EmergencyMedicalTigger

I haven't been on here in forever! I have some questions about HIPAA and have been googling looking for information to pertain to my specific situation when I remembered emtcity. I used to find some very reliable advice, so I'm back to pick the brains of some people who deal with HIPAA and EMS specifically.

A folded hospital face sheet with patient information was left on the desk at the station during 'A' shift. The oncoming crew from 'B' shift saw the paperwork and left it out on the desk. The 'B' shift lieutenant came in later that day, and, upon seeing the paperwork, picked it up and took it with him. The 'B' shift lieutenant then gave the paperwork to the 'A' shift lieutenant and told him his crew left the paperwork out.

Obviously, the crew on 'A' shift has committed a HIPAA violation, but what about the 'B' shift lieutenant? He took the paperwork from it's station and carried it with him. If anything would have happened to the paperwork while in the lieutenant's possession, would the original crew be held liable?

No idea about the location BUT dont forget to go to Emerils Restraunt at the Venation Hotel!!

That is definitely already on my list. My mouth waters thinking about it! I've had a few people tell me it was awesome.

Wow, it's been awhile since I posted. I'm getting married in Las Vegas next month. This is a second time for both of us so we just decided to go by ourselves and spend a week in Vegas. I still have no idea where I want to have the ceremony. The wedding chapels I've looked at just seem a little cheesey for me. They have services that will marry you basically anywhere you want-a travelling minister if you will. So I was thinking, since we met in EMS why not get married at one of the local fire/EMS stations? Are any of you from Vegas? Are there any historic fire stations or anything similar in the area? Also, any suggestions on what we absolutely must do in Vegas during the week would be appreciated. We've booked Blue Man Group, horseback riding, and a helicopter tour to the Grand Canyon.

We do what we do because the job offers different challenges every shift and we're not stuck being a desk jockey. Sometimes we even get to run calls that remind us how much cooler this is than being an acountant. Yeah, every once in awhile we get calls that are disturbing, but try to remember...YOU AREN'T THE ONE WHO PUT THEM IN THAT SITUATION. You got thrown in the middle of things, because something didn't go as planned and you were called for help.

I had to work a code on a 75 year old man Halloween morning at the nursing home with no quality of life. He had no family-only a legal/medical representative. Hospice was supposed to come in a few hours to evaluate him and get a DNR. And here we were shoving a tube in his airway, cracking his ribs, and drilling an IO into his leg, knowing he didn't want any of it. When you take this job, you have a legal and ethical duty to all your patients. We have to have standards where everyone is treated the same. You were just doing your job. Take a deep breath. Take a day off. Get some sleep and come back for another fun-filled shift. It's what we do.

I haven't had a chance to do the research but the first thing I thought of with this case was inhalant abuse. It is really a big problem with the preteen and early adolescent age group. Most of the parents have no idea their kids are doing it unless something bad happens. The same as they have no idea when their kids are playing the choking game. There are often few obvious signs unless you have a really strong suspicion and actually know what to look for. A lot of the mood alterations/moodiness associated with the abuse is probably put down to the phase of preteens and teenagers which is why it is really hard to monitor and prevent it.

There is a very high risk of encephalitis and brain damage from "huffing". I don't have the profile of abusers in front of me but the fact that he is a loner and doesn't have many friends puts him at risk of depression and inhalant abuse. You don't need friends or company to do it and it seems to be a less social form of abuse although they do do it with friends as well.

Good point. I actually mentioned huffing to my partner. It may not be as popular as it was a few years back, but kids find crazier things to do with common household items to get a high.

Honestly, no I didn't. Sorry if this was information was included.

I'm not surprised by ACS's involvement in the trials, does it really surprise you????? Remember when Amiodorone came onto the market?

I've seen the results first hand. I've seen these cardiac arrest victims leave the hospital neuroloically intact. I believe in the device and support its routine use during cardiopulmonary arrest

We carry ResQPods on our trucks. I have witnessed first-hand the pt's gas exchange improve with my end tidal on my LP12 after adding the ResQPod during ventilations. The theory behind the ResQPod makes sense. I wouldn't put it in the snake oil category. Is is absolutely necessary equipment-no. Does it improve your pt's chances post arrest-yes, I believe it does.

The latest update for anyone wondering...He's still in ICU basically in a coma. No menigitis found after multiple tests. Comments in his notes made referencing encephalitis due to unk chemical intoxication. Initially I questioned the mom pretty hard about meds or drugs. My partner blew it off, I think b/c of the pt's age. It just goes to show you how much things have changed since not even 10 or 20 years ago. Kids are getting involved in bad things alot younger.

