wrmedic82

I agree with what everyone is saying here. The problem that I feel is being overlooked is that she is a volunteer. Im not sure how NJ defines duty to act, but where Im from its really a grey area. Just because the department drops a tone for a medical call doesnt mean I have to go. (of course Im gonna go without question) My legal duty to act doesnt come into play until I check en route over the radio. I do both paid and volly work. Personnally she needs to pull her head out her butt, and remember that its the citizens that provide the funding for new equipment, and that she has a direct impact on the PR of her department. If she isnt goint to take care of the citizens she is sworn to protect. If I was living in her district I would be appauled if they asked for additional funding. From a patient care stand point Im not going to allow a guilt cloud over my head cuz a kiddo had flu like symptoms and crashed. (I know that it maybe far fetch).

They do have a Mrx that can opperate with the pads. They have a doohicky that is commonly nicknamed the hockey puck that sticks to the chest with adhesives so to monitor compression depth, rate, and recoil. I like the phillips monitors myself.

Agrees with Spenac's co-workers j/k I do repetitive questioning every now and then also when it comes to assessment. Its 50% of I forgot (we are human)and 50% I want to see if the patient gives me a consistent answer. Im not going to type my complete rational for this. But I will ask you how many times does your patient tell you one thing and the hospital staff another? Although this may not prevent the patient from telling another story at the hospital.(especially is the patient has dementia) It makes me feel better. Dependent on the situation, it could be a good assessment tool. Don't worry so much as far as your partners experience. yes she is a wealth of information, but you have been trained with the same skills(assuming your the lead on the truck or have the same level certification). Perfect those skills and you will be fine. Im not saying to dismiss your partners experience totally though. And how have you tried to resolve this issue with your partner? Have you talked to her about this problem? or does she do this in a sense to try to be funny on scene?

Fiznat, The question isnt whether or not we transport. So assume you have come to the conclusion this person aint goin to the hospital. So the question is how are you going to clear the call. Would you have the person/patient sign a AMA refusal, Release at scene and document the contact and that there were no medical complaints, or would you say this is a false call and clear the scene.

Some great points. But the question I have for some is, if they are AOx4, at what point can you force someone to be transported to the hospital? I can understand CYA and every possible situation that could happen as a result of ETOH intoxication. But at the same time what about the legal aspect?

Dust, Its a little bit of all the above except for when the person actually calls 911. Then of course we roll to the person / patient's house with maybe a response with a CC responder or supervisor. Only thing that scares me to a degree is that now they have a policy that if the lead medic doesnt think patient meets medical necessity, he/she can call the supervisor. If the supervisor gives his blessing after given the assessment done by the lead medic, he/she can refuse to transport a patient. Counterproductive in my opinion. Im sure it will reduce the load, but is it worth the liability?

You respond to a 45/m Man Down (3rd party caller). Upon arrival at patient's side you get a strong alcohol-like odor. You are able to arouse the patient easily. The patient admits to ETOH consumption and states he fell asleep. Patient denies any medical complaints, and refuses any treatment or transport.Patient is AOx4, GCS 14 How would you choose to clear the call?

LMAO

If hospital emergency rooms have to treat regardless if the patient can pay or not, what makes us any better? It is a known fact that in every system is a system abuser. Regardless, we have to treat that patient, even if we think nothing is wrong, as if that person is actually having a medical emergency. Why? Because they are going to probably be the one in the courtroom with you in a lawsuit if something actually was wrong, and your failure to treat caused harm to the patient. In Ft Worth, TX, they have a program in which when a known system abusers get visited by CCEMT-P's in mobile units to check on them to make sure they are alright. Rhyme and reason is because system abusers most of the time just want attention. This actually has reduced the number of calls to these people who abuse the system. If the patient is not doing good, patient care is initiated on the spot, and a MICU is called to respond / transport.

This is just my opinions on the topic. -Lets say he had a pulse when you arrived at his side. I would load and go. -Lets say he DID NOT have a pulse when you arrived at his side. Give him 20 min of my best provided no obvious signs of death. Call medical control tell them what I got, and call it if the the MD is cool with it. I just feel that BCLS / ACLS is better done onscene if possible. -Obvious signs of death with PEA or Asystole - DOS I know everyone views this situation differently, and thats cool. I would go with your training / experience, medical direction, and gut instinct on this one. If your gut says lets go, then by all means. But the questions I would be asking is if its going to be worth saving a guy that more likely than not will live in a vegetative state for the rest of his life? Im sure there are many stories out there, and even here of people surviving and living life despite the odds. And I know some people will even say who are we to make that call. So your always going to have answers on both sides of the fence. I wasnt on the call so I didnt see what you did. But thats a generalized answer w/o variables factored in.

This topic reminds me of this comic

Easy there vent. and your very right about a fib. as I was stating to the OP that it is possible. I know there are many reasons that cause a change in mental status. And yes most EMT-B's are clueless about the pathophys of a fib. But thats kinda getting off the path I was going with this. And I will say that anyone coming to reproach anyone with arrogance is not well accepted by anyone. If an opportunity presents itself to offer insight, experience or education I feel people should take advantage of these opportunities. Its not about one being smarter than the other. And well all cant "get it all". Im not advocating just thrust your nuts in a nurses face to show them how big they are. Like the old proverb says as iron sharpens iron we should sharpen not just ourselves, but others when appropriate.

