crotchitymedic1986

It varies wildly from city to city and state to state. If I had to ballpark it I would say most charge around $300-500 for BLS plus mileage, and between $400-700 for ALS plus mileage, but I have heard of some that charge well over $1000. Why do you ask ? Realize that most services only collect about 50% of what they bill.

I have to disagree with not transporting. I agree that transporting him was probably not going to save his life, but it did give him the best hope. Miracles do happen. In the US, I was not allowed to NOT follow a doctor's order, so maybe I am tainted. We often choose not to "work" patients who have arrested and are not viable, but to let a patient die this way just doesnt seem right to me. Am I the only one that sees it that way ? And can I ask why no helicopters are available in Canada, is it a weather thing, or does socialized medicine not pay for that type of transport ?

I take no offense, and we will always learn more from people we disagree with. If you could not talk her into going, so be it, and I am sure your documentation was very good, but you never answered my question honestly, how long were you on the scene ? What diagnostic tools did you use to ensure the patient was stable enough to be left at home. If the same patient presented to the ER, would an ER doctor release her based on those same simple diagnostic tools you used, or would the doc order some labs and xrays/scans.

Thank you for the compliment, troll in here is a compliment. I am not saying nurses do not earn their pay, but to say they work as hard as say a construction worker is laughable. I have worked ER and ICU, and yes I stayed on my feet and moving for 12 hours, but I rarely broke a sweat. I imagine these nurses are paid very well compared to the average person in any other industry. I would fire them all.

Read up on brain injury from ground level falls for the elderly before you leave another at home.

Lets all cry for the Nurses, I seriously doubt any of them are breaking a sweat at work, despite having more patients to care for, and I doubt they have substandard wages. Most nurses no longer have to draw up meds (the pharmacy does that), most charting is electronic, and they have aides to do the butt whiping. I agree that if you have a company that is abusing its employees, then unionize, but most of the bitching from people today is because they had a few perks removed, because the company is trying to stay profitable. If you have not realize how this economy has hurt collections for any healthcare provider, then I suggest you spend some time with someone in billing.

Only thing I can add, although I can not site the reference to the actual case, hospital property is either defined as within 75 or 100 yards of the physical property (the case involved someone attempting to drive to walk to hospital, made it to edge of property but not physically on property, and hospital staff refused to come assist the pt. off property). Also, a screening exam is just that (basically triage by a nurse), if no life threatening stabilization is required, there is some grey area as to how long they can "park" a patient, once that exam has occurred. One of the grayest areas is when the patient is at an outpatient facility or clinic that is distant to the main facility, and there is a closer non-related facility nearby. The patient by EMTALA should go to the base-related-hospital, but it may be in the patient's best interest to go to the closer non-related facility.

OK, you leave the cocaine on the table, the kids come home from school and something goes horribly wrong. You were the last public safety official in the home; no responsibility ? If it were a Meth Lab, would your answer be different ?

Unions are the reason that general motors is the largest purchaser of viagra in the US, I will let you figure out the symbolism of this fact. No government employee should ever be allowed to be in a union. This is not the 1920's anymore.

Unfortunately Tyler, in your description, you admit you know it is a crime (regardless of whether you agree with it or not), therefore you may have a duty to report. You do not know the children involved, the law is the law. Posession of marijuana is a crime in most states, you may not agree with it, but it is the law.

Correction, the Wyoming Governor does not want to force anyone out of a union, he wants to give everyone the right to choose to be in a Union or not. If you will compare the economies of "right to work states" versus those who have mandatory unions, you will see a stark contrast. If you like unions, move to detroit or pittsburg and see how unions have ruined this country. PS: Anyone that has a job in this economy that pays above minimum wage and has benefits, is an idiot of they choose to go on strike.

what does it matter, just answer the question, its not like we are protecting nuclear codes on this forum. If he is lying about who he is, so be it. I believe in GA you have to take National Registry then apply for a ga number. I am not sure about the other states, but you should be able to google that state's ems office to find out. Most states accept natl registry now.

To answer questions posted: The nurse may or may not report, she says she will, but obviously it will create all kinds of problems if she does. Do we not have an obligation to the child ? She is not old enough to realize the risk she is taking. What if 6 weeks later she has an STD or is pregnant ? Scenario 2, no cop on scene, called in as chest pain. Do you call one ?

I could be wrong but I think HIPPA has specific language that excludes crime activity

I would take you a whole different route. Do the medic thing, get an ER job as medic instead of ambulance (save your back). Use that experience to learn more (instead of a class), hopefully you will find a hospital that would be willing to pay or reimburse you for your PA school. To those who do not know, those who already have a medical background, have a leg up on other candidates trying to get into PA school, so doing Paramedic school is not a bad idea other than it delays PA school, but if that is the poster's long term plan than so be it.

If you know for a fact that a crime has been committed, do you have to report it to the police in your state ? If you do not report it, could your license/certification be pulled ? Could you be held legally liable in a lawsuit if you do not report it ? Here are some scenarios: 1. You respond to band camp, to a 15 year old female who recently had sex with a boy of the same age. It was concentual sex, but something went wrong during or afterwards that scared her and made her report to the camp nurse (no reason to get graphic or perverted here, you pick your own reason). In your state, the age of consent is some age above 16, which she is not, so a crime has been committed. The camp nurse signs your refusal paperwork and you go back in service. Do you have an obligation to report this crime to the officials ? Do you have an obligation to notify the parents ? 2. You have an adult male who develops chest pain after using cocaine, you see the cocaine in his home. Do you have an obligation to let the police know that illegal drugs are in this home ?

