Patients in triage

[spenac]

If you have to work in a you call we haul system there should be a rule like the dump and pump. Dump the patient wherever and pump the gas and go. Resources should not be wasted waiting around.

[Capman]

If you have to work in a you call we haul system there should be a rule like the dump and pump. Dump the patient wherever and pump the gas and go. Resources should not be wasted waiting around.

That is how it is here. Why would you have to wait in the ER? No rooms? Put them on a cot in the hallway of the ER. I couldn't imagine waiting around with patients at the hospital.

"Dump and Pump" Great way of putting it Spen'. Never heard that one around these parts. Now I get to introduce it. LOL

[AnthonyM83]

They don't have hallway cots, just so we don't leave them there. A FEW have hallway chairs...some are even discharged from their chairs.

But seriously, if they did that, you'd have the hallway PACKED. People wouldn't avoid the busy hospitals like the plague.

The main problem, though, even if you only have a few patients in the hallway, is you don't have anyone to keep an eye on all of them. They use us as their techs even after we've given our report and supposedly transferred care. But if something were to happen to them, we'd still be liable I'm sure b/c we're supposed to be watching them...being on our gurneys and all.

[katbemeEMT-B]

Wow, I feel special. When we bring in a patient to one of the three hospitals we transport to, they usually assign us a room when we call in our report. If not, as soon as we walk in the door, we get a room, transfer patient from cot to bed, assist nurse if need be, giving our report while doing all this. Then we are done except to fill out our run report. it takes longer to do to do our report then the actual transport and transfer of care.

[Capman]

Wow, I feel special. When we bring in a patient to one of the three hospitals we transport to, they usually assign us a room when we call in our report. If not, as soon as we walk in the door, we get a room, transfer patient from cot to bed, assist nurse if need be, giving our report while doing all this. Then we are done except to fill out our run report. it takes longer to do to do our report then the actual transport and transfer of care.

You have to do your run reports right there?

We can do our run reports back at the base.

[Dustdevil]

You have to do your run reports right there?

We can do our run reports back at the base.

Your administrator should be fired. The better systems require run reports be completed at the destination, and a copy left for the patient's hospital chart. That is very definitely the ideal way to go, whenever time constraints allow. If you have to run for an emergency before you're finished, that's one thing. But if you're just in a hurry to get back to your recliner to watch Turd Watch, that's BS. These things should be documented while the patient is fresh in your mind, or mistakes will occur. And the hospital should have access to a record of your care. Otherwise, when they say you failed to give them a proper report, you'll have no defence.

No job is done until the paperwork is complete.

[AnthonyM83]

Ummm, I finish mine almost before we get to the hospital?

But that's mainly for BLS runs where patient has a chronic 'stable' problem and I can write while we talk about their condition further. Otherwise, I spent the ride assessing further, even if not really needed, just for practice. Or if patient is worried, it's mainly comfort time.

I used to wait until after, but partners get all huffy when I go back to the rig to write in comfort (and cleanliness), so just learned to do them quick. And honestly in the middle of the night, I want to get going back right away. We're supposed to finish at the ER, though, not at station.

[katbemeEMT-B]

You have to do your run reports right there?

We can do our run reports back at the base.

Yep, we are required to leave a copy for the doc. We still utilize paper forms.

[AnthonyM83]

The main PCR is done by the FD on-scene. They give us a yellow copy for us and a red copy for the receiving hospital. We fill out an additional continuation form which simply has a field for 3 VS & GCS, 3 fields for meds given, and a prompt that says similar to "Patient Condition During Transfer" and just lines.

The county FD's PCR sheet aren't always the most...thorough...I've had one where the text box only said: "chief complaint: Elusive". That's it, then all the check boxes. Or sometimes they flat out lie "Panic Attack, No KO, No Sz activity" when I was there when entire family witnessed the 14yro have a full tonic-clonic seizure x2 minutes w/ hx of epilepsy and patient says she felt the seizure aura, then just waking up.

So, when they BLS a patient with more complication issues than what they wrote down, I'll do a full narrative...but half the time it just gets thrown away. The better hospitals take the time to look at it, but the more overworked hospitals just leave it...I'll see it floating around hours later five runs after.

[CBEMT]

Depends on which hospital, but where we usually go:

Patient is presented to the Ambulance Triage nurse. A tech takes vitals, and BGL and Breathalyzer PRN. Verbal report is taken by the AT nurse, who writes up a triage sheet explaining the chief complaint, hx, rx, allergies, and any interventions given for the nurse who will actually be caring for the patient. At this point we are usually directed to one of a handful of stretchers parked in the triage area. After transfer to the gurney, the patient is generally attacked by one of several Registration clerks assigned to Ambulance Triage.

If the patient requires a trauma/critical care room, we bring them there ourselves.

If a room is available, a Transport associate brings the patient to it after we transfer to the hospital gurney.

If a room is not available, the patients are stacked along the wall and wait their turn according to their triage rank and order of entry.

If the patient is going to the drunk/psych tank or Fast Track, we usually take them ourselves because the stretchers are already there.

The longest I've ever waited for a stretcher was 30 minutes, and then only because they had to bring me a baratric stretcher from downstairs.

These places with 6 hours waits for a bed slay me. So you're telling me I could pull an 8 hours shift and only see one patient? Or end up with gobs of overtime because my punch-out time was 4 hours ago and I'm still sitting here?

You have to do your run reports right there?

We can do our run reports back at the base.

State law says we leave the completed carbon copy there. Ambulance Triage isn't great about sending run sheets to meet up with charts if the patient is gone to a room before I finish, so I'll go so far as to find out which ER unit the patient went to, and leave the copy with the unit secretary (AKA Goddess of the Charts).

Do the ERs ever READ the reports? Never seen it happen. But it needs to be there, so it goes there.