I have a decision to make and I need some advice. I especially would like to hear from those of you who left the truck and are happy OR unhappy with your decision. I like being on the truck. I like my station. I like my fire department first responders. I am getting sick on my shift supervisors. I have been with my service for a little over 3 years and I have been on my current Lt's sh*t list for over 2 years. I've never been formally written up. My Lt has told my partner to write me up a few times to which my partner responds, "Write her up for what?" I like alot of the medics I work with, but I'm getting tired of the attempts at intimidation and the BS threats of "you have a target on your back." I've had coworkers tell me that it's b/c my Lt is intimidated by me. Why?? I don't want his job.

I interviewed for a position with Memorial Hermann in Houston as a transfer coordinator. I will be at a desk for 12 hours, triaging transfers from lower level hospitals, and arranging patient transfers to the main Level I facility or to the surrounding lower level hospitals in the system. It's more money, more opportunity, and better benefits. I would still be able to pick up a few shifts at my part-time 911 job in the boonies just much lower call volume.

The interivew seemed to go well. If I'm offered the job, I still have no idea what to do. Every time I think, I couldn't leave this job (even with all the crap I put up with)-I love it, I get a patient on the truck that reminds me of the negatives that go with our jobs.

Suggestions please....Help!

If there is injury to the breast, then, yes, you may have to touch it during patient care. But other than a partial boob amputation or 12-lead, you shouldn't be touching the patient's breasts. The idiot who fondled the patient should definitely be punished. Take his certification and fire him.

I agree with previous posts. Just to throw this comment out there...What about fiber optic blades? They put out plenty of light, illuminating the entire airway no matter what position the blade is in at the time. This could possibly make intubation more feasible with the opposite hand.

I like some type of encephalitis, w/ the edema, but...

Poisoning of some type- could explain the symptoms? Accidental/intentional prescription drug ingestion? Amy meds in the house?

As we all know, family and patients tend to lie or be in denial, ie, "my baby wouldn't do that." The mom seemed pretty sincere that he hadn't taken anything intentionally. Even as far as recreational drugs, she stated he didn't have very many friends, was a loner, and was not likely to be taking drugs.

I'm going to try and find out what his status is in the morning.

Hmmm...... encephalitis in absence of infection or hyperglycemia hey?

Can't say I have any DD for ya, but I would suspect there is an infection undiagnosed, or unrevieled to you. epstein-Barr comes to mind, but of course meningitis was first. Did the child have all his vaccinations?

Temp?

Side note: One thing that came to mind was maybe the headache was secondary to tinitis from ASA OD.... as I was reading I thought that was where this was gonna go..... obvioustly not the case, but I wanted to type it for my own benefits.

The only thing I could come up with might be west nile. He was current on vaccinations. Temp was normal according to mom. I couldn't take one b/c of how combative he was. I could've tried, but it wouldn't have been very accurate.

Just thought I would throw this out there to see if any of you more experienced medics have any ideas on this. Of course I would get this call after a crappy week of running codes every shift, having a crappy birthday this weekend, and just generally not wanting to be here this morning.

Dispatched to an 11 yo male having headaches x 3 days. AOSTF patient laying in parents' bed screaming b/c fire department had just poked his finger for a glucose check. BGL=187. Hx-ADHD and currently no meds, NKA. Patient started c/o bad headache Thursday, woke up this morning completely disoriented. He would not follow commands or respond appropriately to parents-just walked around the house. When we would stop touching him, he would calm down and become compliant enough that he walked himself to the stretcher. NSR on monitor. Slightly brady on 12-lead (55 bpm), but did not raise concern as he was a very fit 11 yo. He would c/o pain one moment and then not have pain several miutes later. When I would stop talking to him or touching him, he would become lethargic. I was prepared for him to be a little combative, but he completely freaked out when I went to start the IV to the point of trying to grab the needle out of my hand. I said forget it, had my partner upgrade to emergency traffic and just got him to the hospital. His bp remained stable about 120/70 the whole time. The remainder of transport he screamed anytime I would say something. PEARL,mom denies drugs/meds, trauma, sickle cell, fever, neck pain, or any illness other than headache.

My guess was meningitis, my partner thought a tumor. I've seen a good number of psyc patients and violent drug addicts, but this kid was about as close to possessed as I've come across. It took 4ml of Ativan to calm him just so we could leave and not have to help restrain him. He started screaming again after we left, think they were doing a foley. I found out from the hospital he was transferred to Tx Children's with encephalitis. He did not test positive for meningitis. My best friend works at Tx Children's and did an xray on him this afternoon. He's in ICU, intubated, restrained, and posturing from the consistent seizures. They haven't found a reason for the continued swelling in his brain. Anyone run into something similar? I'm completely baffled and in shock that my disoriented, ambulatory patient might now become a vegetable if he survives and he had no symptoms or than disorientation and an unexplained headache.

