.  His venture cap dude was pissed.  So NO it's not as easy as you think.  

well I figured how can you go wrong with the Medical Journal of the Armed forces of India?  They seem like a pretty good outfit.  

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"  

15 hours ago, AFDNREMR said:

My state requires NR for EMT Basic and up. Where I work I am the only EMR who went the extra and got NR everyone I work with think it's not necessary. 

I was a NR EMT-Basic 14 years ago, but I let my NR lapse.

 

then you can only say you are an EMR.  If you identify as and EMT then you are falsely identifying as something you are not. See Easy Peasy.  

I don't think there are really any set medical conditions that cause crush injuries or syndrome, your question is difficult to understand but here is one link. This better not be for a paper that you are having to write and you are wanting us on this site (like many have before) to write your paper for you or do your research.  Yes this has happened before by people who are to freaking lazy to do a Dr. Google search.  

but if you are truly seeking understanding about crush injury look at this link and then take what you learned from this link and expand your search and knowledge. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919827/

But be warned - if the regular members of this site figure out that this was just a Help me do my paper post, your rep here will be ruined and you won't get any future help from anyone especially me.  

I still don't get this mentality that driving a fire truck is somehow more important than driving an ambulance.  Is driving a police car more important as well?  

All of these jobs are important.  

Let's get over ourselves people, we do similar damn jobs, we provide emergency services to the public but in different capacities. 

As soon as the butt hurt over being called ambulance drivers gets done we can get back to the important things.  I don't think I've ever heard of a fire fighter being butt hurt over being called a fire truck driver.  Or a police officer being called a police car driver because they are professional enough to know that at the end of the day, it doesn't matter. 

A dental hygenist I believe also has more schooling than a EMT, a vet tech has more schooling or training as well, and they take care of our animals(which is pathetic if you ask me that we accept that a vet tech needs more training than an EMT does)

If we continue to accept that EMT's who have human lives in their hands can do this job with less hours of training than many other jobs where lives are not in these peoples hands, then we should expect 7.75 per hour, low levels of respect from our health care and emergency services colleagues and the continued AWESOME Sparkly title "Ambulance Driver"

I have a dear dear friend who published a christian study on the book of James.  The stories he told me about getting his book to published status was just short of a study in the life of Job.  Sorry for the biblical references but if his experiences were anywhere near the stories that Our dear friend Spock has to tell, they have to be doozies.  

Way back when there were two certs,  emt and paramedic,  it was easy. 

Good thing I'm in Missouri where I'm grandfathered in and don't need to be Nationally registered to keep my license.  I can keep my paramedic state license and say I'm a Paramedic.  Easy peasy.  

I would say Semantics be damned.  just say how you most comfortably indentify yourself.  

RescueSquad, I do wish you luck on the sale of this game.  I may or may not purchase it.  Depends on discretionary fundage availability. 

Who was your beta tester demographics?  

How many people tested this game to make you realize you had a game that would be successful.

I ask this of you because myself and a co-worker are looking for a business idea to start and we really don't know and I showed him the amazon link and he said, this might be something we could think about for the IT world.  Not a copy but a different kind of game.  

We also thought about maybe one of those monthly boxes.  Who knows.  

Just thinking out loud here.  

I've seen another type of game like this a long time ago. Not sure if it ever made it to commercial release. 

I'm not sure if I'm willing pay money to relive the job that I used to do full time and now do on a very part time basis.  

so why are you trying to give this game free advertising?  I'm pretty sure that the rules her say in order to advert you have to pay to do it. Do you feel so strongly that you would advertise a game that you have no financial interest in?  Not busting your balls just asking a question.  

Are you going to purchase a copy of the game?  

Just some questions I have.