NYCEMS9115

No problem in what the Hospital Healthcare Provider did. The patient is outside the hospital. The patient is on their property. You have a duty to act because you were dispatched. You should have assisted and take patient into the ER with the staffer. You would fill out the PCR as a transfer of care. You can't document as if you transported; it would be problematic if your company were to bill this. No need for signatures; just the name of the In-hospital Care Provider and note that you assisted him/her to take patient into ER. According to your story; you didn't document. This is a QA/QI issue... Ex.(If this is what happened) U/A found pt IFO Jane Doe Mercy Medical. A Staff RN with a hospital stretcher onscene. As Per RN John Doe, he want crew to assist in placing pt onto stretcher because the ER were aware that the patient was coming in. Pt appeared lethargic; difficult to arouse. Noted AOB and pt had poor hygiene. Bystanders found pt there and called 911; one stated he ran into the ER to alert a staff member. No injuries apparent. Pt was incontinent with urine. Crew assisted RN with picking pt up off the pavement and placing pt onto gurney. Due to the instructions of the RN and the ER being 50feet away; PHC assessment and care deferred. Care taken over in ER by staff... NYS EMS Disposition Code: 004 NYC EMS Disposition Code (10 Codes): 10-94B (BLS) Of course this just my opinion; I wasn't there. I do respect your passion in protecting your area from "enemies"; foreign & domestic. Not making fun. That's how NYC EMS was in the 80s (so I've heard from older EMS Care Providers), 90s (I can only tell you about the last half of the 90s), & 2000s... Too many hitters were good for the Employee but bad for the Employer. Hence, bad for the Employee, if Employer closed as a result. "It has happened before and it will happen again. The question is: When?" Armageddon Had to add a comment....

http://www.emsworld.com/web/online/Top-EMS-News/Facilitator-of-Mass-EMT-Scam-Gets-Probation-Plus-5-000-Fine/1$17290 Probation and 5K; that's it!!! Should have their Certification(s) revoked and a $10K fine.

I am all for advancements in PHC/EMS but hearing drugs that are given for various complaints where the complaints are not life threatening such as dizziness. Are we (we meaning EMS/PHC as a whole) going into Internal/Primary Care Prehospital Medicine? I think we are. Benzos for dizziness seems like it is moving into that direction. Well on the surface, that is. I am all for that; job security and longevity but can we advance the education then? Degrees with longer Paramedic didactic training with the abolishing of Certificate Programs. Personal opinion, not fact. No one (when I say no one, I mean 0 people) has to agree with me.

Like you said you're a relatively new Paramedic. Your dream job will to be employed by Philly EMS. You mentioned another goal; that is to run a City EMS. You seem to have lots of energy. Don't get burnout with the EMS Atrocities. Continue your education beyond the Medic. Good luck...

It pays $650-$800/week, includes room/board & food. It's 2hours North of NYC located in the Catskills in NYS... ?? ? http://www.emsjobcenter.com/c/job.cfm?vnet=0&site%5Fid=12090&jb=7995506? ? ? ? Livingston Manor, NY 12758 ?

Scene Safety needs to be taught & re-taught, continually discussed & addressed. It can't be just something that is a critical point in our Patient Assessment Practical. We need to pay attention at all times. Anticipation, preparation, and awareness is the key to Scene Safety. It needs to be reassessed constantly. However, it is impossible to predict every act of violence, no matter how prepared you are...

http://public.health.oregon.gov/ProviderPartnerResources/EMSTraumaSystems/Pages/index.aspx http://www.oregonems.org/ http://www.oregonems.com/ Try corresponding with them. They can probably answer all your questions and direct you to where you need to be... Good luck...

Vitamin Z is the most important thing to get for tired bodies and minds... It cost you nothing, there's no side effects, it's natural, & it is something very enjoyable... Most of us are Vitamin Z deficient and most Practitioners do not prescribe it...

When you have polos or pullovers as EMS/PHC uniforms; you must wash it inside out, in cold water, & gentle cycle. This will prevent tearing and fading. Do not dry it in the dryer. Hang dry it, this will also prevent fading. As for whether polos or pullovers make a Provider look unprofessional; it is obviously subjective. Neat and clean is foremost.

Al Pacino did a very good job in the movie.........

I fully agree... EMS is not just 911. Majority of EMS/PHC are Non-Emergency Transports... My guys, interact with Patients and Facilty Staff Members. Our Policy is that we must wear our ID while on duty. I instruct my crews to have it on; their ID is also their timecard, so there is no excuse they do not have an ID. Many times things change on Transports and even Emergencies like destination change, pickup time pushed back, the patient needs BLS or ALS during Transport, the Practitioner states the Patient is stable for Transport, the Patient will not be Transported, etc... I do not want my Company to take responsiblity for such changes, so the crew gets the name (last name) and title of the person who has made that changed to the scheduled call. The incident is noted on our RightCAD System and on their PCR. I also tell my crews to make sure where all signatures are required (PCR, PCS, and Billing Forms), they have the signer print their name or ask for their name and the crew member will print it for them. I want to answer the question from contracted facilities when they call to bark at us; "Who?!?" It was RN/MD/NP/PA/RRT/PT/Receptionist/Family/HHA/CNA/etc. Jane/John Doe who told us this or that. Hearing someone try to describe the person who told them so, can be useless in identifying the sayer. A name will single out the individual(s). Names are not just a PATIENT RIGHT it is RIGHT for all of us in the Healthcare Industry....

