RatPack

OK, but this moron has over 20 years experience as an EMT. I have the misfortune to know him, and his incompetence is only surpassed by his arrogance.

Arrogance and incompetence are a dangerous combination in this field.

WTF are you talking about? I was unaware you could send a bleed....gimee your address and I'll send you one in the mail...Priority Mail flat rate $4.99...who wants one?

You sound like so many of the patients I pick up who refuse to go to a certain hospital because they "killed" mama...

Sorry to be harsh but try to post in a more inteligible form to invoke a more warm, fuzzy response.

Ya what he said

Sorry did I miss something, you stated this was a productive discussion.

Absoulutes in EMS are rare. Decisions are made on a case by case basis.

If it benefits the patient for a family member to ride in the patient compartment they do, child or senile adult. We have seat belts there too.

There is alot more gray then black and white in EMS, your decisions should reflect that.

As far as making decisions on the fear of litigation. I dont. I base decisions on what is in the best intrest of my patients.

None of that is our problem!! They let their choices go out the window when they or their family activated 911. Now don't get me wrong, they can refuse any kind of treatment that EMS may want to do, but what you are talking about in your post is a hospital problem, not ems. If they are old and senile, then they aren't going to remember anything that goes on and if it is a cultural issue, then, sorry, but we have a job to do. And when it comes to children, parents tend to make the child more aggitated because they cant control themselves. Regardless how you want to look at it to justify somebody riding in that is not seeking medical attention, we still have a job to do and we need to cover our own butts. So what if their feelings get hurt or they get offended, at least you will still have a job. There's nothing that states that we have to allow anybody to ride in.

Well you told us....

On a run last night, our squad was dispatched to the residence of male heart patient, who was unable to get up. Upon arrival found patient lying on floor. Family advised that they were assisting patient back to bed, and he became weak, and was lowered to the floor. Patient is under Hospice care due to severe 25% cardiac output. Patient is lethargic, with vitals as follows. P 168, BP 104/68, R 20. A-patent, B-spontaneous and non-labored, C-normal, warm and dry. Monitor shows a narrow tachycardia, with no visible "P" waves. Patient's family refuses patient to be transported d/t the fact if the patient is transported they would lose their Hospice care. Family advised that they have been instructed that they must call Hospice to determine if they should call 911, and if they do and have him transported, they will lose Hospice care. What are your thoughts on this?

Pt is lethargic. He goes. Just because he has a pre-existing medical issue and is a hospice pt. doesn't exclude him from treatment or the fact that some other entirely different issue has arisen.

Like stated before. Did he want to go?

I dont understand the hospice stance. He will lose hospice care. For what? Seeking medical treatment?

Another angle, if he/they didn't want him to go why did they call? Just curious.

They absolutely do address that. Why do you think food is an issue in the patient compartment? Why do you think no one working in a hospital can eat in the patient care area? It's not because the patients won't like the smell of the food. OSHA could find a dirty needle or a hamburger in the patient compartment. With either one or both, the violation and fine will be given. Honestly, has so few in EMS not taken an OSHA class to understand the hazards that can affect both the provider and the patient? I already know from other posts that there are a few who are clueless about MRSA, VRE, C-Diff and TB. Do the schools and the employers not cover anything about such a crucial subject?

Why don't you just contact your state's OSHA department and ask them if you can dine in the patient compartment of an ambulance? I'm sure they would be happy to send you and your ambulance service the information. They might even make a personal visit.

Easy....

Your missing the point. Review my posts.

I fully understand the OSHA guidelines. I understand this is a violation, I stated that in my first post. That wasn't my question.

It was stated that this could be cause for fines or revocation of ones certification. I simply asked if you had a documented case where this was the outcome. Where a provider was fined or their certification revoked for eating in the pt compartment.

I believe you are talking about the MERCI clot retriever. A few of our stroke centers are using this device.

I believe it has an 8 hour window also.

Have you even been present for an inspection by various agencies? If not, your company will be wise to educate you on the Federal and State regulations. This is all spelled out very clearly in any state statute for certification of an ambulance. Also, many states now do publish the list of ambulance violations on their websites just as when an EMT(P) has a violation of some type. This information is also made available to any facility when contract negotiations are being considered.

Here are a few citations which the food products can also come under the blood borne pathogen safety violation. You can also find out more information by taking one of mandatory OSHA courses offered for other healthcare professionals. The issue is food in a patient compartment exposes the employee to infectious contaminants as well as the patient.

http://osha.gov/pls/oshaweb/owadisp.show_d...&p_id=10725

http://enviro.blr.com/news.aspx?id=15040

http://www.apsta.org/laws-fines.html

http://www.isips.org/reports/Articles/MIC0106p14.pdf

I understand this is an OSHA violation. I'm not arguing that point.

It was stated that fines could be levied against a provider and certifications could be lost. I was just looking for an example of a case in which it happened, where food being in the pt. compartment was the cause of a fine or loss of certification.

These articles dont address that.

The American Heart Association recommends a renewal date.

It is not mandated. However my employer mandates renewal every two years

Just sad.

Especially if true, the guard who sat idly by his car waiting the arrival of paramedics.

Please could you refrence a case in which a certification was lost for food in the pt compartment.

well if OSHA fines you enough it could put the company depending on the size into bankruptcy so they might be forced to close down..

Fair enough.

I would have to check but I believe you can be fined several thousands of dollars and possibly lose your certification for food in the patient compartment. I could be wrong or perhaps that is a state by state thing.

Lose your certification?

This is an OSHA violation, not an OEMS violation.

The best system is one that professionally and competently services the needs of their community.

Come on a 26,000lb truck flying down the road for no intended purpose. Whats the problem?