khanek -
A group of lawyers & "expert" witnesses [former "suit types" from the realm of EMS & healthcare in general] were at an industry confernence discussing the rise of malpractice suits in pre-hospital care [which are on the rise; our paramedic program is incorporating an in-depth"legal issues in EMS" as part of our course beginning with the next recruit class]. Some of the lawsuits that they cited involved the lack of pre-arrival instructions being provided. They pointed out that the days of not providing PAI as a way to stay out of a malpractice suit were quickly passing. I can't cite to you the specific cases & in all fairness the cases were way more complex than advising or not advising to take a medication available in a private residence. They were cases within the U.S. & had occurred within approximately the last three to four years. I am not a lawyer & I can't cite the specific cases or case law [for all I know the lawyers degrees came out of a cracker jack box ]. My assumption would be that as more dispatch services provide PAI that it is becoming a comparable "acceptable" standard.
What I do know is that they advised the same four things that they advise to pre-med students & that I advise to my paramedic students.
1. Stay abreast of current & changing trends within our industry & related industries. If there is something you don't know - research it! Don't just form an off-the cuff opinion or take the advice of one individual or group, even if they appear to be knowledgeable of the topic. [This includes my advice on any given topic. ]
2. Document, Document, Document! - You can never cover your butt with enough paper & ink.
3. A pleasant bedside manner will go further towards keeping someone from suing you more than anything else. Although providing competent care does help . I know of various healthcare providers [not just medics; nurses, physicians, etc.] that provide a lack of adequate care but have a great bedside manner. They seem to face very little threat of malpractice from anyone outside of the industry. I know others who can be a royal jerk in the provision of excellent care who are routinely threatened with lawsuits.
4. As a provider ignorance [of the law or acceptable standards - not just locally, but regionally & nationwide] is no excuse. In this day & age relying on "the good samaritan" statutes & laws just aren't good enough.
As to your example of Nitro; I agree that I don't know how dispatch could appropriately assess a patient, for the administration of Nitro, through only questioning them. But, this was not part of the original thread/question. The question was in regards to ASA, which the American Heart Association now states can be given by instruction from a dispatcher, asking the appropriate rule out questions, prior to EMS contact. If you want to know more please check out the AHA link http://www.americanheart.org/presenter.jhtml?identifier=4456 that was previously cited.
Spenac- You are correct - childbirth is a natural process that has been occurring since life was first created. Death of the newborn & the mother has also been occurring since that time. Having a calm voice to talk a layperson through an event that they are not use to dealing with every day can be very valuable, especially when something less-than-natural occurs. [prolapsed cords; cords around a newborn's neck; post-partum hemorrhage all come to mind as examples with this scenario]. And I do give credit to dispatchers. Not only for getting their job done, but for remaining calm & getting the job done even when they know the brevity & seriousness of any given situation. If you want to continue this conversation you can PM me.
