CAPMEDIC-EMWFR Posted January 27, 2008 Share Posted January 27, 2008 I have to agree with the general opinion here, we are a part of team, the first people to see and treat the patient, what we do impacts the patient's outcome. I can't really add any more to this topic than what has already been said, but the way I see it is that we are more then just taxi drivers, we cannot let anything get in the way of delivering the best care we can to our patients, and that includes passing complete and accurate information to the receiving facility. You can't let things like location of pain or your personal biases, regardless of what they are, against something effect the well-being of your patient. Link to comment Share on other sites More sharing options...
Fluffpaw38 Posted January 27, 2008 Share Posted January 27, 2008 I have to agree with the general opinion here, we are a part of team, the first people to see and treat the patient, what we do impacts the patient's outcome. I can't really add any more to this topic than what has already been said, but the way I see it is that we are more then just taxi drivers, we cannot let anything get in the way of delivering the best care we can to our patients, and that includes passing complete and accurate information to the receiving facility. You can't let things like location of pain or your personal biases, regardless of what they are, against something effect the well-being of your patient. Very well put. Link to comment Share on other sites More sharing options...
CAPMEDIC-EMWFR Posted January 28, 2008 Share Posted January 28, 2008 Very well put. Thank you, I was rather tired when I wrote it but I hope I got my point across . Link to comment Share on other sites More sharing options...
firedoc5 Posted January 28, 2008 Share Posted January 28, 2008 I'd go with ERDoc on this one, epididymitis. I just skimmed over some of the longer posts so I might have missed it, but was there any relief with either hot or cold compresses? A boss I had did have epididymitis. Put him in the hospital for a few days. The man lived his life between his legs. It didn't stop him for long though. :roll: Link to comment Share on other sites More sharing options...
hammerpcp Posted January 29, 2008 Share Posted January 29, 2008 There are no absolutes in medicine. Although it is fun to illicit a reaction by speaking in extremes on this forum I concede that in reality sometimes it IS appropriate to examine the genital. However, it is not ALWAYS appropriate. Many folks (read: men) are sick and desperate and would love for a paramedic- or anyone really- to handle their goodies, and thus are not beyond malingering to achieve this goal. Besides the issue of illegitimate complaints there are also several legitimate complaints involving the genitals or perineum that don't necessarily require an exam either. Vaginal bleeding for example. If the pt is not in any distress and has stable vital signs and can describe to me how much blood has been lost and over what period of time, there is no reason for me to take a look. (Unless I am suspicious that there may be babies head sticking out I guess) As far as the medical "team" goes.....I am skeptical that this even exists. Even when I do a full exam, and have a working diagnoses based on my findings, the fact remains that the hospital staff rarely even take what I have to say into consideration.....and that's if they listen to me at all. Perhaps that is just the situation here, but I doubt it. Also, pts are almost never sent to the waiting area if they are brought in by ambulance. Hence hours and hours of off load delays. So, to argue that taking a look at big Stevo's urinary catheter and palpating his testicles because he has had a little discharge lately is going to speed up his care is completely false. I think I have had my say on this. I am not a bad medic for making a judgment call on what assessments are necessary and appropriate for a particular pt and which ones aren't. You do the same thing every day. Link to comment Share on other sites More sharing options...
spenac Posted January 29, 2008 Author Share Posted January 29, 2008 Vaginal bleeding for example. If the pt is not in any distress and has stable vital signs and can describe to me how much blood has been lost and over what period of time, there is no reason for me to take a look. (Unless I am suspicious that there may be babies head sticking out I guess) Man we keep disagreeing. If I have a female bleeding excessively or bleeding when not her period, she gets checked. I need to see what is happening to provide proper report and treatment. What color the blood is. Whether thick, clotted or thin. Perhaps she is miscarrying even when she doesn't know shes pregnant. I may open the labia in order to inspect for sores, etc. So much can be noted with a hands an eyes on approach. Link to comment Share on other sites More sharing options...
hammerpcp Posted January 29, 2008 Share Posted January 29, 2008 Man we keep disagreeing. If I have a female bleeding excessively or bleeding when not her period, she gets checked. I need to see what is happening to provide proper report and treatment. What color the blood is. Whether thick, clotted or thin. Perhaps she is miscarrying even when she doesn't know shes pregnant. I may open the labia in order to inspect for sores, etc. So much can be noted with a hands an eyes on approach. You're right we do disagree. I don't know what your training is but that is so far out of my level of expertise as an advanced care paramedic I wouldn’t go near it. I also think you would be completely in the wrong if you did. We are talking about a stable patient in no to little distress who is completely capable of describing her symptoms to you, and you are performing a pelvic exam with no training, no experience, and really no idea what you are looking for or even what anything means if you do find it? What does your medical director have to say about your approach? Link to comment Share on other sites More sharing options...
spenac Posted January 29, 2008 Author Share Posted January 29, 2008 You're right we do disagree. I don't know what your training is but that is so far out of my level of expertise as an advanced care paramedic I wouldn’t go near it. I also think you would be completely in the wrong if you did. We are talking about a stable patient in no to little distress who is completely capable of describing her symptoms to you, and you are performing a pelvic exam with no training, no experience, and really no idea what you are looking for or even what anything means if you do find it? What does your medical director have to say about your approach? My medical director expects us to check patients. Other than placing a foley we do not insert anything vaginally. My education does teach me to explain what I am seeing. My description maybe just what is needed to expedite the patients care in the hospital. Link to comment Share on other sites More sharing options...
PRPGfirerescuetech Posted January 29, 2008 Share Posted January 29, 2008 You have two testicles. There was a reason. Smile. Your going to be ok, friend. Link to comment Share on other sites More sharing options...
firedoc5 Posted January 29, 2008 Share Posted January 29, 2008 If I have a female bleeding excessively or bleeding when not her period, she gets checked. __________________________________________________ Had one of our regular, let's say GOMER, one night. vaginal bleeding, not menstruating, no pregnancy, no recent intercourse. At first she denied any foreign object that may have caused any trauma. Between her and her friend's information they gave us something didn't jive. And we asked them all a few times. Their stories were inconsistent each time which caused even more confusion. Got her to the ER and doc did a pelvic. She had a moderate torn uterus. Of course when the ER staff asked she came right out and gave a whole new story. Something about a dare, coke bottle, and broom stick. (I'm not kidding) But the doc asked me why I didn't give the same information as she did. (And I hate it when that happens :cussing: I just explained that I had to go with what she and her friends said and I pointed out that we don't do pelvics in the field. I think he understood the break down of communication. Link to comment Share on other sites More sharing options...
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