Roy and Gage would have taken the scalpel out of the OB kit, make an incision between the bite marks, and sucked out the poison. If I remember correct I think there was an episode where Gage got bit, had to treat himself, and ride to the hospital on top of the rescue truck for some reason. It does vary from snake to snake, elevate the effected body part, start an IV, transport.

Sorry Dwayne I have to disagree. Regardless of the situation, the OP is searching for an answer to educate students or newbies about these type of situations. Yes, this one is pretty easy, but I say you should involve a supervisor and/or MC anytime you encounter a problem where you do not have a protocol or policy to protect you. Not because you are too stupid to figure it out, but because it gives you another layer of cover should it "go sideways" as you state. For this particular call: 1. The woman is 100, anyone over the age of 70 with any medical problem or injury should be transported, if you can talk them into it, regardless of how stable they appear. If you newbies do not learn anything else from the crotch, transport everyone over 70 and all drunks. 2. He states he could not auscultate a B/P 3. The patient could not ambulate under her own power. 4. You have no idea how long she had been on the floor. 5. Unless you have mobile CT or xray, you have no way of knowing if she had a TIA/Stroke or fractured a bone during the fall. A more experienced supervisor may have been able to talk her into going to the hospital, if not, you can then show that you went above and beyond to get her to go. Do you really think she isn't going to fall again ? Hey let's go there. Same hair dressor comes back that night to check on her, and finds her dead. The family is outraged that you did not transport her the first time, and did not attempt to call them when you were out there the first time. You really want to defend leaving this patient at home ? Here is my first "lawyer question" - How long were you on the scene ? 15 minutes, 20 minutes ? Wow, you really went out of your way to help her, let me guess, you wanted to get back to the station so you could watch TV, sleep, or eat ? Did I change anyone's mind ?

If you are unable to get MC involved, then you should rely on your supervisor.

The answer for all "weird" situations is the same, get medical control involved.

I imagine the reference is into not being so scared that you beat yourself in the game. In any sports, confidence makes a big difference. I can see the same in a Paramedic, after years of experience, IV attempts on kid, tough intubations, critical calls, don't scare you like they do the rookie. I do not think there is anything wrong with saying I am confident enough in my skills that I doubt there is a call that I am scared of.

I would caution you against giving it up for now. You never know where you may end up 10 years from now, and its not like Michigan's economy is getting any better. Its not like you have to walk through fire to keep it, so why let it go ?

No, I imagine that if the OP ever comes back and tells us what treatment the patient received in the hospital, it will include high doses of Lasix.

Without much information from eyedawn on the specifics, i would remind everyone of this: 1. Those who do, do, those who cant, teach, those who cant teach, dispatch. 2. Like someone responded, you are advanced in your knowledge because you have a medical background, most of the students in your class probably do not, and maybe the questions you ask in biology 101, would be answered in biology 102, so you are ahead of the class, and you may be bringing up topics that are too much for the current level of the class. Imagine if on day 1 of EMTB school, someone was asking questions about 12-Lead EKG. 3. Most nursing instructors are like me, they went to school over 25 years ago, and medicine has advanced tremendously. They have an obligation to stay "current", but many do not. 4. The teacher may be teaching "the test", not the knowledge; just as many EMT/medic schools teach you how to pass the Natl Registry Exam. Do any of us really care what order the KED straps should be fastened, and who has actually used a KED enough to make it something that should be a pass/fail on a test ? 5. It is usually better to choose to "be nice" versus "being right". As mentioned earlier, you could pay a heavy price for being the pain in the instructor's ass, and a spot in a nursing class these days is a very special spot to hold.

If I were visiting an Asian (true asian, just moved here) for dinner, I dont think I would expect them to cook me a dinner consisting of fried chicken, mashed potatoes, pinto beans, and homemade biscuits. Hopefully if he/she came to my home, they would not expect me to make a traditional asian meal. People who have come to this country should respect our traditions, as we should if we went to their country. We should respect each other and try to honor each other's values if we can. With that being said, why hasn't anyone taken the proactive role (oh i forgot this is ems, we are always reactive, never proactive). I bet that no matter what city you live in, there is a church that represents these various foreigners (muslim, buddhist, johovah witness, mormons, pentecostals, goat worshipers, whatever), why not invite that church to create an inservice to educate you to their beliefs (you could create a file on your laptop that allows you to see these issues by clicking on the "muslim patient icon" you created. Why not go speak to their church, and walk through some scenarios to educate them to what we do (remember the youtube video of the guy transporting a dead patient on the back of a bicycle, and dropping him), maybe they do not know that we can do a 12 lead, and ambulance in their country might be little more than an empty van with lights and sirens. So let's quit whining about what it should be, and get proactive and create what it WILL BE. Nah, lets sit on our fat asses and bitch about it, that is much easier.