My solution is to take the initiative and take everything in despite the request of the lead medic. no one is going to frown on you for doing so except maybe your partner. If it becomes a issue, bring a supervisor into the matter. I highly doubt you will be found at fault. Just remember to be tactful.

just an idea: -boot the computer into safe mode -Log in as Administrator NOT under your name -Remove the acct -Create another acct -the restart the computer. I know this used to work, I have not played with it too much with Vista. But for XP and older OS programs it works really well.

tamaith, I hate to say this but this happens like everyone else says more often than not. To take the advocate of nurses for a second, a single nurse can have as many as 15 patients or more. Im sure chbare can attest to this. A good RN yes will be able to rattle off everything under the sun about a patient. Some things may be left out due to various reasons. It happens we all have to deal with it. LVN's especially at NH typically don't dive into their patient's hx as much as they should. So it should not really be a shock to anyone that they didn't know the patient's hx upon your arrival. As a EMT you are a health care professional. More so, its your job to find out all you can about a patient. Sometimes this means you have to play detective. Sometimes the answers concerning PHx are within the notes, medication lists, etc. Although going based on a med list can at times be misleading, it does kind of give you a clue as to what is going on with your patient(s). This is not really a new challenge, but an old one that you do everyday. If the syncope happened within a residency, and to add a degree of difficulty it was a 3rd party call. You would try to find out what meds your patient is currently taking, and if he is unresponsive you would try to piece what possible hx the patient has based on medications they are currently taking. Most people don't have a sheet just laying around in the open the tells their PHx. At a NH its really no different. Thats why patient assessment is important for every patient encounter you have. Lastly, at every level of medicine there is ignorance due to lack of some type of education. There are really no exceptions to this. Thats why there is always room to learn, and to continue to learn. Where as some people do not take advantage of this, I encourage you to continue to learn all you can. Also encourage others to do the same. If a LVN doesn't know that atrial fibrillation is a cardiac condition, professionally educate them that this is cardiac. Maybe they knew it was cardiac but for whatever reason didn't feel it was pertinent even though it very well could have been. I don't know I wasn't there. But instead of being arrogant, we need to be professional, and help each other out. Just be tactful about it,and be ready to agree to disagree. As for communication to the emergency department. If you have a cell phone. It maybe helpful to ask the ER for a contact number so that you can communicate with the emergency department when you have a incoming patient. This can be really helpful if your bringing in a suspected stroke patient or a STEMI. If your employer wont open the lines of communication like they should, be proactive and do it yourself.

NIMS 300 & 400 is still an actual class room, there are classes online for 300 and 400 that will prepare you for the classes, but if you read the fine print, its not a substitute for the actual class. As for volunteers. For volunteer FD's to get federal funding they must have all fireground personnel NIMS compliant. Otherwise I hope their wallet is big so to be self sufficient w/o federal funding. Also the classes that are on the website that I put in my previous post are all grant funded courses by the DHS.

Correct me if I am wrong. When I was down in FL I was told that first responder was a prerequisite to EMT-B. I know that is not true in TX where I got my certification. But definitely get your EMT-B.

Couldn't have said it any better. When everyone is on the same page it not only puts everyone on the same page, but also helps to reduce emergency workers from unnecessary injury due to freelancing through accountability. Yes its about as boring as watching that long drawn out HIPPA video. But it does have a pay off during moderate (apartment complex fires or bus accidents) to severe ( MCI's ) incidents that you may encounter in your career. I do think that there should be more emphasis in the work place to ensure everyone knows what to do in these situations. Just something to banter around the work place to help not just yourself, but anyone who reads this post. The Texas Engineering Extension Service has classes that can come to your place of employment to teach various things to prepare for such events, as well as the unthinkable. Here is the link. I hope this is helpful. http://www.teex.com/teex.cfm?pageid=OGTpro...templateid=1658

This is my take on the topic. Agree or disagree its all good with me. We have the same problem in our system. Its very easy to become jaded after constant runs for the same guy over and over again. There are some people even that we know who it is before making the scene just based on CC. We had a crew almost 6 months ago pick up a homeless guy that everyone in the company knew. A known alcoholic, and known 911 abuser who would get drunk, and call complaining of CP. Well this call started with the typical routine. Nothing appeared out of the ordinary, except for his 12-lead showing massive AMI. He ended up coding en route to the hospital, and pronounced dead at emergency room. I like my partners stance on this which is treat each patient as if its the first time you have ever met them. I know that repeat abusers are as the little boy that cried wolf. But regardless we cannot let our guard down until we have the technology,and training, to actually R/O life threatening events. I understand some services do, while others don't. I don't like running on calls on people I see more times than my own family for the same complaint or lack there of. But I also like working towards being successful in my job. I would hate to loose what I have worked for, just to find myself trying to be successful somewhere else, or in a profession outside of EMS. Point is we, as much as we would like to, cannot call a spade a spade just yet. I look forward to the day that it would be possible. However I see that day being far off, and not in the near future. I could be wrong.

Will keep him, a brother from another mother in my prayers. And if he is as stubborn as most people I know in EMS, giving up wont be a option, and hopefully he will be fine.

Welcome to emtcity for start. I would have thought since Georgia is a IFSAC state you would get reciprocity. Chalk it up to politics. I'm not too far from your neck of the woods, just on the otherside of the metroplex in fort worth. good luck to ya. Welcome to emtcity for start. I would have thought since Georgia is a IFSAC state you would get reciprocity. Chalk it up to politics. I'm not too far from your neck of the woods, just on the otherside of the metroplex in fort worth. good luck to ya.

Well it all makes sense. When Farrah Fawcett died, God said to her, you had a good career, lived a good life, and did wonderful things to help others. I want to grant you one wish. And she said that she wished all the children of the world would be safe. R.I.P. MJ