So what are you supposed to do if you have a patient screaming in pain with a dislocated knee, and you're only 2 miles from the hospital?? Sorry sir, we're so close to the hospital, you're just gonna have to suck it up. Whatever. The MD is an idiot. Do what's best for your paitents.

You need to lose weight or be canned. I don't think special accomodations should be made for someone's weight/size.

I am morbidly obese. Ok I admit it and am proud of my body image and am comfortable with it. I do not eat particularly excessively and have a genuine real problem with my metabolism.

I have serious problems with uniforms at work. I have to have special ones tailor made for me(at my own cost).

Vehicles are also modified and strengthened to allow me ease of access and safety.

My employers are yearly becoming less sympathetic to my problems and special requirements.

Recently I have been threatened with disciplinary action if I do not lose weight and become fitter.

Those damn pen pushers and money men are claiming my ability to do my job is compromised by my weight problems.

I love my job and am feeling threatened and in need of help.

I am eager to know if anyone else has been in a similar situation and if they can offer any advice.

I'm going...what more reason do you need? LOL

I've got a few people bugging me to go, and I am certainly considering it. Should be a good time. Even better if some EMT Citizens make it!

Always good to see you, Tigger!

Here's a crazy idea...look for the pacer marks on the monitor strip, or notice if the top of the printout states "pacemaker" if you do a 12-lead.

Wow, haven't been on emtcity in a long time. I'll have to get used to navigating the site now that it's a little different. There's alot of new faces. For all the people who remember me-yes, I am still opinionated, but in a good way lol.

I did a search, but didn't see where anyone has mentioned the Texas EMS Conference in Fort Worth at the end of November. Anyone else going??

Edit: I just noticed people can rate a person's reputation and a warn status is posted. LOL Oh boy.

I suppose EMS in PA or more so in my area is worse off than I had originally thought. We have a decent scope of practice, but the docs still get pretty pissy if you do most of the stuff. I got yelled at for doing an EJ or a cardiac arrest patient after failed attempts on the arm. I could only imagine the reaming for cleaning a spine (even with the proper training).

You got yelled at after multiple IV attempts. If the EJ didn't conflict with other care the patient was receiving I don't see what the problem is. The doctor is a moron.

Hello all. It's been awhile since I've posted-just been lurking, not much to say. But as I'm sitting at work doing everything possible to avoid working on my 12 page clinical ethics paper due at the end of the weekend, I came across an article while perusing the latest issue of Texas EMS. Nominations are due for an award called the Star of Texas. This is an award given to nominated peace officers, firefighters, and EMS personnel who were injured or killed in the line of duty. I got to thinkin' this could create some discussion. This award can be seen as a way to honor a first responder, but how much is it promoting unsafe practices? In other words, how can the committee distinguish between those doing their jobs safely? I'm sure the nominations are biased. Do you think the people who nominate a firefighter who died in a burning structure will include that he went in without some of his equipment? Or how about a paramedic who was ambushed by a deranged gunman but did not verify if the scene was safe? I'm sure these details can easily be left out, so when a person such as one described wins an award, what message does that send to those who know what happened on scene?

Comments...

T shirts aren't acceptable. We wear "class B" shirts starting in Nov until June during the day. We get to wear polos at night and during the daytime in between June and Nov, when it's hot outside. It gets pretty hot and steamy along the gulf coast in Texas, but t shirts never look professional.

Tough topics..I'd say my black-and-white answers are pro-choice, pro-death penalty, and pro-euthanasia. For me, it would have to be a really good reason to get an abortion. I think there's a special corner of Hell for women who use it to correct their irresponsible moments. I'm from Texas so there shouldn't be any surprise that I agree with the death penalty. I think we need to off a few more and get it done faster. As for euthanasia, that's someone's personal/religious choice that they have to make. I would never be involved with a patient who wanted me to help them do it though.

I agree, contact a supervisor. Ask the patient if she wants to be taken to the ER by ambulance. If she says "yes," then explain to her you need to leave now. It's an emergent 911 service, so you can't wait on scene that long. Advise her, you would be more than happy to take her to the closest appropriate ER, but you're not passing up a hospital to take her to one an hour away. If the patient wants to go with you and the nurse is refusing you patient contact, then call PD.

I'm trying to make the new year less stressful, so I'm going to start by getting rid of the source of most of my workplace woes. Anyone have any suggestions on how to off my partner and make it look like an accident? He's a total (even more than the normal paramedic) egomaniac. Since he acts like he's working out and drinking protein shakes whenever we're not running calls, I was thinking an interesting dumbell accident or maybe even something in one of his health drinks to make it look like a lethal allergic reaction to soy. Any suggestions?

Worse comes to worse, I'll just run him over with the truck and say my foot slipped. "I swear, I don't know how it went into reverse after I hit him in drive. Damn Ford transmissions, they can be so touchy."

I wish my partner would get moved...soon, very soon..