http://www.health.state.ny.us/professionals/patients/patient_rights/docs/english.pdf http://www.health.state.ny.us/nysdoh/ems/pdf/ambulancebill.pdf In NYS, it is a Patient's Right... Wearing an ID is a Policy of an Employer and for the Employer to enforce. If the patient ask for your name, as a Healthcare Provider in NYS, you must divulge your name. Not doing so is a violation of their Patient Rights... Of course, this is in NYS. I am unsure of other jurisdiction, so I will not comment about other Providers outside NYS, refusing to provide their name or wear their ID badge. How one defines what name they should provide is an individual's preference; family or given name is appropriate... In closing, if you (in NYS) violate a Patient's Right, you are unprofessional. I am not naming you. I am using "you" as a whole... I do not expect everyone to agree with me. This is my opinion but I have provided facts to uphold my argument...

That is 3 football fields. Unless, you're referring to real Rural Areas. I believe it is once you enter the Hospital threshold. There are people who live less than 300yds from the hospital. Regardless, the EMS Providers are not relieved of their duties until properly relieved. Content unchanged; added another point...

It is horrible what the South of the US had to deal with. Nothing can be said to make this any better. I hope people will survive through this. I pray for you and all the people who have suffered. Hopefully, various Alphabet Organizations will help soon. I am truly sorry.... Good luck....

To wear something that identifies your Name, Position, & Employer is fine. If you do not wear identifying markers, it is fine too. However, patients have a right to know who is treating them. All States have Bill of Rights for Patients during their Hospital visit but not every State has one for EMS and Out Patient Services; that needs to be change. Patients have Rights. We can turn blue in the face about Yea or Nay to IDs for EMS but anyone who argues about a Patient's Right to know the name of the Healthcare Provider is showing unprofessionalism.

http://www.emsjobcenter.com/c/job.cfm?vnet=0&site_id=12090&jb=7807068

http://mobile.nytimes.com/article;jsessionid=A5C3D306D1C72EEDA52DC7B0CA7BDF4E.w5?a=798491&f=19 May he Rest in Peace. He helped many people die with dignity; where life had taken their will. The Father of Euthanasia; Dr. Death....

Pedi-Mate vs Car Seat; Pedi-Mate has its advantages. It's easy to clean and maintain. It's light and simple to use. It's so compact, making it easy to store, taking very little shelf space. The great thing about it, is that the child/baby can be placed in a supine, low-fowler's, medium-fowler's & high-fowler's position. Plus, since the Pedi-Mate attaches to the stretcher; if the patient should go into Arrest (Cardiac or Respiratory), CPR/Rescue Breathing can be quickly performed on the patient. There is greater accessibility to the child/baby when they are secured on it. Since the Pedi-Mate is made of rip-resistant nylon; it is not absorbent, so fluid (blood, urine, etc) is easy to detect on the patient (sides and voids). Whereas, on the car seat it is cotton material, so it will soak up the fluid. This is my experience with the Pedi-Mate vs the Car Seat...

C'mon, let's be PC... Hookers are known as Selective Companions. Drug Dealers are known as Alternative Pharmaceutical Distributors. Mob Bosses are know as Organizational Leadership Entrepreneurs. They all have assimilated to America's Current Affairs. We are in the 2010s and the old titles of the 70s, 80s, 90s, and 2000s don't sound hip anymore... I'm just saying.... Lol...

Meant, the law doesn't require it....

http://www.nydmv.state.ny.us/broch/c-1.htm In NYS, having to wear seatbelts on Ambulances are exempt from the Law. No fines or points. Another way to go above and beyond the Government and Governing Body's Policy and Procedure; in this case "Law". I tell my employees; everyone must be fastened in, when the vehicle is in motion. No exceptions. Safety is paramount. If other Ambulance Companies choose not to require this, that's on them, the law does require it.

http://emsseo.com/2011/01/free-ems-downloads/

I know many of you are not from New York. Here are the Hospital Patient Bill of Rights and Ambulance Bill of Rights of NYS: http://www.health.state.ny.us/professionals/patients/patient_rights/docs/english.pdf http://www.health.state.ny.us/nysdoh/ems/pdf/ambulancebill.pdf Patients have a Right to know who you are. Whether you wear a badge, nameplate, or photo ID; you must identify yourself when asked. So nameplates are fine. I do like the embroidery but if the company is paying for the shirt, its not cost effective... I have my guys wear their picture ID... Added a point. Content unchanged...

My name is Bond, James Bond... Wasn't so hard...

In 2000, Lenox Hill used Paramedics in the ER as Triage. This Pilot Program didn't work well. The RN made a big issue and the Paramedics were no longer doing Triage after a year long project. That is the problem with expanding the Role of the Paramedic. Other Healthcare Providers will intervene in this progression if it steps on their toes. Why aren't the Paramedics protesting Nurses on our "Rigs" and "Birds"? EMS is not Medicine or Healthcare in the eyes of laypersons and many Practitioners. It is our (EMS as a whole) fault. We do not petition, advocate, or educate our existence to people who are unaware we exist. This APP may not work in areas where VNA and VNS are relevant. EMS folks crack fun at Nurses but look how far they've progress and look how far we've gotten. Nurses has this voice that demands to be heard. They will wreck havoc if they are not heard. EMS must mirror the Progressions of Nursing... Of course these are my feelings and having others agree is not reason for the post...